[Epidemiological investigation on allergic diseases related to animal dander of cats, dogs and horses].

Abstract: Objective: A multicenter Chinese mainland survey was conducted to investigate the sensitization distribution characteristics of cat, dog and horse dander in patients with allergic diseases, so as to provide clinicians with epidemiological data of common animal allergens and useful information for the prevention and treatment of allergies in cats, dogs and horses. Methods: The epidemiological investigation and design was adopted. This study is based on the national epidemiological survey of allergic diseases led by the first affiliated Hospital of Guangzhou Medical University. From January to December in 2021, a total of 2 122 patients diagnosed with allergic diseases were included in the outpatient department of respiratory department/pediatrics/allergy department of 14 units such as the First Affiliated Hospital of Guangzhou Medical University, and 222 healthy subjects were included as controls from the physical examination center of the above units in the same period. All the subjects filled out the allergic disease questionnaire under the guidance of doctors, and the allergen-specific immunoglobulin E (sIgE) of cats, dogs and horses of all subjects were detected by magnetic particle chemiluminescence system. The epidemiological characteristics of three animal allergens in different diseases, ages and regions were analyzed. Chi square test was used to analyze the frequency difference between groups, t test or Mann Whitney U test was used to test the distribution difference between two groups, and one-way ANOVA or Kruskal Wallis H test was used to compare the distribution difference between multiple groups. Bar chart, Venn-plot and radar chart were drawn to show the sensitization distribution characteristics. A small number of missing values caused by subjects' omission have been excluded during the analysis. Results: The 2 122 patients with allergic diseases were 57.35% male (1 217/2 122) and 40.95% female (869/2 122), and 1.70% (36/2 122) patients had loss of gender information. The age of patients with allergic diseases was 9.0 (6.0, 28.0) years, while that of healthy controls was 29.0 (13.0, 39.0) years old, and there were 1.7% (36/2 122) and 0.9% (2/222) subjects with missing age information, respectively. The proportion of caesarean section in allergic patients was significantly higher than that in healthy controls (31.4% vs. 17.6%,χ2=16.582,P<0.001) [2.5% (54/2 122) of the patient group and 5.4% (12/222) of the control group had missing birth mode information], and the proportion of patients with allergic diseases who reported that both parents had allergic diseases was significantly higher than that of the control group (35.7% vs. 9.5%, χ2=65.171,P<0.001). Patients with allergic diseases are mainly school-age (6-12 years old) and adolescents (12-18 years old). 16.4% of patients with allergic diseases were sensitized to cat dander, 10% and 6% to dog and horse dander. The sensitization rate of cat dander in patients with rhinitis, asthma, conjunctivitis, food allergy and atopic dermatitis was the highest (16.4%-21.6%), followed by dog dander (10.2%-15.2%). The prevalence of allergic rhinitis was the highest among different animal sensitized populations. The proportion of cat, dog and horse allergens sensitized at the same time is between 10%-15%, and the proportion of any two or more animal dander sensitized at the same time is about 45%. Animal allergens are associated with respiratory allergic diseases, especially allergic rhinitis with allergic conjunctivitis. There were significant differences in the distribution of positive rates of three animal allergens in different regions, and the highest positive rate of cat dander was found in all provinces of the country. Conclusion: The sensitization rate of animal dander allergens increased significantly, and the highest was in children and adolescents. Cat dander is the most common animal allergen, followed by dog. Different animals show obvious cross or common sensitization due to their high homology. 目的： 在我国开展多中心的过敏性疾病患者对猫狗马皮屑的致敏分布特征调查，为诊治与预防过敏性疾病提供常见动物过敏原的流行病学数据。 方法： 采用流行病学调查研究设计，依托于由广州医科大学附属第一医院牵头开展的全国过敏性疾病流行病学调查项目，于2021年1至12月在广州医科大学附属第一医院等14家单位的呼吸科、儿科及变态反应科门诊中共纳入2 122例诊断为过敏性疾病患者，同期从上述单位体检中心纳入222例健康受试者作为对照。所有纳入的受试者在医生指导下进行填写过敏性疾病调查问卷，并采用磁微粒化学发光系统检测所有受试者的猫狗马过敏原特异性免疫球蛋白E（sIgE）。分析3种动物过敏原在不同疾病、不同年龄和不同地区之间的流行病学特征。使用χ²检验分析组间频率差异，采用t检验或Mann-Whitney U检验两组间的分布差异，以及采用单因素方差（ANOVA）分析或Kruskal-Wallis H检验比较多组间的分布差异。并绘制条形图、韦恩图和雷达图展示致敏分布特征。因受试者漏填而产生的极少数缺失值在分析过程中已被剔除。 结果： 2 122例过敏性疾病患者中男性占57.35%（1 217/2 122），女性占40.95%（869/2 122），存在1.70%（36/2 122）例患者的性别信息缺失。过敏性疾病患者的年龄为9.0（6.0，28.0）岁，而健康对照组的年龄为29.0（13.0，39.0）岁，并分别存在1.7%（36/2 122）和0.9%（2/222）例受试者的年龄信息缺失。过敏患者组剖腹产的比例明显高于健康对照组（31.4% vs. 17.6%，χ2=16.582，P<0.001）［患者组和对照组分别存在2.5%（54/2 122）和5.4%（12/222）例样本的出生方式信息缺失］。过敏性疾病患者报告父母双方均患过敏性疾病的比例显著高于对照组（35.7% vs. 9.5%，χ2=65.171，P<0.001）。总体上16.4%的过敏性疾病患者对猫皮屑致敏，10%和6%对狗和马皮屑致敏。猫皮屑在鼻炎、哮喘、结膜炎、食物过敏和特应性皮炎患者人群中的致敏率最高，为16.4%~21.6%，狗皮屑次之，为10.2%~15.2%。不同的动物致敏人群中，均以过敏性鼻炎的患病率最高。猫狗马过敏原同时致敏的比例在10%~15%之间，任意两种或以上动物皮屑同时致敏的比例约为45%。动物过敏原与呼吸道过敏性疾病相关，尤以过敏性鼻炎合并过敏性结膜炎最常见。不同地区3种动物过敏原致敏率分布存在明显差异，全国各省份中均以猫皮屑的致敏率最高。 结论： 动物皮屑过敏原的致敏率显著上升，并以儿童和青少年最高。猫皮屑是最常见的动物源性过敏原，其次为狗。不同的动物之间由于其高度的同源性而表现出明显的交叉或共同致敏。.