Exposure to foodborne and orofecal microbes versus airborne viruses in relation to atopy and allergic asthma: epidemiological study
Exposure to foodborne and orofecal microbes versus airborne viruses in relation to atopy and allergic asthma: epidemiological study
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DOI：
10.1136/bmj.320.7232.412
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发表时间：
2000-02-12
影响因子：
105.7
通讯作者：
Bonini, S
中科院分区：
文献类型：
--
作者：
Matricardi, PM;Rosmini, F;Bonini, S
目的调查暴露于食源性和口腔微生物与空气传播的病毒的标志物是否与特应性和呼吸道过敏相关。设计回顾性病例对照研究。参与者240例特应性病例和240例非特应性对照，来自1659名参与者的人群样本，所有意大利男性学员，年龄17- 24岁。设置在意大利卡塞塔的空军学校。主要结果测量弓形虫血清学，幽门螺杆菌、甲型肝炎病毒、麻疹、腮腺炎、风疹、水痘、巨细胞病毒和单纯疱疹病毒1型;皮肤致敏和相关空气变应原的IgE抗体;总IgE浓度;结果与对照组比较，弓形虫感染率低，与对照组比较，差异有统计学意义（P <0.05）特应性参与者中（26%比18%，P = 0.027）、甲型肝炎病毒（30%比16%，P = 0.004）和幽门螺杆菌（18%比15%，P = 0.325）。校正后的特应性比值比随幽门螺杆菌、弓形虫和甲型肝炎病毒暴露梯度而降低（无，比值比1; 1，0.70; 2或3，0.37;趋势P = 0.000045），但不随其他病毒的累积暴露而降低。相反，总IgE浓度与任何感染均无独立相关性。在暴露于至少两种口粪和食源性感染（幽门螺杆菌、弓形虫、甲型肝炎病毒）的受试者中，过敏性哮喘罕见（1/245，0.4%），过敏性鼻炎罕见（16/245，7%）。卫生和西化的半无菌饮食可能通过影响刺激肠道相关淋巴组织的细菌和病原体的总体模式而促进特应性，从而导致过敏性哮喘和鼻炎在发达国家的流行。
Objective To investigate if markers of exposure to foodborne and orofecal microbes versus airborne viruses are associated with atopy and respiratory allergies.Design Retrospective case-control study.Participants 240 atopic cases and 240 non-atopic controls from a population sample of 1659 participants, all Italian male cadets aged 17-24.Setting Air force school in Caserta, Italy.Main outcome measures Serology for Toxoplasma gondii, Helicobacter pylori, hepatitis A virus, measles, mumps, rubella, chickenpox, cytomegalovirus, and herpes simplex virus type 1; skin sensitisation and IgE antibodies to relevant airborne allergens; total IgE concentration; and diagnosis of allergic asthma or rhinitis,Results Compared with controls there tvas a lower prevalence of T gondii (26% v 18%, P = 0.027), hepatitis A virus (30% v 16%, P = 0.004), and H pylori (18% v 15%, P = 0.325) in atopic participants. Adjusted odds ratios of atopy decreased with a gradient of exposure to H pylori, T gondii, and hepatitis A virus (none, odds ratio 1; one, 0.70; two or three, 0.37; P for trend = 0.000045) but not with cumulative exposure to the other viruses. Conversely, total IgE concentration was not independently associated with any infection. Allergic asthma was rare (1/245, 0.4%) and allergic rhinitis infrequent (16/245, 7%) among the participants (245/1659) exposed to at least two orofecal and foodborne infections (H pylori, T gondii, hepatitis A virus).Conclusion Respiratory allergy is less frequent in people heavily exposed to orofecal and foodborne microbes. Hygiene and a westernised, semisterile diet may facilitate atopy by influencing the overall pattern of commensals and pathogens that stimulate the gut associated lymphoid tissue thus contributing to the epidemic of allergic asthma and rhinitis in developed countries.