儿童呼吸道合胞病毒特异性抗体与特应性疾病：一项10年随访研究
Respiratory Syncytial Virus-Specific Antibodies and Atopic Diseases in Children: A 10-Year Follow-Up.
作者信息
Tesari Crnković Helena, Bendelja Krešo, Drkulec Vlado, Gjergja Juraški Romana, Turkalj Mirjana
机构信息
Department of Paediatrics, General County Hospital Požega, Osječka 107, 34000 Požega, Croatia.
Faculty of Medicine, J. J. Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, Croatia.
出版信息
Pathogens. 2023 Apr 1;12(4):546. doi: 10.3390/pathogens12040546.
BACKGROUND
Respiratory syncytial virus (RSV) stimulates the production of specific immunoglobulin (Ig) E and IgG4 antibodies as a hallmark of the Th2 immune response. In this paper, we evaluated the occurrence of atopic diseases in 10-year-old children who were positive for RSV-specific IgG antibodies during infancy.
METHODS
The prospective follow-up of 72 children included a physical examination, an International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and the determination of RSV-specific antibodies and total and allergen-specific IgE.
RESULTS
Children with asthma had their first wheezing episode at a younger age (χ2 8.097, df = 1, = 0.004). RSV-specific IgG4 levels at year one were positively correlated with atopic dermatitis (AD) (tau_b = 0.211, = 0.049) and current AD (tau_b = 0.269, = 0.012); and RSV-specific IgE levels were positively correlated with allergic rhinitis (AR) (tau_b = 0.290, = 0.012) and current AR (tau_b = 0.260, = 0.025). Positive RSV-specific IgE at the age of one increased the chances of asthma occurrence by 5.94 (OR = 5.94, 95% CI = 1.05-33.64; = 0.044) and the chances of AR by more than 15 times (OR = 15.03, 95% CI = 2.08-108.72; = 0.007). A positive family history of atopy increased the chances of asthma occurrence by 5.49 times (OR = 5.49, 95% CI = 1.01-30.07; = 0.049), and a longer duration of exclusive breastfeeding lowered that chance (OR = 0.63, 95% CI = 0.45-0.89; = 0.008). Prenatal smoking increased the chances of AR occurrence by 7.63 times (OR = 7.63, 95% CI = 1.59-36.53; = 0.011).
CONCLUSION
RSV-specific IgE and RSV-specific IgG4 antibodies could be risk markers for the development of atopic diseases in children.
背景
呼吸道合胞病毒（RSV）刺激产生特异性免疫球蛋白（Ig）E和IgG4抗体，作为Th2免疫反应的标志。在本文中，我们评估了婴儿期RSV特异性IgG抗体呈阳性的10岁儿童中特应性疾病的发生情况。
方法
对72名儿童进行前瞻性随访，包括体格检查、儿童哮喘和过敏国际研究（ISAAC）问卷以及RSV特异性抗体、总IgE和过敏原特异性IgE的测定。
结果
哮喘患儿首次喘息发作的年龄较小（χ2 = 8.097，自由度 = 1，P = 0.004）。一岁时RSV特异性IgG4水平与特应性皮炎（AD）呈正相关（tau_b = 0.211，P = 0.049）以及与现患AD呈正相关（tau_b = 0.269，P = 0.012）；RSV特异性IgE水平与过敏性鼻炎（AR）呈正相关（tau_b = 0.290，P = 0.012）以及与现患AR呈正相关（tau_b = 0.260，P = 0.025）。一岁时RSV特异性IgE呈阳性使哮喘发生几率增加5.94倍（比值比[OR] = 5.94，95%可信区间[CI] = 1.05 - 33.64；P = 0.044），使AR发生几率增加超过15倍（OR = 15.03，95% CI = 2.08 - 108.72；P = 0.007）。特应性疾病家族史阳性使哮喘发生几率增加5.49倍（OR = 5.49，95% CI = 1.01 - 30.07；P = 0.049），而纯母乳喂养时间延长则降低了该几率（OR = 0.63，95% CI = 0.45 - 0.89；P = 0.008）。产前吸烟使AR发生几率增加7.63倍（OR = 7.63，95% CI = 1.59 - 36.53；P = 0.011）。
结论
RSV特异性IgE和RSV特异性IgG4抗体可能是儿童特应性疾病发生的风险标志物。
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