Repeated Exposure to Antibiotics in Infancy: A Predisposing Factor for Juvenile Idiopathic Arthritis or a Sign of This Group's Greater Susceptibility to Infections?
Repeated Exposure to Antibiotics in Infancy: A Predisposing Factor for Juvenile Idiopathic Arthritis or a Sign of This Group's Greater Susceptibility to Infections?
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DOI：
10.3899/jrheum.140348
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发表时间：
2015-03-01
影响因子：
3.9
通讯作者：
Vahasalo, Paula
中科院分区：
文献类型：
--
作者：
Arvonen, Miika;Virta, Lauri J.;Vahasalo, Paula
Objective.先前暴露于抗生素与几种自身免疫性疾病的发病机制有关。我们的目的是探讨儿童期接触抗生素是否与发生幼年特发性关节炎（JIA）的风险有关。这些材料收集自国家登记册，其中包含2000-2010年在芬兰出生并在2012年12月底前诊断为JIA的所有儿童（n = 1298）和年龄，性别和出生地匹配的适当对照组（n = 5179）。从出生到索引日期（即，JIA药品的特殊报销日期）。应用条件Logistic回归分析评价抗生素暴露与JIA风险之间的关系。JIA的风险随着从出生到索引日期的抗生素购买次数而增加：= 1次购买与无购买，OR 1.6，95%CI 1.3-1.9，OR呈上升趋势（p < 0.001）。抗生素林可酰胺类和头孢菌素类与JIA的相关性最强（OR分别为6.6，95%CI 3.7-11.7和OR 1.6，95%CI 1.4-1.8）。2岁以前的抗生素暴露与JIA的风险增加相关（OR 1.4，95%CI 1.2-1.6），OR趋势检验（p < 0.001）。早期和反复暴露于抗生素可能使个体易患JIA。或者，这种明显的关联可能反映了对感染和JIA的共同易感性。
Objective. Previous exposure to antibiotics has been associated with the pathogenesis of several autoimmune diseases. Our objective was to explore whether childhood exposure to antibiotics would be associated with the risk of developing juvenile idiopathic arthritis (JIA).Methods. The material was collected from national registers containing all children born in 2000-2010 in Finland and diagnosed with JIA by the end of December 2012 (n = 1298) and appropriate controls (n = 5179) matched for age, sex, and place of birth. All purchases of antibiotics were collected from birth until the index date (i.e., the date of special reimbursement for JIA medications). A conditional logistic regression was performed to evaluate the association between the exposure to antibiotics and the risk of JIA.Results. The risk of JIA increased with the number of antibiotic purchases from birth to the index date: for = 1 purchases versus none, OR 1.6, 95% CI 1.3-1.9 with an upward trend in OR (p < 0.001). Antibiotic groups lincosamides and cephalosporins showed the strongest association with JIA (OR 6.6, 95% CI 3.7-11.7, and OR 1.6, 95% CI 1.4-1.8, respectively). Overall exposure to antibiotics before 2 years of age was associated with an increased risk of JIA (OR 1.4, 95% CI 1.2-1.6), with the trend test of OR (p < 0.001).Conclusion. Previous early and repeated exposure to antibiotics may predispose individuals to develop JIA. Alternatively, the apparent association may reflect shared susceptibility to infections and JIA.