新生儿气道细菌定植与18岁前哮喘和过敏风险的关系
2024/01/26
摘要
背景：我们之前的研究表明，新生儿气道细菌定植与5岁前持续喘息/哮喘风险增加之间存在关联。在这里，我们研究了了18岁之前持续喘息/哮喘和过敏相关特征的关系。
方法：我们使用广义估计方程调查了COPSAC2000母婴队列中1月龄新生儿气道定菌与肺炎链球菌、流感嗜血杆菌和/或卡他性支原体之间的关系，以及18岁前持续喘息/哮喘和过敏相关特征的发展。在COPSAC2010的700名儿童队列中寻求复制。
结果：在 319 名儿童中，有 66名 （21%） 存在新生儿气道定植，7岁之前，定植与持续性喘息/哮喘风险增加 4 倍相关（校正比值比，4.01 （95% CI，1.76-9.12，p<0.001）），但从 7 岁到 18 岁则不然。使用 16S 数据，COPSAC2010队列中的复制显示出类似的结果。7岁之前，定植与急性加重次数增加相关（调整后的发病率比为 3.20 （1.38-7.44，p<0.01）），但从 7 岁到 18 岁则不然。12岁之前，定植与血液嗜酸性粒细胞水平升高（调整后的几何平均比值，1.24 （1.06-1.44），p<0.01）和 TNF-α（调整后的几何平均比值，1.09 （1.02;1.16），p=0.01）相关。与肺功能、支气管反应性、FeNO、过敏致敏、总IgE或特应性皮炎（18岁以下）没有关联。
结论：新生儿气道定植与早发持续性喘息/哮喘、急性发作、血嗜酸性粒细胞升高和血中TNF-α升高有关，在儿童早期最为突出，此后逐渐减弱，到18岁时不再明显。
Bacterial Colonization of the Airway in Neonates and Risk of Asthma and Allergy Until Age 18 Years.
Sunde RB, Thorsen J, Kim M,
Abstrast
Background: We previously showed an association between neonatal bacterial airway colonization and increased risk of persistent wheeze/asthma until age 5 years. Here, we study the association with persistent wheeze/asthma and allergy-related traits until age 18 years.
Methods: We investigated the association between airway colonization with S. pneumoniae, H. influenzae, and/or M. catarrhalis in one-month-old neonates from the COPSAC2000 mother-child cohort and the development of persistent wheeze/asthma and allergy-related traits longitudinally until age 18 using generalized estimating equations. Replication was sought in the similarly designed COPSAC2010 cohort of 700 children.
Results：Neonatal airway colonization was present in 66 (21%) of 319 children and was associated with a 4-fold increased risk of persistent wheeze/asthma (adjusted odds ratio, 4.01 (95% CI, 1.76-9.12, p<0.001)) until age 7, but not from age 7 to 18 years. Replication in the COPSAC2010 cohort showed similar results using 16S data. Colonization was associated with an increased number of exacerbations (adjusted incidence rate ratio, 3.20 (1.38-7.44, p<0.01)) until age 7, but not from age 7 to 18 years. Colonization was associated with increased level of blood eosinophils (adjusted geometric mean ratio, 1.24 (1.06-1.44), p<0.01) and TNF-α (adjusted geometric mean ratio, 1.09 (1.02; 1.16), p=0.01) until age 12 years. There were no associations with lung function, bronchial reactivity, FeNO, allergic sensitization, total-IgE, or atopic dermatitis up to age 18 years.
Conclusions: Neonatal airway colonization was associated with early-onset persistent wheeze/asthma, exacerbations, elevated blood eosinophils, and elevated TNF-α in blood, most prominent in early childhood, thereafter diminishing, and no longer evident by age 18.
背景：我们之前的研究表明，新生儿气道细菌定植与5岁前持续喘息/哮喘风险增加之间存在关联。在这里，我们研究了了18岁之前持续喘息/哮喘和过敏相关特征的关系。
方法：我们使用广义估计方程调查了COPSAC2000母婴队列中1月龄新生儿气道定菌与肺炎链球菌、流感嗜血杆菌和/或卡他性支原体之间的关系，以及18岁前持续喘息/哮喘和过敏相关特征的发展。在COPSAC2010的700名儿童队列中寻求复制。
结果：在 319 名儿童中，有 66名 （21%） 存在新生儿气道定植，7岁之前，定植与持续性喘息/哮喘风险增加 4 倍相关（校正比值比，4.01 （95% CI，1.76-9.12，p<0.001）），但从 7 岁到 18 岁则不然。使用 16S 数据，COPSAC2010队列中的复制显示出类似的结果。7岁之前，定植与急性加重次数增加相关（调整后的发病率比为 3.20 （1.38-7.44，p<0.01）），但从 7 岁到 18 岁则不然。12岁之前，定植与血液嗜酸性粒细胞水平升高（调整后的几何平均比值，1.24 （1.06-1.44），p<0.01）和 TNF-α（调整后的几何平均比值，1.09 （1.02;1.16），p=0.01）相关。与肺功能、支气管反应性、FeNO、过敏致敏、总IgE或特应性皮炎（18岁以下）没有关联。
结论：新生儿气道定植与早发持续性喘息/哮喘、急性发作、血嗜酸性粒细胞升高和血中TNF-α升高有关，在儿童早期最为突出，此后逐渐减弱，到18岁时不再明显。
(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)
(Eur Respir J 2023 Dec 14; doi: 10.1183/13993003.00471-2023. IF：12.339)
(Eur Respir J 2023 Dec 14; doi: 10.1183/13993003.00471-2023. IF：12.339)
Bacterial Colonization of the Airway in Neonates and Risk of Asthma and Allergy Until Age 18 Years.
Sunde RB, Thorsen J, Kim M,
Abstrast
Background: We previously showed an association between neonatal bacterial airway colonization and increased risk of persistent wheeze/asthma until age 5 years. Here, we study the association with persistent wheeze/asthma and allergy-related traits until age 18 years.
Methods: We investigated the association between airway colonization with S. pneumoniae, H. influenzae, and/or M. catarrhalis in one-month-old neonates from the COPSAC2000 mother-child cohort and the development of persistent wheeze/asthma and allergy-related traits longitudinally until age 18 using generalized estimating equations. Replication was sought in the similarly designed COPSAC2010 cohort of 700 children.
Results：Neonatal airway colonization was present in 66 (21%) of 319 children and was associated with a 4-fold increased risk of persistent wheeze/asthma (adjusted odds ratio, 4.01 (95% CI, 1.76-9.12, p<0.001)) until age 7, but not from age 7 to 18 years. Replication in the COPSAC2010 cohort showed similar results using 16S data. Colonization was associated with an increased number of exacerbations (adjusted incidence rate ratio, 3.20 (1.38-7.44, p<0.01)) until age 7, but not from age 7 to 18 years. Colonization was associated with increased level of blood eosinophils (adjusted geometric mean ratio, 1.24 (1.06-1.44), p<0.01) and TNF-α (adjusted geometric mean ratio, 1.09 (1.02; 1.16), p=0.01) until age 12 years. There were no associations with lung function, bronchial reactivity, FeNO, allergic sensitization, total-IgE, or atopic dermatitis up to age 18 years.
Conclusions: Neonatal airway colonization was associated with early-onset persistent wheeze/asthma, exacerbations, elevated blood eosinophils, and elevated TNF-α in blood, most prominent in early childhood, thereafter diminishing, and no longer evident by age 18.
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