Linneberg Allan, Ostergaard Christian, Tvede Michael, Andersen Leif Pervical, Nielsen Niels Henrik, Madsen Flemming, Frølund Lars, Dirksen Asger, Jørgensen Torben
Centre for Preventive Medicine, Glostrup University Hospital, Denmark.
J Allergy Clin Immunol. 2003 Apr;111(4):847-53. doi: 10.1067/mai.2003.1335.
Seropositivity to food-borne and orofecal microorganisms (hepatitis A virus, Helicobacter pylori, and Toxoplasma gondii ), which are considered to be markers of poor hygiene, has been reported to be associated with a lower prevalence of atopy. In contrast, colonization of the gut with Clostridium difficile, a potential intestinal bacterial pathogen, in early childhood may be associated with a higher prevalence of atopy.
The objective of this study was to investigate the association between atopy and exposure to 2 groups of food-borne and orofecal microorganisms: (1) markers of a poor hygiene and (2) intestinal bacterial pathogens.
A cross-sectional population-based study of 15- to 69-year-olds living in Copenhagen, Denmark, was carried out in 1990 to 1991. Atopy was defined as a positive test result for specific IgE to at least 1 of 6 inhalant allergens. Exposure to microorganisms was assessed as IgG seropositivity to microorganisms.
Seropositivity to 2 or 3 markers of poor hygiene (hepatitis A virus, H pylori, and T gondii ) was associated with a lower prevalence of atopy (adjusted odds ratio, 0.5; 95% CI, 0.3 to 0.8). In contrast, seropositivity to 2 or 3 intestinal bacterial pathogens (C difficile, Campylobacter jejuni, and Yersinia enterocolitica ) was associated with a higher prevalence of atopy (adjusted odds ratio, 1.7; 95% CI, 1.2 to 2.6).
Exposure to markers of poor hygiene was associated with a lower prevalence of atopy, whereas exposure to intestinal bacterial pathogens was associated with a higher prevalence of atopy. These findings raise the hypothesis that different groups of food-borne and orofecal microorganisms may have different effects on the risk of atopy.
食源性和口粪传播微生物（甲型肝炎病毒、幽门螺杆菌和弓形虫）的血清阳性被认为是卫生条件差的标志，据报道其与特应性疾病患病率较低有关。相比之下，幼儿期肠道被艰难梭菌（一种潜在的肠道细菌病原体）定植，可能与特应性疾病较高的患病率有关。
本研究的目的是调查特应性疾病与两组食源性和口粪传播微生物暴露之间的关联：（1）卫生条件差的标志；（2）肠道细菌病原体。
1990年至1991年，在丹麦哥本哈根对15至69岁的人群进行了一项基于人群的横断面研究。特应性疾病定义为对6种吸入性变应原中至少1种的特异性IgE检测结果呈阳性。微生物暴露通过对微生物的IgG血清阳性来评估。
对2种或3种卫生条件差的标志（甲型肝炎病毒、幽门螺杆菌和弓形虫）呈血清阳性与特应性疾病患病率较低有关（调整比值比，0.5；95%可信区间，0.3至0.8）。相比之下，对2种或3种肠道细菌病原体（艰难梭菌、空肠弯曲菌和小肠结肠炎耶尔森菌）呈血清阳性与特应性疾病较高的患病率有关（调整比值比，1.7；95%可信区间，1.2至2.6）。
接触卫生条件差的标志与特应性疾病较低的患病率有关，而接触肠道细菌病原体与特应性疾病较高的患病率有关。这些发现提出了一个假设，即不同组的食源性和口粪传播微生物可能对特应性疾病的风险有不同影响。
