Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
Allergy. 2011 Apr;66(4):569-78. doi: 10.1111/j.1398-9995.2010.02512.x. Epub 2010 Nov 18.
The rate of increase in prevalence of allergic disease in some countries implies environmental exposures may be important etiological factors. Our aim was to undertake a systematic review and meta-analysis of epidemiological studies to quantify the association between current intestinal parasite infection and the presence of atopy and to determine whether this relation is species specific.
We searched MEDLINE, EMBASE, LILIACS and CAB Abstracts (to March 2009); reviews; and reference lists from publications. No language restrictions were applied. We included studies that measured current parasite infection using direct fecal microscopy and defined atopy as allergen skin sensitization or presence of specific IgE. We estimated pooled odds ratios (OR) and 95% confidence intervals (95% CI) using data extracted from published papers using random-effects model.
Twenty-one studies met our inclusion criteria. Current parasite infection was associated with a reduced risk of allergen skin sensitization OR 0.69 (95% CI 0.60-0.79; P < 0.01). When we restricted our analyses to current geohelminth infection, the size of effect remained similar OR 0.68 (95% CI 0.60-0.76; P < 0.01). In species-specific analysis, a consistent protective effect was found for infection with Ascaris lumbricoides, Tricuris trichuria, hookworm and Schistosomiasis. There were insufficient data to pool results for atopy defined by the presence of specific IgE.
Intestinal parasite infection appears to protect against allergic sensitization. Work should continue to identify the mechanisms of this effect and means of harnessing these to reduce the global burden of allergic disease.
一些国家过敏性疾病患病率的增长速度表明，环境暴露可能是重要的病因因素。我们的目的是进行系统评价和荟萃分析，以量化当前肠道寄生虫感染与特应性之间的关联，并确定这种关系是否具有物种特异性。
我们检索了 MEDLINE、EMBASE、LILIACS 和 CAB Abstracts（截至 2009 年 3 月）；综述；以及出版物的参考文献列表。未应用语言限制。我们纳入了使用直接粪便显微镜检查测量当前寄生虫感染，并将特应性定义为过敏原皮肤致敏或存在特异性 IgE 的研究。我们使用随机效应模型从已发表的论文中提取数据来估计汇总比值比（OR）和 95%置信区间（95%CI）。
21 项研究符合我们的纳入标准。当前寄生虫感染与过敏原皮肤致敏的风险降低相关，OR 为 0.69（95%CI 0.60-0.79；P < 0.01）。当我们将分析仅限于当前土源性寄生虫感染时，效应大小仍然相似，OR 为 0.68（95%CI 0.60-0.76；P < 0.01）。在物种特异性分析中，发现感染蛔虫、鞭虫、钩虫和血吸虫与保护作用一致。对于特应性定义为特异性 IgE 存在的数据不足，无法进行汇总分析。
肠道寄生虫感染似乎可以预防过敏致敏。应继续努力确定这种作用的机制，并利用这些机制来减轻全球过敏性疾病的负担。
