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评估儿科人群中过敏与多发性硬化易感性风险及疾病活动的关联。

Evaluating the association of allergies with multiple sclerosis susceptibility risk and disease activity in a pediatric population.

作者信息

Bourne Theresa, Waltz Michael, Casper T C, Kavak K, Aaen G, Belman A, Benson L, Candee M, Chitnis T, Graves J, Greenberg B, Gorman M, Harris Y, Krupp L, Lotze T, Mar S, Ness J, Olsen C, Roalstad S, Rodriguez M, Rose J, Rubin J, Schreiner T, Tillema J M, Kahn I, Waldman A, Barcellos L, Waubant E, Weinstock-Guttman B

机构信息

State University of New York, Neurology, United States.

University of Utah, Pediatrics, United States.

出版信息

J Neurol Sci. 2017 Apr 15;375:371-375. doi: 10.1016/j.jns.2017.02.041. Epub 2017 Feb 20.

Abstract

BACKGROUND

Multiple sclerosis (MS) and allergies are both considered to be related to imbalanced Th1 and Th2 immune responses. Previous studies evaluating the relationship between MS and allergies provide conflicting results.

OBJECTIVE

To assess allergies and asthma as risk factors for MS and as predictors of MS relapses in a pediatric cohort.

METHODS

The environment and genetic risk factors for pediatric MS study is a national case-control project with 16 participating US sites. An environmental questionnaire is used that includes history of allergies in the first five years of life. Case-control data are entered in the pediatric MS Network database and cases at 12 of the 16 sites enter relapse data prospectively. Annualized relapse rate was calculated for patients with follow-up and adjusted for age at disease onset, gender, race, ethnicity, and use of disease-modifying therapy (DMT).

RESULTS

We included 271 cases (mean age at disease onset of 15.7years and 62% female) and 418 controls. Relapse data were available for 193 cases. There was no difference in prevalence of allergies or asthma between cases and controls. Patients with food allergies had fewer relapses compared to patients without food allergies (0.14 vs 0.48, p=0.01).

CONCLUSIONS

While allergies and asthma are not associated with pediatric MS, cases with food allergies have fewer relapses compared to those without food allergies.

摘要

背景

多发性硬化症(MS)和过敏均被认为与Th1和Th2免疫反应失衡有关。以往评估MS与过敏之间关系的研究结果相互矛盾。

目的

评估过敏和哮喘作为儿科队列中MS的危险因素以及MS复发的预测因素。

方法

儿科MS环境与遗传危险因素研究是一个由美国16个参与地点开展的全国性病例对照项目。使用一份环境调查问卷,其中包括生命最初五年的过敏史。病例对照数据录入儿科MS网络数据库,16个地点中有12个地点的病例前瞻性地录入复发数据。计算随访患者的年化复发率,并根据疾病发作时的年龄、性别、种族、民族以及疾病修饰治疗(DMT)的使用情况进行调整。

结果

我们纳入了271例病例(疾病发作时的平均年龄为15.7岁,62%为女性)和418例对照。193例病例有复发数据。病例组和对照组在过敏或哮喘患病率方面没有差异。与无食物过敏的患者相比,有食物过敏的患者复发次数较少(0.14对0.48,p = 0.01)。

结论

虽然过敏和哮喘与儿科MS无关,但与无食物过敏的患者相比,有食物过敏的病例复发次数较少。

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