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二酸化窒素 (NO2) に個人的曝露と,子供におけるウイルス誘発性喘息の重症度
A J Chauhan1, Hazel M Inskip, Catherine H Linaker
1Respiratory, Cell, and Molecular Biology Research Division, University of Southampton, Southampton, UK. anoop.chauhan@porthosp.nhs.uk <anoop.chauhan@porthosp.nhs.uk>
Lancet (London, England)
|June 13, 2003
まとめ
高い二酸化窒素 (NO2) 曝露は,ウイルス感染症の前に,子供における喘息の悪化を悪化させる. 空気品質基準の範囲内のレベルであっても,症状の重症度が増加し,肺機能が低下します.
科学分野:
- 環境衛生 環境衛生 環境衛生
- 小児呼吸器医学について
- 空気汚染の毒理学
背景:
- 二酸化窒素 (NO2) は,呼吸器系の問題に関連した一般的な大気汚染物質です.
- ウイルス感染症は,小児における喘息の悪化の主なトリガーです.
- ウイルス誘発性喘息の重度に対するNO2暴露の特定の影響については,さらなる調査が必要である.
研究 の 目的:
- 二酸化窒素 (NO2) 曝露と小児性喘息の悪化の重症度との関係を決定する.
- 証明された呼吸器ウイルス感染症の際に,NO2の曝露が喘息の重症度に影響を与えるかどうかを評価する.
主な方法:
- 喘息を患った114人の子供 (8~11歳) のコホートでは,13ヶ月間,毎日症状,ピーク発気量 (PEF),そして毎週個人的NO2曝露をモニターした.
- 上部呼吸器系疾患のエピソード中に鼻吸液を採取し,RT-PCRを用いて一般的なウイルス検査を行った.
- 一般化された推定方程式は,NO2曝露の三位数 (低,中,高) と感染後の喘息悪化の重症度の関連性を分析した.
主要な成果:
- ウイルスは78%の感染エピソードで検出され,NO2のミディアンは5,10,および21μg/m3で,低,中,および高い三角動物で検出されました.
- 下部呼吸器系症状スコアの有意な増加は,NO2三位体 (p=0.05すべてのウイルス,p=0.01 RSV) で観察されました.
- 高いNO2曝露は,低曝露と比較して,ピコルナウイルスに起因する悪化のPEFの>12 L/minの減少 (p=0.04) と関連付けられました.
結論:
- ウイルスの感染に先立ち,現在の空気質基準でも窒素二酸化物 (NO2) に高い曝露は,子供における喘息悪化の重度の増加と関連しています.
- これは,NO2が呼吸器ウイルス感染症の強化剤として作用し,より重度の喘息のアウトカムにつながることを示唆しています.
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