Bremner S A, Carey I M, DeWilde S, Richards N, Maier W C, Hilton S R, Strachan D P, Cook D G
Division of Community Health Sciences, St George's, University of London, London, UK.
Clin Exp Allergy. 2007 Apr;37(4):512-7. doi: 10.1111/j.1365-2222.2007.02697.x.
It has been hypothesized that early-life exposure to vaccinations, infections or antibacterials influence allergic disease development. Concurrent exposure to grass pollens may alter any effect.
To test the hypothesis that exposure to antibacterials, vaccinations (DTP or MMR) or specific infections during the first grass pollen seasons of life influences the risk of hayfever more than at any other time of the year.
Nested case-control studies were based on birth cohorts within two large databases of computerized patient records from UK general practices: the General Practice Research Database (GPRD) and Doctors' Independent Network (DIN). Seven thousand ninety-eight hayfever cases, diagnosed after age 2, were matched to controls for practice, age, sex and follow-up of control to case ascertainment date. Conditional logistic regression was used to compare exposure by age 1 (age 2 for MMR) inside vs. outside the grass pollen season (May, June, July). Odds ratios (ORs) were pooled across databases.
There were no associations in either database between MMR during vs. outside the grass pollen season and later hayfever. Of 23 infections studied, none were statistically significant; although analyses for the less common conditions were limited by low statistical power. The pooled OR for hayfever comparing exposure to antibacterials only in the grass pollen season with only outside it was 1.20 (95% CI 0.98-1.47) and for DTP was 0.84 (95% CI 0.72-0.98).
Although an interaction between early exposure to microbial agents and concurrent grass pollen exposure on hayfever risk seemed plausible, there was little evidence to support it across a range of analyses. However, the effect of DTP though weak deserves further study.
有假设认为，生命早期接触疫苗、感染或抗菌药物会影响过敏性疾病的发展。同时接触草花粉可能会改变任何影响。
验证以下假设：在生命的首个草花粉季节接触抗菌药物、疫苗（白百破或麻腮风）或特定感染，相比一年中的其他时间，对花粉热风险的影响更大。
巢式病例对照研究基于英国全科医疗计算机化患者记录的两个大型数据库中的出生队列：全科医疗研究数据库（GPRD）和医生独立网络（DIN）。对2岁后诊断出的7098例花粉热病例，按照医疗机构、年龄、性别以及对照至病例确诊日期的随访情况与对照进行匹配。采用条件逻辑回归比较草花粉季节（5月、6月、7月）内与外1岁时（麻腮风疫苗为2岁时）的暴露情况。跨数据库汇总比值比（OR）。
两个数据库中，草花粉季节内与外接种麻腮风疫苗和之后发生花粉热之间均无关联。在所研究的23种感染中，无一具有统计学意义；尽管对较罕见疾病的分析因统计效力低而受限。仅在草花粉季节接触抗菌药物与仅在季节外接触抗菌药物相比，花粉热的汇总OR为1.20（95%可信区间0.98 - 1.47），白百破疫苗的OR为0.84（95%可信区间0.72 - 0.98）。
虽然早期接触微生物制剂与同时接触草花粉对花粉热风险的相互作用似乎有道理，但在一系列分析中几乎没有证据支持这一点。然而，白百破疫苗的影响虽微弱，但值得进一步研究。
