Alvarez Christian S, Avilés-Santa M Larissa, Freedman Neal D, Perreira Krista M, Garcia-Bedoya Olga, Kaplan Robert C, Daviglus Martha L, Graubard Barry I, Talavera Gregory A, Thyagarajan Bharat, Camargo M Constanza
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities, Rockville, MD, USA.
Allergy Asthma Clin Immunol. 2021 Nov 24;17(1):120. doi: 10.1186/s13223-021-00625-3.
The hygiene hypothesis posits that microbial exposure reduces risk of asthma and other respiratory-related diseases. Helicobacter pylori and hepatitis A virus (HAV) are common fecal-oral infections. Our study aimed to examine associations of seropositivity to these agents with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
A total of 12,471 HCHS/SOL participants with baseline data on self-reported physician-diagnosed asthma, and antibodies anti-H. pylori and anti-HAV were included in this cross-sectional analysis. Multivariable logistic regression models were used to estimate the odds ratios and 95% confidence intervals for the overall associations of seropositivity to each agent with asthma. Analyses were also stratified by Hispanic/Latino background. Effect modification by smoking status and nativity were tested. An analysis restricted to individuals with spirometry-defined chronic obstructive pulmonary disease (COPD) was also considered.
The weighted overall prevalence of asthma was 16.6%. The weighted seroprevalence of H. pylori was 56.6% and of HAV was 76.6%, and they significantly differed by Hispanic/Latino background. After accounting for age, sex, education and other key confounders, we found no associations between H. pylori or HAV seropositivity with asthma (with and without COPD), either for all individuals combined or for any of the six specific backgrounds. There were no significant interactions by smoking and nativity.
Our findings did not provide support for the role of H. pylori or HAV, as evidence of the hygiene hypothesis in asthma among the large and diverse Hispanic/Latino populations of the HCHS/SOL. Trial registration NCT02060344.
卫生假说认为，接触微生物可降低患哮喘和其他呼吸道相关疾病的风险。幽门螺杆菌和甲型肝炎病毒（HAV）是常见的粪-口传播感染源。我们的研究旨在探讨西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）中这些病原体的血清阳性与哮喘之间的关联。
本横断面分析纳入了12471名HCHS/SOL参与者，他们有关于自我报告的医生诊断哮喘的基线数据，以及抗幽门螺杆菌和抗HAV抗体。多变量逻辑回归模型用于估计每种病原体血清阳性与哮喘总体关联的比值比和95%置信区间。分析也按西班牙裔/拉丁裔背景进行分层。检验了吸烟状况和出生地的效应修饰。还考虑了一项仅限于肺活量测定定义的慢性阻塞性肺疾病（COPD）患者的分析。
哮喘的加权总体患病率为16.6%。幽门螺杆菌的加权血清阳性率为56.6%，HAV的加权血清阳性率为76.6%，且它们在西班牙裔/拉丁裔背景之间存在显著差异。在考虑年龄、性别、教育程度和其他关键混杂因素后，我们发现幽门螺杆菌或HAV血清阳性与哮喘（有或无COPD）之间无关联，无论是所有个体合并分析还是六个特定背景中的任何一个背景。吸烟和出生地均无显著交互作用。
我们的研究结果不支持幽门螺杆菌或HAV在卫生假说中对HCHS/SOL中庞大且多样化的西班牙裔/拉丁裔人群哮喘的作用。试验注册号NCT02060344。
