Department of Parasitology, Faculty of Medicine, University of Indonesia, Salemba 6, Jakarta 10430, Indonesia ; Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Parasitology, Faculty of Medicine, University of Indonesia, Salemba 6, Jakarta 10430, Indonesia.
Allergy Asthma Clin Immunol. 2013 Apr 8;9(1):13. doi: 10.1186/1710-1492-9-13. eCollection 2013.
Helminth infections and allergies are associated with TH2 responses. Whereas the development of TH2 responses and allergic disorders in pediatric populations has been examined in affluent countries, no or little data exist from low income regions of the world. The aim of this study is to examine factors influencing the development of TH2 responses of children born in areas endemic for helminth infections and to relate these factors to atopic sensitization at 4 years of age.
Data were collected from pregnant mothers on helminth infections, education and socioeconomic status (SES). Total IgE, IL-5 in response to mitogen, and helminth antigens were measured in children at 2, 5, 12, 24 and 48 months of age. Skin prick testing (SPT) and allergen-specific IgE were determined at 4 years of age.
Strong TH2 responses were seen at 5 months of age and increased with time. Although maternal filarial infection was associated with helminth-antigen specific TH2 responses, it was low maternal education or SES but not helminth infection, which was associated with the development of high total IgE and PHA-induced IL-5. At 4 years of age when allergen reactivity was assessed by SPT, the high general TH2 responses did not translate into higher prevalence of SPT. The risk factor for SPT reactivity was low maternal education which decreased the risk of SPT positivity to allergens (adjusted OR, 0.32; 95% CI, 0.12 - 0.87) independently of maternal filarial infection which tended to reduce the child's risk for being SPT positive (adjusted OR, 0.35; 95% CI, 0.07 - 1.70).
In areas endemic for helminths, potent TH2 responses were seen early in life, but did not translate into a higher SPT reactivity to allergens. Therefore, in many parts of the world TH2 responses in general and IgE in particular cannot be used for diagnosis of allergic diseases.
蠕虫感染和过敏与 TH2 反应有关。尽管在富裕国家已经研究了儿科人群中 TH2 反应和过敏疾病的发展，但来自世界低收入地区的相关数据很少或几乎没有。本研究的目的是研究影响在蠕虫感染流行地区出生的儿童 TH2 反应发展的因素，并将这些因素与 4 岁时的特应性致敏相关联。
从孕妇那里收集有关蠕虫感染、教育和社会经济地位（SES）的数据。在儿童 2、5、12、24 和 48 个月时测量总 IgE、对有丝分裂原的 IL-5 以及蠕虫抗原的反应。在 4 岁时进行皮肤点刺试验（SPT）和过敏原特异性 IgE 测定。
在 5 个月时观察到强烈的 TH2 反应，并随时间增加而增加。尽管母体丝虫感染与蠕虫抗原特异性 TH2 反应相关，但与总 IgE 和 PHA 诱导的 IL-5 发展相关的是低母亲教育或 SES，而不是蠕虫感染。在 4 岁时通过 SPT 评估过敏原反应性时，高总 TH2 反应并未转化为更高的 SPT 阳性率。SPT 反应的危险因素是低母亲教育，这降低了对过敏原 SPT 阳性的风险（调整后的 OR，0.32；95%CI，0.12 - 0.87），而与母体丝虫感染无关，后者倾向于降低儿童 SPT 阳性的风险（调整后的 OR，0.35；95%CI，0.07 - 1.70）。
在蠕虫流行地区，生命早期就出现了强烈的 TH2 反应，但并未转化为对过敏原的更高 SPT 反应性。因此，在世界许多地区，TH2 反应特别是 IgE 不能用于诊断过敏疾病。
