von Hertzen Leena C, Laatikainen Tiina, Mäkelä Mika J, Jousilahti Pekka, Kosunen Timo U, Petays Tuula, Pussinen Pirkko J, Haahtela Tari, Vartiainen Erkki
Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Int Arch Allergy Immunol. 2006;140(2):89-95. doi: 10.1159/000092251. Epub 2006 Mar 22.
Evidence of the influence of pathogen exposure on the development of atopy and atopic disease is not unequivocal. We investigated the association between markers of infections and occurrence of atopy among adults in eastern Finland and western Russia, two adjacent areas with profound differences in living conditions and lifestyles.
Randomly selected adults aged 25-54 years from Finland (n = 790) and from Russia (n = 387) participated in the study. Skin prick tests were performed to 11 common airborne allergens, and at least one positive prick reaction was considered to indicate atopy. Antibodies to different pathogens including hepatitis A virus (HAV), Helicobacter pylori, Toxoplasma gondii, herpes simplex virus (HSV), Chlamydia pneumoniae and the periodontal pathogens Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans were measured.
In Finland 34.3% and in Russia 23.3% of the study population was atopic (p < 0.001). Seroprevalences to all these pathogens were significantly higher among the Russians. In multivariate logistic regression analysis, only H. pylori was inversely associated with atopy in Russia. A further stepwise analysis revealed that H. pylori alone can explain 32% of the difference in atopy between the countries, and T. gondii, A. actinomycetemcomitans, HSV and C. pneumoniae had a slightly additive effect, whereas, unexpectedly, seropositivity to HAV and, to a lesser extent, P. gingivalis had an opposite effect. The net result of the stepwise analysis showed that 44% of the difference in atopy between the countries could be explained by seropositivity to these seven pathogens.
Seropositivity to select pathogens, particularly to H. pylori, could explain a substantial part of the difference in atopy prevalence between Finland and Russia. Exposure to HAV was not associated with protection against atopy in this adult population.
病原体暴露对特应性和特应性疾病发展的影响尚无明确证据。我们调查了芬兰东部和俄罗斯西部成年人感染标志物与特应性发生之间的关联，这两个相邻地区在生活条件和生活方式上存在巨大差异。
从芬兰（n = 790）和俄罗斯（n = 387）随机选取25 - 54岁的成年人参与研究。对11种常见空气传播变应原进行皮肤点刺试验，至少一次阳性点刺反应被视为特应性的指标。检测了针对不同病原体的抗体，包括甲型肝炎病毒（HAV）、幽门螺杆菌、弓形虫、单纯疱疹病毒（HSV）、肺炎衣原体以及牙周病原体牙龈卟啉单胞菌和伴放线放线杆菌。
芬兰34.3%的研究人群和俄罗斯23.3%的研究人群患有特应性疾病（p < 0.001）。俄罗斯人对所有这些病原体的血清阳性率显著更高。在多因素逻辑回归分析中，仅幽门螺杆菌在俄罗斯与特应性呈负相关。进一步的逐步分析表明，仅幽门螺杆菌就能解释两国特应性差异的32%，弓形虫、伴放线放线杆菌、HSV和肺炎衣原体有轻微的累加效应，而出乎意料的是，HAV血清阳性以及在较小程度上牙龈卟啉单胞菌血清阳性有相反的作用。逐步分析的最终结果表明，这七种病原体的血清阳性可解释两国特应性差异的44%。
对特定病原体，尤其是幽门螺杆菌的血清阳性可解释芬兰和俄罗斯特应性患病率差异的很大一部分。在该成年人群中，接触HAV与预防特应性无关。
