防尘螨措施及其在儿童哮喘中的研究进展
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摘要
室内变应原是哮喘发作的重要危险因素,其中尘螨是室内最常见的吸入性变应原之一。室内常见尘螨为户尘螨及粉尘螨,其主要变应原为尘螨Ⅰ类变应原和尘螨Ⅱ类变应原,具有强烈的免疫刺激性。尘螨变应原影响儿童健康,长期暴露在尘螨变应原中会增加哮喘的发病风险,哮喘儿童接触尘螨变应原将引起哮喘急性发作,哮喘控制不佳等。对哮喘儿童采取有效的尘螨干预措施,可以显著减少尘螨变应原,但其在儿童哮喘中的作用仍有较大争议。未来,防尘螨措施在儿童哮喘中的应用需进一步研究,以助于改善哮喘儿童的生活质量及预后。
Indoor allergens is an important risk factor for asthma exacerbation,and dust mite is one of the most common inhalation allergens in the room. The common indoor dust mites are Dermatophagoides pteronyssinus and Dermatophagoides farinae. Their main allergens are dust mite type Ⅰ allergen and dust mite type Ⅱ allergen,which have strong immune stimulation. Dust mite allergens affect children's health,and long-term exposure to dust mite allergens increases the risk of asthma. Exposure to dust mite allergens in asthmatic children will lead to acute attack and poor control of asthma. Effective dust mite intervention in asthmatic children can significantly reduce dust mite allergens,but its role in childhood asthma is still controversial. In the future,the application of dust mite prevention measures in children with asthma needs further study to help improve the quality of life and prognosis.
Indoor allergens is an important risk factor for asthma exacerbation,and dust mite is one of the most common inhalation allergens in the room. The common indoor dust mites are Dermatophagoides pteronyssinus and Dermatophagoides farinae. Their main allergens are dust mite type Ⅰ allergen and dust mite type Ⅱ allergen,which have strong immune stimulation. Dust mite allergens affect children's health,and long-term exposure to dust mite allergens increases the risk of asthma. Exposure to dust mite allergens in asthmatic children will lead to acute attack and poor control of asthma. Effective dust mite intervention in asthmatic children can significantly reduce dust mite allergens,but its role in childhood asthma is still controversial. In the future,the application of dust mite prevention measures in children with asthma needs further study to help improve the quality of life and prognosis.
引文
[1]Hasegawa K,Bittner JC,Nonas SA,et al.Children and adults with frequent hospitalizations for asthma exacerbation,2012-2013:Amulticenter observational study[J].J Allergy Clin Immunol Pract,2015,3(5):751-758.
[2]Voorhorst R,Spieksma FT,Varekamp H,et al.The house-dust mite(Dermatophagoides pteronyssinus)and the allergens it produces.Identity with the house-dust allergen[J].J Allergy,1967,39(6):325-339.
[3]Chan TF,Ji KM,Yim AK,et al.The draft genome,transcriptome,and microbiome of Dermatophagoides farinae reveal a broad spectrum of dust mite allergens[J].J Allergy Clin Immunol,2015,135(2):539-548.
[4]俞黎黎,张承伯,滕飞翔,等.我国尘螨分布的Meta分析[J].中国病原生物学杂志,2017,12(5):423-427,433.
[5]Calderon MA,Linneberg A,Kleine-Tebbe J,et al.Respiratory allergy caused by house dust mites:What do we really know?[J].J Allergy Clin Immunol,2015,136(1):38-48.
[6]Tovey ER,Chapman MD,Platts-Mills TA.Mite faeces are a major source of house dust allergens[J].Nature,1981,289(5798):592-593.
[7]Huang FL,Liao EC,Yu SJ.House dust mite allergy:Its innate immune response and immunotherapy[J].Immunobiology,2018,223(3):300-302.
[8]Jacquet A.Innate immune responses in house dust mite allergy[J].ISRN Allergy,2013,2013:735031.
[9]Trian T,Allard B,Dupin I,et al.House dust mites induce proliferation of severe asthmatic smooth muscle cells via an epithelium-dependent pathway[J].Am J Respir Crit Care Med,2015,191(5):538-546.
