Domestic dog exposure at birth reduces the incidence of atopic dermatitis
Domestic dog exposure at birth reduces the incidence of atopic dermatitis
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DOI：
10.1111/all.12980
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发表时间：
2016-12-01
期刊：
影响因子：
12.4
通讯作者：
Bisgaard, H.
中科院分区：
文献类型：
--
作者：
Thorsteinsdottir, S.;Thyssen, J. P.;Bisgaard, H.
背景虽然特应性皮炎的病因复杂且知之甚少，但新生儿暴露在疾病发生中是重要的。然而，狗暴露对特应性皮炎风险的影响尚未得到解决。目的我们调查了家犬暴露是否会影响儿童出生前3年特应性皮炎的风险。方法哥本哈根儿童哮喘前瞻性研究(COPSAC)是正在进行的前瞻性出生队列研究。在同一研究地点，按照相同的方案分析了411名患有哮喘的母亲所生的孩子(COPSAC(2000))和700名未被挑选的儿童(COPSAC(2010))的数据。根据Hanifin-Rajka标准对特应性皮炎进行前瞻性诊断。父母有哮喘、湿疹或鼻炎的病史由医生自我报告的诊断来定义。在COPSAC(2000)中，在COPSAC(2010)队列中，在孩子出生后和怀孕24周时采集针对8种吸入性变应原的母体特异性血清IgE。结果在COPSAC(2000)和COPSAC(2010)队列中，家犬暴露儿童患特应性皮炎的风险显著降低(调整后HR=0.46[0.25~0.87]，P=0.02；调整后HR=0.58[0.36~0.93]，P=0.03)。在COPSAC(2010)中，特应性皮炎的风险随着狗的数量的增加而呈剂量依赖性地下降(调整后的HR=0.58[0.38-0.89]，P=0.01)。保护作用仅限于未选择的COPSAC(2010)队列中患有特应性疾病的母亲所生的孩子(调整后HR=0.39[0.19-0.82]，P=0.01)，而对非特应性疾病母亲所生的孩子没有影响(调整后HR=0.92[0.49-1.73]，P=0.79)。父亲的特应性状态不影响特应性皮炎的风险。CD14T/T基因型与家犬暴露之间没有显著的交互作用(COPSAC(2000)，P=0.36；COPSAC(2010)队列，P=0.42)。结论新生儿家犬暴露在两个独立的出生队列中，并以剂量依赖的方式显著降低特应性皮炎的风险。虽然涉及的机制尚不清楚，但我们的发现提出了一个问题，即宫内暴露是否会影响特应性皮炎的风险，并强调早期环境对疾病轨迹的重要性。
BackgroundWhile the etiopathogenesis of atopic dermatitis is complex and poorly understood, neonatal exposures are important for disease occurrence. However, the effect of dog exposure on the risk of atopic dermatitis is unresolved.ObjectiveWe investigated whether domestic dog exposure affected the risk of atopic dermatitis in children during the first 3 years of life.MethodsCopenhagen Prospective Studies on Asthma in Childhood (COPSAC) are ongoing prospective clinical birth cohort studies. Data from 411 children born to mothers with asthma (COPSAC(2000)) and 700 unselected children (COPSAC(2010)) were analyzed following the same protocols at the same research site. Atopic dermatitis was diagnosed prospectively according to the Hanifin-Rajka criteria. Parental history of asthma, eczema, or rhinitis was defined by self-reported physician diagnosis. In the COPSAC(2000), maternal specific serum IgE against eight inhalant allergens was sampled after the children's birth and at pregnancy week 24 in the COPSAC(2010) cohort. Associations between dog exposure and atopic dermatitis were analyzed by Cox proportional hazard regression models and adjusted for lifestyle confounders.ResultsIn the COPSAC(2000) and COPSAC(2010) cohorts, the risk of atopic dermatitis was significantly lower in children with domestic dog exposure (adjustedHR = 0.46 [0.25-0.87], P = 0.02; and adjustedHR = 0.58 [0.36-0.93], P = 0.03, respectively). The risk of atopic dermatitis decreased in a dose-dependent manner with increasing number of dogs (adjustedHR = 0.58 [0.38-0.89], P = 0.01) in the COPSAC(2010). The protective effect was restricted to children born to mothers with atopic disease in the unselected COPSAC(2010) cohort (adjustedHR = 0.39 [0.19-0.82], P = 0.01), as no effect was observed in children born to mothers without atopic disease (adjustedHR = 0.92 [0.49-1.73], P = 0.79). Paternal atopic status did not affect the risk of atopic dermatitis. We found no significant interaction between the CD14 T/T genotype and domestic dog exposure in either cohort (COPSAC(2000), P = 0.36; and COPSAC(2010) cohort, P = 0.42).ConclusionNeonatal domestic dog exposure was associated with a strongly reduced risk of atopic dermatitis in two independent birth cohorts and in a dose-dependent manner. While the mechanisms involved are unclear, our findings raise the question of whether in utero exposures may affect the risk of atopic dermatitis and emphasize the importance of the early environment for disease trajectory.