Maternal hookworm modifies risk factors for childhood eczema: results from a birth cohort in Uganda
Maternal hookworm modifies risk factors for childhood eczema: results from a birth cohort in Uganda
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DOI：
10.1111/pai.12251
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发表时间：
2014-08-01
影响因子：
4.4
通讯作者：
Elliott, Alison M.
中科院分区：
文献类型：
--
作者：
Mpairwe, Harriet;Ndibazza, Juliet;Elliott, Alison M.
背景：蠕虫可以防止过敏。早期生活蠕虫暴露可能是至关重要的，但这还没有得到充分investigated. Objective. To调查是否蠕虫在怀孕和幼儿期与儿童湿疹incidence.Methods：恩德培母亲和婴儿的研究，驱虫治疗试验，2003年至2005年在乌干达的孕妇。每年对母亲在怀孕期间和孩子进行蠕虫调查。从出生到五岁，医生都诊断出了湿疹。在试验队列中进行了一项计划的观察性分析，以调查蠕虫和eczema.Results之间的关联：对2345例活产儿童的数据进行了分析。钩虫是最常见的母体蠕虫（45%）。儿童期蠕虫不太普遍。发病率为4.68/100人年。母亲钩虫与湿疹发病率降低相关[校正风险比（95%置信区间），p值：0.71（0.51-0.99），0.04]和湿疹已知危险因素的改良效应：如果母亲没有钩虫病，儿童中的嗜皮肤病特异性IgE与湿疹发病率呈正相关[2.72（1.11-6.63），0.03]，但如果母亲患有钩虫则不存在[0.41（0.10-1.69），0.22]，相互作用p值= 0.03。对于母亲的湿疹病史也观察到类似的相互作用{[2.87（1.31-6.27，0.008）与[0.73（0.23-2.30），0.60]，交互作用p值= 0.05}，女性{[1.82（1.22-2.73），0.004对比[0.96（0.60-1.53），0.87]，相互作用p值= 0.04}和过敏原特异性IgE。儿童鞭虫和钩虫与湿疹呈负相关。结论：母亲钩虫修改湿疹的已知危险因素的影响。早期蠕虫暴露影响过敏的机制需要调查。蠕虫或蠕虫产品以及妊娠期间的干预可能是过敏的一级预防。
Background: Worms may protect against allergy. Early-life worm exposure may be critical, but this has not been fully investigated.Objectives: To investigate whether worms in pregnancy and in early childhood are associated with childhood eczema incidence.Methods: The Entebbe Mother and Baby Study, an anthelminthic treatment trial, enrolled pregnant women between 2003 and 2005 in Uganda. Mothers were investigated for worms during pregnancy and children annually. Eczema was doctor-diagnosed from birth to age five years. A planned observational analysis was conducted within the trial cohort to investigate associations between worms and eczema.Results: Data for 2345 live-born children were analysed. Hookworm was the most prevalent maternal worm (45%). Childhood worms were less prevalent. Eczema incidence was 4.68/100 person-years. Maternal hookworm was associated with reduced eczema incidence [adjusted hazard ratio (95% confidence interval), p-value: 0.71(0.51-0.99), 0.04] and modified effects of known risk factors for eczema: Dermatophagoides-specific IgE in children was positively associated with eczema incidence if the mother had no hookworm [2.72(1.11-6.63), 0.03], but not if the mother had hookworm [0.41(0.10-1.69), 0.22], interaction p-value = 0.03. Similar interactions were seen for maternal history of eczema {[2.87(1.31-6.27, 0.008) vs. [0.73(0.23-2.30), 0.60], interaction p-value = 0.05}, female gender {[1.82(1.22-2.73), 0.004 vs. [0.96 (0.60-1.53), 0.87], interaction p-value = 0.04} and allergen-specific IgE. Childhood Trichuris trichiura and hookworm were inversely associated with eczema.Conclusions: Maternal hookworm modifies effects of known risk factors for eczema. Mechanisms by which early-life worm exposures influence allergy need investigation. Worms or worm products, and intervention during pregnancy have potential for primary prevention of allergy.