Indoor Allergens And Asthma

室内过敏原和哮喘

• 批准号: 7168263
• 负责人: Darryl C Zeldin
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7168263
• 关键词: Fungi; Mus musculus; air sampling /monitoring; allergens; asthma; clinical trials; cockroach; domestic animals; endotoxins; environmental exposure; enzyme linked immunosorbent assay; household; human morbidity; human subject; low socioeconomic status; patient oriented research; pyroglyphid; questionnaires; respiratory disorder epidemiology; urban area

Our asthma research program involves both exposure assessment and prevention components, and focuses on the relationship between exposure to common indoor allergens and asthma prevalence/morbidity. The National Allergen Survey, a study of allergen types and levels in floor and bedding dust in the nation's housing, is the first study to provide estimates of allergen exposure in the U.S. population. It encompasses 831 homes in 75 primary sampling units located throughout the country. The major endpoints are measurements of dust mite, cockroach, cat, dog, mouse, rat and fungal allergen levels, and endotoxin in dust samples collected from an array of sites in the surveyed homes. Results from analysis of dust mite allergens suggest that approximately 24% of U.S. homes have beds that contain >10 microgram dust mite allergen/gram dust (a level previously associated with symptomatic asthma) and approximately 46% of U.S. homes have beds that contain >2 microgram dust mite allergen/gram dust (a level previously associated with mite allergen sensitization). The likelihood of having a high dust mite allergen level in the bed was greater for older homes, non-western region homes, lower income households and bedrooms with higher humidity. Dog and cat allergens were universally present in U.S. homes. Levels were higher among homes with an indoor dog and/or cat; however, among homes without an indoor pet, mean allergen concentrations were still well above proposed thresholds for allergic sensitization and disease. Mouse allergen was detectable in approximately 82% of U.S. homes and levels exceeded proposed sentization thresholds in 22% of homes. The likelihood of having high mouse allergen levels in the kitchen was greater in high rise apartments, mobile homes, older homes, low income homes, homes where rodent or cockroach problems were reported, and when floor mopping was performed instead of vacuuming. This nationally representative survey has (a) provided current estimates of indoor allergen exposure in the U.S. population, (b) established a database that can be used to stimulate future studies which attempt to correlate allergen exposure to disease outcome, (c) provided a baseline that can be used as a reference point for future allergen surveys, and (d) facilitated evaluation of regional, ethnic, socioeconomic, and housing characteristic differences in the allergen burden. We have also conducted a randomized clinical trial to test the feasibility/effectiveness of environmental interventions in reducing cockroach allergen levels in inner-city North Carolina homes. Our study demonstrated that the combination of cockroach extermination and intensive cleaning can significantly reduce cockroach allergen levels in highly infested homes. Moreover, the effect can be maintained for up to 12 months with continued extermination. Surprisingly, cockroach extermination alone can also significantly reduce cockroach allergen levels in low income homes over a 6 month period. The results of these studies will be used to design a prevention trial to determine if environmental intervention aimed at reducing indoor allergen levels can prevent sensitization and decrease the prevalence and morbidity of asthma in high risk children living in poverty.

我们的哮喘研究计划既涉及暴露评估和预防成分，又关注暴露于常见室内过敏原与哮喘患病率/发病率之间的关系。全国过敏原调查是对美国住房中地板和床上用品灰尘中的过敏原类型和水平的研究，是第一项提供对美国人群过敏原暴露的估计的研究。它涵盖了全国75个主要采样单元中的831套房屋。主要终点是测量尘螨，蟑螂，猫，狗，老鼠，大鼠和真菌过敏原水平，以及从调查房屋中的一系列地点收集的灰尘样品中的内毒素。分析粉尘螨过敏原的结果表明，大约24％的美国房屋具有> 10微克灰尘螨/克灰尘（以前与有症状性哮喘相关的水平），并且约46％的美国房屋具有> 2微克粉尘螨/克粉尘（以前与Mite Altergen Arnergen Altergen敏化相关的水平）。对于较老的房屋，非西部地区房屋，低收入家庭和卧室较高的湿度，床上具有高灰尘螨过敏原水平的可能性更大。狗和猫过敏原在美国的房屋中普遍存在。室内狗和/或猫的房屋中的水平更高；但是，在没有室内宠物的房屋中，平均过敏原浓度仍高于提议的过敏敏化和疾病的阈值。在大约82％的美国房屋中可检测到小鼠过敏原，并且在22％的房屋中超过了拟议的宣传阈值。在高层公寓，移动房屋，较旧的房屋，低收入房屋，报告啮齿动物或蟑螂问题的房屋以及进行地板拖把时，而不是吸尘时，在厨房中具有高小鼠过敏原水平的可能性更大。 This nationally representative survey has (a) provided current estimates of indoor allergen exposure in the U.S. population, (b) established a database that can be used to stimulate future studies which attempt to correlate allergen exposure to disease outcome, (c) provided a baseline that can be used as a reference point for future allergen surveys, and (d) facilitated evaluation of regional, ethnic, socioeconomic, and housing characteristic differences in the过敏原负担。我们还进行了一项随机临床试验，以测试环境干预措施在降低北卡罗来纳州北卡罗来纳州房屋中蟑螂过敏原水平的可行性/有效性。我们的研究表明，蟑螂灭绝和强化清洁的结合可以显着降低高度感染的房屋中的蟑螂过敏原水平。此外，随着持续的灭绝，该效果可以保持长达12个月。令人惊讶的是，仅蟑螂灭绝也可以显着降低6个月内低收入家庭中的蟑螂过敏原水平。这些研究的结果将用于设计预防试验，以确定旨在降低室内过敏原水平的环境干预是否可以防止敏感性，并降低居住在贫困中的高风险儿童哮喘的患病率和发病率和发病率。