居室内粉螨孳生及分布情况

目的 研究居室粉螨孳生及分布情况.方法 于2005年4-7月收集张家港市过敏性哮喘患者(40名)及同一居住区域内居住条件相似,无任何变应性疾病的健康者(40名)居室床面、地面、家具、空调隔尘网及空气中的灰尘样本各1份,用直接镜检法分离、鉴定粉螨.结果 共收集样本400份,其粉螨孳生率为52.25%(209/400).共检获粉螨2 746只,隶属于7科15种.以麦食螨科的孳生率(46.25%,185/400)和相对丰度(54.26%,1 490/2 746)最高;其次是粉螨科(孳生率和相对丰度分别为34.5%,23.89%)及食甜螨科(孳生率和相对丰度分别为19.25%,18.14%).健康者居室各部位粉螨孳生密度较高,与过敏性哮喘患者比较,差异有统计学意义(P＜0.01).结论 张家港市部分居室粉螨孳生情况较严重,健康者居室各部位粉螨孳生密度高于过敏性哮喘患者,螨过敏性哮喘患者发病可能主要取决于个体特异性.     

哮喘患者居室内尘螨孳生种类、密度及其与抗原浓度的相关性研究

目的调查海口市哮喘患者居室孳生尘螨种类、密度及其与抗原浓度的相关性。方法采集哮喘患者居室尘样,在光镜下分类、计数,并用ELISA法测定Der P1浓度。结果制片616张,鉴定出16种螨,其中热带无爪螨占71.75%,屋尘螨占9.25%。哮喘患者居室尘样螨孳生密度和抗原浓度均高于正常对照组,差异均有统计学意义(P<0.01),二者间相关性显著(r=0.716,P<0.01)。结论热带无爪螨为本地区优势螨种,居室尘螨抗原浓度的检测似可替代活螨计数法评价室内尘螨孳生情况。     

环境内毒素暴露与哮喘

内毒素暴露对哮喘具有双向效应。在职业环境中高水平的内毒素可导致慢性支气管炎和非特应性哮喘的患病率增高;相反,在职业或非职业环境中高水平内毒素暴露对抗原过敏的形成可能具有一定的保护作用,能降低特应性哮喘的患病风险。     

嘉兴地区哮喘儿童过敏原检测的临床分析与预防

[目的]了解嘉兴地区哮喘息儿过敏原状况以指导临床防治. [方法]采用酶联免疫法检测150例支气管哮喘儿童的过敏原特异性IgE抗体. [结果]各年龄组吸入性抗原中螨特异性IgE阳性率最高(平均69.33%),随着年龄增长阳性率显著增加.在食物性抗原中以牛奶特异性IgE阳性率最高(11.3%). [结论]螨虫和牛奶是儿童哮喘的主要触发因素,蟑螂、花粉是嘉兴地区重要的哮喘触发因素.     

哮喘儿童过敏原特异性IgE抗体测定与分析

目的了解哮喘患儿过敏原状况以指导临床防治。方法采用酶联免疫吸附法检测156例支气管哮喘儿童的过敏原特异性IgE抗体。结果各年龄组吸入性抗原中螨特异性IgE阳性率最高(平均70.5%),随着年龄增长阳性率显著增加。在食物性抗原中以牛奶特异性IgE阳性率最高(26.9%)。蟑螂特异性IgE阳性率随着年龄增长阳性率增加(8.3%~15.7%)。结论螨虫和牛奶是儿童哮喘的主要触发因素,蟑螂是杭州地区重要的哮喘触发因素。     

工作场所与居室粉螨变应原含量相关性研究

目的：探讨特定职业人群工作场所与居室粉螨变应原的相关性。方法：选取面粉、中药材及粮食加工人员（粉螨变应原暴露人群）各10名为实验组，对其工作场所的浮尘、落尘及居室内地板尘、床铺尘进行取样，另取本校教职工10名为对照，同样取样共160份。ELISA法检测样品中粉螨变应原的含量。结果：实验组工作场所变应原含量明显高于居室内；浮尘变应原含量与床铺尘、地板尘具有相关性（r6=0．40，P〈0．0l；r6=0．32，P〈0．05），对照组工作场所与居室内变应原含量无明显差异，浮尘与床铺尘变应原含量无显著相关性。结论：粉螨变应原暴露人群的工作场所及居室内粉螨变应原污染严重，并存在从工作场所向居室的变应原转移。     

