IngentaConnect Atopic disease and its determinants

Authors: A. Resch¹; U. Schlipköter¹; A. Crispin¹; H. Behrendt²; J. Heinrich³; H. E. Wichmann³; J. Ring²; T. Schäfer⁴

Source: Clinical & Experimental Allergy, Volume 34, Number 8, August 2004 , pp. 1184-1191(8)

Publisher: Blackwell Publishing

Abstract:

Summary Background

Atopic diseases develop on a genetic background and are modulated by environmental factors among which some infectious diseases are thought to have a protective influence. Objective

The aim of this study was to determine the influence of infectious diseases in younger ages, bacterial and viral, on atopic diseases and sensitization to aero- and foodallergens in adults. Methods

A population-based sample of 4262 subjects aged 25–74 years were interviewed concerning their history of infectious disease within the first 18 years of life. Information about allergic disease, including atopic eczema, allergic rhinitis (AR), and asthma was obtained. A blood sample was drawn and analysed for allergen-specific IgE antibodies against food- and aeroallergens. Results

Multiple logistic regression analyses identified viral infection to be associated with AR (adjusted odds ratio (OR)=1.39; 95% confidence interval (95% CI): 1.13–1.72) and sensitization to aeroallergens (OR=1.21; 95% CI: 1.05–1.41). Bacterial disease was a negative predictor for atopy development in the subgroup of patients sensitized to nutritional allergens with concomitant atopic eczema (OR=0.34; 95% CI: 0.11–0.99), AR (OR=0.67; 95% CI: 0.42–1.07), or asthma (OR=0.41; 95% CI: 0.19–0.87). Influences of viral and bacterial infection on AR differed with regard to family history of atopic disease. Conclusion

In our study population, history of viral infection was consistently positively associated with AR. Our data suggests that bacterial infections might be preventive for specific subgroups of atopy.

Keywords: adults; allergic rhinitis; allergy; asthma; atopic eczema; atopy; bacterial; hayfever; infection; sensitization; viral

Document Type: Research article

DOI: 10.1111/j.1365-2222.2004.02016.x

Affiliations: 1: Department of Medical Informatics, Biometry, and Epidemiology, Ludwig-Maximilians-University, Munich, Germany, 2: Division of Environmental Dermatology and Allergology, GSF – National Research Centre for Environment and Health/Technical University Munich, Germany, 3: GSF – National Research Centre for Environment and Health, Institute of Epidemiology, Neuherberg, Germany and 4: Department of Social Medicine, Medical University, Lübeck, Germany

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Atopic disease and its determinants – a focus on the potential role of childhood infection