Grüber C, Kulig M, Bergmann R, Guggenmoos-Holzmann I, Wahn U
Children's Hospital, Charité Campus Virchow, Medical Faculty of Humboldt Universität, Berlin, Germany.
Pediatrics. 2001 Mar;107(3):E36. doi: 10.1542/peds.107.3.e36.
Bacille Calmette-Guérin (BCG) is a strong T helper 1 incentive and, thus, may contribute to a decreased risk of T helper 2-dependent atopic disease.
To investigate the natural course of specific immunoglobulin E (IgE) responses and atopic disease in BCG-vaccinated and nonvaccinated children.
Seven hundred seventy-four children from a prospectively followed birth cohort.
Physical examination and case history were performed at 3, 6, 12, 18, 24, 36, 48, 60, 72, and 84 months of age. Total and specific serum IgE levels to 9 common inhalant and food allergens were determined (CAP; Pharmacia, Freiburg, Germany) at 12, 24, 36, 60, 72, and 84 months of age. Purified protein derivative (PPD) skin testing was performed at 84 months.
Period and lifetime prevalences of atopic dermatitis and recurrent wheezing tended to be lower in the BCG-vaccinated group early in life, whereas no such trend was found after the second birthday or for allergic rhinitis. The proportion of children remaining free of clinical manifestations tended to be higher in the BCG-vaccinated group but differences decreased over time. No statistically significant differences were found for total IgE levels (median). Atopic sensitization tended to be lower among BCG-vaccinated children during the first 2 years of life. The diameter of the skin reaction to PPD did not correlate with total serum IgE. Clinical and serologic correlates of atopy were not significantly different between children with a skin test diameter of >/=5 mm and those with a smaller diameter.
These results do not support the hypothesis that BCG vaccination in early infancy is associated with a subsequently markedly decreased risk of atopic sensitization or allergy. In addition, PPD skin test reactivity was not impaired in atopic individuals.
卡介苗（BCG）是一种强大的辅助性T细胞1型刺激剂，因此可能有助于降低依赖辅助性T细胞2型的特应性疾病的风险。
调查接种卡介苗和未接种卡介苗儿童特异性免疫球蛋白E（IgE）反应和特应性疾病的自然病程。
来自一个前瞻性随访出生队列的774名儿童。
在3、6、12、18、24、36、48、60、72和84月龄时进行体格检查和病史询问。在12、24、36、60、72和84月龄时测定针对9种常见吸入性和食物过敏原的总血清IgE水平和特异性血清IgE水平（免疫捕获法；德国弗赖堡的法玛西亚公司）。在84月龄时进行纯化蛋白衍生物（PPD）皮肤试验。
卡介苗接种组在生命早期特应性皮炎和反复喘息的时期患病率和终生患病率往往较低，而在两岁生日后或对于过敏性鼻炎则未发现这种趋势。卡介苗接种组中无临床表现的儿童比例往往较高，但差异随时间减小。总IgE水平（中位数）未发现统计学显著差异。在生命的头两年，卡介苗接种儿童的特应性致敏倾向较低。PPD皮肤反应直径与总血清IgE无关。皮肤试验直径≥5mm的儿童和直径较小的儿童之间，特应性的临床和血清学相关性无显著差异。
这些结果不支持婴儿早期接种卡介苗与随后特应性致敏或过敏风险显著降低相关的假设。此外，特应性个体的PPD皮肤试验反应性未受损。
