呼出气一氧化氮与哮喘和常年性致敏相关的上呼吸道炎症性疾病相关性的横断面研究
2021/09/24
摘要
背景：呼出气一氧化氮 (FeNO)是众所周知的2型炎症标志物。FeNO 在哮喘和过敏性鼻炎中升高，IgE 致敏是主要决定因素。
目的：在一项基于多中心人群的研究中，我们的目标是在对哮喘和致敏因素进行调整后，观察上呼吸道炎症性疾病（UAID）和FeNO之间是否存在独立相关性。
方法：共有741名哮喘受试者和4155名非哮喘受试者参加了欧洲共同体呼吸健康调查(ECRHS III)的第二次随访，进行了 FeNO 测量。致敏状态是基于对空气传播过敏原IgE的测量；哮喘、UAID和药物的信息是通过访谈问卷收集的。调整后的多元回归模型评估了UAID和FeNO之间的独立相关性，并进行了常年致敏和哮喘对UAID和FeNO之间关系的交互作用检验。
结果：调整了常年致敏、哮喘和其他混杂因素后，UAID与较高的FeNO相关：4.4(0.9-7.9)%较高FeNO与现发性鼻炎相关，4.8(0.7-9.2)%较高FeNO与鼻结膜炎相关。在现发性鼻炎与FeNO（p=0.03）之间以及鼻结膜炎与FeNO（p=0.03）之间的关系中，发现了与常年致敏的显著相互作用。在通过哮喘和常年过敏分层后，在伴有常年致敏的非哮喘受试者中，现发性鼻炎与FeNO之间的相关性仍然存在，现发性鼻炎受试者的FeNO水平比未患鼻炎的受试者高12.1（0.2-25.5）%。
结论：现发性鼻炎和鼻结膜炎与高FeNO有关，且与常年致敏有相互作用。这进一步强调了联合气道疾病的概念，即上呼吸道和下呼吸道的症状和炎症之间存在相关性，FeNO和鼻炎之间的关系需要考虑致敏性。
Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitization
Christina Krantz, Simone Accordini, Kjell Alving, Angelo G Corsico, Pascal Demoly, Diogenes S Ferreira, Bertil Forsberg, Judith Garcia-Aymerich, Thorarinn Gislason, Joachim Heinrich, Rain Jõgi, Ane Johannessen, Bénédicte Leynaert, Alessandro Marcon, Jesús Martínez-Moratalla Rovira, Elisabet Nerpin, Dennis Nowak, Anna-Carin Olin, Mario Olivieri, Antonio Pereira-Vega, Chantal Raherison-Semjen, Francisco Gómez Real, Torben Sigsgaard, Guilia Squillacioti, Christer Janson, Andrei Malinovschi, European Community Respiratory Health Survey III
Abstract
BACKGROUND:Fractional exhaled nitric oxide (FeNO) is a well-known marker of type-2 inflammation. FeNO is elevated in asthma and allergic rhinitis, with IgE sensitisation as a major determinant.
OBJECTIVE:We aimed to see if there was an independent association between upper airway inflammatory disorders (UAID) and FeNO, after adjustment for asthma and sensitisation, in a multi-centre population-based study.
METHODS:A total of 741 subjects with current asthma and 4,155 non-asthmatic subjects participating in the second follow-up of the European Community Respiratory Health Survey (ECRHS III) underwent FeNO measurements. Sensitisation status was based on measurement of IgE against airborne allergens; information on asthma, UAID and medication was collected through interview-led questionnaires. Independent associations between UAID and FeNO was assessed in adjusted multivariate regression models and test for interaction with perennial sensitisation and asthma on the relation between UAID and FeNO were made.
RESULTS:UAID were associated with higher FeNO after adjusting for perennial sensitisation, asthma and other confounders: with 4.4 (0.9-7.9) % higher FeNO in relation to current rhinitis and 4.8 (0.7-9.2)% higher FeNO in relation to rhinoconjunctivitis. A significant interaction with perennial sensitisation was found in the relationship between current rhinitis and FeNO (p=0.03) and between rhinoconjunctivitis and FeNO (p=0.03). After stratification by asthma and perennial sensitisation, the association between current rhinitis and FeNO remained in non-asthmatic subjects with perennial sensitisation, with 12.1 (0.2-25.5) % higher FeNO in subjects with current rhinitis than in those without.
CONCLUSIONS:Current rhinitis and rhinoconjunctivitis was associated with higher FeNO, with an interaction with perennial sensitisation. This further highlights the concept of united airway disease, with correlations between symptoms and inflammation in the upper and lower airways and that sensitisation needs to be accounted for in the relation between FeNO and rhinitis.
