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早期 EBV 感染可预防持续性 IgE 致敏。

Early-life EBV infection protects against persistent IgE sensitization.

机构信息

Department of Immunology, Wenner-Gren Institute, Stockholm University, 10691-Stockholm, Sweden.

出版信息

J Allergy Clin Immunol. 2010 Feb;125(2):433-8. doi: 10.1016/j.jaci.2009.09.033. Epub 2009 Dec 5.

Abstract

BACKGROUND

Infection with EBV has previously been implicated in influencing allergic disorders, but its precise role remains contradictory. The timing of primary infection may contribute to the discrepancies.

OBJECTIVE

This study aimed at investigating whether the time-point of primary EBV infection during childhood could be of importance in modulating the risk of developing IgE sensitization.

METHODS

A total of 219 Swedish infants were followed prospectively to 5 years of age with clinical examinations, skin prick testing, specific IgE analyses, and determination of serostatus against EBV.

RESULTS

After analysis of the children's EBV serostatus, we found that 5-year-olds who were infected with EBV before the age of 2 years were at a significantly lower risk of being persistently IgE-sensitized-that is, sensitized at both 2 and 5 years of age (adjusted odds ratio, 0.34; 95% CI, 0.12-0.94). In contrast, contraction of EBV after 2 years of age was highly associated with late-onset IgE sensitization (adjusted odds ratio, 4.64; 95% CI, 1.57-13.69). Persistently sensitized 5-year-olds had higher specific-IgE levels than children with late-onset IgE sensitization (P < .01).

CONCLUSION

Our data support the value of early-life microbial exposure for protection against the development of IgE sensitization and underscore the proximate postnatal years as an important period during which EBV could contribute to an allergo-protective immune profile.

摘要

背景

EBV 感染先前被认为会影响过敏疾病,但确切作用仍存在争议。初次感染的时间可能是导致差异的原因之一。

目的

本研究旨在探讨儿童时期初次 EBV 感染的时间点是否会影响 IgE 致敏的风险。

方法

219 名瑞典婴儿进行前瞻性随访至 5 岁,进行临床检查、皮肤点刺试验、特异性 IgE 分析以及 EBV 血清学检测。

结果

对儿童 EBV 血清学状态进行分析后发现,2 岁前感染 EBV 的 5 岁儿童持续性 IgE 致敏(即 2 岁和 5 岁时均致敏)的风险显著降低(调整后的优势比,0.34;95%CI,0.12-0.94)。相比之下,2 岁后感染 EBV 与迟发性 IgE 致敏高度相关(调整后的优势比,4.64;95%CI,1.57-13.69)。持续性致敏的 5 岁儿童的特异性 IgE 水平高于迟发性 IgE 致敏儿童(P <.01)。

结论

我们的数据支持生命早期微生物暴露对预防 IgE 致敏的价值,并强调了出生后数年是 EBV 可能有助于形成过敏保护免疫特征的重要时期。

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