①虽然儿童特应性湿疹的危险因素很多，但对中老年人湿疹的表型知之甚少。②我们试图研究空气污染、特异反应性和成年湿疹之间的关系。③这项分析是基于834名德国妇女的研究，该研究是关于空气污染对肺功能、炎症和衰老的影响。采用第二次随访(2007-2010)的问卷调查方法，对55岁以后湿疹的发病症状和调查前12个月及以下湿疹的流行症状进行评估。在基线(1985-1994)和2007-2010年测量血清总IgE水平。采用土地利用回归法评价了空气污染的暴露程度。采用调整后的逻辑回归模型来估计空气污染与湿疹和流行症状之间的关系。加权遗传风险评分用于研究特应性湿疹相关风险等位基因对这种关联的影响。④接触氧化氮(二氧化氮和氮氧化物)和可吸入颗粒物(细颗粒物空气动力学直径≤2.5μm [PM2.5]和颗粒物的空气动力学直径< 10μm)与湿疹发病的可能性之间有显著的相关性(例如, PM2.5每4.7μg /立方米;比值比,1.45;95%可信区间,1.06 - -1.99)。这些关联在非特应性湿疹中更为明显; (如PM2.5,对于没有花粉热或IgE水平升高的参与者，优势比为1.65,95%可信区间为1.15-2.34)。对特应性湿疹风险等位基因较少的携带者来说，空气污染与湿疹的相关性更强。⑤老年人非特应性湿疹与交通相关的空气污染物有关，其表型与遗传性特应性湿疹不同。
JACI Volume 143, Issue 1, January 2019, Pages 378-385
Nonatopic eczema in elderly women: Effect of air pollution and genes
Although many risk factors have been described for atopic eczema in children, little is known about the eczema phenotype in middle-aged or elderly adults.
We sought to examine the association between air pollution, atopy, and eczema in adulthood.
This analysis was based on 834 women from the Study on the influence of Air pollution on Lung Function, Inflammation and Ageing cohort in Germany. Incident symptoms of eczema after age 55 years and prevalent symptoms of eczema 12 months or less before investigation were assessed by means of questionnaire at the second follow-up (2007-2010). Total serum IgE levels were measured at baseline (1985-1994) and in 2007-2010. Exposure to air pollution was assessed by using land-use regression. Adjusted logistic regression models were applied to estimate the association between air pollution and incident and prevalent symptoms of eczema. Weighted genetic risk scores were used to investigate the effect of atopic eczema–related risk alleles on this association.
Exposures to oxides of nitrogen (nitrogen dioxide and nitrogen oxides) and particulate matter (fine particulate matter with an aerodynamic diameter of ≤2.5 μm [PM2.5] and particulate matter with an aerodynamic diameter of <10 μm) were significantly associated with increased odds of incident eczema (eg, with PM2.5 per 4.7 μg/m3; odds ratio, 1.45; 95% CI, 1.06-1.99). These associations were slightly more pronounced with nonatopic eczema (eg, with PM2.5; odds ratio of 1.65 and 95% CI of 1.15-2.34 for participants without hay fever or increased IgE levels). Associations with air pollution were stronger in carriers of fewer risk alleles for atopic eczema.
Nonatopic eczema in the elderly is associated with traffic-related air pollutants, and this phenotype differs from genetically driven atopic eczema.