| Summary: | 碩士 === 國立臺灣大學 === 職業醫學與工業衛生研究所 === 102 === In many countries, the prevalence of allergic diseases, such as asthma, allergic rhinitis, atopic dermatitis is arising in recent years. Similar trend was also observed in Taiwan, especially for the high prevalence among young people and children. The causes leading to allergy vary, such as allergen contact, gender, age, and environmental exposures. Even the blood metal concentrations might affect allergic reactions. Thus, in this study, we tried to investigate the relationship between allergic reactions and multiple blood metal levels of the preschool children in Taiwan.
Study subjects in this study were recruited from a previous study entitled “Survey on blood lead levels of the preschool children”, sponsored by the Bureau of Health Promotion (BHP) in 2011. Through a stratified sampling strategy based on different administrative division levels, study subjects were recruited from 80 kindergartens nationwide. Questionnaires were administered to get study subjects’ demographic information, allergic status, and environmental metal exposure factors. The blood samples being successfully analyzed for lead, copper, manganese, zinc, arsenic, selenium, mercury and total IgE in the previous BHP study in 2011 were used to determine allergen-specific IgE in the present study for the study subjects who have sufficient amount of serum left from the previous study. ICP-MS(inductively coupled plasma mass spectrometry) was applied for the determination of metal levels in blood samples, while the analyses for serum total IgE and allergen-specific IgE were carried out using ECLIA(electrochemiluminescence immunoassay) and MAST(multiple antigen simultaneous test), respectively.
The means of blood Pb, Cu, Mn, Zn, As, Se, Hg levels were 21.9±14.8 μg/L, 965±163 μg/L, 14.6±3.73 μg/L, 4758±772 μg/L, 4.06±2.8 μg/L, 111±19.3 μg/L, 5.44±3.01 μg/L, respectively. The mean total IgE level was 291±415 IU/mL. On the other hand, allergen-specific IgE were classified into four levels based on CLA-1 Luminometer grading criteria. The highest proportions of study subjects classified as CLA IV were found to be allergic to D. Farinae (31.5%, 56 study subjects) and D. Pterony (30.9%, 55 study subjects), respectively. Twenty eight study subjects (15.7%) were classified as CLA IV for being allergic to house dust. Another 12 study subjects (6.7%) were classified as CLA IV for being allergic to cockroach. Few study subjects were reported to be allergic to latex, clam, soybeans, chicken feathers, eucalyptus, Japanese cedar, cat fur and dog fur, only 2~5 study subjects being classified as CLA II for these allergens, respectively.
The results showed that the increment in blood copper level by 1 μg/L would enhance the odds ratio for sneeze, running nose (OR=1.004, 95% CI=1.001~1.006), atopic dermatitis (OR=1.005, 95% CI=1.001~1.01), and being allergic to D. Farinae (OR=1.003, 95% CI=1.000~1.007) and D. Pterony (OR=1.004, 95% CI=1.000~1.007). Study subjects characterized with relatively high blood manganese level by 1 μg/L tended to have low odds ratios for being allergic to D. Farinae (OR=0.787, 95% CI=0.675~0.918), D. Pterony (OR=0.82, 95% CI=0.707~0.944) and house dust (OR=0.837, 95% CI=0.723~0.968). Meanwhile, the increment in blood selenium level by 1 μg/L would decrease the odds ratio for being allergic to cockroach (OR=1.08, 95% CI=1.003~1.15).
Findings in the present study suggested that children’s blood metal levels would modify the odds ratios for being allergic to specific allergens, especially for the impact of blood manganese level on the response of allergen-specific IgE. On the other hand, study subjects who had asthma tended to present relatively low blood manganese, zinc, selenium levels, similar to the relationship found in previous studies, though not statistically significant. Results of the present study provided preliminary information regarding the relationship between blood metal levels and the responses of allergen-specific IgE, for which the relevant studies are limited at the current time. However, more evidences are warranted to confirm such a relationship for better understanding the interaction mechanisms between metal exposure and the response of allergen-specific IgE.
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