出生时母体子宫内细菌生长与新生儿15～17岁时发生哮喘及过敏性疾病之间的关系
2009/07/09
背景：出生时母体气道和肠道内的微生物可能对新生儿成年后哮喘及其它过敏性疾病的发病产生一定影响。
目的：评价分娩时母体子宫内细菌生长与后代哮喘及其它过敏性疾病发病之间的关系。
方法：记录Kuopio大学医院1990～1992年间460名剖宫产儿童的母亲子宫内的细菌培养结果。当儿童长至15～17岁时，对儿童母亲进行自评问卷调查，同时，对其中的382名儿童进行皮肤点刺试验。
结果：与出生时母体子宫细菌培养阴性的儿童相比，出生时母亲子宫内存在致病性厌氧菌和链球菌属增殖，与儿童15～17岁时诊断哮喘显著相关。即使经过Bonferroni校正后仍然存在上述相关关系。母体子宫内细菌培养阳性与儿童其他过敏性疾病发病无显著相关性。
结论：本研究结果显示，出生时特异性的子宫内细菌感染会增加后代哮喘的患病风险，炎症可能参与其致病过程。因此，母亲阴道内微生物和子宫内感染对儿童哮喘发病的影响应成为今后的研究方向之一。
（陈欣 审校）
J Allergy Clin Immunol. 2009 May 5. [Epub ahead of print]
Intrauterine bacterial growth at birth and risk of asthma and allergic sensitization among offspring at the age of 15 to 17 years
Keski-Nisula L, Katila ML, Remes S, Heinonen S, Pekkanen J.
BACKGROUND: Microbial colonization of the airways and intestine during birth might have an effect on the risk of asthma and allergic diseases later in life.
OBJECTIVE: We sought to evaluate the association between intrauterine microbial growth at the time of delivery and the development of asthma and allergic sensitization among offspring.
METHODS: Intrauterine bacterial culture results were recorded at the time of cesarean delivery of 460 children who were born at Kuopio University Hospital during 1990-1992. When the children reached the age of 15 to 17 years, self-administered questionnaires were sent to the mothers, and 382 of the children were also examined by using skin prick tests.
RESULTS: Intrauterine growth of potential pathogenic anaerobic bacteria and Streptococcus species at birth was associated with an increased risk of doctor-diagnosed asthma ever (odds ratio [OR], 4.51 [95% CI, 1.56-13.0]; OR, 2.53 [95% CI, 1.19-5.38]) and doctor-diagnosed current asthma (OR, 7.34 [95% CI, 2.44-22.03]; OR, 3.37 [95% CI, 1.46-7.76]) at the age of 15 to 17 years compared with the risk seen in subjects with negative microbial cultures. These findings remained significant also after applying the Bonferroni correction. No significant association after the Bonferroni correction was detected between intrauterine microbial growth and allergic sensitization among offspring.
CONCLUSION: The results of this study indicated that specific intrauterine microbial growth at the time of birth might increase the risk of asthma among offspring through inflammatory mechanisms. These results indicate new potential targets for future studies on the effects of maternal vaginal microflora and intrauterine infection in the development of asthma among children.
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使用Sauchinone抑制过敏原诱导的、Th2驱动的气道炎症
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ACE活性增加与哮喘、COPD以及COPD共患疾病的发病无关
