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Environmental determinants of total IgE among school children living in the rural Tropics: importance of geohelminth infections and effect of anthelmintic treatment.
BMC Immunology ( IF 2.9 ) Pub Date : 2008-06-27 , DOI: 10.1186/1471-2172-9-33
Philip J Cooper 1 , Neal Alexander , Ana-Lucia Moncayo , Susana M Benitez , Martha E Chico , Maritza G Vaca , George E Griffin
Affiliation  

BACKGROUND The environmental factors that determine the elevated levels of polyclonal IgE observed in populations living in the Tropics are poorly understood but may include geohelminth infections. We investigated the association between geohelminth infections and total IgE levels in school children in rural tropical Ecuador, and assessed the effect on IgE of repeated anthelmintic treatments over a period of 12 months. The study was nested within a cluster-randomized study that randomized 68 schools to receive either 400 mg of albendazole every 2 months over a year or no treatment. We studied random samples of children completing follow-up and representing four groups stratified by the presence of geohelminth infection at baseline and treatment allocation. We measured levels of total IgE and anti-A. lumbricoides IgG (used as a measure of past and current geohelminth infectious exposure) in blood samples collected at the start of the study and after 12 months. RESULTS We observed elevated levels of total IgE (compared to standard reference values) at the start of the study in this population of school children (geometric mean, 1,004 IU/mL, range 12 to 22,608 IU/mL)) and baseline IgE levels were strongly associated with parameters of geohelminth infection but not with age, nutritional and socioeconomic status. After 12 months, levels of IgE fell significantly in the treatment (by 35.1%) and no treatment (by 10.4%) groups, respectively, but the fall was significantly greater in the treatment group. Falls in IgE were independently associated with albendazole treatment, having a baseline geohelminth infection and with high baseline levels of anti-A. lumbricoides IgG. Increases in IgE at 12 months were associated with the presence of geohelminth infections and increasing levels of anti-A. lumbricoides IgG at 12 months independent of treatment allocation. CONCLUSION The data provide evidence that geohelminth infections are an important determinant of total IgE in school children in the rural Tropics and that periodic anthelmintic treatments over 12 months are associated with reductions in IgE. The failure of anthelmintic treatment to reduce IgE levels to that considered normal in industrialized countries may be attributed to continued exposure of children to geohelminths or to the effects of infections in early life in programming a long-lasting Th2-biassed immunity.

中文翻译:

生活在热带农村地区的学童中总 IgE 的环境决定因素:土蠕虫感染的重要性和驱虫治疗的效果。

背景 对生活在热带地区的人群中观察到的多克隆 IgE 水平升高的环境因素了解甚少,但可能包括土蠕虫感染。我们调查了厄瓜多尔热带农村地区学童的土蠕虫感染与总 IgE 水平之间的关系,并评估了 12 个月内反复驱虫治疗对 IgE 的影响。该研究嵌套在一项集群随机研究中,该研究随机分配了 68 所学校,在一年内每 2 个月接受 400 毫克阿苯达唑或不接受治疗。我们研究了完成随访并代表四组的儿童的随机样本,这些样本按基线时土蠕虫感染的存在和治疗分配进行分层。我们测量了总 IgE 和抗 A 的水平。研究开始时和 12 个月后收集的血液样本中的 lumbricoides IgG(用作过去和当前土蠕虫感染暴露的量度)。结果 在研究开始时,我们观察到该学童人群的总 IgE 水平升高(与标准参考值相比)(几何平均值,1,004 IU/mL,范围 12 至 22,608 IU/mL),基线 IgE 水平为与土蠕虫感染的参数密切相关,但与年龄、营养和社会经济地位无关。12个月后,治疗组(下降35.1%)和未治疗组(下降10.4%)的IgE水平分别显着下降,但治疗组下降幅度更大。IgE 下降与阿苯达唑治疗独立相关,具有基线土蠕虫感染和具有高基线水平的抗 A。蚯蚓 IgG。12 个月时 IgE 的增加与土蠕虫感染的存在和抗 A 水平的增加有关。独立于治疗分配的 12 个月时的 lumbricoides IgG。结论 数据提供的证据表明,土蠕虫感染是热带农村学童总 IgE 的一个重要决定因素,并且超过 12 个月的定期驱虫治疗与 IgE 的降低有关。驱虫治疗未能将 IgE 水平降低到工业化国家认为正常的水平,这可能是由于儿童持续暴露于土蠕虫或生命早期感染对长期 Th2 偏向免疫的影响。12 个月时 IgE 的增加与土蠕虫感染的存在和抗 A 水平的增加有关。独立于治疗分配的 12 个月时的 lumbricoides IgG。结论 数据提供的证据表明,土蠕虫感染是热带农村学童总 IgE 的一个重要决定因素,并且超过 12 个月的定期驱虫治疗与 IgE 的降低有关。驱虫治疗未能将 IgE 水平降低到工业化国家认为正常的水平,这可能是由于儿童持续接触土蠕虫或早期感染对长期 Th2 偏向免疫的影响。12 个月时 IgE 的增加与土蠕虫感染的存在和抗 A 水平的增加有关。独立于治疗分配的 12 个月时的 lumbricoides IgG。结论 数据提供的证据表明,土蠕虫感染是热带农村学童总 IgE 的一个重要决定因素,并且超过 12 个月的定期驱虫治疗与 IgE 的降低有关。驱虫治疗未能将 IgE 水平降低到工业化国家认为正常的水平,这可能是由于儿童持续暴露于土蠕虫或生命早期感染对长期 Th2 偏向免疫的影响。独立于治疗分配的 12 个月时的 lumbricoides IgG。结论 数据提供的证据表明,土蠕虫感染是热带农村学童总 IgE 的一个重要决定因素,并且超过 12 个月的定期驱虫治疗与 IgE 的降低有关。驱虫治疗未能将 IgE 水平降低到工业化国家认为正常的水平,这可能是由于儿童持续暴露于土蠕虫或生命早期感染对长期 Th2 偏向免疫的影响。独立于治疗分配的 12 个月时的 lumbricoides IgG。结论 数据提供的证据表明,土蠕虫感染是热带农村学童总 IgE 的一个重要决定因素,并且超过 12 个月的定期驱虫治疗与 IgE 的降低有关。驱虫治疗未能将 IgE 水平降低到工业化国家认为正常的水平,这可能是由于儿童持续接触土蠕虫或早期感染对长期 Th2 偏向免疫的影响。
更新日期:2019-11-01
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