背景：呼出气一氧化氮 (FeNO)是众所周知的2型炎症标志物。FeNO 在哮喘和过敏性鼻炎中升高，IgE 致敏是主要决定因素。
目的：在一项基于多中心人群的研究中，我们的目标是在对哮喘和致敏因素进行调整后，观察上呼吸道炎症性疾病（UAID）和FeNO之间是否存在独立相关性。
方法：共有741名哮喘受试者和4155名非哮喘受试者参加了欧洲共同体呼吸健康调查(ECRHS III)的第二次随访，进行了 FeNO 测量。致敏状态是基于对空气传播过敏原IgE的测量；哮喘、UAID和药物的信息是通过访谈问卷收集的。调整后的多元回归模型评估了UAID和FeNO之间的独立相关性，并进行了常年致敏和哮喘对UAID和FeNO之间关系的交互作用检验。
结果：调整了常年致敏、哮喘和其他混杂因素后，UAID与较高的FeNO相关：4.4(0.9-7.9)%较高FeNO与现发性鼻炎相关，4.8(0.7-9.2)%较高FeNO与鼻结膜炎相关。在现发性鼻炎与FeNO（p=0.03）之间以及鼻结膜炎与FeNO（p=0.03）之间的关系中，发现了与常年致敏的显著相互作用。在通过哮喘和常年过敏分层后，在伴有常年致敏的非哮喘受试者中，现发性鼻炎与FeNO之间的相关性仍然存在，现发性鼻炎受试者的FeNO水平比未患鼻炎的受试者高12.1（0.2-25.5）%。
结论：现发性鼻炎和鼻结膜炎与高FeNO有关，且与常年致敏有相互作用。这进一步强调了联合气道疾病的概念，即上呼吸道和下呼吸道的症状和炎症之间存在相关性，FeNO和鼻炎之间的关系需要考虑致敏性。
(中日友好医院呼吸与危重症医学科 王静茹 摘译 林江涛 审校)
(Clin Exp Allergy 2021 Sep 18. doi: 10.1111/cea.14019.)
(Clin Exp Allergy 2021 Sep 18. doi: 10.1111/cea.14019.)
Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitization
Christina Krantz, Simone Accordini, Kjell Alving, Angelo G Corsico, Pascal Demoly, Diogenes S Ferreira, Bertil Forsberg, Judith Garcia-Aymerich, Thorarinn Gislason, Joachim Heinrich, Rain Jõgi, Ane Johannessen, Bénédicte Leynaert, Alessandro Marcon, Jesús Martínez-Moratalla Rovira, Elisabet Nerpin, Dennis Nowak, Anna-Carin Olin, Mario Olivieri, Antonio Pereira-Vega, Chantal Raherison-Semjen, Francisco Gómez Real, Torben Sigsgaard, Guilia Squillacioti, Christer Janson, Andrei Malinovschi, European Community Respiratory Health Survey III
Abstract
BACKGROUND:Fractional exhaled nitric oxide (FeNO) is a well-known marker of type-2 inflammation. FeNO is elevated in asthma and allergic rhinitis, with IgE sensitisation as a major determinant.
OBJECTIVE:We aimed to see if there was an independent association between upper airway inflammatory disorders (UAID) and FeNO, after adjustment for asthma and sensitisation, in a multi-centre population-based study.
METHODS:A total of 741 subjects with current asthma and 4,155 non-asthmatic subjects participating in the second follow-up of the European Community Respiratory Health Survey (ECRHS III) underwent FeNO measurements. Sensitisation status was based on measurement of IgE against airborne allergens; information on asthma, UAID and medication was collected through interview-led questionnaires. Independent associations between UAID and FeNO was assessed in adjusted multivariate regression models and test for interaction with perennial sensitisation and asthma on the relation between UAID and FeNO were made.
RESULTS:UAID were associated with higher FeNO after adjusting for perennial sensitisation, asthma and other confounders: with 4.4 (0.9-7.9) % higher FeNO in relation to current rhinitis and 4.8 (0.7-9.2)% higher FeNO in relation to rhinoconjunctivitis. A significant interaction with perennial sensitisation was found in the relationship between current rhinitis and FeNO (p=0.03) and between rhinoconjunctivitis and FeNO (p=0.03). After stratification by asthma and perennial sensitisation, the association between current rhinitis and FeNO remained in non-asthmatic subjects with perennial sensitisation, with 12.1 (0.2-25.5) % higher FeNO in subjects with current rhinitis than in those without.
CONCLUSIONS:Current rhinitis and rhinoconjunctivitis was associated with higher FeNO, with an interaction with perennial sensitisation. This further highlights the concept of united airway disease, with correlations between symptoms and inflammation in the upper and lower airways and that sensitisation needs to be accounted for in the relation between FeNO and rhinitis.
上一篇：
体力活动在哮喘学龄前儿童哮喘控制中的作用及其免疫调节作用
下一篇：
鼻病毒诱发哮喘急性加重时的肺固有淋巴细胞反应：一项临床试验
