固有免疫基因与变应性鼻炎的早期生活风险因素之间的相互作用。
Interactions between innate immunity genes and early-life risk factors in allergic rhinitis.
机构信息
Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea.
Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea.
出版信息
Allergy Asthma Immunol Res. 2015 May;7(3):241-8. doi: 10.4168/aair.2015.7.3.241. Epub 2015 Mar 18.
PURPOSE
Allergic rhinitis (AR) is a common chronic disease. Many factors could affect the development of AR. We investigated early-life factors, such as delivery mode, feeding method, and use of antibiotics during infancy, which could affect the development of AR. In addition, how interactions between these factors and innate gene polymorphisms influence the development of AR was investigated.
METHODS
A cross-sectional study of 1,828 children aged 9-12 years was conducted. Three early-life factors and AR were assessed by a questionnaire. Skin prick tests were done. Polymorphisms of TLR4 (rs1927911) and CD14 (rs2569190) were genotyped.
RESULTS
Use of antibiotics during infancy increased the risk of AR (aOR [95% CI] 1.511 [1.222-2.037]) and atopic AR (aOR [95% CI], 1.565 [1.078-2.272]). There were synergistic interactions between caesarean delivery, formula feeding, and use of antibiotics in the rate of atopic AR (aOR [95% CI], 3.038 [1.256-7.347]). Additional analyses revealed that the risk for the development of AR or atopic AR subjects with the TLR4 CC genotype were highest when all the 3 early-life factors were present (aOR [95% CI], 5.127 [1.265-20.780] for AR; 6.078 [1.499-24.649] for atopic AR). In addition, the risk for the development of AR or atopic AR in subjects with the CD14 TT genotype were highest when all the 3 early-life factors were present (aOR [95% CI], 5.960 [1.421-15.002] for AR; 6.714 [1.440-31.312] for atopic AR).
CONCLUSIONS
Delivery mode, feeding method, and use of antibiotics during infancy appeared to have synergistic interactions in the development of AR. Gene-environment interactions between polymorphism of innate genes and early- life risk factors might affect the development of AR.
目的
过敏性鼻炎（AR）是一种常见的慢性疾病。许多因素可能会影响 AR 的发展。我们研究了生命早期的因素，如分娩方式、喂养方式和婴儿期使用抗生素，这些因素可能会影响 AR 的发展。此外，还研究了这些因素与先天基因多态性之间的相互作用如何影响 AR 的发展。
方法
对 1828 名 9-12 岁的儿童进行了横断面研究。通过问卷调查评估三种生命早期因素与 AR。进行皮肤点刺试验。对 TLR4（rs1927911）和 CD14（rs2569190）的多态性进行基因分型。
结果
婴儿期使用抗生素会增加 AR（优势比[95%可信区间]1.511[1.222-2.037]）和特应性 AR（优势比[95%可信区间]1.565[1.078-2.272]）的风险。剖腹产、配方奶喂养和使用抗生素在特应性 AR 的发生率方面存在协同作用（优势比[95%可信区间]3.038[1.256-7.347]）。进一步分析表明，当所有三种生命早期因素都存在时，TLR4 CC 基因型的 AR 或特应性 AR 患者的发病风险最高（AR 的优势比[95%可信区间]5.127[1.265-20.780]；特应性 AR 的优势比[95%可信区间]6.078[1.499-24.649]）。此外，当所有三种生命早期因素都存在时，CD14 TT 基因型的 AR 或特应性 AR 患者的发病风险最高（AR 的优势比[95%可信区间]5.960[1.421-15.002]；特应性 AR 的优势比[95%可信区间]6.714[1.440-31.312]）。
结论
分娩方式、喂养方式和婴儿期使用抗生素似乎在 AR 的发展中具有协同作用。先天基因多态性与生命早期危险因素之间的基因-环境相互作用可能会影响 AR 的发展。
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