江苏地区尘螨暴露、尘螨过敏在外源性哮喘中的作用

1992年7月至1993年4月于江苏地区用病例对照研究的方法着重对尘螨暴露、尘螨过敏与外源性哮喘的联系进行非条件Logistic回归分析。以对象床褥上鸟嘌呤含量为尘螨暴露水平的指标,血清中尘螨特异性IgE为尘螨过敏的指标。结果表明:尘螨暴露、尘螨过敏、双亲过敏史和出生于高螨密度月份均与外源性哮喘发生有显著联系。尘螨暴露的人群归因危险度百分比(PAR%)达70.29%。据此,对外源性哮喘的防治提出了建议。     

肠螨病一例报道

肠螨病一例报道蔡茹粉螨多在贮藏食物和房舍内生存繁殖，某些粉螨生存能力特强，偶可在人体内生存成为兼性寄生虫。因此，由粉螨寄生肠腔引起的肠螨病（Ｉｎｔｅｒｔｉｎａｌａｃａｒｉａｓｉｓ）国内外均有报道。我们近期经治１例。例：男，６岁，近１月来出现厌食、烦燥...     

杭州及其周边地区哮喘患儿过敏原分析

【目的】探讨杭州及其周边地区哮喘患儿的过敏原情况，为今后该地区哮喘防治工作提供指导依据。【方法】应用屋尘、尘螨等12种常见过敏原和IgE对167例哮喘患儿进行检测，计算各种过敏原的阳性率并与哮喘发病情况作比较。【结果】167例哮喘息儿中过敏原检测阳性率最高前三位分别为尘、粉螨和屋尘，占过敏原检测阳性哮喘息儿67．4％，其中1、2、3、4种过敏原阳性及其构成比分别为45例（53．0％），25例（29．4％），12例（14．1％），3例（3．5％）。【结论】儿童哮喘的发作与过敏原关系密切。杭州及其周边地区哮喘患儿的过敏原最常见为尘、粉螨和屋尘，检测并避免接触过敏原是防治儿童哮喘的重要环节。     

SPT法和IVT法检测儿童哮喘变应原比较分析研究

[目的]通过对160例哮喘儿童变应原检测方法回顾性分析,探讨其在临床中的应用价值.[方法]对哮喘儿童进行变应原检测,皮肤点刺试验(SPT)选用德国默克公司生产的"变应原试液";变应原体外筛选系统(IVT)检测选用美国ASI公司的变应原体外试剂盒.就两种方法的检测相关性进行分析.[结果]SPT法主要吸入性变应原中阳性率,螨虫83.10%,霉菌48.80%,兽毛40%,早春花粉20%.IVT法主要吸入性变应原中阳性率:螨、粉螨80%,霉菌48.1%,动物皮毛25.6%;蟑螂、蚊子15..6%,主要食入性变应原中阳性率:虾蟹24.4%,牛奶18.1%,鱼10.6%.160例总IgE抗体阳性率为90.6%.[结论]SPT法与IVT法两种方法检测变应原差异无统计学意义.IVT检测变应原适宜于大中型医院批量的检测;SPT检测变应原适用于基层医院开展此项工作.     

Health effects of organic dust exposure in dairy farmers

Exposure to farm dust may cause asthma, rhinitis, allergic alveolitis, organic dust toxic syndrome, and chronic bronchitis. Febrile reactions to inhaled dusts are common and are usually of a toxic rather than an allergic type. Some evidence indicates that dairy farmers may have an increased prevalence of chronic bronchitis, allergic asthma, rhinitis, and chronic airflow limitation, but this has not been conclusively shown. Storage mites and cow dander are important allergens in dairy farming. Inflammation of airways may in part be caused by immediate or delayed hypersensitivity. Other mechanisms, such as activation of inflammatory cells from toxic agents or high exposure levels, may be of considerable importance in causing airway and lung disease.     

