Annesi I, Oryszczyn M P
INSERM U169, Recherches en Epidémiologie, Villejuif. Etudies epidémiologiques de l'allergie infantile.
Rev Mal Respir. 1994;11(4):325-44.
Allergy is the conjunction of hereditary predisposition and risk factors encountered in the environment, phenomenon which can be observed very early in individual life. The aim of this review is to present the contribution of epidemiology in the study of allergic response in childhood, from sensitization to clinical manifestations as eczema, asthma and rhinitis. The first contribution of epidemiology has consisted in estimating the scatter of the allergic response, the presence of circulating antibodies against allergens (IgE and IgG), the evaluation of immediate hypersensitivity (such as the response to skin prick tests) and the prevalence of clinical manifestations. Then, knowledge of allergic response has been improved by the contribution of aetiological epidemiology. Various risk factors have been described according to the different stages during life in which their effects are observable. In prenatal life, potential risk factors are maternal immunity and smoking during pregnancy. Later in perinatal or neonatal life they are perinatal complications, month of birth and maternal smoking. Lastly, in infancy a role can be played by feeding, immunological deficiencies, infections, parental smoking and early exposure to allergens or pollution. Perceiving these risk factors helps to determine strategies to prevent allergy occurrence.
过敏是遗传易感性与环境中遇到的风险因素共同作用的结果，这种现象在个体生命早期即可观察到。本综述的目的是阐述流行病学在儿童过敏反应研究中的作用，涵盖从致敏到湿疹、哮喘和鼻炎等临床表现的过程。流行病学的首要贡献在于估计过敏反应的分布情况、针对过敏原的循环抗体（IgE和IgG）的存在情况、即时超敏反应的评估（如对皮肤点刺试验的反应）以及临床表现的患病率。随后，病因流行病学的贡献进一步增进了对过敏反应的认识。根据在生命不同阶段可观察到其影响的各种风险因素已被描述。在产前阶段，潜在风险因素有母体免疫和孕期吸烟。在围产期或新生儿期后期，风险因素包括围产期并发症、出生月份和母体吸烟。最后，在婴儿期，喂养、免疫缺陷、感染、父母吸烟以及早期接触过敏原或污染都可能起作用。认识这些风险因素有助于确定预防过敏发生的策略。
