哮喘联盟

   摘要
   基本原理：早期的卫生假说通过缺乏感染源来解释过敏的发展；如今在富裕的人群中过度清洁似乎已经替代了这一概念。然而，并无调查研究显示家庭或个人的清洁度与过敏性疾病相关。
   测量方法及主要结果：收集城市PAULA出生队列中 399例受试者学龄期有关其家庭或个人清洁度以及过敏性疾病的全面调查问卷信息。评估地板和床褥粉尘的细菌标记物，以及与清洁度和过敏性疾病相关的细菌标记物。个体清洁度与地板和床褥的细菌混合物呈负相关，然而家庭清洁度可有效降少灰尘数量而不是微生物标记物。暴露于胞壁酸与学龄期哮喘较低的发病率相关（校正优势比为 0.59 [0.39-0.90]）。在出生第一年里，床垫内毒素与特异性致敏作用（0.73 [0.56-0.96]）和学龄期哮喘(0.72 [0.55-0.95])呈负相关。不管粉尘参数与清洁度和过敏性疾病的相关性如何，过敏性疾病的发展与家庭和个体清洁度无关。
   结论：室内粉尘的细菌暴露决定了儿童期的哮喘和过敏性疾病。室内粉尘参数客观的反映了个体清洁度（如洗手）及家庭清洁度。然而，无论是个体还是家庭清洁度，均与哮喘和过敏性疾病的预防无关。其它不受个人卫生水平影响的室内粉尘微生物可能起到一定的作用。
 

（苏欣 审校）
Am J Respir Crit Care Med. 2015 Jan 13. [Epub ahead of print]

 

Asthma and the Hygiene Hypothesis - Does Cleanliness Matter?
 

Weber J1, Illi S, Nowak D, Schierl R, Holst O, von Mutius E, Ege MJ.
 

Abstract
RATIONALE：The early hygiene hypothesis explained the development of allergies by a lack of infections; nowadays the aspect of excessive cleanliness in affluent populations seems to have replaced this concept. Yet, no investigation has shown that home or personal cleanliness relate to allergic diseases.
MEASUREMENTS AND MAIN RESULTS：Comprehensive questionnaire information on home or personal cleanliness and allergic health conditions at school age was collected in 399 participants of the urban PAULA birth cohort. Bacterial markers were assessed in floor and mattress dust and were related to cleanliness and allergic diseases. Personal cleanliness was inversely related to bacterial compounds on floors and mattresses, whereas home cleanliness effectively reduced dust amount but not microbial markers. Exposure to muramic acid related to a lower prevalence of school age asthma (adjusted odds ratio 0.59 [0.39-0.90]). Mattress endotoxin in the first year of life was inversely associated with atopic sensitization (0.73 [0.56-0.96]) and asthma at school age (0.72 [0.55-0.95]). Despite the associations of dust parameters both with cleanliness and allergic health conditions, the development of allergies was not related to home and personal cleanliness.
CONCLUSIONS：Bacterial exposure in house dust determined childhood asthma and allergies. Personal cleanliness, such as washing hands, and home cleanliness were objectively reflected by dust parameters in homes. However, neither personal nor home cleanliness were associated with protection from asthma and allergies. Other microbial components in house dust not affected by personal hygiene are likely to play a role.
 

Am J Respir Crit Care Med. 2015 Jan 13. [Epub ahead of print]