Food hypersensitivity and allergic diseases

Allergic disease is a common cause of morbidity, particularly in young children. The prevalence of allergic disease has increased in the last 20 y in most countries. The sequential order of occurrence of allergy is food hypersensitivity, gastrointestinal manifestations, atopic eczema, asthma and hay fever. A variety of factors increase the risk of allergic disease, for example hereditary predisposition, exposure to 'allergenic' foods and environmental triggers such as house dust mites and tobacco in early life. Prolonged breast feeding, the use of a partial whey hydrolysed formula, delayed introduction of certain 'allergenic foods', and avoidance of inhalant allergens reduces the incidence of eczema and asthma, especially in high-risk infants. These preventive measures are extremely cost-effective and should be adopted widely at the community level.     

Allergy to house dust mites and asthma

House dust mites have been shown to be important sources of indoor allergens associated with asthma and other allergic conditions. Asthma is a chronic respiratory disease that affects millions of people worldwide, and numerous scientific studies have shown that the prevalence of asthma is increasing. The most common dust mite species around the world include Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), Euroglyphus maynei (Em) and Blomia tropicalis (Bt). Over the past three decades, many important allergens from these species have been identified and characterized at the molecular level. The biological function of several house dust mite allergens has been elucidated, with many of them showing enzymatic activity. However, Bt allergens remain the least studied, even though this mite is very common in tropical and subtropical regions of the world, including Puerto Rico. Therefore, it is very important to include Bt in diagnostic and therapeutic strategies for house dust mite induced allergy and asthma, particularly in areas where Bt exposure and sensitization is high. Recombinant DNA technology, as well as other molecular biology and immunological techniques, have played a fundamental role in advances towards a better understanding of the biology of house dust mites and their role in allergic diseases. This kind of study also contributes to the understanding of the complex immunologic mechanisms involved in allergic reactions. The development of effective diagnostic and therapeutic approaches depends on the continuity of research of house dust mite allergens. The objectives of this review are to describe the most important aspects of house dust mite allergy and to acquaint the scientific community with the latest findings pertaining to house dust mite allergens, particularly those derived from Bt.     

海口地区138例哮喘患儿血清总IgE水平及过敏原检测分析

目的:探讨海口地区哮喘患儿血清中总IgE水平及主要过敏原种类。方法:采用德国欧蒙印迹法分别检测138例哮喘患儿及40例健康儿童的过敏原种类,并采用美国贝克曼化学发光仪DXI800检测血清中总IgE含量。结果:40例健康儿童血清总IgE含量为116.29±91.60μg/L,过敏原检测均为阴性;138例哮喘患儿总IgE的含量为2 126.17±1 942.69μg/L,138例哮喘患儿总IgE阳性率为73.2%,总IgE水平明显高于对照组过敏原阳性率68.1%(P<0.01),且大多数患儿被多种过敏原致敏。吸入组最高为屋尘57例,其次为屋尘螨/粉尘螨46例;食入组最高为虾20例,其次为鸡蛋白、蟹。结论:通过对哮喘患儿测定血清总IgE水平,并结合过敏原的测定,可了解患儿过敏的变应原,寻找病因,尽量避免接触此类过敏原,减少发病。     

从化地区哮喘患儿变应原皮肤点刺试验的临床研究

【目的】 了解从化地区支气管哮喘发病相关的主要致敏变应原及其特点,指导选择特异性免疫治疗对象。 【方法】 对382 例支气管哮喘缓解期患儿,用德国默克公司生产的阿罗格食入组及吸入组点刺试剂进行皮肤点刺试验,组胺液为阳性对照,生理盐水为阴性对照。 【结果】 哮喘患儿皮肤点刺试验阳性率为 88.5%。吸入变应原总阳性率为81.2%,吸入变应原中以粉尘螨和屋尘螨阳性率居高,分别为77.2%和71.2%;食入变应原总阳性率为32.7%,居前两位的为小虾19.9%,花生6.3%。在吸入变应原中高龄组与低龄组比较差异有统计学意义(P<0.05),食入变应原中高龄组与低龄组比较差异无统计学意义(P>0.05)。哮喘或哮喘并鼻炎患儿均以螨类过敏最常见,两组间螨类、霉菌类、动物皮毛类、蟑螂及杂草变应原阳性率差异均无统计学意义。 【结论】 从化地区支气管哮喘患儿发病相关的吸入变应原主要是粉尘螨、屋尘螨,食入变应原主要是小虾、花生。3~14岁儿童哮喘患儿随着年龄增长,对吸入性变应原更为敏感。哮喘与哮喘并鼻炎患者共同的变应原主要是螨类,其次为霉菌类、动物皮毛类,为哮喘的防治提供了指导作用。     

