在美國(guó),，每10個(gè)兒童當(dāng)中就有一個(gè)遭受哮喘的折磨,，但是造成這種疾病產(chǎn)生的潛在性環(huán)境因素仍然不廣為人知。如今,，來(lái)自美國(guó)辛辛那提大學(xué),、美國(guó)環(huán)境保護(hù)局(Environmental Protection Agency, EPA)和辛辛那提兒童醫(yī)院醫(yī)學(xué)中心的研究人員發(fā)現(xiàn)新證據(jù)表明嬰兒期間接觸三種類型霉菌---赭曲霉(Aspergillus ochraceus)、爪甲曲霉(Aspergillus unguis)和變幻青霉(Penicillium variabile)---可能與兒童期間患上哮喘存在直接關(guān)聯(lián),。論文第一作者Tiina Reponen博士和同事們將這些研究發(fā)現(xiàn)發(fā)表在2012年8月那期Journal of Allergy and Clinical Immunology期刊上,。
在對(duì)將近300名嬰兒的長(zhǎng)期群體研究中，研究人員在這些嬰兒的頭四年里每年評(píng)估了他們的過(guò)敏癥發(fā)生情況和呼吸健康,，然后在7歲時(shí)再次進(jìn)行評(píng)估,。研究人員也監(jiān)控家里過(guò)敏原和霉菌。所有參與研究的嬰兒出生時(shí),，每名嬰兒雙親當(dāng)中至少有一位患有過(guò)敏癥,。
他們發(fā)現(xiàn)父母患有過(guò)敏癥的兒童當(dāng)中25%的人在7歲時(shí)就已患有哮喘。在評(píng)估的多種室內(nèi)污染物當(dāng)中,，只有嬰兒期間接觸霉菌能被作為他們7歲時(shí)患上哮喘的風(fēng)險(xiǎn)因素,。
研究人員利用一種基于DNA的霉菌水平分析工具---環(huán)境相對(duì)發(fā)霉指數(shù)(environmental relative moldiness index, ERMI)---而確定出在高風(fēng)險(xiǎn)的研究群體當(dāng)中，接觸赭曲霉,、爪甲曲霉和變幻青霉與患上哮喘相關(guān)聯(lián),。ERMI工具是由美國(guó)環(huán)境保護(hù)局開(kāi)發(fā)的，能夠?qū)?6種不同類型的霉菌分析結(jié)果結(jié)合在一起而計(jì)算出一種描述家庭中積累霉菌負(fù)擔(dān)(cumulative mold burden)的指數(shù),。
Reponen說(shuō),，“這項(xiàng)發(fā)現(xiàn)提供強(qiáng)大的證據(jù)表明室內(nèi)霉菌促進(jìn)哮喘產(chǎn)生,，同時(shí)也強(qiáng)調(diào)人們急需修復(fù)家庭中的水漬損失，特別是低收入的城市區(qū)域,。靶向特異性霉菌物種的治療可能是一種更加有效的方法,。”(生物谷：Bioon.com)
本文編譯自Infants exposed to specific molds have higher asthma risk
doi: 10.1016/j.jaci.2012.05.030
PMC:
PMID:
Infant origins of childhood asthma associated with specific molds
Tiina Reponen, PhD, James Lockey, MS, MD, David I. Bernstein, MD, Stephen J. Vesper, PhD, Linda Levin, PhD, Gurjit K. Khurana Hershey, MD, PhD, Shu Zheng, PhD, Patrick Ryan, PhD, Sergey A. Grinshpun, PhD, Manuel Villareal, MD, Grace LeMasters, PhD
Background The specific cause or causes of asthma development must be identified to prevent this disease. Objective Our hypothesis was that specific mold exposures are associated with childhood asthma development. Methods Infants were identified from birth certificates. Dust samples were collected from 289 homes when the infants were 8 months of age. Samples were analyzed for concentrations of 36 molds that comprise the Environmental Relative Moldiness Index (ERMI) and endotoxin, house dust mite, cat, dog, and cockroach allergens. Children were evaluated at age 7 years for asthma based on reported symptoms and objective measures of lung function. Host, environmental exposure, and home characteristics evaluated included a history of parental asthma, race, sex, upper and lower respiratory tract symptoms, season of birth, family income, cigarette smoke exposure, air conditioning, use of a dehumidifier, presence of carpeting, age of home, and visible mold at age 1 year and child's positive skin prick test response to aeroallergens and molds at age 7 years. Results Asthma was diagnosed in 24% of the children at age 7 years. A statistically significant increase in asthma risk at age 7 years was associated with high ERMI values in the child's home in infancy (adjusted relative risk for a 10-unit increase in ERMI value, 1.8; 95% CI, 1.5-2.2). The summation of levels of 3 mold species, Aspergillus ochraceus, Aspergillus unguis, and Penicillium variabile, was significantly associated with asthma (adjusted relative risk, 2.2; 95% CI, 1.8-2.7). Conclusion In this birth cohort study exposure during infancy to 3 mold species common to water-damaged buildings was associated with childhood asthma at age 7 years.
