背景:小鼠致敏和暴露与未控制的哮喘有关,但是它们是否与哮喘的严重程度有关,固有疾病特征和长期结果预测因子,不清楚。
目的:研究城市儿童中小鼠致敏和/或暴露与哮喘严重程度之间的关系。
方法:共有645名哮喘未控制的儿童(5-17岁)接受了小鼠致敏评估。致敏儿童在卧室灰尘中测量了小鼠过敏原。小鼠致敏之间的关系,过敏原水平,和哮喘严重程度测量(治疗步骤和综合哮喘严重程度指数[CASI])使用校正年龄的回归模型进行检查,性别,atopy,研究地点,种族,种族,和保险。
结果:研究人群主要是少数民族(69.6%的黑人,20.8%西班牙裔),低收入(61.8%),小鼠致敏(54.4%)。平均±SD治疗步骤为3.2±1.6,相当于中等剂量吸入皮质类固醇。平均值±SDCASI为6.5±3.4,反映中度持续性哮喘。小鼠致敏与更高的治疗步骤相关(3.5vs2.9,小鼠致敏vs非致敏,P<.001),独立于潜在的混杂因素(β[95%CI],0.36[0.07-0.64];P=.01)。小鼠致敏与CASI独立相关(β[95%CI],0.82[0.16-1.47];P=.02)。在小鼠致敏的参与者中,较高的卧室地板和床Musm1与治疗步骤独立相关(β[95%CI],0.26[0.09-0.43];P=0.002和β[95%CI],0.22[0.01-0.43];P=.04),分别。较高的卧室楼层Musm1与CASI独立相关(β[95%CI],0.43[0.05-0.81];P=0.03)。
结论:小鼠致敏和暴露与哮喘严重程度相关,在低收入人群中,少数民族儿童。需要进一步的研究来确定减少小鼠致敏哮喘患者的过敏原暴露是否可以减轻严重程度。最终改变儿童哮喘的自然史。
BACKGROUND: Mouse sensitization and exposure are associated with uncontrolled asthma, but whether they are associated with asthma severity, an intrinsic disease characteristic and long-term outcome predictor, is unclear.
OBJECTIVE: To examine relationships between mouse sensitization and/or exposure and asthma severity in urban children.
METHODS: A total of 645 children (5-17 years) with uncontrolled asthma underwent mouse sensitization evaluation. Sensitized children had mouse allergen measured in bedroom dust. Relationships between mouse sensitization, allergen levels, and asthma severity measures (treatment step and Composite Asthma Severity Index [CASI]) were examined using regression models adjusted for age, sex, atopy, study site, race, ethnicity, and insurance.
RESULTS: The study population was predominantly minority (69.6% black, 20.8% Hispanic), low income (61.8%), and mouse sensitized (54.4%). Mean ± SD treatment step was 3.2 ± 1.6, equivalent to medium-dose inhaled corticosteroid. Mean ± SD CASI was 6.5 ± 3.4, reflecting moderate persistent asthma. Mouse sensitization was associated with higher treatment step (3.5 vs 2.9, mouse-sensitized vs nonsensitized, P < .001), independent of potential confounders (β [95% CI], 0.36 [0.07-0.64]; P = .01). Mouse sensitization was associated independently with CASI (β [95% CI], 0.82 [0.16-1.47]; P = .02). Among mouse-sensitized participants, higher bedroom floor and bed Mus m 1 were independently associated with treatment step (β [95% CI], 0.26 [0.09-0.43]; P = .002 and β [95% CI], 0.22 [0.01-0.43]; P = .04), respectively. Higher bedroom floor Mus m 1 was independently associated with CASI (β [95% CI], 0.43 [0.05-0.81]; P = .03).
CONCLUSIONS: Mouse sensitization and exposure are associated with asthma severity, among low-income, minority children. Further studies are needed to determine whether reducing allergen exposure among mouse-sensitized patients with asthma can reduce severity, ultimately altering childhood asthma natural history.