[10]Aubier M,Thabut G,Hamidi F,et al.Airway smooth muscle enlargement is associated with protease-activated receptor 2/ligand overexpression in patients with difficult-to-control severe asthma[J].J Allergy Clin Immunol,2016,138(3):729-739.
[11]Miller JD.The role of dust mites in allergy[J].Clin Rev Allergy Immunol,2018[2019-03-26].https://www.ncbi.nlm.nih.gov/pubmed/29936683.[published online ahead of print Jun.23,2018]
[12]Bisgaard H,Bnnelykke K.Long-term studies of the natural history of asthma in childhood[J].J Allergy Clin Immunol,2010,126(2):187-197;quiz 198-199.
[13]Lodge CJ,Lowe AJ,Gurrin LC,et al.House dust mite sensitization in toddlers predicts current wheeze at age 12 years[J].J Allergy Clin Immunol,2011,128(4):782-788.
[14]Dick S,Friend A,Dynes K,et al.A systematic review of associations between environmental exposures and development of asthma in children aged up to 9 years[J].BMJ Open,2014,4(11):e006554.
[15]Holt PG,Rowe J,Kusel M,et al.Toward improved prediction of risk for atopy and asthma among preschoolers:A prospective cohort study[J].J Allergy Clin Immunol,2010,125(3):653-659.e1-659.e7.
[16]Langley SJ,Goldthorpe S,Craven M,et al.Exposure and sensitization to indoor allergens:Association with lung function,bronchial reactivity,and exhaled nitric oxide measures in asthma[J].J Allergy Clin Immunol,2003,112(2):362-368.
[17]Simpson A,Tan VY,Winn J,et al.Beyond atopy:Multiple patterns of sensitization in relation to asthma in a birth cohort study[J].Am J Respir Crit Care Med,2010,181(11):1200-1206.
[18]Celedon JC,Milton DK,Ramsey CD,et al.Exposure to dust mite allergen and endotoxin in early life and asthma and atopy in childhood[J].J Allergy Clin Immunol,2007,120(1):144-149.
[19]Torrent M,Sunyer J,Garcia R,et al.Early-life allergen exposure and atopy,asthma,and wheeze up to 6 years of age[J].Am JRespir Crit Care Med,2007,176(5):446-453.
[20]Tovey ER,Almqvist C,Li Q,et al.Nonlinear relationship of mite allergen exposure to mite sensitization and asthma in a birth cohort[J].J Allergy Clin Immunol,2008,122(1):114-118,118.e1-5.
[21]Richgels PK,Yamani A,Chougnet CA,et al.Maternal house dust mite exposure during pregnancy enhances severity of house dust mite-induced asthma in murine offspring[J].J Allergy Clin Immunol,2017,140(5):1404-1415.
[22]Beck AF,Huang B,Kercsmar CM,et al.Allergen sensitization profiles in a population-based cohort of children hospitalized for asthma[J].Ann Am Thorac Soc,2015,12(3):376-384.
[23]Global Initiative for Asthma.2017 GINA Report:Global Strategy for Asthma Management and Prevention[EB/OL].(2017)[2019-03-26].https://ginasthma.org/wp-content/uploads/2019/04/wmsGINA-2017-main-report-final_V2.pdf.
[24]于静淼,孙劲旅,尹佳,等.北京地区尘螨过敏患者家庭螨类调查[J].中华临床免疫和变态反应杂志,2014,8(3):188-194.
[25]Murray CS,Foden P,Sumner H,et al.Preventing severe asthma exacerbations in children.A randomized trial of mite-impermeable bedcovers[J].Am J Respir Crit Care Med,2017,196(2):150-158.
[26]Arroyave WD,Rabito FA,Carlson JC,et al.Impermeable dust mite covers in the primary and tertiary prevention of allergic disease:A meta-analysis[J].Ann Allergy Asthma Immunol,2014,112(3):237-248.
[27]Cipriani F,Calamelli E,Ricci G.Allergen avoidance in allergic asthma[J].Front Pediatr,2017,5:103.
[28]van Boven FE,Arends LR,Braunstahl GJ,et al.A reintroduction of environmental mite allergen control strategies for asthma treatment and the debate on their effectiveness[J].Clin Exp Allergy,2019,49(4):400-409.
