Exposure to endotoxin decreases the risk of atopic eczema in infancy: A cohort study
Exposure to endotoxin decreases the risk of atopic eczema in infancy: A cohort study
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DOI：
10.1067/mai.2001.119026
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发表时间：
2001-11-01
影响因子：
14.2
通讯作者：
Heinrich, J
中科院分区：
文献类型：
--
作者：
Gehring, U;Bolte, G;Heinrich, J
背景资料：先前的研究表明，早期接触猫和狗对特应性湿疹，哮喘，过敏性鼻炎和特应性致敏在以后的生活中的发展具有保护作用。特别是，在儿童早期较高的微生物暴露于内毒素可能有助于这种effect.Objective：我们在一项正在进行的出生队列研究（丽莎）中检查了室内灰尘中的细菌内毒素与特应性湿疹、感染和生命第一年期间的喘息之间的关系。对1884例足月和正常体重新生儿的数据进行了分析，这些新生儿具有关于暴露于生物污染物和混杂变量的完整信息。出生3个月后，从母亲和孩子的床垫上取样。结果：在出生后的前6个月，在第五个五分位数的婴儿中，母亲床垫灰尘中的内毒素暴露显著降低了特应性湿疹的风险。（比值比[OR]，0.50; 95%CI，0.28-0.88），而呼吸道感染的风险增加咳嗽伴呼吸道感染、支气管炎或两者兼有（OR，1.73; 95%CI，1.28-2.33）。在出生后的前6个月内，喘息的风险也显著增加（OR，2.37; 95% CI，1.40-4.03）。在整个生命的第一年，这些关联减弱，除了喘息的风险，这仍然是显着的（OR，1.60; 95%CI，1.10-2.30）。我们的研究结果支持卫生学假设，即在生命早期暴露于高浓度的内毒素可能会在生命的前6个月内防止特应性湿疹的发展，沿着非特异性呼吸道疾病的流行。
Background: Previous studies have shown a protective effect of early exposure to cats and dogs on the development of atopic eczema, asthma, allergic rhinitis, and atopic sensitization in later life. In particular, a higher microbial exposure to endotoxin in early childhood might contribute to this effect.Objective: We examined the associations between bacterial endotoxin in house dust and atopic eczema, infections, and wheezing during the first year of life in an ongoing birth cohort study (LISA).Methods: Data of 1884 term and normal-weight neonates with complete information on exposure to biocontaminants and confounding variables were analyzed. House dust from the mothers' and the children's mattresses was sampled 3 months after birth. Endotoxin content was quantified by using a chromogenic kinetic limulus amoebocyte lysate test.Results: During the first 6 months of life, the risk of atopic eczema was significantly decreased by endotoxin exposure in dust from mothers' mattresses in the fifth quintile (odds ratio [OR], 0.50; 95% CI, 0.28-0.88), whereas the risk was increased for respiratory infections (OR, 1.69; 95% CI, 1.25-2.28) and cough with respiratory infection, bronchitis, or both (OR, 1.73; 95% CI, 1.28-2.33). The risk of wheezing was also significantly increased during the first 6 months of life (OR, 2.37; 95% CI, 1.40-4.03). For the entire first year of life, these associations attenuated, except for the risk of wheezing, which remained significant (OR, 1.60; 95% CI, 1.10-2.30).Conclusion: Our findings support the hygiene hypothesis that exposure to high concentrations of endotoxin very early in life might protect against the development of atopic eczema within the first 6 months of life, along with an increased prevalence of nonspecific respiratory diseases.