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1岁以内接触狗和猫与6至7岁时过敏致敏风险的关系

Exposure to dogs and cats in the first year of life and risk of allergic sensitization at 6 to 7 years of age.

作者信息

Ownby Dennis R, Johnson Christine Cole, Peterson Edward L

机构信息

Section of Allergy and Immunology, Department of Pediatrics, BG-1019, Medical College of Georgia, Augusta, GA 30912-3790, USA.

出版信息

JAMA. 2002 Aug 28;288(8):963-72. doi: 10.1001/jama.288.8.963.

Abstract

CONTEXT

Childhood asthma is strongly associated with allergic sensitization. Studies have suggested that animal exposure during infancy reduces subsequent allergic sensitization.

OBJECTIVE

To evaluate the relationship between dog and cat exposure in the first year of life and allergic sensitization at 6 to 7 years of age.

DESIGN, SETTING, AND SUBJECTS: Prospective birth cohort study of healthy, full-term infants enrolled in a health maintenance organization in suburban Detroit, Mich, who were born between April 15, 1987, and August 31, 1989, and followed up yearly to a mean age of 6.7 years. Of 835 children initially in the study at birth, 474 (57%) completed follow-up evaluations at age 6 to 7 years.

MAIN OUTCOME MEASURES

Atopy, defined as any skin prick test positivity to 6 common aeroallergens (dust mites [Dermatophagoides farinae, D pteronyssinus], dog, cat, short ragweed [Ambrosia artemisiifolia], and blue grass [Poa pratensis]); seroatopy, defined as any positive allergen-specific IgE test result for the same 6 allergens or for Alternaria species.

RESULTS

The prevalence of any skin prick test positivity (atopy) at age 6 to 7 years was 33.6% with no dog or cat exposure in the first year of life, 34.3% with exposure to 1 dog or cat, and 15.4% with exposure to 2 or more dogs or cats (P =.005). The prevalence of any positive allergen-specific IgE test result (seroatopy) was 38.5% with no dog or cat exposure, 41.2% with exposure to 1 dog or cat, and 17.9% with exposure to 2 or more dogs or cats (P =.003). After adjustment for cord serum IgE concentration, sex, older siblings, parental smoking, parental asthma, bedroom dust mite allergen levels at 2 years, and current dog and cat ownership, exposure to 2 or more dogs or cats in the first year of life was associated with a significantly lower risk of atopy (adjusted odds ratio, 0.23; 95% confidence interval, 0.09-0.60) and seroatopy (adjusted odds ratio, 0.33; 95% confidence interval, 0.13-0.83).

CONCLUSION

Exposure to 2 or more dogs or cats in the first year of life may reduce subsequent risk of allergic sensitization to multiple allergens during childhood.

摘要

背景

儿童哮喘与过敏致敏密切相关。研究表明,婴儿期接触动物可降低随后的过敏致敏风险。

目的

评估生命第一年接触狗和猫与6至7岁时过敏致敏之间的关系。

设计、地点和研究对象:对密歇根州底特律郊区一家健康维护组织中健康的足月婴儿进行前瞻性出生队列研究,这些婴儿于1987年4月15日至1989年8月31日出生,每年进行随访,平均年龄为6.7岁。出生时最初纳入研究的835名儿童中,474名(57%)在6至7岁时完成了随访评估。

主要观察指标

特应性,定义为对6种常见气传变应原(粉尘螨[屋尘螨、粉尘螨]、狗、猫、豚草[豚草]和早熟禾)皮肤点刺试验呈阳性;血清特应性,定义为对相同6种变应原或链格孢属的任何变应原特异性IgE检测结果呈阳性。

结果

6至7岁时,生命第一年未接触狗或猫的儿童中,任何皮肤点刺试验阳性(特应性)的患病率为33.6%,接触1只狗或猫的患病率为34.3%,接触2只或更多狗或猫的患病率为15.4%(P = 0.005)。任何变应原特异性IgE检测结果阳性(血清特应性)的患病率,未接触狗或猫的为38.5%,接触1只狗或猫的为41.2%,接触2只或更多狗或猫的为17.9%(P = 0.003)。在对脐血IgE浓度、性别、年长同胞、父母吸烟、父母哮喘、2岁时卧室粉尘螨变应原水平以及当前是否养狗和猫进行校正后,生命第一年接触2只或更多狗或猫与特应性风险显著降低相关(校正比值比,0.23;95%置信区间,0.09 - 0.60),与血清特应性风险也显著降低相关(校正比值比,0.33;95%置信区间,0.13 - 0.83)。

结论

生命第一年接触2只或更多狗或猫可能会降低儿童期随后对多种变应原过敏致敏的风险。

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