Effects of treating helminths during pregnancy and early childhood on risk of allergy-related outcomes: Follow-up of a randomized controlled trial.
Effects of treating helminths during pregnancy and early childhood on risk of allergy-related outcomes: Follow-up of a randomized controlled trial.
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DOI：
10.1111/pai.12804
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发表时间：
2017-12
期刊：
影响因子：
--
通讯作者：
Elliott AM
中科院分区：
文献类型：
--
作者：
Namara B;Nash S;Lule SA;Akurut H;Mpairwe H;Akello F;Tumusiime J;Kizza M;Kabagenyi J;Nkurunungi G;Muhangi L;Webb EL;Muwanga M;Elliott AM
蠕虫感染在低收入国家很常见，可以预防与过敏有关的疾病。及早暴露可能是一个关键。在恩德培母婴研究中，在怀孕期间治疗蠕虫会导致儿童早期湿疹的发生率增加。我们跟踪队列，以确定这是否会导致学龄儿童哮喘发病率的增加。这项在乌干达恩德培进行的随机、双盲、安慰剂对照试验有三种干预措施。在怀孕期间，妇女被随机分为阿苯达唑组和安慰剂组，以及吡喹酮组和安慰剂组。他们的孩子从15个月到5个月独立随机服用季度阿苯达唑和安慰剂。我们在这里报告对9岁儿童的随访。9年后的主要结果是最近报道的喘息，对常见过敏原的皮肤点刺试验阳性(SPT)，以及对尘螨或蟑螂的过敏原特异性IgE阳性。次要结果是5至9年间医生诊断的哮喘和湿疹发生率，9至9年间最近的湿疹、鼻炎和荨麻疹，以及对个别过敏原的SPT和IgE反应。2507名孕妇参加了调查；9岁时观察了1215名儿童，其中1188名纳入了这项分析。报告的喘息在9岁时很少见(3.7%)，而SPT阳性(25.0%)和IgE阳性(44.1%)很常见。没有证据表明这三种干预措施中的任何一种对任何主要结果都有治疗效果。在其他暴露没有变化的情况下，对蠕虫进行产前和早期治疗，不太可能在这个热带低收入环境中增加儿童后期特应性疾病的风险。
Helminth infections, common in low‐income countries, may protect against allergy‐related disease. Early exposure may be a key. In the Entebbe Mother and Baby Study, treating helminths during pregnancy resulted in increased eczema rates in early childhood. We followed the cohort to determine whether this translated to increased asthma rates at school age. This randomized, double‐blind, placebo‐controlled trial, conducted in Entebbe, Uganda, had three interventions. During pregnancy, women were randomized, simultaneously, to albendazole vs placebo and to praziquantel vs placebo. Their children were independently randomized to quarterly albendazole vs placebo from age 15 months to 5 years. We here report follow‐up to age 9 years. Primary outcomes at 9 years were recent reported wheeze, skin prick test positivity (SPT) to common allergens and allergen‐specific IgE positivity to dust mite or cockroach. Secondary outcomes were doctor‐diagnosed asthma and eczema rates between 5 and 9 years, recent eczema, rhinitis and urticaria at 9 years, and SPT and IgE responses to individual allergens. 2507 pregnant women were enrolled; 1215 children were seen at age nine, of whom 1188 are included in this analysis. Reported wheeze was rare at 9 years (3.7%) while SPT positivity (25.0%) and IgE positivity (44.1%) were common. There was no evidence of a treatment effect for any of the three interventions on any of the primary outcomes. Prenatal and early‐life treatment of helminths, in the absence of change in other exposures, is unlikely to increase the risk of atopic diseases later in childhood in this tropical, low‐income setting.
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DOI：
10.1093/infdis/jiu234
发表时间：
2014-10-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Pinot de Moira A;Fitzsimmons CM;Jones FM;Wilson S;Cahen P;Tukahebwa E;Mpairwe H;Mwatha JK;Bethony JM;Skov PS;Kabatereine NB;Dunne DW
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影响因子：
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影响因子：
5.5
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DOI：
10.1016/j.jaci.2016.07.007
发表时间：
2016-09
期刊：
The Journal of allergy and clinical immunology
影响因子：
--
作者：
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通讯作者：
McSorley HJ
影响因子：
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Mpairwe, Harriet;Ndibazza, Juliet;Elliott, Alison M.
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