Thunderstorm asthma in seasonal allergic rhinitis: The TAISAR study

被引：7

作者：

Douglass, Jo A. ^{[1
]}

Lodge, Caroline ^{[2
]}

Chan, Samantha ^{[5
]}

Doherty, Alice ^{[2
]}

Tan, Ju Ann ^{[5
]}

Jin, Celina ^{[5
]}

Stewart, Alastair ^{[3
]}

Southcott, Anne M. ^{[7
]}

Gillman, Andrew ^{[7
]}

Lee, Joy ^{[8
]}

Csutoros, Danny ^{[9
]}

Hannan, Liam ^{[10
]}

Ruane, Laurence ^{[11
]}

Barnes, Sara ^{[12
]}

Irving, Lou ^{[6
]}

Harun, Nur-Shirin ^{[6
]}

Lachapelle, Phillipe ^{[13
]}

Spriggs, Kymble ^{[5
]}

Sutherland, Michael ^{[14
]}

See, Katharine ^{[10
]}

McDonald, Christine F. ^{[8
]}

Conron, Matthew ^{[15
]}

Radhakrishna, Naghmeh ^{[15
]}

Worsnop, Christopher ^{[8
]}

Johnston, Fay H. ^{[16
]}

Davies, Janet M. ^{[17
]}

Bryant, Vanessa ^{[18
]}

Iles, Linda ^{[19
]}

Ranson, David ^{[19
]}

Spanos, Paresa ^{[20
]}

Vicendese, Don ^{[21
]}

Lowe, Adrian ^{[2
]}

Newbigin, Edward J. ^{[4
]}

Bardin, Philip ^{[11
]}

Dharmage, Shyamali ^{[2
]}

机构：

[1] Univ Melbourne, Dept Med, Parkville, Vic, Australia

[2] Univ Melbourne, Allergy & Lung Hlth Unit, Parkville, Vic, Australia

[3] Univ Melbourne, Dept Pharmacol & Therapeut, Parkville, Vic, Australia

[4] Univ Melbourne, Sch BioSci, Parkville, Vic, Australia

[5] Royal Melbourne Hosp, Dept Clin Immunol & Allergy, Parkville, Vic, Australia

[6] Royal Melbourne Hosp, Dept Resp Med, Parkville, Vic, Australia

[7] Western Hlth Footscray, Melbourne, Vic, Australia

[8] Austin Hlth, Dept Resp & Sleep Med, Melbourne, Vic, Australia

[9] State Govt Victoria, Dept Hlth & Human Serv, Melbourne, Vic, Australia

[10] Northern Hlth, Dept Resp Med, Epping, NSW, Australia

[11] Monash Hosp & Univ, Monash Lung Sleep Allergy & Immunol, Clayton, Vic, Australia

[12] Monash Hlth, Dept Allergy, Clayton, Vic, Australia

[13] Univ Sherbrooke, Pulm Div, Sherbrooke, PQ, Canada

[14] Univ Melbourne, Dept Med, Richmond, Vic, Australia

[15] St Vincents Hosp, Dept Resp Med, Fitzroy, Vic, Australia

[16] Univ Tasmania, Menzies Inst Med Res, Hobart, Tas, Australia

[17] Univ Queensland, Ctr Immunol & Infect Control, Herston, Qld, Australia

[18] Walter & Eliza Hall Inst Med Res 1G Royal Parade, Immunol Div, Parkville, Vic, Australia

[19] Monash Univ, Victorian Inst Forens Med, Clayton, Vic, Australia

[20] Coroners Court Victoria, Southbank, Vic, Australia

[21] La Trobe Univ, Dept Math & Stat, Essendon, Australia

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY | 2022年 / 149卷 / 05期

关键词：

Asthma; thunderstorm; epidemic; seasonal allergic rhinitis; ryegrass pollen; specific IgE; spirometry; ACQ; EXHALED NITRIC-OXIDE; BLOOD EOSINOPHILS; MELBOURNE; SEVERITY; EPIDEMIC; OUTBREAK; DISEASE; RISK; IGE;

D O I：

10.1016/j.jaci.2021.10.028

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Background: Asthma epidemics associated with thunderstorms have had catastrophic effects on individuals and emergency services. Seasonal allergic rhinitis (SAR) is present in the vast majority of people who develop thunderstorm asthma (TA), but there is little evidence regarding risk factors for TA among the SAR population. Objective: We sought to identify risk factors for a history of TA and hospital presentation in a cohort of individuals with SAR. Methods: This multicenter study recruited adults from Melbourne, Australia, with a past diagnosis of TA and/or self-reported SAR. Clinical information, spirometry results, white blood cell count, ryegrass pollen-specific (RGP-sp) IgE concentration, and fractional exhaled nitric oxide were measured to identify risk factors for a history of TA in individuals with SAR. Results: From a total of 228 individuals with SAR, 35%(80 of 228) reported SAR only (the I-SAR group), 37% (84 of 228) reported TA symptoms but had not attended hospital for treatment (the O-TA group), and 28%(64 of 228) had presented to the hospital for TA(the H-TA group). All patients in the H-TA group reported a previous asthma diagnosis. Logistic regression analysis of factors associated with O-TA and H-TA indicated that lower FEV1 value and an Asthma Control Questionnaire score higher than 1.5 were associated with H-TA. Higher blood RGP-sp IgE concentration, eosinophil counts, and fractional exhaled nitric oxide level were significantly associated with both O-TA and H-TA. Receiver operating curve analysis showed an RGP-sp IgE concentration higher than 10.1 kU/ L and a prebronchodilator FEV1 value of 90% or lower to be biomarkers of increased H-TA risk. Conclusion: Clinical tests can identify risk of a history of TA in individuals with SAR and thereby inform patient-specific treatment recommendations.

引用

页码：1607 / 1616

页数：10