目的:本研究的目的是探讨无哮喘或有哮喘的CR个体变应原致敏模式的差异。根据哮喘的严重程度。
方法:对1066名成年人进行评估。由专家鉴定出哮喘和慢性并过敏性鼻炎,问卷调查和皮肤点刺试验。从皮肤点刺试验到空气过敏原扩展面板,表型表征是可行的,总IgE和肺功能。使用问卷调查和临床评估,参与者被分为:慢性鼻炎(CRA)和慢性鼻炎+哮喘,后者细分为CR+轻度哮喘(CRMA)和CR+中度至重度哮喘(CRMSA)。Aerollergen致敏是通过对与鼻症状和/或哮喘相关的一种或多种过敏原的阳性点刺试验来定义的。CR与哮喘之间的关系通过多变量逻辑回归进行评估。通过在逻辑回归模型中引入相互作用项,校正了混杂因素,检查了CR致敏模式对哮喘严重程度和预后的影响改变的证据。
结果:与CRA相比,哮喘患者对气敏原的致敏频率更高(CRMA70.4%;CRMSA65.0%;CRA47.0%;p=0.000)。同样,哮喘的存在与空气过敏原多重致敏相关(51.5%)(OR=2.10,95%CI1.27~3.50).此外,对螨虫的敏感,蟑螂,动物上皮,草,和霉菌,哮喘患者较高(56.8%,24.3%,12%,7.13%和10.3%,分别)。对链格孢菌的致敏作用,在哮喘组中,根茎孢菌和狗上皮是唯一的。伴随哮喘诊断与至少一种过敏原的过敏原致敏阳性直接相关(62.7%,OR=2.45,95%CI1.80-3.34)和政治敏感性(51.5%,OR=2.10,95%CI1.27-3.50)。
结论:在CR患者中,哮喘与多种过敏原致敏相关。在CR和哮喘患者中观察到一些独特的气溶胶过敏原致敏特征。然而,在致敏与哮喘严重程度的关系中没有发现差异,这表明特应性不是CR患者哮喘严重程度的主要潜在机制。
方法:第3级。
OBJECTIVE: The aim of this study was to explore the differences in the pattern of allergen sensitization in CR individuals without or with asthma, according to asthma severity.
METHODS: A total of 1066 adults were evaluated. Asthma and chronic⁄allergic rhinits were identified by specialists, questionnaries and skin-prick test. The phenotypic characterization was avaliable from skin-prick test to an aeroallergen extended panel, total IgE and pulmonary function. Using questionnaires and clinical evaluation, participants were classified into the groups: chronic rhinitis alone (CRA) and chronic rhinitis + asthma, the latter subdivided into CR + mild asthma (CRMA) and CR + moderate to severe asthma (CRMSA). Aerollergen sensitization was defined by a positive prick test to one or more allergens associated with nasal symptoms and/or asthma. The association between CR and asthma was evaluated by multivariable logistic regression. The evidence of effect modification of pattern of sensitization in CR on the association with asthma severity and outcomes was examined by introducing interactions terms in the logistic regression models adjusting for confounders.
RESULTS: Frequency of sensitization to aeroallergens was higher in association with asthma in comparison to CRA (CRMA 70.4%; CRMSA 65.0%; CRA 47.0%; p = 0.000). Similarly, the presence of asthma was associated to aeroallergen multiple sensitization (51.5%) (OR = 2.10, 95% CI 1.27-3.50). Additionally, the sensitization to mites, cockroaches, animal epithelium, grasses, and molds, were higher in asthma (56.8%, 24.3%, 12%, 7.13% and 10.3%, respectively). Sensitization to Alternaria alternata, Cladosporium herbarum and dog epithelium was exclusive in asthma groups. A concomitant asthma diagnosis was directly associated with a positive allergen sensitization at least one allergen (62.7%, OR = 2.45, 95% CI 1.80-3.34) and polissensitization (51.5%, OR = 2.10, 95% CI 1.27-3.50).
CONCLUSIONS: Asthma is associated with multiple allergen sensitization among patients with CR. Some unique profiles of aeroallergen sensitization were observed in patients with CR and asthma. Nevertheless, no difference was found in the sensitization in relation to asthma severity, which suggest atopy is not the main underlying mechanism for asthma severity among patients with CR.
METHODS: Level 3.