Hasin T, Dagan R, Boutboul G, Derazne E, Atias O, Cohen D
Medical Department, Hadassah Mt Scopus University Hospital, Jerusalem, Israel.
Epidemiol Infect. 2007 Jan;135(1):118-25. doi: 10.1017/S0950268806006455. Epub 2006 Jun 2.
We examined the association between socioeconomic status and the level of serum antibodies to selected faeco-orally transmitted pathogens among Israeli adolescents. Random samples of eighty volunteers aged 12-15 years from high (HSL), medium (MSL) and low (LSL) standard of living towns were included in the study. Serum samples were examined by radioimmunoassay for HAV and by in-house-developed ELISA systems for IgA and IgG antibody levels against Shigella sonnei, S. flexneri, E. coli O157:H7 lipopolysacchride and Cryptosporidium parvum antigens. Seropositivity to HAV was highest (98.8%) in the LSL towns and lowest (25%) in the HSL towns, showing a statistically significant linear trend. Antibody levels to the other enteropathogens had gender variation, with higher titres in females. Significantly lower titres in the HSL towns were found for: IgA anti-S. sonnei in females (P<0.001); IgG anti-S. sonnei in females (P=0.024) and males (P=0.033); IgG anti-S. flexneri in females (P=0.016). Inverse linear association with socioeconomic status was found for IgA anti-C. parvum in females (P<0.001); IgA anti-E. coli O157:H7 in females (P<0.001) and males (P=0.024). A statistically significant association between HAV seropositivity and higher titres of IgA anti-S. sonnei and E. coli O157:H7 was shown. In conclusion, exposure to enteropathogens transmitted via the faecal-oral route in communities of lower socioeconomic status is reflected in a higher prevalence of lifelong lasting antibodies to HAV, and higher levels of antibodies to bacterial and protozoan enteropathogens. Among females, the levels of specific serum antibodies are higher and more strongly associated with low socioeconomic status.
我们研究了以色列青少年的社会经济地位与针对特定经粪-口传播病原体的血清抗体水平之间的关联。研究纳入了来自高生活水平（HSL）、中等生活水平（MSL）和低生活水平（LSL）城镇的80名12 - 15岁志愿者的随机样本。血清样本通过放射免疫分析法检测甲型肝炎病毒（HAV），并通过自行研发的酶联免疫吸附测定（ELISA）系统检测针对宋内志贺菌、福氏志贺菌、大肠杆菌O157:H7脂多糖和微小隐孢子虫抗原的IgA和IgG抗体水平。LSL城镇中对HAV的血清阳性率最高（98.8%），HSL城镇中最低（25%），呈现出统计学上显著的线性趋势。针对其他肠道病原体的抗体水平存在性别差异，女性的滴度更高。在HSL城镇中，女性抗宋内志贺菌IgA（P<0.001）；女性抗宋内志贺菌IgG（P=0.024）和男性抗宋内志贺菌IgG（P=0.033）；女性抗福氏志贺菌IgG（P=0.016）的滴度显著较低。女性抗微小隐孢子虫IgA（P<0.001）；女性抗大肠杆菌O157:H7 IgA（P<0.001）和男性抗大肠杆菌O157:H7 IgA（P=0.024）与社会经济地位呈负线性关联。HAV血清阳性与抗宋内志贺菌IgA和抗大肠杆菌O157:H7的较高滴度之间存在统计学上显著的关联。总之，社会经济地位较低社区中通过粪-口途径传播的肠道病原体暴露表现为对HAV的终身持久抗体患病率较高，以及对细菌性和原生动物性肠道病原体的抗体水平较高。在女性中，特定血清抗体水平更高，且与低社会经济地位的关联更强。
