Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
Sci Rep. 2017 Aug 22;7(1):9053. doi: 10.1038/s41598-017-07894-2.
The relationship between cesarean section (CS) and allergic disorders such as asthma and wheezing has been inconsistent, and the mechanisms for their connection remained largely unknown. We aimed to investigate whether CS is associated with infantile wheeze and to explore the connection between CS and several risk factors known to correlate with allergy development. Mononuclear cells were isolated from cord blood and assessed for cytokine responses by ELISA. Bacteria from nasopharyngeal specimens were identified with traditional culture methods. Infant lung function tests were performed at 6 and 12 months of age. IgE levels and clinical outcomes were assessed at 12 months. The result showed that children delivered by CS were associated with increased risk of wheezing (aHR 1.63; 95% CI: 1.01-2.62) and decreased compliance of the respiratory system at 12 months (p = 0.045). In addition, CS was associated with reduced TLR1-2- triggered TNF-α and IL-6 responses at birth. By12 months of age, children delivered by CS had significantly less airway bacterial clearance. Our findings suggested that CS was associated with decreased pro-inflammatory cytokine response to TLR1-2 stimulation, followed by higher abundance of bacterial colonization in the airway during late infancy, thus increasing the risk of infantile wheezing.
剖宫产（CS）与哮喘和喘息等过敏疾病之间的关系一直不一致，其联系的机制在很大程度上仍不清楚。我们旨在研究 CS 是否与婴儿喘息有关，并探讨 CS 与几种已知与过敏发展相关的风险因素之间的联系。从脐血中分离出单核细胞，并通过 ELISA 评估细胞因子反应。用传统培养方法鉴定鼻咽标本中的细菌。在 6 个月和 12 个月时进行婴儿肺功能测试。在 12 个月时评估 IgE 水平和临床结果。结果表明，CS 分娩的儿童喘息风险增加（aHR 1.63；95%CI：1.01-2.62），12 个月时呼吸系统顺应性降低（p=0.045）。此外，CS 与出生时 TLR1-2 触发的 TNF-α和 IL-6 反应减少有关。到 12 个月时，CS 分娩的儿童气道细菌清除能力明显降低。我们的研究结果表明，CS 与 TLR1-2 刺激的促炎细胞因子反应降低有关，随后在婴儿后期气道中细菌定植增加，从而增加了婴儿喘息的风险。
