背景:“卫生假说”指出,由于过度卫生的环境而减少对微生物抗原的暴露会增加患自身免疫性疾病的风险,包括特应性疾病和哮喘。近几十年来,随着卫生条件的改善,许多微生物的流行率逐渐下降。更具体地说,多项研究报道,幽门螺杆菌感染的减少与哮喘和过敏性疾病的增加呈负相关.
目的:评估儿童人群中与幽门螺杆菌血清阳性相关的特应性疾病的患病率。
方法:北撒丁岛的儿童,意大利,出于任何原因转诊到当地儿童医院,进行了调查以确定风险因素,尤其是幽门螺杆菌感染,与特应性疾病相关。一份经过验证的问卷,包括人口统计,房子大小,母乳喂养史,residence,学校或日托中心的出勤率,接触动物,并且由训练有素的儿科医生根据父母的回答和儿童记录填写了特应性疾病-包括哮喘的明确诊断。从每个参与者收集血液样品,并通过局部验证的ELISA测试评估针对幽门螺杆菌的免疫球蛋白G。
结果:在492名儿童(240名女性)中,幽门螺杆菌感染的血清阳性率为11.7%。32名儿童确诊为哮喘,12名确诊为过敏。没有一个孩子表现出这两种情况。在有或没有特应性的儿童之间未检测到幽门螺杆菌血清阳性的统计学差异(8.4%与12.6;p=0.233)。尽管特应性疾病在暴露于传统特应性危险因素的儿童中更为常见,在调整所有协变量后,没有一个显示出显著。
结论:血清学评估的幽门螺杆菌感染与儿童特应性疾病风险降低没有显著相关。
BACKGROUND: The \"hygiene hypothesis\" states that reduced exposure to microbial antigens due to an excessively hygienic environment can increase the risk of developing autoimmune diseases, including atopic disorders and asthma. In recent decades, there has been a progressive decline in the prevalence of numerous microorganisms following improved hygienic-sanitary conditions. More specifically, several studies reported an inverse association between the reduction in Helicobacter pylori infection and the rise of asthma and allergic disorders.
OBJECTIVE: To evaluate the prevalence of atopic disorders in a pediatric population in relation to seropositivity against H. pylori.
METHODS: Children from Northern Sardinia, Italy, referred to the local Children\'s Hospital for any reason, were investigated to identify risk factors, especially H. pylori infection, associated with atopic disorders. A validated questionnaire, including demographics, house size, history of breastfeeding, residence, school or daycare center attendance, exposure to animals, and a defined diagnosis of
atopy-including asthma-was filled out by a trained pediatrician according to parents\' answers and child records. A blood sample was collected from each participant and immunoglobulin G against H. pylori was assessed by a locally validated ELISA test.
RESULTS: The seroprevalence of H. pylori infection was 11.7% among 492 children (240 females). Thirty-two children had a confirmed diagnosis of asthma and 12 of allergy. No one child showed both conditions. Statistically significant differences in H. pylori seropositivity were not detected between children with or without
atopy (8.4% vs. 12.6; p = 0.233). Although atopic disorders were more frequent in children exposed to traditional atopic risk factors, none of them showed to be significant after adjusting for all covariates.
CONCLUSIONS: Serologically assessed H. pylori infection was not significantly associated with a reduced risk of atopic diseases in children.