학동기전 아토피피부염 환아에서 항원 감작과 천식의 빈도와의 관계
Relationship between Allergen Sensitization and Frequency ofAsthma in Preschool Atopic Dermatitis Children
2
조회
0
다운로드
4
인용
0
참고문헌
초록
목 적 : 아토피피부염은 영아 초기부터 나타나는 소아기의 가장 흔한 염증성 피부 질환으로 유전적 소인과 함께 여러 환경요인에 의한 항원 감작이 병의 경과에 상당한 영향을 주는 것으로 되어있다. 소아천식의 대부분이 6세 이전에 발병하고, 특히 학동기전 소아의 경우 실내에서 보내는 시간의 증가로 아토피피부염 환아에서 경우 실내 흡입항원 감작이 천식의 빈도에 상당한 영향을 줄 것으로 사료된다. 따라서 저자들은 학동기전 아토피피부염 환아에서 연령에 따른 항원 감작을 비교하고, 항원 감작의 변화와 천식 빈도와의 관계를 알고자 본 연구를 실시하였다. 방 법 : 최근 3년간 본원 소아과 알레르기 클리닉을 방문한 환아 중 아토피피부염으로 진단된 6세 이하 환아 312명을 대상으로, 2세 이하, 3-4세, 5-6세의 세 군으로 나누어 각 연령군에서 항원 감작 정도 및 천식 증상의 동반 여부를 비교였다. 항원 감작은 CAP-FEIA 방법을 이용하여 음식항원 5종과 흡입항원 5종에 대한 특이 IgE를 확인하였고, 0.35 kU/L 이상의 특이 IgE치 즉 class I 이상을 양성 항원 감작으로 정의하였다. 결 과 : 아토피피부염 환아 312례 중 천식의 동반은 139례(44.6%)였으며, 항원 감작군은 186례(59.6%)로 나타났다. 항원 감작군에서 천식의 빈도는 93례(50.0%), 비 감작군에서의 천식의 빈도는 46례(36.5%)로 항원 감작군에서 좀 더 높게 나타났다.(P=0.021) 연령에 따른 항원 감작의 정도는 2세 이하 군에서는 음식항원에 대한 감작이(OR=2.2, P<0.05), 5-6세 군에서는 Dp, Df에 대한 감작이(OR=4.4, P=0.018)(OR=2.6, P= 0.030) 각각 의미 있었으며, 천식의 빈도는 5-6세 군에서 의미 있게 높았고(OR=3.5, P=0.006), Dp에 대한 항원 감작이 천식의 빈도 및 중증도와 관련이 있는 것으로 나타났다.(P=0.019, P= 0.037)
Abstract
Purpose : Atopic dermatitis is affected by genetic and environmental factors. Bronchial asthma often develops in atopic dermatitis children. Allergen sensitization may affect the frequency of asthma in preschool atopic dermatitis children. So, we performed this study to know the relationship between allergen sensitization and the frequency of asthma in preschool atopic dermatitis children. Methods : Three-hundred twelve of the children with atopic dermatitis in preschool aged children were divided into 3 groups; ≤2, 3-4 and 5-6 year olds group and compared about change of allergen sensitization and the frequency of asthma by age. Specific IgE of allergens were evaluated using CAP-FEIA test. Results : IgE mediated atopic dermatitis was 59.6% and the frequency of asthma was 44.6%. IgE mediated asthma was 50% and non-IgE mediated asthma was 36.5%.(P=0.021) In the before or at 2 year-olds group, food allergens(OR=2.2, P=0.023) and in the aged 5-6 year-olds group, Dp and Df played a important role in atopic dermatitis(OR=4.4, P=0.018) (OR=2.6, P=0.030). In the latter group, the risk of the frequency of asthma was higher and the degree of Dp sensitization affected to the severity of asthma. Conclusion : In preschool-aged atopic dermatitis children, food allergens may be major role in infancy and aeroallergen in 5-6 year-old group. Dermatophagoides Pteronyssinus(Dp) and Dermatophagoides Farinae(Df) sensitization may be associated with the frequency of asthma.
