van Benten Inesz, Koopman Laurens, Niesters Bert, Hop Wim, van Middelkoop Barbara, de Waal Leon, van Drunen Kees, Osterhaus Albert, Neijens Herman, Fokkens Wytske
Department of Otorhinolaryngology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Pediatr Allergy Immunol. 2003 Oct;14(5):363-70. doi: 10.1034/j.1399-3038.2003.00064.x.
Respiratory infections in infancy may protect against developing Th2-mediated allergic disease (hygiene hypothesis). To estimate the relative contribution of particular viruses to the development of the immune system and allergic disease, we investigated longitudinally the prevalence of respiratory viral infections in infants. One hundred and twenty-six healthy infants were included in this prospective birth cohort study in their first year of life. Physical examination was performed and nasal brush samples were taken during routine visits every 6 months and during an upper respiratory tract infection (URTI) (sick visits). The prevalence of respiratory viral infections in infants with URTI, infants with rhinitis without general malaise and infants without nasal symptoms was studied. Rhinovirus was the most prevalent pathogen during URTI and rhinitis in 0- to 2-year-old infants ( approximately 40%). During URTI, also respiratory syncytial virus ( approximately 20%) and coronavirus ( approximately 10%) infections were found, which were rarely detected in infants with rhinitis. Surprisingly, in 20% of infants who did not present with nasal symptoms, rhinovirus infections were also detected. During routine visits at 12 months, a higher prevalence of rhinovirus infections was found in infants who attended day-care compared with those who did not. We did not observe a relation between breast-feeding or smoking by one or both parents and the prevalence of rhinovirus infections. The parental history of atopy was not related to the prevalence of rhinovirus infection, indicating that the genetic risk of allergic disease does not seem to increase the chance of rhinovirus infections. In conclusion, rhinovirus infection is the most prevalent respiratory viral infection in infants. It may therefore affect the maturation of the immune system and the development of allergic disease considerably.
婴儿期的呼吸道感染可能会预防Th2介导的过敏性疾病的发生（卫生假说）。为了评估特定病毒对免疫系统发育和过敏性疾病的相对影响，我们对婴儿呼吸道病毒感染的患病率进行了纵向调查。126名健康婴儿被纳入了这项前瞻性出生队列研究，研究他们生命的第一年。每6个月进行一次常规检查，并在常规访视期间以及上呼吸道感染（URTI）（患病访视）期间采集鼻拭子样本。我们研究了患有URTI的婴儿、患有鼻炎但无全身不适的婴儿以及无鼻部症状的婴儿中呼吸道病毒感染的患病率。鼻病毒是0至2岁婴儿URTI和鼻炎期间最常见的病原体（约40%）。在URTI期间，还发现了呼吸道合胞病毒（约20%）和冠状病毒（约10%）感染，而在患有鼻炎的婴儿中很少检测到。令人惊讶的是，在20%没有鼻部症状的婴儿中也检测到了鼻病毒感染。在12个月的常规访视中，发现参加日托的婴儿中鼻病毒感染的患病率高于未参加日托的婴儿。我们没有观察到母乳喂养或父母一方或双方吸烟与鼻病毒感染患病率之间的关系。过敏性疾病的家族史与鼻病毒感染的患病率无关，这表明过敏性疾病的遗传风险似乎不会增加鼻病毒感染的几率。总之，鼻病毒感染是婴儿中最常见的呼吸道病毒感染。因此，它可能会对免疫系统的成熟和过敏性疾病的发展产生相当大的影响。
