Atopic disease and its determinants -- a focus on the potential role of childhood infection.
BACKGROUND
Atopic diseases develop on a genetic background and are modulated by environmental factors among which some infectious diseases are thought to have a protective influence.


OBJECTIVE
The aim of this study was to determine the influence of infectious diseases in younger ages, bacterial and viral, on atopic diseases and sensitization to aero- and food-allergens in adults.


METHODS
A population-based sample of 4262 subjects aged 25-74 years were interviewed concerning their history of infectious disease within the first 18 years of life. Information about allergic disease, including atopic eczema, allergic rhinitis (AR), and asthma was obtained. A blood sample was drawn and analysed for allergen-specific IgE antibodies against food- and aero-allergens.


RESULTS
Multiple logistic regression analyses identified viral infection to be associated with AR (adjusted odds ratio (OR) = 1.39; 95% confidence interval (95% CI): 1.13-1.72) and sensitization to aeroallergens (OR = 1.21; 95% CI: 1.05-1.41). Bacterial disease was a negative predictor for atopy development in the subgroup of patients sensitized to nutritional allergens with concomitant atopic eczema (OR = 0.34; 95% CI: 0.11-0.99), AR (OR = 0.67; 95% CI: 0.42-1.07), or asthma (OR = 0.41; 95% CI: 0.19-0.87). Influences of viral and bacterial infection on AR differed with regard to family history of atopic disease.


CONCLUSIONS
In our study population, history of viral infection was consistently positively associated with AR. Our data suggests that bacterial infections might be preventive for specific subgroups of atopy.
Resch
A
A
Department of Medical Informatics, Biometry, and Epidemiology, Ludwig-Maximilians-University, Munich, Germany. ansgar.resch@pfizer.com
Schlipköter
U
U
Crispin
A
A
Behrendt
H
H
Heinrich
J
J
Wichmann
H E
HE
Ring
J
J
Schäfer
T
T
D000328:Adult; D000367:Age Factors; D000368:Aged; D000485:Allergens / Q000276:immunology; D000818:Animals; D000829:Animals, Domestic; D000906:Antibodies / Q000097:blood; D001424:Bacterial Infections / Q000150:complications; D002415:Cats; D002648:Child; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D005858:Germany; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology* / Q000235:genetics / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D007239:Infections / Q000150:complications* / Q000276:immunology; D016015:Logistic Models; D008875:Middle Aged; D012424:Rural Population; D012737:Sex Factors; D014777:Virus Diseases / Q000150:complications
D000485:Allergens; D000906:Antibodies; D007073:Immunoglobulin E