哮喘联盟

   摘要
   背景与目的：虽然越来越多的证据表明哮喘可能与食物过敏(FA)有关，但是，目前为止，食物参与诱发呼吸道症状还没有被充分证实。本研究的目的在于评估食物过敏对学龄期哮喘儿童呼吸道症状和气道反应性(BHR)的影响。
   方法：研究最初纳入了362名哮喘儿童。最终有22名伴有食物过敏和18名无食物过敏的儿童纳入本次研究。双盲安慰剂对照食物激发试验(DBPCFC)完成前、后分别进行肺功能检查和乙酰甲胆碱激发试验(MIC)。
   结果：全部362名哮喘儿童中，9名(2.5%)出现了食物诱发的哮喘反应。两组研究人群中，过敏原或安慰剂激发前、后平均FEV1没有差异。DBPCFC后，有17名(4.7%)哮喘儿童气道反应性增高。伴有食物过敏的儿童中，过敏原激发试验前平均PC20（FEV1较基线下降20%的累积激发浓度）为1.41 ± 1.12 mg/ml，激发试验后平均为0.86 ± 0.71 mg/ml(P = 0.002)；而无食物过敏的儿童中，该值分别为1.93 ± 1.68 mg/ml和2.02 ± 1.75 mg/ml(P > 0.05)。伴有过敏的儿童较无过敏的儿童，过敏原激发试验后有显著差异(P = 0.007)。
   结论：虽然食物过敏很少能导致学龄期哮喘儿童食物诱发哮喘，但是，它能使气道反应性增高，即使食物激发试验后没有出现明显的呼吸道症状及FEV1降低。
 

（杨冬 审校）
 Pediatr Pulmonol. 2016 Jan 5. doi: 10.1002/ppul.23373. [Epub ahead of print]
 

The impact of food allergens on airway responsiveness in schoolchildren with asthma: A DBPCFC study.
 

Krogulska A1, Dynowski J1, Jędrzejczyk M1, Sardecka I1, Małachowska B2, Wąsowska-Królikowska K1.
 

Abstract
BACKGROUND AND OBJECTIVE:Despite the growing evidence of a possible link between asthma and food allergy (FA), so far, the involvement of food in inducing respiratory symptoms has not been fully evaluated. The objective of this study was to evaluate the impact of food allergens on respiratory symptoms and bronchial reactivity (BHR) in schoolchildren with asthma.
METHODS:The initial study group consisted of 362 children with asthma. In the end, 22 children with concomitant FA, and 18 without FA, were selected to participate in the study. Spirometry and Methacholine Inhalation Challenge (MIC) were conducted prior to and after the completion of a double blind placebo control food challenge (DBPCFC).
RESULTS:The food-induced asthmatic reactions were observed in nine (2.5%) out of all 362 children with asthma. Mean FEV1 prior to and after allergen or placebo challenge did not differ between the groups studied. Increase of BHR after DBPCFC was seen in 17 (4.7%) children with asthma. The mean PC20 value in children with FA was 1.41 ± 1.12 mg/ml prior to the allergen challenge and 0.86 ± 0.71 mg/ml (P = 0.002) after the test, whereas these values were 1.93 ± 1.68 mg/ml and 2.02 ± 1.75 mg/ml, respectively, in children without FA (P > 0.05). Significant differences were noted after the allergen provocation in children with FA as compared to children without FA (P = 0.007).
CONCLUSIONS:Although food allergens are a rare trigger of food-induced asthmatic reactions in schoolchildren with asthma, they could enhance BHR, despite a lack of evident clinical respiratory signs and decreased in FEV1 values after food challenge.
 

Pediatr Pulmonol. 2016 Jan 5. doi: 10.1002/ppul.23373. [Epub ahead of print]