Difficult-to-treat asthma patients from ethnic minority groups in central England are at an enhanced risk of house dust mite sensitisation

IF 4.6 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2023-10-08 DOI:10.1002/clt2.12303

Adel H. Mansur, Julie Marsh, Ali Bahron, Maximillian Thomas, Gareth Walters, John Busby, Liam G. Heaney, Mamidipudi Thirumala Krishna

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Abstract

Background

House dust mite (HDM) is the most common sensitising allergen in asthma. Ethnic minority groups (EMGs) in the UK are more likely to live in deprived conditionings with a greater exposure to HDM and other aero-allergens.

Aim

To compare the ethnicity-based patterns of sensitisation to aero-allergens and the impact of ethnicity on clinical outcomes in patients with difficult-to-treat asthma (DTA).

Methods

Data of patients with DTA were extracted from the registry of the Birmingham Regional Severe Asthma Service (BRSAS), which have a catchment population of 7.3million from Central England. Patients from White and EMG backgrounds were compared in terms of the prevalence of atopy, total serum immunoglobulin E (IgE), specific serum IgE (ssIgE) and asthma related clinical outcomes. Logistic regression analysis was conducted to explore ethnicity-based risk factors for HDM sensitisation.

Results

A total of 1272 patients [White 1016 (79.9%), EMG 256 (20.1%) EMG] with a median age of 51 years (range 16–97) were included in the analysis. Patients from EMG were more likely (64%) to reside in the worst scale of index of multiple deprivation (IMD) than the White patients (25.5%), p < 0.0001. Positive HDM sensitisation was more prevalent in the EMG than in the White group [142/216 (66%) versus 375/842 (45%), p < 0.0001]. The median HDM ssIgE level was higher in the EMG than in the White group [3.0 KUA/L (IQR 0.06, 11.5) versus 0.1 (0.01, 3.0), p < 0.000001]. The odds ratio for positive sensitisation to HDM conveyed by the EMG status was 2.61 (95%CI, 1.8–3.8), p < 0.0001. Compared to the White group, the EMG had higher median total serum IgE [326 KU/L (115, 971) versus 114 (29.8, 434.8), p < 0.000001], higher blood eosinophil count (0.36 × 10⁹(0.18, 0.62) versus 0.23 (0.1,0.47), p < 0.000001), were marginally more atopic (79.2% vs. 75.6%, p = 0.098) and were less likely to being on maintenance oral corticosteroids (22% vs. 39.7%, p < 0.0001).

Conclusion

In this DTA cohort, positive HDM sensitisation was greater amongst the EMG than the White patients. The EMG status was a significant risk factor for HDM sensitisation.

Abstract Image

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来自英格兰中部少数民族的难以治疗的哮喘患者患屋尘螨致敏的风险增加

背景屋尘螨（HDM）是哮喘最常见的致敏过敏原。英国的少数民族（EMG）更有可能生活在贫困条件下，更容易接触HDM和其他空气过敏原。目的比较难治哮喘（DTA）患者对空气过敏原的基于种族的致敏模式以及种族对临床结果的影响。方法从伯明翰地区严重哮喘服务中心（BRSAS）的登记处提取DTA患者的数据，该服务中心有来自英格兰中部的730万人口。比较来自白人和EMG背景的患者的特应性患病率、总血清免疫球蛋白E（IgE）、特异性血清IgE（ssIgE）和哮喘相关临床结果。进行Logistic回归分析以探讨HDM致敏的基于种族的风险因素。结果共有1272名患者[White 1016（79.9%），EMG 256（20.1%）EMG]被纳入分析，中位年龄为51岁（范围16-97）。EMG患者（64%）比白人患者（25.5%）更有可能处于多重剥夺指数（IMD）的最差等级；0.0001。EMG中HDM阳性敏感性比White组更普遍[142/216（66%）对375/842（45%），p<；0.0001]。EMG的中位HDM ssIgE水平高于White组[3.0 KUA/L（IQR 0.06，11.5）对0.1（0.01，3.0），p<；0.00001]。EMG状态对HDM阳性敏感的比值比为2.61（95%CI，1.8-3.8），p<；0.0001。与白色组相比，EMG具有较高的中位总血清IgE[326KU/L（115971）对114（29.8434.8），p<；0.00001]，较高的血液嗜酸性粒细胞计数（0.36×109（0.18，0.62）对0.23（0.1,0.47），p<；0.000001），特应性略高（79.2%对75.6%，p=0.098），并且不太可能维持口服皮质类固醇（22%对39.7%，p＜0.0001）。结论在该DTA队列中，EMG患者的HDM阳性敏感性高于白人患者。EMG状态是HDM致敏的重要危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.