참고문헌 (33)
- "Epidemiology" (2002), Marcel Dekker, Inc
- "Atopic dermatitis:new insights and opportunities for therapeutic intervention", 105, pp.860~876 (2000)
- "Atopic dermatitis", 361, pp.151~160 (2003)
- "Decreased level of ceramides in stratum corneum of atopic dermatitis:an etiologic factor in atopic dry skin", 96, pp.523~6 (1991)
- "Exposure to a high concentration of mite allergen in early infancy is a risk factor for developing atopic dermatitis:a 3-year follow- up study", 12, pp.11~16 (2001)
- "The natural course of atopic dermatitis from birth to age 7 years and the association with asthma", 113, pp.925~931 (2004)
- "Development of allergies and asthma in infants and young children with atopic dermatitis-a prospective follow-up to 7 years of age", 55, pp.240~245 (2000)
- "Clinical symptoms and IgE responses to common food proteins in atopic and healthy children", 14, pp.551~9 (1984)
- "Correlation between age and allergens in pediatric atopic dermatitis", 93, pp.334~338 (2004)
- "Bronchial hyperresponsiveness in children with atopic dermatitis", 91, pp.13~6 (1993)
- "Atopic dermatitis:clinical relevance of food hypersensitivity reactions", 113, pp.447~51 (1988)
- "Enhanced allergic sensitization related to parental smoking", 67, pp.496~500 (1992)
- "Diagnostic features of atopic dermatitis", 92, pp.44~7 (1980)
- "Diagnosis of Bronchial asthma in preschool children", 14, pp.130~132 (2004)
- "Guidelines for the Diagnosis and Management of Asthma-Update on selected Topics 2002" (2002), NIH publ
- "Relationship between Sensitization to Outdoor Aeroallergen and Month of Birth", 15, pp.257~262 (2005)
- "Natural history of sensitizations in atopic dermatitis A 3-year follow-up in 250 children food allergy and high risk of respiratory symptoms"
- "Clinical course of cow's milk protein allergy", intolerance and atopic diseases in childhood, 2002, pp.13, 23~28
- "Prediction of tolerance on the basis of quantification of egg white-specific IgE antibodies in children with egg allergy", 110, pp.304~309 (2002)
- "Atopic dermatitis and the atopic march", 112, pp.118~127 (2003)
- "Mucosal Immunity", 111, pp.1595~1600 (2003)
- "Prediction of sensitization to inhalent allergens in childhood atopic dermatitis and sensitization to food allergens", 28, pp.1397~1403 (1998)
- "Food allergy as a risk factor for life-threatening asthma in childhood:a case- controlled study", 112, pp.168~174 (2003)
- "Long-lasting sensitization to food during the first two years precedes allergic airway disease", 9, pp.61~67 (1998)
- "IgE antibody quantification and the probability of wheeze in preschool children", 116, pp.744~749 (2005)
- "Eczematous skin reaction from patch testing with aeroallergens in atopic children with and without atopic dermatitis", 10, pp.209~13 (1993)
- "Breastfeeding as prophylaxis against atopic disease:prospective follow-up study until 17 years old", 346, pp.1065~1069 (1995)
- "Does early exposure to cat or dog protect against later allergy development?", 29, pp.611~617 (1999)
- "Month of birth and grass pollen or mite sensitization in children with respiratory allergy:a significant relationship", 18, pp.269~74 (1988)
- "Natural history of food allergy", 61, pp.83~7 (1988)
- "The pattern of atopic sensitization is associated with the development of asthma in childhood", 108, pp.709~714 (2001)
- "Immune Response to House Dust Mite in Patients with Asthma", 13, pp.302~11 (1993)
- "Quantification of IgE antibodies simplifies the classification of allergic diseases in 4-year-old children:A report from the prospective birth cohort study-BAMSE", 14, pp.441~447 (2003)