Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
J Korean Med Sci. 2012 Nov;27(11):1320-6. doi: 10.3346/jkms.2012.27.11.1320. Epub 2012 Oct 30.
Since the risk of developing allergic disease increases in individuals exposed to allergens previously, even during the neonatal period, the immunologic status of a fetus may be important in the subsequent development of allergy. We evaluated the fetal factors to predict atopic dermatitis (AD) at 12 months in 412 infants of a COhort for Childhood Origin of Asthma and Allergic Diseases (COCOA) in the general Korean population. Cord blood mononuclear cells (CBMCs) were stimulated with ovalbumin and phytohemagglutinin and cellular proliferative response and concentrations of interleukin-13 and interferon-γ, were measured. The risk of developing AD was greater in boys than girls (OR 1.97, 95% CI 1.26-3.09), infants delivered by cesarean section than vaginally (OR 1.93, 95% CI 1.14-3.26) and infants with than without parental history of AD (OR 2.34, 95% CI 1.29-4.24). The CBMC proliferative response to phytohemagglutinin stimulation was higher in infants with than without AD (P = 0.048), but no difference was observed in ovalbumin-stimulated cells (P = 0.771). Risk factors for the development of AD at 12 months include male gender, delivery by cesarean section and parental history of AD. Increased CBMC proliferative response to phytohemagglutinin stimulation may predict the development of AD at 12 months.
由于先前接触过敏原的个体患过敏性疾病的风险增加,甚至在新生儿期也是如此,因此胎儿的免疫状态可能对随后发生的过敏具有重要意义。我们评估了胎儿因素,以预测在韩国普通人群的儿童哮喘和过敏疾病起源队列(COCOA)中的 412 名婴儿中,12 个月时是否患有特应性皮炎(AD)。用卵清蛋白和植物血凝素刺激脐带血单个核细胞(CBMC),并测量细胞增殖反应以及白细胞介素-13 和干扰素-γ的浓度。与女孩相比,男孩发生 AD 的风险更高(OR 1.97,95%CI 1.26-3.09),剖宫产儿比阴道分娩儿的风险更高(OR 1.93,95%CI 1.14-3.26),且有父母 AD 病史的婴儿比无父母 AD 病史的婴儿的风险更高(OR 2.34,95%CI 1.29-4.24)。与无 AD 的婴儿相比,AD 婴儿的 CBMC 对植物血凝素刺激的增殖反应更高(P = 0.048),但卵清蛋白刺激的细胞无差异(P = 0.771)。12 个月时发生 AD 的危险因素包括男性,剖宫产分娩和父母的 AD 病史。CBMC 对植物血凝素刺激的增殖反应增加可能预示着 12 个月时 AD 的发生。