Hygiene Hypothesis New Engl J Med 2002 347

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위생가설 (Hygiene Hypothesis) (New Engl J Med 2002; 347: 911 -20)

위생가설 (Hygiene Hypothesis) (New Engl J Med 2002; 347: 911 -20)

Atopic dermatitis Infection Food Steroid/ allergen immunomodulation Super-Ag antibiotics avoidance irritants stress Skin inflammation

Atopic dermatitis Infection Food Steroid/ allergen immunomodulation Super-Ag antibiotics avoidance irritants stress Skin inflammation avoidance Scratching Pruritus Skin hydration /moisturizing antihistamine Dry skin

Environment and Atopic Dermatitis • Indoor environment • Outdoor environment • Allergens • Irritants

Environment and Atopic Dermatitis • Indoor environment • Outdoor environment • Allergens • Irritants

Familiar and environmental factors influencing atopic dermatitis in the childhood • J Eur Acad

Familiar and environmental factors influencing atopic dermatitis in the childhood • J Eur Acad Dermatol Venereol 2006; 20: 418 -22 • Objectives – Family, birth weight (BW), home environment • Methods – Case vs. control (461 : 343) in Hungary – Questionnaires (retrospective) • Results – (+) : higher BW, small households, carpet, indoor pets – No : nursery, heating system, indoor smoking

Atopic eczema and the home environment • Br J Dermatol 2001; 145: 730 -6

Atopic eczema and the home environment • Br J Dermatol 2001; 145: 730 -6 • Objectives – To assess the home environmental factors • Methods – Cross sectional case-control (1, 350 : 1, 056) in UK • Results – (+) : dampness, radiator, synthetic pillow – (-) : frequent vacuuming

Early life risk factors for atopic dermatitis in Ethiopian children • J Allergy Clin

Early life risk factors for atopic dermatitis in Ethiopian children • J Allergy Clin Immunol 2005 • Objectives – To establish the risk factors in AD (parasite) • Methods – Cross-sectional case-control study (ISAAC) – Case vs. control (306 : 426) • Results – Prevalence rate = 4. 2% – (+) : malaria, piped drinking water – No : parasite infection, family size, breast feeding

Risk factors and prevalence of asthma or atopic dermatitis in young children by a

Risk factors and prevalence of asthma or atopic dermatitis in young children by a questionnaire Survey • J Nippon Med Sci 2004 • Objectives – Risk factors & prevalence of AD (altitude) • Methods – 24, 631 children in Japan – ATS-DLD questionnaire • Results – (+) : male, age↑, FHx(+), higher altitude

Factors influencing AD – A questionnaire survey of schoolchildren’s perceptions • Br J Dermatol

Factors influencing AD – A questionnaire survey of schoolchildren’s perceptions • Br J Dermatol 2004 • Objectives – To determine the exacerbating factors • Methods – Questionnaire survey in UK (악화/호전 인자) – 250 AD children • Results – 악화 : sweating, wool, hot weather – 호전 : topical steroid, moisturizers, medicine – No effects of food on AD Sx (60%)

The incidence of AD in school entrants is associated with individual life style factors

The incidence of AD in school entrants is associated with individual life style factors but not with local environmental factors in Hannover, Germany • Br J Dermatol 2002; 147: 95 -104 • Objectives – To assess the life-style factors on AD • Methods – 4, 219 AD children, Germany (questionnaire) • Results – (+) : more privileged SES, German nationality, ↑paternal SES, ↑daily duration of father’s professional work, lack of paternal shift work – No : air pollution, urbanization

Environmental associations with eczema in early life • Br J Dermatol 2001; 144: 795

Environmental associations with eczema in early life • Br J Dermatol 2001; 144: 795 -802 • Objectives – To investigate role of dietary & environmental factors ass. with development of AE • Methods – Prospective cohort study in UK (n=624) • Results – (+) : maternal education, maternal allergy Hx – (-) : crowded home

