Department of Pulmonology, Military Hospital, Luanda, Angola; CISA-Centro de Investigação em Saúde de Angola, Caxito, Bengo, Angola; GRUBI-Systematic Reviews Group, University of Beira Interior, Covilhã, Portugal.
GRUBI-Systematic Reviews Group, University of Beira Interior, Covilhã, Portugal; Aveiro Healthcare Centre, Aradas Family Health Unit, Aveiro, Portugal; Faculty of Health Sciences, University of Beira Interior, CACB-Clinical Academic Centre of Beiras, Covilhã, Aveiro, Portugal.
J Allergy Clin Immunol. 2022 Jun;149(6):2139-2152. doi: 10.1016/j.jaci.2021.12.777. Epub 2021 Dec 28.
There is considerable research interest in the role of helminth infections in the development of allergic diseases. However, findings from previous studies are mixed. Existing systematic reviews of these studies are outdated. We performed a systematic review of the global literature on the association between helminth infections and development and clinical outcomes of allergic diseases.
We searched Cochrane Library, MEDLINE, EMBASE, ISI Web of Science, PubMed, Global Index Medicus, Scielo, KoreaMed, Google Scholar, and Lilacs for studies published up to January 2020. We included observational epidemiological studies (cohort, case-control, and cross-sectional studies) of children and adults reporting associations between helminth infections and asthma, allergic rhinitis, eczema, and atopy. We performed random-effects meta-analysis to summarize the effect estimates.
We included 80 studies with 99,967 participants. In the meta-analyses, we did not observe an overall association between helminth infections and allergic diseases. There was, however, evidence that Ascaris lumbricoides infections were associated with an increased risk of bronchial hyperreactivity in children (risk ratio, 1.41; 95% CI, 1.17-1.70; I = 50; P for I = .09), and were associated with an increased risk of atopy among helminth-infected adults (risk ratio, 1.37; 95% CI, 1.18-1.61; I = 52; P for I = .02). We found no study that addressed the association between helminth infection and clinical outcomes of allergic diseases. The overall strength of the underlying evidence was low to moderate.
Helminth infections may increase the risk of bronchial hyperreactivity in children and atopy in adults. Well-designed longitudinal cohorts may help clarify potential causal associations between chronic helminth infections and allergic diseases.
寄生虫感染在过敏性疾病的发展中的作用引起了相当大的研究兴趣。然而，先前研究的结果存在差异。这些研究的现有系统评价已经过时。我们对寄生虫感染与过敏性疾病的发展和临床结局之间的关系进行了全球文献的系统评价。
我们在 Cochrane Library、MEDLINE、EMBASE、ISI Web of Science、PubMed、全球医学索引、Scielo、韩国医学数据库、Google Scholar 和 Lilacs 中检索了截至 2020 年 1 月发表的研究。我们纳入了关于儿童和成人中寄生虫感染与哮喘、过敏性鼻炎、特应性皮炎和特应性之间关联的观察性流行病学研究（队列研究、病例对照研究和横断面研究）。我们进行了随机效应荟萃分析来总结效应估计值。
我们纳入了 80 项研究，共有 99967 名参与者。在荟萃分析中，我们没有观察到寄生虫感染与过敏性疾病之间存在总体关联。然而，有证据表明，蛔虫感染与儿童的支气管高反应性风险增加有关（风险比，1.41；95%置信区间，1.17-1.70；I ² = 50；P 对于 I ² =.09），并且与感染寄生虫的成年人中的特应性风险增加有关（风险比，1.37；95%置信区间，1.18-1.61；I ² = 52；P 对于 I ² =.02）。我们没有发现研究解决寄生虫感染与过敏性疾病的临床结局之间的关系。潜在证据的总体强度为低到中度。
寄生虫感染可能会增加儿童支气管高反应性和成年人特应性的风险。精心设计的纵向队列研究可能有助于阐明慢性寄生虫感染与过敏性疾病之间的潜在因果关系。
