Shaheen S O, Aaby P, Hall A J, Barker D J, Heyes C B, Shiell A W, Goudiaby A
Medical Research Council Environmental Epidemiology Unit, University of Southampton, Southhampton General Hospital, UK.
Lancet. 1996 Jun 29;347(9018):1792-6. doi: 10.1016/s0140-6736(96)91617-7.
Epidemiological studies have led to speculation that infections in early childhood may prevent allergic sensitisation but evidence to support this hypothesis is lacking. We investigated whether measles infection protects against the development of atopy in children of Guinea-Bissau, West Africa.
We conducted a historical cohort study in Bandim, a semi-rural district of Bissau, the capital of Guinea-Bissau. 395 young adults, first surveyed in 1978-80 aged 0-6 years, were followed up in 1994. Our analyses were restricted to 262 individuals still living in Bandim for whom a measles history, documented in childhood, was judged to be reliable. We defined atopy as skin-prick test positivity (> or = 3 mm weal) to one or more of seven allergens.
17 (12.8 percent) of 133 participants who had had measles infection were atopic compared with 33 (25.6 percent) of 129 of those who had been vaccinated and not had measles (odds ratio, adjusted for potential confounding variables 0.36 [95 percent CI 0.17-0.78], p=O.O1). Participants who had been breastfed for more than a year were less likely to have a positive skin test to housedust mite. After adjustment for breastfeeding and other variables, measles infection was associated with a large reduction in the risk of skin-prick test positivity to housedust mite (odds ratio for Dermatophagoides pteronyssinus 0.20 [0.05-0.81], p=0.02; D farinae 0.20 [0.06-0.71], p=0.01).
Measles infection may prevent the development of atopy in African children.
流行病学研究引发了这样的推测，即儿童早期感染可能预防过敏致敏，但缺乏支持这一假说的证据。我们调查了麻疹感染是否能预防西非几内亚比绍儿童患特应性疾病。
我们在几内亚比绍首都比绍的一个半农村地区班迪姆进行了一项历史性队列研究。1978 - 1980年首次调查时年龄在0 - 6岁的395名年轻人于1994年接受了随访。我们的分析仅限于仍居住在班迪姆的262人，其儿童时期记录的麻疹病史被判定为可靠。我们将特应性定义为对七种变应原中的一种或多种进行皮肤点刺试验呈阳性（风团≥3毫米）。
133名患过麻疹感染的参与者中有17名（12.8%）患有特应性疾病，相比之下，129名接种过疫苗但未患麻疹的参与者中有33名（25.6%）患有特应性疾病（校正潜在混杂变量后的优势比为0.36 [95%可信区间0.17 - 0.78]，p = 0.01）。母乳喂养超过一年的参与者对屋尘螨皮肤试验呈阳性的可能性较小。在对母乳喂养和其他变量进行校正后，麻疹感染与皮肤点刺试验对屋尘螨呈阳性的风险大幅降低相关（对粉尘螨的优势比为0.20 [0.05 - 0.81]，p = 0.02；对粉螨的优势比为0.20 [0.06 - 0.71]，p = 0.01）。
麻疹感染可能预防非洲儿童患特应性疾病。
