Atopic dermatitis and the hygiene hypothesis: a case-control study

Gibbs, Sam; Surridge, Heidi; Adamson, Ruth; Cohen, B. J.; Bentham, Graham; Reading, Richard

doi:10.1093/ije/dyg267

Cited by 51 publications

(12 citation statements)

References 48 publications

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“…Our EBV incidence estimates are comparable to results from previous UK studies [36–38]. Differences in paediatric EBV prevalence by ethnic group have been reported from two US studies [22, 39] and one in the Netherlands [32].…”

Section: Discussionsupporting

confidence: 89%

Cytomegalovirus, Epstein-Barr virus and varicella zoster virus infection in the first two years of life: a cohort study in Bradford, UK

et al. 2017

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BackgroundCytomegalovirus (CMV), Epstein Barr virus (EBV) and varicella-zoster virus (VZV) are common herpesviruses frequently acquired in childhood, which establish persistent, latent infection and are likely to impact the developing immune system. Little is known about the epidemiology of CMV and EBV infections in contemporary UK paediatric populations, particularly whether age at infection differs by ethnic group.MethodsChildren enrolled in the Born in Bradford Allergy and Infection Study had a blood sample taken and a questionnaire completed at 12 and 24 months of age. Ordered logistic regression quantified associations between ethnicity and other risk factors and age at CMV/EBV/VZV infection (<12 months, 12–24 months, uninfected at 24 months).ResultsPakistani children (n = 472) were more likely to be infected with CMV and EBV at a younger age than White British children (n = 391) (CMV: adjusted odds ratio (OR) 2.53, 95% confidence interval (CI) 1.47–4.33; EBV: adjusted OR 2.16, 95% CI 1.43–3.26). Conversely, Pakistani children had lower odds of being VZV infected in the second year than White British children (adjusted OR 0.57, 95% CI 0.33–0.97). There was a strong association between increasing birth order and later CMV infection in Pakistani children.ConclusionsWe report large differences in CMV and EBV incidence in the first 2 years between Pakistani and White British children born in Bradford, which cannot be explained by differences in risk factors for infection. Our data will inform the optimum schedule for future CMV and EBV vaccination programmes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2319-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 89%

Cytomegalovirus, Epstein-Barr virus and varicella zoster virus infection in the first two years of life: a cohort study in Bradford, UK

et al. 2017

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“…Karmaus et al [16 ]found this effect to be strongest among atopic mothers. Gibbs et al [17 ]reported in a case control study that increased exposure to infection did not protect children from atopic dermatitis, in spite of a strong birth order effect.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Allergy Symptoms and Total IgE in a New York City Cohort and Their Association with Birth Order

Goldstein

Perzanowski

Lendor

et al. 2005

Int Arch Allergy Immunol

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Background: An inverse association between birth order and allergic disease has been widely observed, but has not been examined in the high asthma prevalence, inner-city populations of the United States. As part of an ongoing prospective birth cohort study, the prevalence of early phenotypes of asthma and/or allergy was compared with those reported in other studies, and the association with birth order was evaluated. Methods: Children of Dominican and African-American mothers living in Northern Manhattan underwent detailed periodic questionnaires. Total IgE from the mothers (n = 321) and the children at birth (n = 291) and at ages 24 (n = 244) and 36 (n = 155) months was measured. The association between birth order and allergy symptoms was evaluated at 12 (n = 350), 24 (n = 290) and 36 (n = 247) months. Results: Total serum IgE was detectable (>0.5 IU/ml) in 35% of the children’s cord blood and averaged 15 and 21 IU/ml at ages 24 and 36 months, respectively. They were not significantly different at any age between children with and without older siblings. Additionally, at these ages, there were no consistent associations between birth order and either wheeze, itchy eyes or eczema. Conclusions: Despite a substantially higher prevalence of asthma in the Northern Manhattan community compared with other areas, total IgE levels at ages 24 and 36 months, but not cord blood, are similar to those reported in other areas of the world. In this community, results at this age do not support a protective effect of higher birth order.

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“…Possible explanations to this phenomenon are attributing to the level of stress and the difference in abiotic factors such as air and water and life span or health of people. Most importantly, distribution of helpful microorganisms is mainly derived from the types of foods consumed (19,20). The potential roles of microbiome on diverse disorders are summarized below.…”

Section: Introductionmentioning

confidence: 99%

Immune Disorders and Its Correlation with Gut Microbiome

Hwang

Im²,

2012

Immune Netw

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Allergic disorders such as atopic dermatitis and asthma are common hyper-immune disorders in industrialized countries. Along with genetic association, environmental factors and gut microbiota have been suggested as major triggering factors for the development of atopic dermatitis. Numerous studies support the association of hygiene hypothesis in allergic immune disorders that a lack of early childhood exposure to diverse microorganism increases susceptibility to allergic diseases. Among the symbiotic microorganisms (e.g. gut flora or probiotics), probiotics confer health benefits through multiple action mechanisms including modification of immune response in gut associated lymphoid tissue (GALT). Although many human clinical trials and mouse studies demonstrated the beneficial effects of probiotics in diverse immune disorders, this effect is strain specific and needs to apply specific probiotics for specific allergic diseases. Herein, we briefly review the diverse functions and regulation mechanisms of probiotics in diverse disorders.

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Atopic dermatitis and the hygiene hypothesis: a case-control study

Abstract: Increased exposure to infection does not explain the reduced risk of AD in second and subsequent siblings. More generally, these data cast doubt on the hygiene hypothesis as a causal explanation for AD in young children.

Cited by 51 publications

References 48 publications

Cytomegalovirus, Epstein-Barr virus and varicella zoster virus infection in the first two years of life: a cohort study in Bradford, UK

Cytomegalovirus, Epstein-Barr virus and varicella zoster virus infection in the first two years of life: a cohort study in Bradford, UK

Prevalence of Allergy Symptoms and Total IgE in a New York City Cohort and Their Association with Birth Order

Immune Disorders and Its Correlation with Gut Microbiome

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