出生时接种卡介苗对幼儿特应性或过敏性疾病发展的影响。

The effect of BCG vaccine at birth on the development of atopy or allergic disease in young children.

作者信息

Townley R G, Barlan I B, Patino C, Vichyanond P, Minervini M C, Simasathien T, Nettagul R, Bahceciler N N, Basdemir D, Akkoc T, Pongprueksa S, Hopp R J

机构信息

Creighton University School of Medicine, Omaha, Nebraska, USA.

出版信息

Ann Allergy Asthma Immunol. 2004 Mar;92(3):350-5. doi: 10.1016/S1081-1206(10)61574-8.

DOI:10.1016/S1081-1206(10)61574-8

PMID:15049400

Abstract

BACKGROUND

Exposure to infectious diseases may reduce the development of asthma or allergy. In particular, the role of the BCG vaccine in modulating asthma or allergy has been a source of speculation.

OBJECTIVE

To study newborns from 3 international sites to evaluate the prospective effect of BCG vaccine on allergic diseases or atopic development.

METHODS

Infants were enrolled from newborn and well-infant clinics in Thailand, Argentina, and Turkey. The standard BCG vaccine for each country was given at birth. Parents who consented to have their infant included in the protocol completed an allergy family questionnaire. Infants underwent a standard purified protein derivative (PPD) test at 9 to 12 months of age, and the reaction size was measured. At the age of 2 years, the children returned to be studied. Allergy skin tests to common allergens appropriate to location and age were performed, and the parents completed the International Study of Allergy and Asthma in Childhood questionnaire. The PPD reaction size was compared with the presence of atopy and allergy questionnaire responses.

RESULTS

A total of 1,704 infants were studied. Statistical significance was found between a negative PPD response vs any positive PPD response and the risk of having an allergic history at the age of 2 years in Turkey (relative risk, 2.11; 95% confidence interval, 1.25-3.55; P = .005) and Thailand (relative risk, 2.16; 95% confidence interval, 1.18-3.94; P = .02) but not Argentina (relative risk, 1.09; 95% confidence interval, 0.70-1.68; P = .70).

CONCLUSIONS

This study further supports the role of infectious agents in modulating asthma and allergy development.

摘要

背景

接触传染病可能会降低哮喘或过敏的发病率。特别是，卡介苗在调节哮喘或过敏方面的作用一直是人们猜测的对象。

目的

研究来自3个国际地点的新生儿，以评估卡介苗对过敏性疾病或特应性发展的前瞻性影响。

方法

从泰国、阿根廷和土耳其的新生儿及健康婴儿诊所招募婴儿。各国的标准卡介苗在出生时接种。同意将其婴儿纳入该方案的父母填写了一份过敏家族问卷。婴儿在9至12个月大时接受标准的结核菌素纯蛋白衍化物（PPD）试验，并测量反应大小。在2岁时，这些儿童再次接受研究。对适合当地和年龄的常见过敏原进行过敏皮肤试验，父母填写儿童哮喘和过敏国际研究问卷。将PPD反应大小与特应性的存在情况及过敏问卷回答进行比较。

结果

共研究了1704名婴儿。在土耳其（相对风险，2.11；95%置信区间，1.25 - 3.55；P = 0.005）和泰国（相对风险，2.16；95%置信区间，1.18 - 3.94；P = 0.02），PPD阴性反应与任何阳性反应以及2岁时有过敏史的风险之间存在统计学显著性差异，但在阿根廷不存在（相对风险，1.09；95%置信区间，0.70 - 1.68；P = 0.70）。