Csoma Zsanett, Kemény Lajos, Boda Krisztina, Dobozy Attila
Szegedi Tudományegyetem, Altalános Orvostudományi Kar, Szentgyörgyi Albert Orvos- és Gyógyszerésztudományi Centrum, Bórgyógyászati és Allergológiai Klinika.
Orv Hetil. 2002 Sep 29;143(39):2235-9.
In the last decades the prevalence of atopic diseases has increased highly in developed countries. Although the reasons for this increase are not clear, it has been hypothesized that a reduction in infections and immunization programs may contribute to the increased prevalence of atopic diseases.
In the present study the relationship between tuberculin response and atopic disease was investigated.
A total of 1012 children vaccinated with BCG were included in the study. All the children were given five tuberculin units PPD, and PPD indurations were recorded after 72 h. The test result was considered to be positive if the induration size was greater than 9 mm. The atopic anamnesis (atopic dermatitis, rhinitis, conjunctivitis, asthma, urticaria) in the children and their families were investigated using a questionnaire.
608 individual (60.1%) had positive and 404 (39.9%) had negative tuberculin test. Positive atopic personal anamnesis was found in 31.74% in children with positive tuberculin skin test, whereas 39.85% was found in children with negative tuberculin test (p < 0.009, Fischer-test). Similarly more positive family anamnesis for atopic diseases was found among children with negative tuberculin test. In children with negative tuberculin test the prevalence of allergic conjunctivitis and rhinitis was significantly higher as compared to the group with positive tuberculin test.
The authors found an inverse correlation between tuberculin response and atopy status. The observed decreased tuberculin sensitivity in atopic individuals is, however, probably not the cause, but rather the consequence of the disturbed immune regulation in atopic diseases.
在过去几十年中，发达国家特应性疾病的患病率大幅上升。尽管这种上升的原因尚不清楚，但据推测，感染减少和免疫规划可能导致了特应性疾病患病率的增加。
在本研究中，调查了结核菌素反应与特应性疾病之间的关系。
共有1012名接种卡介苗的儿童纳入本研究。所有儿童均接种5个结核菌素单位的结核菌素纯蛋白衍生物（PPD），72小时后记录PPD硬结情况。硬结大小大于9mm时，试验结果被视为阳性。通过问卷调查对儿童及其家庭的特应性病史（特应性皮炎、鼻炎、结膜炎、哮喘、荨麻疹）进行调查。
608人（60.1%）结核菌素试验呈阳性，404人（39.9%）呈阴性。结核菌素皮肤试验阳性的儿童中，31.74%有特应性个人病史，而结核菌素试验阴性的儿童中这一比例为39.85%（p<0.009，费舍尔检验）。同样，结核菌素试验阴性的儿童中，特应性疾病的家族病史阳性率更高。与结核菌素试验阳性组相比，结核菌素试验阴性的儿童中过敏性结膜炎和鼻炎的患病率显著更高。
作者发现结核菌素反应与特应性状态呈负相关。然而，在特应性个体中观察到的结核菌素敏感性降低可能不是原因，而是特应性疾病中免疫调节紊乱的结果。
