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儿童过敏性疾病和特应性致敏与麻疹疫苗接种及麻疹感染的关系。

Allergic disease and atopic sensitization in children in relation to measles vaccination and measles infection.

作者信息

Rosenlund Helen, Bergström Anna, Alm Johan S, Swartz Jackie, Scheynius Annika, van Hage Marianne, Johansen Kari, Brunekreef Bert, von Mutius Erika, Ege Markus J, Riedler Josef, Braun-Fahrländer Charlotte, Waser Marco, Pershagen Göran

机构信息

Karolinska Institutet, Institute of Environmental Medicine, Department of Environmental Epidemiology, Box 210, SE-171 77 Stockholm, Sweden.

出版信息

Pediatrics. 2009 Mar;123(3):771-8. doi: 10.1542/peds.2008-0013.

Abstract

OBJECTIVE

Our aim was to investigate the role of measles vaccination and measles infection in the development of allergic disease and atopic sensitization.

METHODS

A total of 14 893 children were included from the cross-sectional, multicenter Prevention of Allergy-Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle study, conducted in 5 European countries (Austria, Germany, the Netherlands, Sweden, and Switzerland). The children were between 5 and 13 years of age and represented farm children, Steiner-school children, and 2 reference groups. Children attending Steiner schools often have an anthroposophic (holistic) lifestyle in which some immunizations are avoided or postponed. Parental questionnaires provided information on exposure and lifestyle factors as well as symptoms and diagnoses in the children. A sample of the children was invited for additional tests, and 4049 children provided a blood sample for immunoglobulin E analyses. Only children with complete information on measles vaccination and infection were included in the analyses (84%).

RESULTS

In the whole group of children, atopic sensitization was inversely associated with measles infection, and a similar tendency was seen for measles vaccination. To reduce risks of disease-related modification of exposure, children who reported symptoms of wheezing and/or eczema debuting during first year of life were excluded from some analyses. After this exclusion, inverse associations were observed between measles infection and "any allergic symptom" and "any diagnosis of allergy by a physician." However, no associations were found between measles vaccination and allergic disease.

CONCLUSION

Our data suggest that measles infection may protect against allergic disease in children.

摘要

目的

我们的目的是研究麻疹疫苗接种和麻疹感染在过敏性疾病及特应性致敏发展过程中的作用。

方法

从一项在5个欧洲国家(奥地利、德国、荷兰、瑞典和瑞士)开展的横断面、多中心研究“儿童与农业及人智学生活方式相关的致敏危险因素预防过敏研究”中纳入了总共14893名儿童。这些儿童年龄在5至13岁之间,包括农场儿童、施泰纳学校儿童以及2个参照组。就读于施泰纳学校的儿童通常具有人智学(整体)生活方式,其中一些免疫接种会被避免或推迟。家长问卷提供了有关儿童接触情况、生活方式因素以及症状和诊断的信息。邀请了部分儿童进行额外检测,4049名儿童提供了血样用于免疫球蛋白E分析。分析仅纳入了麻疹疫苗接种和感染信息完整的儿童(84%)。

结果

在整个儿童组中,特应性致敏与麻疹感染呈负相关,麻疹疫苗接种也呈现出类似趋势。为降低疾病相关暴露改变的风险,在一些分析中排除了在生命第一年出现喘息和/或湿疹症状的儿童。排除这些儿童后,观察到麻疹感染与“任何过敏症状”以及“医生做出的任何过敏诊断”之间存在负相关。然而,未发现麻疹疫苗接种与过敏性疾病之间存在关联。

结论

我们的数据表明麻疹感染可能对儿童过敏性疾病具有保护作用。

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