Hygiene Hypothesis New Engl J Med 2002 347
- Slides: 43
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 avoidance Scratching Pruritus Skin hydration /moisturizing antihistamine Dry skin
Environment and Atopic Dermatitis • Indoor environment • Outdoor environment • Allergens • Irritants
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 • 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 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 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 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 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 -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 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 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; 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 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 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 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 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, 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↑
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