[29]Wilson JM,Platts-Mills T.Home environmental interventions for house dust mite[J].J Allergy Clin Immunol Pract,2018,6(1):1-7.
[30]Htut T,Higenbottam TW,Gill GW,et al.Eradication of house dust mite from homes of atopic asthmatic subjects:A double-blind trial[J].J Allergy Clin Immunol,2001,107(1):55-60.
[31]Lau S,Wahn J,Schulz G,et al.Placebo-controlled study of the mite allergen-reducing effect of tannic acid plus benzyl benzoate on carpets in homes of children with house dust mite sensitization and asthma[J].Pediatr Allergy Immunol,2002,13(1):31-36.
[32]Shani Z,Scott RG,Schofield LS,et al.Effect of a home intervention program on pediatric asthma in an environmental justice community[J].Health Promot Pract,2015,16(2):291-298.
[33]Schauer U,Bergmann KC,Gerstlauer M,et al.Improved asthma control in patients with severe,persistent allergic asthma after 12months of nightly temperature-controlled laminar airflow:An observational study with retrospective comparisons[J].Eur Clin Respir J,2015,2.
[34]El-Ghitany EM,Abd EM.Environmental intervention for house dust mite control in childhood bronchial asthma[J].Environ Health Prev Med,2012,17(5):377-384.
[35]Smith H,Horney D,Jones C,et al.Pragmatic randomized controlled trial of an allergy intervention for children aged 6-16 with asthma and rhinitis in general practice[J].Clin Exp Allergy,2016,46(9):1227-1235.
[36]Marks GB,Mihrshahi S,Kemp AS,et al.Prevention of asthma during the first 5 years of life:A randomized controlled trial[J].JAllergy Clin Immunol,2006,118(1):53-61.
[37]Huiyan W,Yuhe G,Juan W,et al.The importance of allergen avoidance in high risk infants and sensitized patients:A metaanalysis study[J].Allergy Asthma Immunol Res,2014,6(6):525-534.
[38]G?tzsche PC,Johansen HK.House dust mite control measures for asthma:Systematic review[J].Allergy,2008,63(6):646-659.
[39]Platts-Mills T.Allergen avoidance in the treatment of asthma:Problems with the meta-analyses[J].J Allergy Clin Immunol,2008,122(4):694-696.
[40]Tovey ER,Willenborg CM,Crisafulli DA,et al.Most personal exposure to house dust mite aeroallergen occurs during the day[J].PLo S One,2013,8(7):e69900.
[41]Tovey ER,Liu-Brennan D,Garden FL,et al.Time-based measurement of personal mite allergen bioaerosol exposure over 24 hour periods[J].PLo S One,2016,11(5):e153414.
[42]BTS/SIGN.British guideline on the management of asthma2016[EB/OL].(2016)[2019-03-26].https://www.britthoracic.org.uk/document-library/guidelines/asthma/btssignasthma-guideline-2016.
[43]Scadding GK,Kariyawasam HH,Scadding G,et al.BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis(Revised Edition 2017;First edition 2007)[J].Clin Exp Allergy,2017,47(7):856-889.
[44]中华医学会儿科学分会中华儿科杂志编辑委员会.儿童过敏性疾病诊断及治疗专家共识[J].中华儿科杂志,2019,57(3):164-171.
[2]Voorhorst R,Spieksma FT,Varekamp H,et al.The house-dust mite(Dermatophagoides pteronyssinus)and the allergens it produces.Identity with the house-dust allergen[J].J Allergy,1967,39(6):325-339.
[3]Chan TF,Ji KM,Yim AK,et al.The draft genome,transcriptome,and microbiome of Dermatophagoides farinae reveal a broad spectrum of dust mite allergens[J].J Allergy Clin Immunol,2015,135(2):539-548.
[4]俞黎黎,张承伯,滕飞翔,等.我国尘螨分布的Meta分析[J].中国病原生物学杂志,2017,12(5):423-427,433.
[5]Calderon MA,Linneberg A,Kleine-Tebbe J,et al.Respiratory allergy caused by house dust mites:What do we really know?[J].J Allergy Clin Immunol,2015,136(1):38-48.
