School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Clin Exp Allergy. 2011 Oct;41(10):1422-30. doi: 10.1111/j.1365-2222.2011.03831.x. Epub 2011 Aug 10.
Epidemiological studies have suggested that gastro-intestinal infections including Helicobacter pylori, intestinal microflora (commensal bacteria) and geohelminths may influence the risk of asthma and allergy but data from early life are lacking.
We aimed to determine the independent effects of these infections on allergic disease symptoms and sensitization in an Ethiopian birth cohort.
In 2008/09, 878 children (87% of the 1006 original singletons in a population-based birth cohort) were followed up at age 3 and interview data obtained on allergic symptoms and potential confounders. Allergen skin tests to Dermatophagoides pteronyssinus and cockroach were performed, levels of Der p 1 and Bla g 1 in the child's bedding measured and stool samples analysed for geohelminths and, in a random subsample, enterococci, lactobacilli, bifidobacteria and H. pylori antigen. The independent effects of each exposure on wheeze, eczema, hayfever and sensitization were determined using multiple logistic regression.
Children were commonly infected with H. pylori (41%; 253/616), enterococci (38.1%; 207/544), lactobacilli (31.1%; 169/544) and bifidobacteria (18.9%; 103/544) whereas geohelminths were only found in 8.5% (75/866). H. pylori infection was associated with a borderline significant reduced risk of eczema (adjusted OR 0.49, 95% CI 0.24-1.01, P=0.05) and D. pteronyssinus sensitization (adjusted OR 0.42, 95% CI 0.17-1.08, P=0.07). Geohelminths and intestinal microflora were not significantly associated with any of the outcomes measured.
Among young children in a developing country, we found evidence to support the hypothesis of a protective effect of H. pylori infection on the risk of allergic disease. Further investigation of the mechanism of this effect is therefore of potential therapeutic and preventive value.
流行病学研究表明，胃肠道感染，包括幽门螺杆菌、肠道微生物群（共生细菌）和土源性寄生虫，可能会影响哮喘和过敏的风险，但早期生活的数据却很缺乏。
我们旨在确定这些感染对埃塞俄比亚出生队列中过敏性疾病症状和过敏致敏的独立影响。
2008/09 年，对 878 名儿童（在基于人群的出生队列中 1006 名单胎儿童的 87%）进行了随访，在 3 岁时获得了过敏症状和潜在混杂因素的访谈数据。对尘螨和蟑螂进行了过敏原皮肤试验，测量了儿童床上用品中 Der p 1 和 Bla g 1 的水平，并对粪便样本进行了土源性寄生虫分析，在随机亚样本中还进行了肠球菌、乳酸菌、双歧杆菌和幽门螺杆菌抗原分析。使用多变量逻辑回归确定每种暴露对喘息、湿疹、花粉热和致敏的独立影响。
儿童普遍感染幽门螺杆菌（41%，253/616）、肠球菌（38.1%，207/544）、乳酸菌（31.1%，169/544）和双歧杆菌（18.9%，103/544），而土源性寄生虫仅在 8.5%（75/866）中发现。幽门螺杆菌感染与湿疹（调整后的比值比 0.49，95%置信区间 0.24-1.01，P=0.05）和对尘螨过敏（调整后的比值比 0.42，95%置信区间 0.17-1.08，P=0.07）的风险呈边缘显著降低相关。土源性寄生虫和肠道微生物群与所测量的任何结果均无显著相关性。
在发展中国家的幼儿中，我们有证据支持幽门螺杆菌感染对过敏性疾病风险具有保护作用的假设。因此，进一步研究这种作用的机制具有潜在的治疗和预防价值。
