소아 아토피 천식 환자에서 실내 흡입 알레르겐 특이 IgE 농도와 총 IgE 농도 및 기도 과민성 사이의 연관성
Relationship of Indoor Aeroallergen Specific IgE with Total IgE and Airway Hyperresponsiveness in Children with Atopic Asthma
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목 적 : 아토피 천식 소아에서 실내 흡입 알레르겐에 대한 특이 IgE의 농도의 총 IgE 농도에 대한 기여도를 분석하고, 특이 IgE 농도와 기도 과민성 및 폐기능 사이의 관계를 알아보고자 하였다. 방 법 : 청주 지역에 거주하는 5-16세의 아토피 천식 소아 232명을 대상으로 하였다. 주요 실내 알레르겐인 Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Alternaria, 바퀴, 개 상피항원, 고양이 상피항원에 대한 혈청 특이 IgE 농도와 총 IgE 농도를 측정하였다. 집먼지진드기에 감작된 180명의 소아에서 %FEV1 과 메타콜린 PC20을 측정하였다. 결 과 : 혈청 특이 IgE 양성률은 Der p (90.0%)와 Der f (92.7%)를 포함한 집먼지진드기에 대해 가장 높았으며, Alternaria에 대한 양성률(21.6%)은 두 번째로 높았다. Der p와 Der f 특이 IgE 농도가 총 IgE 농도에서 차지하는 비율은 다른 흡입 알레르겐에 비해 월등히 높았으며,(P<0.001) Der f가 Der p 보다 높은 비율을 차지하였다.(P< 0.001) 특이 IgE 농도와 총 IgE 농도 사이에서 Der p (r=0.677, P<0.001), Der f (r=0.657, P< 0.001)로 유의한 상관관계를 보였다. Der f에 대한 특이 IgE의 농도가 높을수록 기도 과민성이 높은 비율로 관찰되었고 FEV1은 감소하였다. 결 론 : 청주 지역 소아 아토피 천식 환자의 대다수에서 관찰된 총 IgE의 상승은 집먼지진드기에 대한 IgE 반응에 의하였으며 집먼지진드기 특이 IgE 농도는 기도 과민성과 폐기능 감소와 유의한 관련성을 나타내었다.
Abstract
Purpose : We assessed the relationship of indoor aeroallergen specific IgE levels with total IgE level, airway hyperresponsiveness (AHR) and lung function in children with atopic asthma. Methods : Two hundred twenty-eight children with atopic asthma in Cheongju area were studied. Sera were assayed for total IgE and specific IgE antibodies to important indoor allergens including Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Alternaria, cats, dogs, and cockroaches. One hundred eighty children sensitized to house dust mites (HDMs) were evaluated for %FEV1 and methacholine PC20. Results : Serum specific IgE to HDMs presented the highest prevalence (90.0% for Der p and 92.7% for Der f), followed by specific IgE to Alternaria (21.6%). A contribution of ＞10% of the total was only common for IgE antibody to Der p or Der f. The level of specific IgE to Der p (r=0.677, P＜0.001) or Der f (r=0.657, P＜0.001) was significantly correlated with total IgE level. Higher level of Der f-specific IgE was associated with higher incidence of AHR and FEV1 decline. Conclusion : Concentration of specific IgE antibody produced to HDMs provides an explanation for the higher total IgE levels found in a major portion of children with atopic asthma and has a close relationship with AHR and lung function.
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