Department of Faculty Pediatrics, Siberian State Medical University, Tomsk, Russian Federation.
Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
Allergy. 2017 Jul;72(7):1096-1104. doi: 10.1111/all.13120. Epub 2017 Jan 25.
Most studies on the relationship between helminth infections and atopic disorders have been conducted in (sub)tropical developing countries where exposure to multiple parasites and lifestyle can confound the relationship. We aimed to study the relationship between infection with the fish-borne helminth Opishorchis felineus and specific IgE, skin prick testing, and atopic symptoms in Western Siberia, with lifestyle and hygiene standards of a developed country.
Schoolchildren aged 7-11 years were sampled from one urban and two rural regions. Skin prick tests (SPT) and specific IgE (sIgE) against food and aeroallergens were measured, and data on allergic symptoms and on demographic and socioeconomic factors were collected by questionnaire. Diagnosis of opisthorchiasis was based on PCR performed on stool samples.
Of the 732 children included, 34.9% had opisthorchiasis. The sensitization to any allergen when estimated by positive SPT was 12.8%, while much higher, 24.0%, when measured by sIgE. Atopic symptoms in the past year (flexural eczema and/or rhinoconjunctivitis) were reported in 12.4% of the children. SPT was positively related to flexural eczema and rhinoconjunctivitis, but not to wheezing. Opisthorchiasis showed association with lower SPT response, as well as borderline association with low IgE reactivity to any allergen. However, the effect of opisthorchiasis on SPT response was not mediated by IgE, suggesting that opisthorchiasis influences SPT response through another mechanism. Opisthorchiasis also showed borderline association with lower atopic symptoms.
There is a negative association between a chronic helminth infection and skin prick test reactivity even in a developed country.
大多数关于寄生虫感染与特应性疾病之间关系的研究都是在（亚热带）发展中国家进行的，这些国家中寄生虫暴露和生活方式会使这种关系复杂化。我们的目的是研究在西伯利亚西部，在寄生虫感染与鱼源性蠕虫华支睾吸虫（Opishorchis felineus）和特定 IgE、皮肤点刺试验以及特应性症状之间的关系，这里的生活方式和卫生标准与发达国家相似。
从一个城市和两个农村地区抽取了 7-11 岁的学童。测量了皮肤点刺试验（SPT）和针对食物和空气过敏原的特异性 IgE（sIgE），并通过问卷收集了过敏症状以及人口统计学和社会经济学因素的数据。粪便样本的 PCR 检测用于诊断华支睾吸虫病。
在 732 名儿童中，34.9%患有华支睾吸虫病。当通过阳性 SPT 估计时，对任何过敏原的致敏率为 12.8%，而当通过 sIgE 测量时，致敏率则高达 24.0%。过去一年中有 12.4%的儿童报告出现特应性症状（屈侧湿疹和/或鼻结膜炎）。SPT 与屈侧湿疹和鼻结膜炎呈正相关，但与喘息无关。华支睾吸虫病与较低的 SPT 反应有关，与任何过敏原的低 IgE 反应呈边缘关联。然而，华支睾吸虫病对 SPT 反应的影响不是通过 IgE 介导的，这表明华支睾吸虫病通过另一种机制影响 SPT 反应。华支睾吸虫病也与较低的特应性症状呈边缘关联。
即使在发达国家，慢性寄生虫感染与皮肤点刺试验反应之间也存在负相关。
