J Allergy Clin Immun：婴儿接触特定霉菌有更高风险患上哮喘

在美国，每10个儿童当中就有一个遭受哮喘的折磨，但是造成这种疾病产生的潜在性环境因素仍然不广为人知。如今，来自美国辛辛那提大学、美国环境保护局(Environmental Protection Agency, EPA)和辛辛那提儿童医院医学中心的研究人员发现新证据表明婴儿期间接触三种类型霉菌---赭曲霉(Aspergillus ochraceus)、爪甲曲霉(Aspergillus unguis)和变幻青霉(Penicillium variabile)---可能与儿童期间患上哮喘存在直接关联。论文第一作者Tiina Reponen博士和同事们将这些研究发现发表在2012年8月那期Journal of Allergy and Clinical Immunology期刊上。

在对将近300名婴儿的长期群体研究中，研究人员在这些婴儿的头四年里每年评估了他们的过敏症发生情况和呼吸健康，然后在7岁时再次进行评估。研究人员也监控家里过敏原和霉菌。所有参与研究的婴儿出生时，每名婴儿双亲当中至少有一位患有过敏症。

他们发现父母患有过敏症的儿童当中25%的人在7岁时就已患有哮喘。在评估的多种室内污染物当中，只有婴儿期间接触霉菌能被作为他们7岁时患上哮喘的风险因素。

研究人员利用一种基于DNA的霉菌水平分析工具---环境相对发霉指数(environmental relative moldiness index, ERMI)---而确定出在高风险的研究群体当中，接触赭曲霉、爪甲曲霉和变幻青霉与患上哮喘相关联。ERMI工具是由美国环境保护局开发的，能够将36种不同类型的霉菌分析结果结合在一起而计算出一种描述家庭中积累霉菌负担(cumulative mold burden)的指数。

Reponen说，“这项发现提供强大的证据表明室内霉菌促进哮喘产生，同时也强调人们急需修复家庭中的水渍损失，特别是低收入的城市区域。靶向特异性霉菌物种的治疗可能是一种更加有效的方法。”

本文编译自Infants exposed to specific molds have higher asthma risk

doi: 10.1016/j.jaci.2012.05.030
PMC:
PMID:

Infant origins of childhood asthma associated with specific molds

Tiina Reponen, PhD, James Lockey, MS, MD, David I. Bernstein, MD, Stephen J. Vesper, PhD, Linda Levin, PhD, Gurjit K. Khurana Hershey, MD, PhD, Shu Zheng, PhD, Patrick Ryan, PhD, Sergey A. Grinshpun, PhD, Manuel Villareal, MD, Grace LeMasters, PhD

Background The specific cause or causes of asthma development must be identified to prevent this disease. Objective Our hypothesis was that specific mold exposures are associated with childhood asthma development. Methods Infants were identified from birth certificates. Dust samples were collected from 289 homes when the infants were 8 months of age. Samples were analyzed for concentrations of 36 molds that comprise the Environmental Relative Moldiness Index (ERMI) and endotoxin, house dust mite, cat, dog, and cockroach allergens. Children were evaluated at age 7 years for asthma based on reported symptoms and objective measures of lung function. Host, environmental exposure, and home characteristics evaluated included a history of parental asthma, race, sex, upper and lower respiratory tract symptoms, season of birth, family income, cigarette smoke exposure, air conditioning, use of a dehumidifier, presence of carpeting, age of home, and visible mold at age 1 year and child's positive skin prick test response to aeroallergens and molds at age 7 years. Results Asthma was diagnosed in 24% of the children at age 7 years. A statistically significant increase in asthma risk at age 7 years was associated with high ERMI values in the child's home in infancy (adjusted relative risk for a 10-unit increase in ERMI value, 1.8; 95% CI, 1.5-2.2). The summation of levels of 3 mold species, Aspergillus ochraceus, Aspergillus unguis, and Penicillium variabile, was significantly associated with asthma (adjusted relative risk, 2.2; 95% CI, 1.8-2.7). Conclusion In this birth cohort study exposure during infancy to 3 mold species common to water-damaged buildings was associated with childhood asthma at age 7 years.