Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan.
Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 40201, Taiwan.
Postgrad Med J. 2024 Aug 16;100(1187):649-656. doi: 10.1093/postmj/qgae041.
The pathogenesis of atopic dermatitis (AD) remains unclear. Nontyphoidal Salmonella (NTS) infection might trigger immune-mediated reactions. We aimed to examine NTS and the risk of subsequent AD.
From 2002 to 2015, eligible patients (aged 0-100 years) with NTS were identified. NTS and non-NTS groups were matched at a 1:10 ratio on age and sex. We utilized conditional multivariable Cox proportional hazard models to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for AD development. Subgroup analyses were conducted based on age, sex, and severity of NTS infection. We utilized landmark analysis to explore the time-dependent hazard of AD following NTS.
In the NTS group (N = 6624), 403 developed AD. After full adjustment of demographics and comorbidities, the NTS group had a higher risk of AD than the reference group (aHR = 1.217, 95% CI = 1.096-1.352). Age-stratified analysis revealed that NTS group exhibited an elevated risk compared to the reference group, particularly among those aged 13-30 years (aHR = 1.25, 95% CI = 1.017-1.559), individuals aged 31-50 years (aHR = 1.388, 95% CI = 1.112-1.733), those aged 51-70 years (aHR = 1.301, 95% CI = 1.008-1.679), and individuals aged 71 years and over (aHR = 1.791, 95% CI = 1.260-2.545). Severe NTS was associated with a higher risk of AD than the reference group (aHR = 2.411, 95% CI = 1.577-3.685). Landmark analysis showed generally consistent findings.
Minimizing exposure to NTS infection may represent a prospective strategy for averting the onset and progression of atopic dermatitis.
特应性皮炎(AD)的发病机制尚不清楚。非伤寒沙门氏菌(NTS)感染可能引发免疫介导的反应。本研究旨在探讨 NTS 与随后发生 AD 的风险。
从 2002 年到 2015 年,确定了患有 NTS 的合格患者(年龄 0-100 岁)。NTS 和非 NTS 组按年龄和性别 1:10 比例匹配。我们利用条件多变量 Cox 比例风险模型来估计 AD 发展的调整后危险比(aHR)和 95%置信区间(CI)。根据年龄、性别和 NTS 感染严重程度进行亚组分析。我们利用 landmark 分析来探讨 NTS 后 AD 的时间依赖性危险。
在 NTS 组(N=6624)中,有 403 人发生 AD。在充分调整人口统计学和合并症后,NTS 组发生 AD 的风险高于对照组(aHR=1.217,95%CI=1.096-1.352)。年龄分层分析显示,与对照组相比,NTS 组发生 AD 的风险增加,尤其是在 13-30 岁(aHR=1.25,95%CI=1.017-1.559)、31-50 岁(aHR=1.388,95%CI=1.112-1.733)、51-70 岁(aHR=1.301,95%CI=1.008-1.679)和 71 岁及以上(aHR=1.791,95%CI=1.260-2.545)的人群中。严重的 NTS 与 AD 风险高于对照组相关(aHR=2.411,95%CI=1.577-3.685)。landmark 分析显示了大致一致的结果。
尽量减少 NTS 感染的暴露可能是预防特应性皮炎发病和进展的一种前瞻性策略。