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养狗及高内毒素对婴儿期喘息和特应性的影响。

Influence of dog ownership and high endotoxin on wheezing and atopy during infancy.

作者信息

Campo Paloma, Kalra Harpinder K, Levin Linda, Reponen Tiina, Olds Rolanda, Lummus Zana L, Cho Seung-Hyun, Khurana Hershey Gurjit K, Lockey James, Villareal Manuel, Stanforth Sherry, Lemasters Grace, Bernstein David I

机构信息

Department of Internal Medicine, Immunology Division, University of Cincinnati, Cincinnati, OH 45267-0563, USA.

出版信息

J Allergy Clin Immunol. 2006 Dec;118(6):1271-8. doi: 10.1016/j.jaci.2006.08.008. Epub 2006 Sep 26.

Abstract

BACKGROUND

Increased exposure to microbial products early in life may protect from development of atopic disorders in childhood. Few studies have examined the relationship of endotoxin exposure and pet ownership on atopy and wheezing during infancy.

OBJECTIVE

Evaluate relationships among high endotoxin exposure, pet ownership, atopy, and wheezing in high-risk infants.

METHODS

Infants (n = 532; mean age, 12.5 +/- 0.8 months) with at least 1 parent with confirmed atopy were recruited. A complete medical history and skin prick testing to foods and aeroallergens were performed at age 1 year. House dust samples were analyzed for endotoxin.

RESULTS

Prevalences of wheezing were not independently associated with dog or cat ownership or endotoxin levels. Percutaneous reactivity to at least 1 allergen was observed in 28.6% of infants. Univariate analyses showed significant associations of any wheezing, recurrent wheezing, and recurrent wheezing with an event with daycare attendance, number of siblings, respiratory infections, maternal smoking, and history of parental asthma. Logistic regression adjusting for the latter variables showed that recurrent wheezing (odds ratio, 0.4; 95% CI, 0.1-0.9) as well as 2 other wheeze outcomes were significantly reduced in homes with high endotoxin exposure in the presence of 2 or more dogs.

CONCLUSION

Pet ownership or endotoxin did not independently modify aeroallergen sensitization or wheezing during infancy. However, high endotoxin exposure in the presence of multiple dogs was associated with reduced wheezing in infants.

CLINICAL IMPLICATIONS

A home environment with many dogs and high levels of endotoxin may be conducive to reduced wheezing in infancy.

摘要

背景

生命早期接触微生物产物增加可能预防儿童期特应性疾病的发生。很少有研究探讨内毒素暴露及养宠物与婴儿期特应性疾病和喘息之间的关系。

目的

评估高危婴儿中高内毒素暴露、养宠物、特应性疾病和喘息之间的关系。

方法

招募至少有1名确诊为特应性疾病的父母的婴儿(n = 532;平均年龄12.5±0.8个月)。在1岁时进行完整的病史采集以及针对食物和空气变应原的皮肤点刺试验。对家庭灰尘样本进行内毒素分析。

结果

喘息的患病率与养狗或养猫及内毒素水平无独立相关性。28.6%的婴儿对至少1种变应原存在经皮反应性。单因素分析显示,任何喘息、反复喘息以及反复喘息伴发作与日托、同胞数量、呼吸道感染、母亲吸烟和父母哮喘病史之间存在显著关联。对后述变量进行逻辑回归分析显示,在有2只或更多只狗且内毒素暴露高的家庭中,反复喘息(比值比,0.4;95%可信区间,0.1 - 0.9)以及其他2种喘息结局显著降低。

结论

养宠物或内毒素并未独立改变婴儿期对空气变应原的致敏或喘息情况。然而,在有多只狗的情况下高内毒素暴露与婴儿喘息减少有关。

临床意义

有许多狗且内毒素水平高的家庭环境可能有助于减少婴儿期喘息。

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