Source: Annual Congress 2002 - New aspects of asthma epidemiology
Disease area: Airway diseases

Abstract

To test the possiblity that an inverse association between antibodies to gastro-intestinal (GI) pathogens and atopy could result from a lower host response to antigenic stimuli rather than lower exposure to pathogens in atopic subjects, we have investigated the association between atopy and antibodies to GI pathogens and to tetanus toxoid in young adults who all received tetanus immunisation in childhood. The subjects were drawn from a cohort of 3,942 schoolchildren in Aberdeen who took part in a cross-sectional study of asthma prevalence in 1989. In 1999 2,082 were traced and 711 attended the clinic for skin prick tests and venous blood samples for measurement of antibodies to H. Pylori, Hepatitis A, T.Gondii and Tetanus toxoid. Atopy was defined as one or more positive skin prick test >3mm. Antibody levels were classed as positive according to the manufacturers' instructions.
Complete data were collected on 336 men and 324 women aged 18-22 yrs. 38% of the subjects were atopic; 31% had antibodies to H Pylori, 8% to Hepatitis A, 2% to T. Gondii, and 38% had antibodies to one or more GI pathogen. 81% of subjects had antibodies to tetanus toxoid > 1 IU/mL (29% >5 IU/mL). Those who had positive antibody responses to one or more GI pathogen were less likely to be atopic: OR (adjusted for age, gender and current smoking) 0.46 (95% CI 0.28, 0.75; p=0.001). No association was found between antibodies to tetanus toxoid (either >1.1 IU/mL or >5IU/mL) and atopy. The results provide support for the hygiene hypothesis in a population with low levels of antibodies to GI pathogens, rather than the suggestion that lower host responses might confound this association.

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P. Srivastava, G. McNeill, T. Reid, W. J. Anderson, P. Helms (Foresterhill, United Kingdom). Exposure to gastro-intestinal pathogens is associated with lower risk of atopy but not asthma in young UK adults. Eur Respir J 2002; 20: Suppl. 38, 161

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