Association between indoor renovation activities and eczema in early childhood • Int J Hyg

Association between indoor renovation activities and eczema in early childhood • Int J Hyg Environ Health 2006; 209: 241 -7 • Objective : to evaluate the effect of exposure to risk factors such as indoor air pollution during early childhood • Methods : - birth cohort comprising of 2536 children in epidemiologic study (LISS: Leipzig infection, allergy and airway diseases sutdy among school starters) - redecoration activities (painting, floor covering, new furniture) before birth and in the first year of life

Body burden of mercury is associated with acute atopic eczema and total Ig. E

Body burden of mercury is associated with acute atopic eczema and total Ig. E in children from southern Germany • J Allergy Clin Immunol 2004; 114: 457 -9 • Objective : to investigate the associations of body burdens of (heavy) metals with AE • Methods : - cross-sectional study with all school beginners in Augsburg, Bavaria in 1996 (n=1673) - recruitment : 164 children with AE (76 with acute symptoms and 98 without acute symptoms), 213 controls - concentration of arsenic, cadmium and mercury in morning urine by atopic absorption spectrometry

Sublingual immunotherapy in mite-sensitized children with atopic dermatitis • J Allergy Clin Immunol 2007;

Sublingual immunotherapy in mite-sensitized children with atopic dermatitis • J Allergy Clin Immunol 2007; 120: 164 -70 • Objective : to assess the effect of sublingual IT in children with AD • Methods : - a randomized, double-blind, placebo-controlled study - 56 children with AD (5 -16 years) who are sensitized to dust mite alone - 28 with IT, 28 without IT - IT for 18 months

Meteorological influence on Na. OH irritation varies with body site • Arch Dermatol Res

Meteorological influence on Na. OH irritation varies with body site • Arch Dermatol Res 2005 • Objectives – To assess the dry air & cold weather on AD • Methods – 544 occupational dermatitis – SMART (Swift Modified Alkaline Resistance Test) – Local ambient temperature, absolute humidity • Results – (+) : low temperature & humidity (esp. ≤ 6℃, ≤ 8 mg/L)

An exploratory prospective observational study of environmental factors exacerbating AE in children • Br

An exploratory prospective observational study of environmental factors exacerbating AE in children • Br J Dermatol 2006 • Objectives – To assess trigger factors in AD • Methods – 25 AD children in Ireland & UK – Using diary over 4 wk (prospective study) • Results – Stress, damp & hot weather scratch scores.

Influence of weather and climate on subjective symptom intensity in atopic eczema • Int

Influence of weather and climate on subjective symptom intensity in atopic eczema • Int J Biometerol 2000 • Objectives – To assess the meteorological factors • Methods – 7 -year investigation (1983 -1989) in Swiss – 2, 106 AD(15 meteorological variables on itch) • Results – No : gender, age, atopic respiratory disease – (-) : air temperature, pressure, H 2 O pressure, duration of sunshine – (+) : snowfall, fog, thunderstorm

Concentrations and determinants of NO 2 in homes of Ashford, UK and Barcelona and

Concentrations and determinants of NO 2 in homes of Ashford, UK and Barcelona and Menorca, Spain • Indoor air 2004 • Objectives – To assess indoor NO 2 & gas combustion, ETS • Methods – 1, 421 home of AD (using filter for 7~15 days) – Cohort study • Results – NO 2 : Barcelona > Ashford & Menorca – Sources of NO 2 : heating/cooking fuel, parental smoking

Trends of prevalence of AD in schoolchildren : A longitudinal study in Osaka prefecture,

Trends of prevalence of AD in schoolchildren : A longitudinal study in Osaka prefecture, Japan from 1985 to 1997 • Br J Dermatol 2001 • Objectives – To assess the relationship between prevalence and environmental factors • Methods – 4, 000 Japan primary school (1985 -1997) • Results – Increment of AD prevalence stopped in 1993. – (+) : air pollution↓, income index↑

Allergy trigger-free room

Allergy trigger-free room