Rodrigues L C, Newcombe P J, Cunha S S, Alcantara-Neves N M, Genser B, Cruz A A, Simoes S M, Fiaccone R, Amorim L, Cooper P J, Barreto M L
London School of Hygiene and Tropical Medicine, London, UK.
Clin Exp Allergy. 2008 Nov;38(11):1769-77. doi: 10.1111/j.1365-2222.2008.03027.x. Epub 2008 Jun 10.
Allergic diseases cause a large and increasing burden in developed countries and in urban centres in middle-income countries. The causes of this increase are unknown and, currently, there are no interventions to prevent the development of allergic diseases. The 'hygiene hypothesis' has tried to explain the increase through a reduction in the frequency of childhood infections causing a failure to program the immune system for adequate immune regulation. Intestinal helminth parasites are prevalent in childhood in developing countries and are associated with a lower prevalence of allergen skin test reactivity and asthma.
To investigate whether children who had intestinal helminth infections during early childhood have a lower prevalence of allergen skin test reactivity later in childhood.
We re-visited a population of 1055 children from whom stool samples had been collected for detection of intestinal helminth infections for another study, and collected new stool samples and performed allergen skin prick testing. Information on potential confounding variables was collected.
Children with heavy infections with Trichuris trichiura in early childhood had a significantly reduced prevalence of allergen skin test reactivity in later childhood, even in the absence of T. trichiura infection at the time of skin testing in later childhood.
Early heavy infections with T. trichiura may protect against the development of allergen skin test reactivity in later childhood. Novel treatments to program immune-regulation in early childhood in a way that mimics the effects of early infections with T. trichiura may offer new strategies for the prevention of allergic disease.
过敏性疾病在发达国家以及中等收入国家的城市中心造成了巨大且不断增加的负担。这种增加的原因尚不清楚，目前也没有预防过敏性疾病发生的干预措施。“卫生假说”试图通过儿童期感染频率的降低来解释这种增加，这导致免疫系统未能进行充分免疫调节的编程。肠道蠕虫寄生虫在发展中国家的儿童期很普遍，并且与较低的过敏原皮肤试验反应性和哮喘患病率相关。
调查幼儿期有肠道蠕虫感染的儿童在童年后期过敏原皮肤试验反应性的患病率是否较低。
我们回访了1055名儿童，这些儿童的粪便样本曾为另一项研究而采集用于检测肠道蠕虫感染，我们收集了新的粪便样本并进行了过敏原皮肤点刺试验。收集了有关潜在混杂变量的信息。
幼儿期重度感染毛首鞭形线虫的儿童在童年后期过敏原皮肤试验反应性的患病率显著降低，即使在童年后期皮肤试验时没有毛首鞭形线虫感染。
幼儿期重度感染毛首鞭形线虫可能预防童年后期过敏原皮肤试验反应性的发生。以模仿幼儿期毛首鞭形线虫早期感染效果的方式对幼儿期免疫调节进行编程的新疗法可能为预防过敏性疾病提供新策略。