[6]Tovey ER,Chapman MD,Platts-Mills TA.Mite faeces are a major source of house dust allergens[J].Nature,1981,289(5798):592-593.
[7]Huang FL,Liao EC,Yu SJ.House dust mite allergy:Its innate immune response and immunotherapy[J].Immunobiology,2018,223(3):300-302.
[8]Jacquet A.Innate immune responses in house dust mite allergy[J].ISRN Allergy,2013,2013:735031.
[9]Trian T,Allard B,Dupin I,et al.House dust mites induce proliferation of severe asthmatic smooth muscle cells via an epithelium-dependent pathway[J].Am J Respir Crit Care Med,2015,191(5):538-546.
[10]Aubier M,Thabut G,Hamidi F,et al.Airway smooth muscle enlargement is associated with protease-activated receptor 2/ligand overexpression in patients with difficult-to-control severe asthma[J].J Allergy Clin Immunol,2016,138(3):729-739.
[11]Miller JD.The role of dust mites in allergy[J].Clin Rev Allergy Immunol,2018[2019-03-26].https://www.ncbi.nlm.nih.gov/pubmed/29936683.[published online ahead of print Jun.23,2018]
[12]Bisgaard H,Bnnelykke K.Long-term studies of the natural history of asthma in childhood[J].J Allergy Clin Immunol,2010,126(2):187-197;quiz 198-199.
[13]Lodge CJ,Lowe AJ,Gurrin LC,et al.House dust mite sensitization in toddlers predicts current wheeze at age 12 years[J].J Allergy Clin Immunol,2011,128(4):782-788.
[14]Dick S,Friend A,Dynes K,et al.A systematic review of associations between environmental exposures and development of asthma in children aged up to 9 years[J].BMJ Open,2014,4(11):e006554.
[15]Holt PG,Rowe J,Kusel M,et al.Toward improved prediction of risk for atopy and asthma among preschoolers:A prospective cohort study[J].J Allergy Clin Immunol,2010,125(3):653-659.e1-659.e7.
[16]Langley SJ,Goldthorpe S,Craven M,et al.Exposure and sensitization to indoor allergens:Association with lung function,bronchial reactivity,and exhaled nitric oxide measures in asthma[J].J Allergy Clin Immunol,2003,112(2):362-368.
[17]Simpson A,Tan VY,Winn J,et al.Beyond atopy:Multiple patterns of sensitization in relation to asthma in a birth cohort study[J].Am J Respir Crit Care Med,2010,181(11):1200-1206.
[18]Celedon JC,Milton DK,Ramsey CD,et al.Exposure to dust mite allergen and endotoxin in early life and asthma and atopy in childhood[J].J Allergy Clin Immunol,2007,120(1):144-149.
[19]Torrent M,Sunyer J,Garcia R,et al.Early-life allergen exposure and atopy,asthma,and wheeze up to 6 years of age[J].Am JRespir Crit Care Med,2007,176(5):446-453.
[20]Tovey ER,Almqvist C,Li Q,et al.Nonlinear relationship of mite allergen exposure to mite sensitization and asthma in a birth cohort[J].J Allergy Clin Immunol,2008,122(1):114-118,118.e1-5.
[21]Richgels PK,Yamani A,Chougnet CA,et al.Maternal house dust mite exposure during pregnancy enhances severity of house dust mite-induced asthma in murine offspring[J].J Allergy Clin Immunol,2017,140(5):1404-1415.
[22]Beck AF,Huang B,Kercsmar CM,et al.Allergen sensitization profiles in a population-based cohort of children hospitalized for asthma[J].Ann Am Thorac Soc,2015,12(3):376-384.
[23]Global Initiative for Asthma.2017 GINA Report:Global Strategy for Asthma Management and Prevention[EB/OL].(2017)[2019-03-26].https://ginasthma.org/wp-content/uploads/2019/04/wmsGINA-2017-main-report-final_V2.pdf.
[24]于静淼,孙劲旅,尹佳,等.北京地区尘螨过敏患者家庭螨类调查[J].中华临床免疫和变态反应杂志,2014,8(3):188-194.
