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Markers of microbial exposure lower the incidence of atopic dermatitis

机译：微生物暴露的标记降低了特应性皮炎的发生率

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Abstract Background The hygiene hypothesis proposes that reduced exposure to infectious agents in early life would explain the increase of allergic and autoimmune diseases observed over the past decades in high‐income countries. Methods We conducted a matched case‐control study on incident atopic dermatitis (AD). Cases were 426 outpatient children with a first diagnosis of?incident AD. Controls were 426 children attending a pediatric/dermatological visit for nonatopic disorders matched to cases (1:1). Particular attention was paid to the time elapsed between the markers of microbial exposure and disease onset, and we considered for controls the same time window of exposures from birth as his/her matched case. Odds ratios (ORs) were computed using multivariable conditional logistic regression models, according to center, sex, age, and period of enrollment, and including as potential confounders a family history of any allergy in parents, type of delivery, having siblings, keeping pets, age at weaning, and having had ≥4 infections. Results The OR of AD first occurrence was 0.35 ( P ‐value?=?.039) for children who had experienced ≥4 infections compared with those with no infections. A decreasing trend in risk was observed with increasing number of siblings ( P ‐value?=?.023), the protective effect reaching about 40% for children with 2 or more siblings (OR?=?0.62; P ‐value?=?.048). Pet keeping, in particular daily contact with dogs, was inversely associated with AD risk (OR?=?0.40; P ‐value?=?.004). Conclusions These results support the hygiene hypothesis in its broad sense. Early‐life environmental exposures, including pathogens and commensals, act as “microbes contact carriers” influencing immune system balance early in life.
机译：摘要背景技术卫生假设提出降低暴露于早期生命中的传染病的暴露将解释过去几十年在高收入国家观察到的过敏和自身免疫疾病的增加。方法我们对事件的特应性皮炎（AD）进行了匹配的病例对照研究。病例为426名门诊患儿童，第一次诊断？事件广告。对照组是426名儿童参加儿科/皮肤病的儿童，对于案件（1：1）匹配的非植物障碍。特别注意微生物暴露和疾病发作标志物之间经过的时间，我们考虑控制同一时间从出生时作为他/她的匹配案。使用多变量条件逻辑回归模型计算差距（ORS），根据中央，性别，年龄和招生期，包括潜在的混淆，包括父母的任何过敏的家​​族史，交货类型，患兄弟姐妹，保留宠物，断奶年龄，并且患有≥4感染。结果≥4感染的儿童与没有感染的人相比，AD第一次出现的结果为0.35（P-value？=β.039）。越来越多的兄弟姐妹（p-value？= 023）观察到风险的趋势降低（P-value？023），对于2个或更多兄弟姐妹的儿童达到约40％（或？= 0.62; p-value？ .048）。宠物保存，特别是与狗的每日接触，与广告风险相反（或？=？0.40; P -Value？=Δ= 004）。结论这些结果在其广义上支持了卫生假设。早期环境暴露，包括病原体和共生，充当“微生物接触载体”，影响生活早期的免疫系统平衡。

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