Amarasekera Manori, Gunawardena Nipul Kithsiri, de Silva Nilanthi Renuka, Douglass Jo Anne, O'Hehir Robyn Elizabeth, Weerasinghe Anura
Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama 11010, Sri Lanka.
Asia Pac Allergy. 2012 Apr;2(2):122-8. doi: 10.5415/apallergy.2012.2.2.122. Epub 2012 Apr 30.
The effect of helminth infections on allergic diseases is still inconclusive. Furthermore, the effect of helminth infections on childhood allergic diseases in a tropical area where prevalence of helminth infections has undergone dramatic changes is not well documented.
To investigate the relationship between allergic diseases and helminth infection in a cohort of schoolchildren in an area that has undergone dramatic changes in intensity of helminth infections.
Children attending grade 5 were recruited from 17 schools in Western Province of Sri Lanka. They were assessed for allergic diseases using the International Study of Asthma and Allergies in Childhood questionnaire. Their serum total IgE (tIgE) and allergen-specific IgE (sIgE) for five common aeroallergens were measured by ImmunoCAP® method and stools were examined for the presence of helminth infections.
A total of 640 children (mean age 10 years) were recruited to the study. Of them, 33.7% had evidence of allergic disease and 15.5% had helminth infections. Majority of infections (68.9%) were of low intensity. A significant relationship between allergic disease and helminth infections was not observed, however, a trend toward protective role of helminth infections against allergic diseases was noted. Multivariate analysis showed helminth infections to be an independent predictor of high tIgE levels whereas allergic disease was not. Allergic sensitization (atopy) was a significant risk factor for allergic disease only among non-infected children (odds ratio 3.025, p = 0.022) but not in infected children. The ratio of sIgE to tIgE was higher in non-infected children.
Though not significant, a reduced risk of allergy in helminth-infected children was observed in this population. A Decrease in intensity of helminth infections may have contributed to the reduced capacity of immune-modulation by helminths in this paediatric population.
蠕虫感染对过敏性疾病的影响尚无定论。此外，在蠕虫感染率发生显著变化的热带地区，蠕虫感染对儿童过敏性疾病的影响尚无充分记录。
在一个蠕虫感染强度发生显著变化的地区，调查一组学童中过敏性疾病与蠕虫感染之间的关系。
从斯里兰卡西部省份的17所学校招募五年级学生。使用儿童哮喘和过敏国际研究问卷对他们进行过敏性疾病评估。采用免疫化学发光法测定他们血清中五种常见气传变应原的总IgE（tIgE）和变应原特异性IgE（sIgE），并检查粪便中是否存在蠕虫感染。
共招募了640名儿童（平均年龄10岁）参与研究。其中，33.7%有过敏性疾病证据，15.5%有蠕虫感染。大多数感染（68.9%）强度较低。未观察到过敏性疾病与蠕虫感染之间存在显著关系，然而，注意到蠕虫感染对过敏性疾病有保护作用的趋势。多变量分析显示，蠕虫感染是高tIgE水平的独立预测因素，而过敏性疾病不是。变应性致敏（特应性）仅在未感染儿童中是过敏性疾病的显著危险因素（优势比3.025，p = 0.022），而在感染儿童中不是。未感染儿童的sIgE与tIgE之比更高。
在该人群中，虽然不显著，但观察到蠕虫感染儿童的过敏风险降低。蠕虫感染强度的降低可能导致该儿科人群中蠕虫免疫调节能力下降。