[25]Murray CS,Foden P,Sumner H,et al.Preventing severe asthma exacerbations in children.A randomized trial of mite-impermeable bedcovers[J].Am J Respir Crit Care Med,2017,196(2):150-158.
[26]Arroyave WD,Rabito FA,Carlson JC,et al.Impermeable dust mite covers in the primary and tertiary prevention of allergic disease:A meta-analysis[J].Ann Allergy Asthma Immunol,2014,112(3):237-248.
[27]Cipriani F,Calamelli E,Ricci G.Allergen avoidance in allergic asthma[J].Front Pediatr,2017,5:103.
[28]van Boven FE,Arends LR,Braunstahl GJ,et al.A reintroduction of environmental mite allergen control strategies for asthma treatment and the debate on their effectiveness[J].Clin Exp Allergy,2019,49(4):400-409.
[29]Wilson JM,Platts-Mills T.Home environmental interventions for house dust mite[J].J Allergy Clin Immunol Pract,2018,6(1):1-7.
[30]Htut T,Higenbottam TW,Gill GW,et al.Eradication of house dust mite from homes of atopic asthmatic subjects:A double-blind trial[J].J Allergy Clin Immunol,2001,107(1):55-60.
[31]Lau S,Wahn J,Schulz G,et al.Placebo-controlled study of the mite allergen-reducing effect of tannic acid plus benzyl benzoate on carpets in homes of children with house dust mite sensitization and asthma[J].Pediatr Allergy Immunol,2002,13(1):31-36.
[32]Shani Z,Scott RG,Schofield LS,et al.Effect of a home intervention program on pediatric asthma in an environmental justice community[J].Health Promot Pract,2015,16(2):291-298.
[33]Schauer U,Bergmann KC,Gerstlauer M,et al.Improved asthma control in patients with severe,persistent allergic asthma after 12months of nightly temperature-controlled laminar airflow:An observational study with retrospective comparisons[J].Eur Clin Respir J,2015,2.
[34]El-Ghitany EM,Abd EM.Environmental intervention for house dust mite control in childhood bronchial asthma[J].Environ Health Prev Med,2012,17(5):377-384.
[35]Smith H,Horney D,Jones C,et al.Pragmatic randomized controlled trial of an allergy intervention for children aged 6-16 with asthma and rhinitis in general practice[J].Clin Exp Allergy,2016,46(9):1227-1235.
[36]Marks GB,Mihrshahi S,Kemp AS,et al.Prevention of asthma during the first 5 years of life:A randomized controlled trial[J].JAllergy Clin Immunol,2006,118(1):53-61.
[37]Huiyan W,Yuhe G,Juan W,et al.The importance of allergen avoidance in high risk infants and sensitized patients:A metaanalysis study[J].Allergy Asthma Immunol Res,2014,6(6):525-534.
[38]G?tzsche PC,Johansen HK.House dust mite control measures for asthma:Systematic review[J].Allergy,2008,63(6):646-659.
[39]Platts-Mills T.Allergen avoidance in the treatment of asthma:Problems with the meta-analyses[J].J Allergy Clin Immunol,2008,122(4):694-696.
[40]Tovey ER,Willenborg CM,Crisafulli DA,et al.Most personal exposure to house dust mite aeroallergen occurs during the day[J].PLo S One,2013,8(7):e69900.
[41]Tovey ER,Liu-Brennan D,Garden FL,et al.Time-based measurement of personal mite allergen bioaerosol exposure over 24 hour periods[J].PLo S One,2016,11(5):e153414.
[42]BTS/SIGN.British guideline on the management of asthma2016[EB/OL].(2016)[2019-03-26].https://www.britthoracic.org.uk/document-library/guidelines/asthma/btssignasthma-guideline-2016.
[43]Scadding GK,Kariyawasam HH,Scadding G,et al.BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis(Revised Edition 2017;First edition 2007)[J].Clin Exp Allergy,2017,47(7):856-889.
[44]中华医学会儿科学分会中华儿科杂志编辑委员会.儿童过敏性疾病诊断及治疗专家共识[J].中华儿科杂志,2019,57(3):164-171.