早期宠物饲养与哮喘和过敏性致敏的关系：对欧盟儿童队列网络中超过77000名儿童的荟萃分析
2022/03/17
摘要
背景：早期养猫和狗与儿童哮喘的关联研究报告了不一致的结果。有几个因素可以解释这些不一致，包括宠物的类型，时间和暴露程度。
目的：研究学龄儿童早期养猫养狗与哮喘的关联，包括类型（猫与狗）、时间（从不、产前或幼儿）、拥有程度（拥有宠物的数量）的作用，以及过敏致敏的作用。
方法：我们使用了来自欧盟儿童队列网络中9个出生队列的77434名5-11岁母子二人组的协调数据。通过DataSHIELD平台，使用调整后的逻辑回归模型，分别对每个队列进行拟合，并使用随机效应荟萃分析进行组合，进行相关性分析。
结果：早期养猫和养狗的比率分别为12%～45%和7%～47%，哮喘患病率在2%～20%之间。养猫或养狗与哮喘之间没有总体关联（比值比[OR]= 0.97 [95% CI = 0.87-1.09]和0.92 [95% CI = 0.85-1.01]）。拥有猫或狗的时间和程度对该关联没有很大影响。猫和狗的拥有量也与猫和狗特有的过敏致敏无关（OR = 0.92 [95% CI = 0.75-1.13]和0.93 [95% CI = 0.57-1.54]）。然而，猫和狗特异性过敏致敏与学龄哮喘密切相关（OR = 6.69 [95% CI = 4.91-9.10]和5.98 [95% CI = 3.14-11.36]）。还有一些迹象表明拥有猫狗和致敏之间存在相互作用，这表明拥有猫狗可能会加剧与宠物特异性致敏相关的风险，但在没有致敏的情况下提供一些预防哮喘的保护。
结论：本研究结果并不支持早期养猫和狗本身会增加学龄期哮喘的风险，但它们确实表明，拥有猫和狗可能会加剧与猫和狗特有过敏致敏相关的风险。
Associations of early-life pet ownership with asthma and allergic sensitization: A meta-analysis of more than 77,000 children from the EU Child Cohort Network
Pinot de Moira A, Strandberg-Larsen K.
Abstrast
BACKGROUND: Studies examining associations of early-life cat and dog ownership with childhood asthma have reported inconsistent results. Several factors could explain these inconsistencies, including type of pet, timing, and degree of exposure.
OBJECTIVE:Our aim was to study associations of early-life cat and dog ownership with asthma in school-aged children, including the role of type (cat vs dog), timing (never, prenatal, or early childhood), and degree of ownership (number of pets owned), and the role of allergic sensitization.
METHODS: We used harmonized data from 77,434 mother-child dyads from 9 birth cohorts in the European Union Child Cohort Network when the child was 5 to 11 years old. Associations were examined through the DataSHIELD platform by using adjusted logistic regression models, which were fitted separately for each cohort and combined by using random effects meta-analysis.
RESULTS: The prevalence of early-life cat and dog ownership ranged from 12% to 45% and 7% to 47%, respectively, and the prevalence of asthma ranged from 2% to 20%. There was no overall association between either cat or dog ownership and asthma (odds ratio [OR] = 0.97 [95% CI = 0.87-1.09] and 0.92 [95% CI = 0.85-1.01], respectively). Timing and degree of ownership did not strongly influence associations. Cat and dog ownership were also not associated with cat- and dog-specific allergic sensitization (OR = 0.92 [95% CI = 0.75-1.13] and 0.93 [95% CI = 0.57-1.54], respectively). However, cat- and dog-specific allergic sensitization was strongly associated with school-age asthma (OR = 6.69 [95% CI = 4.91-9.10] and 5.98 [95% CI = 3.14-11.36], respectively). There was also some indication of an interaction between ownership and sensitization, suggesting that ownership may exacerbate the risks associated with pet-specific sensitization but offer some protection against asthma in the absence of sensitization.
CONCLUSION:Our findings do not support early-life cat and dog ownership in themselves increasing the risk of school-age asthma, but they do suggest that ownership may potentially exacerbate the risks associated with cat- and dog-specific allergic sensitization.
