摘要
背景：儿童血液嗜酸性粒细胞与过敏性疾病亚型之间的关系仍有待研究。本研究旨在探讨儿童血液嗜酸性粒细胞与哮喘、鼻炎和皮炎亚型之间的关系，以及年龄的调节作用。
方法：我们收集了2014-2019年广州医科大学第一附属医院5026例(0-13岁)儿童的血细胞计数和血清免疫球蛋白E(igE)检测结果。采用多变量调整的广义相加模型来模拟嗜酸性粒细胞与过敏症状之间的暴露-反应关系。在两个年龄类别中评估相关性的稳健性。
结果：嗜酸性粒细胞与过敏性哮喘/鼻炎的相关性呈正非线性，在Q4水平(≥0.51,109/L)有平台期。相反，嗜酸性粒细胞与非过敏性哮喘和鼻炎风险之间的暴露-响应曲线呈负线性关系，特别是当嗜酸性粒细胞水平大于Q3(≥0.30,109/L)时，其暴露-响应曲线具有统计学意义。与同龄儿童相比，血液嗜酸性粒细胞水平较高(≥0.35,109/L)的学龄儿童(6-13岁)更容易发生过敏性哮喘[相互作用导致的相对过高风险(RERI)，2.51;95% CI,1.24-3.78]，变应性鼻炎(RERI,2.79;95% CI,1.14-4.45)，但无过敏性皮炎(RERI不显著)。
结论：较高的嗜酸性粒细胞计数与儿童过敏亚型症状的风险增加和非过敏亚型风险降低相关。此外，嗜酸性粒细胞与过敏性哮喘/鼻炎之间的相关性在学龄儿童中更明显。这些发现可能有助于为过敏相关症状的临床用药提供新的见解。
Childhood blood eosinophils and symptoms of allergic disorders: a cross-sectional study in Southern China
X. Q. Hou, W. T. Luo, H. Gan, T. H. Chen and B. Q. Sun
Abstract
BACKGROUNDS：The relationship between childhood blood eosinophils and subtypes of allergic diseases remains understudied. This study aimed to examine the associations between childhood blood eosinophils and subtypes of asthma, rhinitis and dermatitis, as well as the modifying effect of age.
METHODS：We obtained concurrent blood cell counts and serum Immunoglobulin E (IgE) test results in 5026 children (0–13, years) from First Affiliated Hospital of Guangzhou Medical University from 2014 to 2019. Generalized additive models with multivariable adjustments were utilized to model the exposure-response relationship between eosinophils and allergic symptoms. The robustness of the association was assessed in two age categories.
RESULTS：The association of eosinophils with allergic asthma/rhinitis was positively nonlinear, with a plateau at levels of Q4 (≥0.51, 109 /L). Conversely, exposure-response curves between eosinophils and the risk of non-allergic asthma and rhinitis were negatively linear, and especially, became statistically significant when levels of eosinophils were larger than Q3 (≥0.30, 109 / L). Compared with their counterparts, school-aged children (6–13, years) with a higher level of blood eosinophils (≥0.35, 109 /L) were more likely to suffer from allergic asthma [relative excess risk due to interaction (RERI), 2.51; 95% CI, 1.24–3.78], allergic rhinitis (RERI, 2.79; 95% CI, 1.14–4.45) but not allergic dermatitis (RERI not significant).
CONCLUSIONS：Higher eosinophil counts were associated with the increased risk of allergic subtype symptoms and the decreased risk of non-allergic subtypes in children. Moreover, the associations between eosinophils and allergic asthma/rhinitis were accentuated in the school-aged child. These findings may contribute to providing novel insights for clinical administration relevance of allergic-related symptoms.
背景：儿童血液嗜酸性粒细胞与过敏性疾病亚型之间的关系仍有待研究。本研究旨在探讨儿童血液嗜酸性粒细胞与哮喘、鼻炎和皮炎亚型之间的关系，以及年龄的调节作用。
方法：我们收集了2014-2019年广州医科大学第一附属医院5026例(0-13岁)儿童的血细胞计数和血清免疫球蛋白E(igE)检测结果。采用多变量调整的广义相加模型来模拟嗜酸性粒细胞与过敏症状之间的暴露-反应关系。在两个年龄类别中评估相关性的稳健性。
结果：嗜酸性粒细胞与过敏性哮喘/鼻炎的相关性呈正非线性，在Q4水平(≥0.51,109/L)有平台期。相反，嗜酸性粒细胞与非过敏性哮喘和鼻炎风险之间的暴露-响应曲线呈负线性关系，特别是当嗜酸性粒细胞水平大于Q3(≥0.30,109/L)时，其暴露-响应曲线具有统计学意义。与同龄儿童相比，血液嗜酸性粒细胞水平较高(≥0.35,109/L)的学龄儿童(6-13岁)更容易发生过敏性哮喘[相互作用导致的相对过高风险(RERI)，2.51;95% CI,1.24-3.78]，变应性鼻炎(RERI,2.79;95% CI,1.14-4.45)，但无过敏性皮炎(RERI不显著)。
结论：较高的嗜酸性粒细胞计数与儿童过敏亚型症状的风险增加和非过敏亚型风险降低相关。此外，嗜酸性粒细胞与过敏性哮喘/鼻炎之间的相关性在学龄儿童中更明显。这些发现可能有助于为过敏相关症状的临床用药提供新的见解。
（中日友好医院呼吸与危重症医学科 李春晓 摘译 林江涛 审校）
（Annals of Medicine, 2022, 54(1): 2929-2940 DOI: 10.1080/07853890.2022.2134584）
（Annals of Medicine, 2022, 54(1): 2929-2940 DOI: 10.1080/07853890.2022.2134584）
Childhood blood eosinophils and symptoms of allergic disorders: a cross-sectional study in Southern China
X. Q. Hou, W. T. Luo, H. Gan, T. H. Chen and B. Q. Sun
Abstract
BACKGROUNDS：The relationship between childhood blood eosinophils and subtypes of allergic diseases remains understudied. This study aimed to examine the associations between childhood blood eosinophils and subtypes of asthma, rhinitis and dermatitis, as well as the modifying effect of age.
METHODS：We obtained concurrent blood cell counts and serum Immunoglobulin E (IgE) test results in 5026 children (0–13, years) from First Affiliated Hospital of Guangzhou Medical University from 2014 to 2019. Generalized additive models with multivariable adjustments were utilized to model the exposure-response relationship between eosinophils and allergic symptoms. The robustness of the association was assessed in two age categories.
RESULTS：The association of eosinophils with allergic asthma/rhinitis was positively nonlinear, with a plateau at levels of Q4 (≥0.51, 109 /L). Conversely, exposure-response curves between eosinophils and the risk of non-allergic asthma and rhinitis were negatively linear, and especially, became statistically significant when levels of eosinophils were larger than Q3 (≥0.30, 109 / L). Compared with their counterparts, school-aged children (6–13, years) with a higher level of blood eosinophils (≥0.35, 109 /L) were more likely to suffer from allergic asthma [relative excess risk due to interaction (RERI), 2.51; 95% CI, 1.24–3.78], allergic rhinitis (RERI, 2.79; 95% CI, 1.14–4.45) but not allergic dermatitis (RERI not significant).
CONCLUSIONS：Higher eosinophil counts were associated with the increased risk of allergic subtype symptoms and the decreased risk of non-allergic subtypes in children. Moreover, the associations between eosinophils and allergic asthma/rhinitis were accentuated in the school-aged child. These findings may contribute to providing novel insights for clinical administration relevance of allergic-related symptoms.
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