Fundación Ecuatoriana Para Investigación en Salud, Quito, Ecuador.
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Parasite Immunol. 2019 Jun;41(6):e12590. doi: 10.1111/pim.12590. Epub 2018 Oct 17.
There is considerable interest as to potential protective effects of soil-transmitted helminths (STH) against allergy and allergic diseases. Here, we discuss findings of studies done of the effects of STH parasites on atopy and allergic diseases in Ecuador. While cross-sectional studies have consistently shown a reduced prevalence of allergen skin prick test (SPT) reactivity among infected schoolchildren, the removal of these infections by repeated deworming did not affect SPT prevalence over the short-term (ie, 12 months) but may have increased SPT prevalence over the long-term (ie, 15-17 years). In the case of allergic symptoms, cross-sectional studies have generally not shown associations with STH and intervention studies showed no impact on prevalence. However, a birth cohort suggested that early STH infections might reduce wheeze by 5 years. Allergic sensitization to Ascaris, however, explained a significant proportion of wheezing among rural schoolchildren. Studies of the effects of STH on immune and inflammatory responses indicated a potential role of STH in contributing to more robust regulation. The effects of STH on allergy are likely to be determined by history of exposure over the life-course and by interactions with a wide variety of other infectious and non-infectious factors.
人们对土壤传播性蠕虫（STH）对过敏和过敏性疾病的潜在保护作用非常感兴趣。在这里，我们讨论了在厄瓜多尔进行的关于 STH 寄生虫对特应性和过敏性疾病影响的研究结果。虽然横断面研究一致表明，受感染的学龄儿童过敏原皮肤点刺试验（SPT）反应的患病率降低，但通过反复驱虫消除这些感染在短期内（即 12 个月）并不会影响 SPT 的患病率，但可能会在长期（即 15-17 年）内增加 SPT 的患病率。就过敏症状而言，横断面研究通常没有显示与 STH 的关联，干预研究也没有显示对患病率有影响。然而，一项出生队列研究表明，早期 STH 感染可能使喘息减少 5 年。然而，对蛔虫过敏的致敏解释了农村学龄儿童喘息的很大一部分原因。关于 STH 对免疫和炎症反应影响的研究表明，STH 在促进更强大的调节方面可能具有潜在作用。STH 对过敏的影响可能取决于一生中的暴露史，并与各种其他传染性和非传染性因素相互作用。
