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哮喘的早期生活事件——饮食

Early life events in asthma--diet.

作者信息

Devereux Graham

机构信息

Department of Environmental and Occupational Medicine, University of Aberdeen, Aberdeen, UK.

出版信息

Pediatr Pulmonol. 2007 Aug;42(8):663-73. doi: 10.1002/ppul.20640.

Abstract

It has been hypothesized that the recent increase in the prevalence of asthma may, in part, be a consequence of changing diet. There is now increasing interest in the possibility that childhood asthma may be influenced by maternal diet during pregnancy and/or diet during early childhood. A number of observational studies and a childhood fish oil supplementation study provide little support for the notion that early childhood intake of polyunsaturated fatty acids (PUFAs) influence the development of childhood asthma. Recent work however, suggests that supplementation of maternal diet with fish oil is associated with altered neonatal immune responses to allergens. Further work is required to establish whether this immunological observation is translated into clinical outcomes. Two birth cohorts have now reported reduced maternal intake of vitamin E, zinc and vitamin D during pregnancy to be associated with increased asthma and wheezing outcomes in children up to the age of 5 years. Early life diet could modulate the likelihood of childhood asthma by affecting fetal airway development and/or influencing the initial early life interactions between allergens and the immune system. In animal models, vitamin E, zinc and vitamin D have been shown to modify fetal lung development and vitamin E, zinc, vitamin D and PUFA can modulate T-cell responses. Further research, particularly, early life intervention studies need to be carried out to establish whether early life dietary intervention can be used as a public health measure to reduce the prevalence of childhood asthma.

摘要

据推测,近期哮喘患病率的上升可能部分归因于饮食的改变。现在人们越来越关注儿童哮喘可能受到孕期母亲饮食和/或幼儿期饮食影响的可能性。一些观察性研究以及一项儿童鱼油补充剂研究几乎没有为幼儿期摄入多不饱和脂肪酸(PUFA)会影响儿童哮喘发展这一观点提供支持。然而,近期的研究表明,孕期母亲饮食中补充鱼油与新生儿对过敏原的免疫反应改变有关。需要进一步研究来确定这种免疫学观察结果是否会转化为临床结果。现在有两个出生队列报告称,孕期母亲维生素E、锌和维生素D摄入量的减少与5岁以下儿童哮喘和喘息发病率的增加有关。生命早期的饮食可能通过影响胎儿气道发育和/或影响过敏原与免疫系统之间最初的早期生命相互作用来调节儿童患哮喘的可能性。在动物模型中,维生素E、锌和维生素D已被证明可改变胎儿肺部发育,维生素E、锌、维生素D和PUFA可调节T细胞反应。需要开展进一步研究,尤其是生命早期干预研究,以确定生命早期饮食干预是否可用作一项公共卫生措施来降低儿童哮喘的患病率。

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