过敏性疾病和IgE抗体升高可能增加呼吸道感染风险

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过敏性疾病和IgE抗体升高可能增加呼吸道感染风险。芬兰的一项最新研究表明,过敏性疾病会增加成人上呼吸道和下呼吸道感染的风险。而且特异性的IgE抗体水平的增加也能增加呼吸道感染的可能。

芬兰奥鲁大学(University of Oulu)的Maritta Jaakkola和他的研究团队声称:「过敏性疾病的发病率很高,本研究发现过敏性疾病可以增加呼吸道感染的风险,甚至会引起严重的下呼吸道感染。因此,这对于临床预防和治疗过敏性疾病很重要」。

Maritta Jaakkola的研究包括随机选取的1008名21~63岁的成人,其中73%的检测了血液IgE抗体。其中218名(21.6%)患者伴有过敏性鼻炎,344名患者(34.1%)过敏性皮炎,76名患者(7.5%)既往或现在存在过敏性哮喘。

最后研究发现,既往12月内患有过敏性疾病者比正常人上呼吸道感染的风险高59%,下呼吸道感染的风险更高,是正常人的2倍。

其中哮喘与下呼吸道感染相关性更显著,伴有哮喘者是正常人下呼吸道感染的风险的4.7倍。而过敏性皮炎与呼吸道感染的相关性相对较弱,伴有过敏性皮炎的患者下呼吸道感染和上呼吸道感染的风险分别是正常人分别的1.8倍和1.6倍。

血液特异性IgE水平升高也与呼吸道感染有相关性,IgE水平与下呼吸道感染呈直线相关性。另外研究还发现,过敏源复查分数高于4分者上呼吸道感染最危险。

如果过敏性疾病和高水平的IgE水平联合起来看,与呼吸道感染风险的相关性更明显,可以显著的增加下呼吸道感染的可能,是正常人的2.23倍。但是两者联合起来与上呼吸道感染风险并无显著相性。

Background

Atopic diseases, including allergic rhinitis, allergic dermatitis and asthma, are common diseases with a prevalence of 30–40% worldwide and are thus of great global public health importance. Allergic inflammation may influence the immunity against infections, so atopic individuals could be susceptible to respiratory infections. No previous population-based study has addressed the relation between atopy and respiratory infections in adulthood. We assessed the relation between atopic disease, specific IgE antibodies and the occurrence of upper and lower respiratory infections in the past 12 months among working-aged adults.

Methods and Findings

A population-based cross-sectional study of 1008 atopic and non-atopic adults 21–63 years old was conducted. Information on atopic diseases, allergy tests and respiratory infections was collected by a questionnaire. Specific IgE antibodies to common aeroallergens were measured in serum. Adults with atopic disease had a significantly increased risk of lower respiratory tract infections (LRTI; including acute bronchitis and pneumonia) with an adjusted risk ratio (RR) 2.24 (95% confidence interval [CI] 1.43, 3.52) and upper respiratory tract infections (URTI; including common cold, sinusitis, tonsillitis, and otitis media) with an adjusted RR 1.55 (1.14, 2.10). The risk of LRTIs increased with increasing level of specific IgE (linear trend P = 0.059).

Conclusions

This study provides new evidence that working-aged adults with atopic disease experience significantly more LRTIs and URTIs than non-atopics. The occurrence of respiratory infections increased with increasing levels of specific IgE antibodies to common aeroallergens, showing a dose-response pattern with LRTIs. From the clinical point of view it is important to recognize that those with atopies are a risk group for respiratory infections, including more severe LRTIs.

参考文献:Aino Rantala. et.al. Respiratory Infections in Adults with Atopic Disease and IgE Antibodies to Common Aeroallergens

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