van den Biggelaar A H, van Ree R, Rodrigues L C, Lell B, Deelder A M, Kremsner P G, Yazdanbakhsh M
Department of Parasitology, Leiden University Medical Centre, The Netherlands.
Lancet. 2000 Nov 18;356(9243):1723-7. doi: 10.1016/S0140-6736(00)03206-2.
Most of the effort directed at understanding the role infections have in preventing allergy has focused on bacteria and viruses and their ability to divert the immune system towards T-helper-1 responses and away from proallergic T-helper-2 responses. However, helminth infections, highly prevalent in large parts of the developing world, where allergy is uncommon, stimulate strong T-helper-2 responses. We investigated the influence of chronic helminth infections on the prevalence of atopy and aimed to understand the relation at a detailed immunological level.
520 Gabonese schoolchildren were tested for skin reaction to house-dust mite and other allergens, for Schistosoma haematobium eggs in urine, and for microfilariae in blood samples. Total and mite-specific IgE antibodies were measured. A subsample selected on the basis of their skin test to house-dust mite received detailed immunological investigations.
Children with urinary schistosomiasis had a lower prevalence of a positive skin reaction to house-dust mite than those free of this infection (odds ratio 0.32 [95% CI 0.16-0.63]). The degree of sensitisation to house-dust mite could not explain this difference in skin-prick positivity. Schistosome-antigen-specific concentrations of interleukin-10 were significantly higher in infected children, and higher specific concentrations of this anti-inflammatory cytokine were negatively associated with the outcome of skin-test reactivity to mite (0.53 [0.30-0.96]). No association between polyclonal IgE antibodies and skin-test results was found.
The anti-inflammatory cytokine, interleukin-10, induced in chronic schistosomiasis, appears central to suppressing atopy in African children.
大多数旨在了解感染在预防过敏中所起作用的研究都集中在细菌和病毒上，以及它们将免疫系统导向辅助性T细胞1型反应、远离促过敏性辅助性T细胞2型反应的能力。然而，在发展中世界的大部分地区高度流行的蠕虫感染，在这些地区过敏并不常见，却会刺激强烈的辅助性T细胞2型反应。我们研究了慢性蠕虫感染对特应性患病率的影响，并旨在从详细的免疫学层面了解这种关系。
对520名加蓬学童进行了针对屋尘螨和其他过敏原的皮肤反应测试、尿液中埃及血吸虫卵检测以及血样中微丝蚴检测。测量了总IgE抗体和螨特异性IgE抗体。根据对屋尘螨的皮肤测试选择了一个子样本进行详细的免疫学研究。
患有泌尿血吸虫病的儿童对屋尘螨皮肤反应呈阳性的患病率低于未感染这种疾病的儿童（比值比0.32 [95%置信区间0.16 - 0.63]）。对屋尘螨的致敏程度无法解释皮肤点刺阳性的这种差异。感染儿童中白细胞介素-10的血吸虫抗原特异性浓度显著更高，且这种抗炎细胞因子的更高特异性浓度与对螨的皮肤测试反应结果呈负相关（0.53 [0.30 - 0.96]）。未发现多克隆IgE抗体与皮肤测试结果之间存在关联。
慢性血吸虫病中诱导产生的抗炎细胞因子白细胞介素-10，似乎是抑制非洲儿童特应性的关键因素。
