Exposure to Environmental Microorganisms and Childhood Asthma

作者：Markus Johannes Ege, M. Mayer, Anne‐Cécile Normand, Jon Genuneit, William Cookson, Charlotte Braun‐Fahrländer, Dick J. J. Heederik, Renaud Piarroux, Erika von Mutius · 发表于：New England Journal of Medicine · 年份：2011 · DOI：10.1056/nejmoa1007302 · 被引用次数：1552 · 研究领域：Indoor Air Quality and Microbial Exposure、Occupational exposure and asthma、Pediatric health and respiratory diseases

BACKGROUND: Children who grow up in environments that afford them a wide range of microbial exposures, such as traditional farms, are protected from childhood asthma and atopy. In previous studies, markers of microbial exposure have been inversely related to these conditions. METHODS: In two cross-sectional studies, we compared children living on farms with those in a reference group with respect to the prevalence of asthma and atopy and to the diversity of microbial exposure. In one study--PARSIFAL (Prevention of Allergy-Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle)--samples of mattress dust were screened for bacterial DNA with the use of single-strand conformation polymorphism (SSCP) analyses to detect environmental bacteria that cannot be measured by means of culture techniques. In the other study--GABRIELA (Multidisciplinary Study to Identify the Genetic and Environmental Causes of Asthma in the European Community [GABRIEL] Advanced Study)--samples of settled dust from children's rooms were evaluated for bacterial and fungal taxa with the use of culture techniques. RESULTS: In both studies, children who lived on farms had lower prevalences of asthma and atopy and were exposed to a greater variety of environmental microorganisms than the children in the reference group. In turn, diversity of microbial exposure was inversely related to the risk of asthma (odds ratio for PARSIFAL, 0.62; 95% confidence interval [CI], 0.44 to 0.89;...