Reimerink J, Stelma F, Rockx B, Brouwer D, Stobberingh E, van Ree R, Dompeling E, Mommers M, Thijs C, Koopmans M
Laboratory for Infectious Diseases and Screening, National Institute of Public Health and the Environment (RIVM), Bilthoven, Maastricht, Amsterdam, The Netherlands.
Clin Exp Allergy. 2009 Feb;39(2):254-60. doi: 10.1111/j.1365-2222.2008.03128.x. Epub 2008 Nov 17.
The increase in incidence of atopic diseases (ADs) in the developed world over the past decades has been associated with reduced exposure of childhood infections.
To investigate the relation between early intestinal viral infections in relation to the development of atopic symptoms (eczema, wheeze and atopic sensitization) in the first and second year(s) of life.
In the KOALA Birth Cohort Study, we assessed IgG seropositivity for rota- and norovirus (GGI.1 and GGII.4) at 1 year of age. This was related to allergic sensitization [specific immunoglobulin E (IgE)] at 1 and 2 years, and parent reported eczema and wheeze in the first 2 years, using logistic regression analysis adjusted for confounders.
Rotavirus seropositivity (39%) was associated with an unexpected higher risk of recurrent wheeze in the first and second year of life [adjusted odds ratio (OR) 3.1 and 95% confidence intervals (CI) 1.1-9.1] and persistent and new recurrent wheeze (adjusted OR 2.7 and 95% CI 1.1-6.2). No further associations were found between intestinal viral seropositivity and atopic manifestations.
Our data did not show a clear protection by enteric viral infections in young children on development of IgE response to allergens, but rotavirus infection in the first year was a risk factor for wheeze. However, this needs to be followed up to older ages in order to establish the true importance of intestinal viral infections and especially cumulative effects in AD aetiology. Exposure to rotavirus may offer a new and interesting focus on infant wheeze and later asthma development.
在过去几十年中,发达国家特应性疾病(ADs)发病率的增加与儿童期感染暴露减少有关。
研究生命第一年和第二年早期肠道病毒感染与特应性症状(湿疹、喘息和特应性致敏)发展之间的关系。
在考拉出生队列研究中,我们评估了1岁时轮状病毒和诺如病毒(GGI.1和GGII.4)的IgG血清阳性率。这与1岁和2岁时的过敏致敏[特异性免疫球蛋白E(IgE)]以及父母报告的前两年的湿疹和喘息有关,使用针对混杂因素进行调整的逻辑回归分析。
轮状病毒血清阳性率(39%)与生命第一年和第二年反复喘息的意外较高风险相关[调整后的优势比(OR)为3.1,95%置信区间(CI)为1.1 - 9.1]以及持续性和新的反复喘息(调整后的OR为2.7,95%CI为1.1 - 6.2)。未发现肠道病毒血清阳性与特应性表现之间有进一步关联。
我们的数据未显示幼儿肠道病毒感染对IgE对过敏原反应的发展有明显保护作用,但第一年的轮状病毒感染是喘息的一个危险因素。然而,这需要随访至更大年龄,以确定肠道病毒感染的真正重要性,尤其是在AD病因中的累积效应。接触轮状病毒可能为婴儿喘息和后期哮喘发展提供一个新的有趣关注点。