Exposure to Environmental Microorganisms and Childhood Asthma
Exposure to Environmental Microorganisms and Childhood Asthma
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DOI：
10.1056/nejmoa1007302
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发表时间：
2011-02-24
影响因子：
158.5
通讯作者：
von Mutius, Erika
中科院分区：
文献类型：
--
作者：
Ege, Markus J.;Mayer, Melanie;von Mutius, Erika
在传统农场等微生物暴露环境中长大的儿童，可以免受儿童哮喘和特应性疾病的影响。在以前的研究中，微生物暴露的标志物已呈负相关，这些conditions.METHODSIn两个横断面研究，我们比较了生活在农场的儿童与那些在一个参考组的哮喘和特应性疾病的患病率和微生物暴露的多样性。在一项研究中- PARSIFAL（预防过敏-与农业和人类生活方式有关的儿童致敏风险因素）-使用单链构象多态性（SSCP）分析筛选床垫灰尘样本的细菌DNA，以检测无法通过培养技术测量的环境细菌。在另一项研究中- GABRIELA（确定欧洲共同体哮喘遗传和环境原因的多学科研究[GABRIEL]高级研究）-使用培养技术评估儿童房间沉降灰尘样本的细菌和真菌分类群。生活在农场的儿童哮喘和特应性的发病率较低，并且比参照组的儿童暴露于更多种类的环境微生物。反过来，微生物暴露的多样性与哮喘风险呈负相关（PARSIFAL的比值比为0.62; 95%置信区间[CI]为0.44至0.89; GABRIELA的比值比为0.86; 95% CI为0.75至0.99）。此外，某些更有限的暴露也与哮喘的风险呈负相关;这包括暴露于真菌分类群中的真菌（调整的比值比，0.37; 95%CI，0.18至0.76）和各种细菌物种，包括单核细胞增生李斯特菌，芽孢杆菌属，棒状杆菌属等（调整优势比，0.57; 95%CI，0.38 - 0.86）.结论生活在农场的儿童比对照组儿童暴露于更广泛的微生物，这种暴露解释了哮喘和在农场长大之间的负相关关系的很大一部分。（由德国研究共同体和欧洲委员会资助。
BACKGROUNDChildren who grow up in environments that afford them a wide range of microbial exposures, such as traditional farms, are protected from childhood asthma and atopy. In previous studies, markers of microbial exposure have been inversely related to these conditions.METHODSIn two cross-sectional studies, we compared children living on farms with those in a reference group with respect to the prevalence of asthma and atopy and to the diversity of microbial exposure. In one study - PARSIFAL (Prevention of Allergy - Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle) - samples of mattress dust were screened for bacterial DNA with the use of single-strand conformation polymorphism (SSCP) analyses to detect environmental bacteria that cannot be measured by means of culture techniques. In the other study - GABRIELA (Multidisciplinary Study to Identify the Genetic and Environmental Causes of Asthma in the European Community [GABRIEL] Advanced Study) - samples of settled dust from children's rooms were evaluated for bacterial and fungal taxa with the use of culture techniques.RESULTSIn both studies, children who lived on farms had lower prevalences of asthma and atopy and were exposed to a greater variety of environmental microorganisms than the children in the reference group. In turn, diversity of microbial exposure was inversely related to the risk of asthma (odds ratio for PARSIFAL, 0.62; 95% confidence interval [CI], 0.44 to 0.89; odds ratio for GABRIELA, 0.86; 95% CI, 0.75 to 0.99). In addition, the presence of certain more circumscribed exposures was also inversely related to the risk of asthma; this included exposure to species in the fungal taxon eurotium (adjusted odds ratio, 0.37; 95% CI, 0.18 to 0.76) and to a variety of bacterial species, including Listeria monocytogenes, bacillus species, corynebacterium species, and others (adjusted odds ratio, 0.57; 95% CI, 0.38 to 0.86).CONCLUSIONSChildren living on farms were exposed to a wider range of microbes than were children in the reference group, and this exposure explains a substantial fraction of the inverse relation between asthma and growing up on a farm. (Funded by the Deutsche Forschungsgemeinschaft and the European Commission.)