Respiratory Infections Precede Adult-Onset Asthma 英文参考文献.docVIP

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Respiratory Infections Precede Adult-Onset Asthma 英文参考文献.doc

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RespiratoryInfectionsPrecedeAdult-OnsetAsthma AinoRantala1,JouniJ.K.Jaakkola1*,MarittaS.Jaakkola2 1Center for Environmental and Respiratory Health Research, Institute of Health Sciences, University of Oulu, Oulu, Finland, 2Respiratory Medicine Unit, Center for EnvironmentalandRespiratoryHealthResearch,InstituteofClinicalMedicine,UniversityofOuluandOuluUniversityHospital,Oulu,Finland Abstract Background:Respiratoryinfectionsinearlylifeareassociatedwithanincreasedriskofdevelopingasthmabutthereislittle evidenceontheroleofinfectionsforonsetofasthmainadults.Theobjectiveofthisstudywastoassesstherelationofthe occurrence of respiratory infections in the past 12 months to adult-onset asthma in a population-based incident case- controlstudyofadults21–63yearsofage. Methods/PrincipalFindings: We recruited all new clinically diagnosed cases of asthma (n=521) during a 2.5-year study period and randomly selected controls (n=932) in a geographically defined area in South Finland. Information on respiratoryinfectionswascollectedbyaself-administeredquestionnaire.Thediagnosisofasthmawasbasedonsymptoms and reversible airflow obstruction in lung function measurements. The risk of asthma onset was strongly increased in subjectswhohadexperiencedinthepreceding12monthslowerrespiratorytractinfections(includingacutebronchitisand pneumonia) with an adjusted odds ratio (OR) 7.18 (95% confidence interval [CI] 5.16–9.99), or upper respiratory tract infections (including common cold, sinusitis, tonsillitis, and otitis media) with an adjusted OR 2.26 (95% CI 1.72–2.97). Individuals with personal atopy and/or parental atopy were more susceptible to the effects of respiratory infections on asthmaonsetthannon-atopicpersons. Conclusions/Significance:Thisstudyprovidesnewevidencethatrecentlyexperiencedrespiratoryinfectionsareastrong determinantforadult-onsetasthma.Reducingsuchinfectionsmightpreventonsetofasthmainadulthood,especiallyin individualswithatopyorhereditarypropensitytoit. Citation: Rantala A,