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dc.contributor.authorObihara, C.C.
dc.contributor.authorBeyers, N.
dc.contributor.authorGie, R.P.
dc.contributor.authorHoekstra, M.O.
dc.contributor.authorFincham, J.E.
dc.contributor.authorMarais, B.J.
dc.contributor.authorLombard, C.J.
dc.contributor.authorDini, L.A.
dc.contributor.authorKimpen, J.L.L.
dc.identifier.citationObihara CC, Beyers N, Gie RP, Hoekstra MO, Fincham JE, Marais BJ, et al. Respiratory atopic disease, Ascaris-immunoglobulin E and tuberculin testing in urban South African children. CLINICAL AND EXPERIMENTAL ALLERGYen_US
dc.description.abstractBackground Epidemiological relation of intestinal helminth infection and atopic disease, both associated with a T-helper (Th) 2 immune response, is controversial, as it has been reported that helminth infection may either suppress or pre-dispose to atopic disease. This relation has not been tested in an area with a high burden of Mycobacterium tuberculosis (MTB) infection, a known Th1-stimulating infection. Objective To study the association of intestinal helminth infection and atopic disease in a community where helminth infection is endemic and MTB infection is high. Methods Three-hundred and fifty-nine randomly selected children aged 6–14 years from a poor urban suburb were tested with allergy questionnaire, skin prick test (SPT) to common aeroallergens, Ascaris-specific IgE (Ascaris-sIgE), fecal examination for pathogenic intestinal helminths and tuberculin skin testing (TST). Histamine bronchoprovocation was tested in the group of children aged 10 years and older. Results were corrected for demographic variables, socioeconomic status, parental allergy, environmental tobacco smoke (ETS) exposure in the household, recent anthelminthic treatment and for clustering in the sampling unit. Results Ascaris-sIgE was elevated in 48% of children, Ascaris eggs were found in 15% and TST was positive in 53%. Children with elevated Ascaris-sIgE had significantly increased risk of positive SPT to aeroallergens, particularly house dust mite, atopic asthma (ever and recent), atopic rhinitis (ever and recent) and increased atopy-related bronchial hyper-responsiveness. In children with negative TST (o10 mm), elevated Ascaris-sIgE was associated with significantly increased risk of atopic symptoms (adjusted odds ratio (ORadj) 6.5; 95% confidence interval (CI) 1.9–22.4), whereas in those with positive TST (X10 mm) this association disappeared (ORadj 0.96; 95% CI 0.4–2.8). Conclusions These results suggest that immune response to Ascaris (Ascaris-sIgE) may be a risk factor of atopic disease in populations exposed to mild Ascaris infection and that MTB infection may be protective against this risk, probably by stimulation of anti-inflammatory networks.en_US
dc.description.sponsorshipWe thank all the parents and children who participated in this study. We are indebted to Prof. P.C. Potter (Allergy Diagnostic and Clinical Research Unit, University of Cape Town, South Africa) for the serum IgE analyses and allergy diagnostics. We are also indebted to Ann Toerien for carrying out the allergy and tuberculin skin tests, Jerome Cornelius for the successful fieldwork and Dr Vera Adams (Nutritional Intervention Research Unit, Medical Research Council of South Africa, Cape Town, South Africa). We also thank Edwin Videler and Johan Mouton (Lung Function Laboratory of the Department of Respiratory Medicine, Stellenbosch University), and Rita van Deventer (Parasitology Reference Unit, National Institute for Communicable Diseases, National Health Laboratory Services, Johannesburg, South Africa). Sources of support and grants: C.C.O is a recipient of a grant from the Ter Meulen Fund, Royal Netherlands Academy of Arts and Sciences. This study was funded by the Stellenbosch University (through funding from the South African Department of Trade and Industry, THRIP fund) and the Wilhelmina Children’s Hospital, University Medical Center Utrecht, the Netherlands.en_US
dc.publisherBlackwell Publishing Ltd.en_US
dc.rightsAttribution 3.0 United States*
dc.subjectAscaris specific IgEen_US
dc.subjectAtopic diseaseen_US
dc.titleRespiratory atopic disease, Ascaris-immunoglobulin E and tuberculin testing in urban South African childrenen_US
dc.contributor.departmentBiostatistics Unit, Medical Research Council of South Africaen_US
dc.identifier.journalClinical and Experimental Allergyen_US
dc.research.unitBiomedical Research and Innovation Platformen_US

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Attribution 3.0 United States
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