Exposure to dogs and cats in the first year of life and risk of allergic sensitization at 6 to 7 years of age
Exposure to dogs and cats in the first year of life and risk of allergic sensitization at 6 to 7 years of age
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DOI：
10.1001/jama.288.8.963
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发表时间：
2002-08-28
影响因子：
120.7
通讯作者：
Peterson, EL
中科院分区：
文献类型：
--
作者：
Ownby, DR;Johnson, CC;Peterson, EL
儿童哮喘与过敏性致敏密切相关。研究表明，动物在婴儿期接触会减少随后的过敏反应。目的探讨幼儿1岁接触猫狗与6 ~ 7岁过敏致敏的关系。设计、环境和研究对象：对1987年4月15日至1989年8月31日出生于密歇根州底特律郊区一家健康维护组织的健康足月婴儿进行前瞻性出生队列研究，每年随访至平均年龄6.7岁。在835名出生时参与研究的儿童中，474名（57%）在6至7岁时完成了随访评估。特应性，定义为对6种常见空气过敏原（尘螨[Dermatophagoides farinae， D pteronyssinus]，狗，猫，短豚草[Ambrosia artemisiifolia]和蓝草[Poa pratensis]）的任何皮肤点刺试验阳性；血清学，定义为相同的6种过敏原或交替菌的任何阳性的过敏原特异性IgE测试结果。结果6 ~ 7岁儿童皮肤点刺试验阳性（特应性）发生率为33.6%，一岁未接触狗或猫者为33.3%，接触1只狗或猫者为34.3%，接触2只及以上狗或猫者为15.4% （P = 0.005）。过敏原特异性IgE测试阳性（血清学）在未接触狗或猫的人群中占38.5%，接触过1只狗或猫的人群中占41.2%，接触过2只或2只以上狗或猫的人群中占17.9% （P = 0.003）。在调整了脐带血清IgE浓度、性别、哥哥姐姐、父母吸烟、父母哮喘、2岁时卧室尘螨过敏原水平以及目前养狗养猫等因素后，一岁时接触2只或更多狗或猫与特应性（调整优势比0.23；95%可信区间0.09-0.60）和血清特应性（调整优势比0.33；95%可信区间0.13-0.83）的风险显著降低相关。结论1岁接触2只或2只以上狗或猫可降低儿童时期对多种过敏原过敏的风险。
Context Childhood asthma is strongly associated with allergic sensitization. Studies have suggested that animal exposure during infancy reduces subsequent allergic sensitization.Objective To evaluate the relationship between dog and cat exposure in the first year of life and allergic sensitization at 6 to 7 years of age.Design, Setting, and Subjects Prospective birth cohort study of healthy, fullterm infants enrolled in a health maintenance organization in suburban Detroit, Mich, who were born between April 15,1987, and August 31,1989, and followed up yearly to a mean age of 6.7 years. Of 835 children initially in the study at birth, 474 (57%) completed follow-up evaluations at age 6 to 7 years.Main Outcome Measures Atopy, defined as any skin prick test positivity to 6 common aeroallergens (dust mites [Dermatophagoides farinae, D pteronyssinus], dog, cat, short ragweed [Ambrosia artemisiifolia], and blue grass [Poa pratensis]); seroatopy, defined as any positive allergen-specific IgE test result for the same 6 allergens or for Alternaria species.Results The prevalence of any skin prick test positivity (atopy) at age 6 to 7 years was 33.6% with no dog or cat exposure in the first year of life, 34.3% with exposure to 1 dog or cat, and 15.4% with exposure to 2 or more dogs or cats (P = .005). The prevalence of any positive allergen-specific IgE test result (seroatopy) was 38.5% with no dog or cat exposure, 41.2% with exposure to 1 dog or cat, and 17.9% with exposure to 2 or more dogs or cats (P = .003). After adjustment for cord serum IgE concentration, sex, older siblings, parental smoking, parental asthma, bedroom dust mite allergen levels at 2 years, and current dog and cat ownership, exposure to 2 or more dogs or cats in the first year of life was associated with a significantly lower risk of atopy (adjusted odds ratio, 0.23; 95% confidence interval, 0.09-0.60) and seroatopy (adjusted odds ratio, 0.33; 95% confidence interval, 0.13-0.83).Conclusion Exposure to 2 or more dogs or cats in the first year of life may reduce subsequent risk of allergic sensitization to multiple allergens during childhood.