广州市儿童常见过敏性疾病的过敏原检测结果分析

目的 了解广州市儿童常见过敏性疾病的过敏原分布状况,为不同过敏性疾病患儿的环境过敏原防治提供依据.方法 纳入喘息性疾病及哮喘(1 013例)、过敏性鼻炎(660例)、过敏性结膜炎(422例)、湿疹(2 762例)、特应性皮炎(831例)和荨麻疹(1 181例)患儿共6 869例,经免疫印迹法检测血清过敏原E型特异性抗体...     

Allergens causing occupational asthma: an evidence-based evaluation of the literature

Purpose

The aim of this work is to provide an evidence-based evaluation and overview of causative substances in order to improve disease management.

Methods

We conducted a database search with MEDLINE via PubMed, screened reference lists of relevant reviews and matched our findings with a list of agents denoted as “may cause sensitisation by inhalation” by the phrase H334 (till 2011 R42). After exclusion of inappropriate publications, quality of the selected studies was rated with the Scottish Intercollegiate Guideline Network (SIGN) grading system. The evidence level for each causative agent was graded using the modified Royal College of General Practitioners (RCGP) three-star system.

Results

A total of 865 relevant papers were identified, which covered 372 different causes of allergic work-related asthma. The highest level achieved using the SIGN grading system was 2++ indicating a high-quality study with a very low risk of confounding or bias and a high probability of a causal relationship. According to the modified RCGP three-star grading system, the strongest evidence of association with an individual agent, profession or worksite (“***”) was found to be the co-exposure to various laboratory animals. An association with moderate evidence level (“**”) was obtained for α-amylase from Aspergillus oryzae, various enzymes from Bacillus subtilis, papain, bakery (flour, amylase, storage mites), western red cedar, latex, psyllium, farming (animals, cereal, hay, straw and storage mites), storage mites, rat, carmine, egg proteins, atlantic salmon, fishmeal, norway lobster, prawn, snow crab, seafood, trout and turbot, reactive dyes, toluene diisocyanates and platinum salts.

Conclusion

This work comprises the largest list of occupational agents and worksites causing allergic asthma. For the first time, these agents are assessed in an evidence-based manner. The identified respiratory allergic agents or worksites with at least moderate evidence for causing work-related asthma may help primary care physicians and occupational physicians in diagnostics and management of cases suffering from work-related asthma. Furthermore, this work may possibly provide a major contribution to prevention and may also initiate more detailed investigations for broadening and updating these evidence-based evaluations.     

The prevention of mite‐allergic asthma

Asthma is common in day‐to‐day practice in most surgeries, yet GPs would have to content themselves with treating the symptoms and prescribing prophylactic drugs only. This paper tries to probe into the possibility for active prevention of asthma. House dust mites are now considered as one of the causal factors for allergic asthma. It is the commonest allergen encountered in the UK and since there is a constant exposure to these allergens, their avoidance if it is implemented methodically, may alter the prevalence of asthma as well as in the improvements of its symptoms. There are several well‐studied methods to avoid these allergens, but none of them would be effective when applied individually. A few measures will have to be integrated to combat the complex nature of this disease. These measures are not frequently implemented as there is no standard guideline and moreover, the results of clinical trials on these methods are often conflicting. However, it was found that when these measures are applied consistently for more than 6 months, all methods have proven to be effective. The authors have compiled a feasible approach to tackle this complicated problem.