背景：早期养猫和狗与儿童哮喘的关联研究报告了不一致的结果。有几个因素可以解释这些不一致，包括宠物的类型，时间和暴露程度。
目的：研究学龄儿童早期养猫养狗与哮喘的关联，包括类型（猫与狗）、时间（从不、产前或幼儿）、拥有程度（拥有宠物的数量）的作用，以及过敏致敏的作用。
方法：我们使用了来自欧盟儿童队列网络中9个出生队列的77434名5-11岁母子二人组的协调数据。通过DataSHIELD平台，使用调整后的逻辑回归模型，分别对每个队列进行拟合，并使用随机效应荟萃分析进行组合，进行相关性分析。
结果：早期养猫和养狗的比率分别为12%～45%和7%～47%，哮喘患病率在2%～20%之间。养猫或养狗与哮喘之间没有总体关联（比值比[OR]= 0.97 [95% CI = 0.87-1.09]和0.92 [95% CI = 0.85-1.01]）。拥有猫或狗的时间和程度对该关联没有很大影响。猫和狗的拥有量也与猫和狗特有的过敏致敏无关（OR = 0.92 [95% CI = 0.75-1.13]和0.93 [95% CI = 0.57-1.54]）。然而，猫和狗特异性过敏致敏与学龄哮喘密切相关（OR = 6.69 [95% CI = 4.91-9.10]和5.98 [95% CI = 3.14-11.36]）。还有一些迹象表明拥有猫狗和致敏之间存在相互作用，这表明拥有猫狗可能会加剧与宠物特异性致敏相关的风险，但在没有致敏的情况下提供一些预防哮喘的保护。
结论：本研究结果并不支持早期养猫和狗本身会增加学龄期哮喘的风险，但它们确实表明，拥有猫和狗可能会加剧与猫和狗特有过敏致敏相关的风险。
(中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校)
(J Allergy Clin Immunol. 2022 Feb 10;S0091-6749(22)00149-X. doi: 10.1016/j.jaci.2022.01.023.)
(J Allergy Clin Immunol. 2022 Feb 10;S0091-6749(22)00149-X. doi: 10.1016/j.jaci.2022.01.023.)
Associations of early-life pet ownership with asthma and allergic sensitization: A meta-analysis of more than 77,000 children from the EU Child Cohort Network
Pinot de Moira A, Strandberg-Larsen K.
Abstrast
BACKGROUND: Studies examining associations of early-life cat and dog ownership with childhood asthma have reported inconsistent results. Several factors could explain these inconsistencies, including type of pet, timing, and degree of exposure.
OBJECTIVE:Our aim was to study associations of early-life cat and dog ownership with asthma in school-aged children, including the role of type (cat vs dog), timing (never, prenatal, or early childhood), and degree of ownership (number of pets owned), and the role of allergic sensitization.
METHODS: We used harmonized data from 77,434 mother-child dyads from 9 birth cohorts in the European Union Child Cohort Network when the child was 5 to 11 years old. Associations were examined through the DataSHIELD platform by using adjusted logistic regression models, which were fitted separately for each cohort and combined by using random effects meta-analysis.
RESULTS: The prevalence of early-life cat and dog ownership ranged from 12% to 45% and 7% to 47%, respectively, and the prevalence of asthma ranged from 2% to 20%. There was no overall association between either cat or dog ownership and asthma (odds ratio [OR] = 0.97 [95% CI = 0.87-1.09] and 0.92 [95% CI = 0.85-1.01], respectively). Timing and degree of ownership did not strongly influence associations. Cat and dog ownership were also not associated with cat- and dog-specific allergic sensitization (OR = 0.92 [95% CI = 0.75-1.13] and 0.93 [95% CI = 0.57-1.54], respectively). However, cat- and dog-specific allergic sensitization was strongly associated with school-age asthma (OR = 6.69 [95% CI = 4.91-9.10] and 5.98 [95% CI = 3.14-11.36], respectively). There was also some indication of an interaction between ownership and sensitization, suggesting that ownership may exacerbate the risks associated with pet-specific sensitization but offer some protection against asthma in the absence of sensitization.
CONCLUSION:Our findings do not support early-life cat and dog ownership in themselves increasing the risk of school-age asthma, but they do suggest that ownership may potentially exacerbate the risks associated with cat- and dog-specific allergic sensitization.
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既往烟草暴露对重症哮喘患者气道嗜酸性粒细胞活化及自身免疫的影响
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小气道功能障碍在哮喘控制和恶化中的作用：一项使用亚特兰蒂斯研究数据的纵向观察分析
