Department of Pediatrics, Division of Pneumology, Immunology Charité, Universitätsmedizin Berlin, Berlin, Germany.
Department of Pediatrics, Division of Pneumology, Immunology Charité, Universitätsmedizin Berlin, Berlin, Germany.
Ann Allergy Asthma Immunol. 2019 Jan;122(1):25-32. doi: 10.1016/j.anai.2018.05.012. Epub 2018 May 25.
We present an overview of important results obtained during the first 20 years of the Multicenter Allergy Study (MAS), one of the first and longest-running population-based birth cohorts focusing on asthma and allergy.
DATA SOURCE/STUDY SELECTIONS: The MAS is an observational population-based allergy-risk enriched cohort of 1,314 newborns enrolled in Germany in 1990. Assessments of various lifestyle and environmental exposures took place at 19 points, including 9 clinical visits for physical examinations and biosampling up to age 20 years.
A positive allergic family history was a strong predictor of asthma from childhood up to adulthood, more so for allergic multimorbidity than single allergic entities. For asthma prevalence, the early male preponderance shifted toward females during adolescence, leading to a sex-balanced distribution by age 20 years. Eczema prevalence switched toward a clear and persisting female predominance, whereas allergic rhinitis continued to affect more males up to age 20 years. The immunoglobulin (Ig) E antibody response to grass evolved in many allergic children from a simple, often mono- and oligomolecular to a polymolecular sensitization stage ("molecular spreading"). Indoor allergen exposure increased the risk for specific sensitization, which was linked to asthma and impaired lung function at early school-age. Moreover, the MAS birth cohort has made important contributions to the investigation of genetic factors in the manifestation of clinical subphenotypes and in the long-term temporal trajectory of allergic diseases.
Follow-up assessments over 2 decades provided new insights into risk factors and predictors for eczema, rhinitis, and asthma up to adulthood to develop better prevention strategies.
我们总结了多中心过敏研究（MAS）最初 20 年的重要研究结果，该研究是首批也是持续时间最长的以哮喘和过敏为重点的基于人群的出生队列研究之一。
资料来源/研究选择：MAS 是一项观察性基于人群的过敏风险增强队列研究，纳入了 1990 年在德国出生的 1314 名新生儿。共进行了 19 次各种生活方式和环境暴露评估，包括 9 次临床就诊进行体格检查和生物样本采集，直至 20 岁。
阳性过敏家族史是儿童期至成年期哮喘的强烈预测因素，对多种过敏合并症的预测作用强于单一过敏实体。就哮喘患病率而言，早期男性优势在青春期后转向女性，到 20 岁时性别平衡。湿疹患病率转向明确且持续的女性优势，而过敏性鼻炎在 20 岁之前仍更多影响男性。许多过敏儿童的免疫球蛋白（Ig）E 抗体对草的反应从简单的、通常是单分子和寡分子发展到多分子致敏阶段（“分子扩散”）。室内过敏原暴露增加了特定致敏的风险，这与儿童早期的哮喘和肺功能受损有关。此外，MAS 出生队列还为研究遗传因素在临床亚表型表现和过敏疾病的长期时间轨迹中的作用做出了重要贡献。
20 多年的随访评估为湿疹、鼻炎和哮喘直至成年的危险因素和预测因素提供了新的见解，以制定更好的预防策略。
