Background: Suggestions that immunisation influences allergic disease risk, ei ther positively (pertussis) or negatively (BCG)-are of concern for vaccination policy. Aims: To determine whether DTP, MMR, and BCG vaccin...Background: Suggestions that immunisation influences allergic disease risk, ei ther positively (pertussis) or negatively (BCG)-are of concern for vaccination policy. Aims: To determine whether DTP, MMR, and BCG vaccination in infancy infl uenced hay fever risk. Methods: Case-control study of 7098 hay fever cases and controls, within two primary care databases. One control per case was matched fo r practice, age, and sex. Odds ratios (OR)were derived using conditional logisti c regression. Results: Compared to those completing in month 5 (base group) (39. 3%), DTP unvaccinated children (4.3%) had a similar risk of hay fever (OR = 0. 94, 95%Cl 0.73 to 1.23). However, those completing after 12months (4.2%) had a reduced risk (OR = 0.60, 95%Cl 0.45 to 0.76) compared to the base group. Compa red to those vaccinated in month 14 (base group) (29.5%), MMR unvaccinated chil dren (2.3%) had an OR of 0.79 (95%Cl 0.58 to 1.08). Completion of MMR after tw o years was associated with reduced hay fever risk (OR = 0.62, 95%Cl 0.48 to 0. 80) compared to the base group. The effects of late immunisation with DTP and MM R were independent. Those vaccinated with BCG by age 2 (2.4%) had an odds ratio of 1.28 (95%Cl 0.96 to 1.70). Adjustment for consulting behaviour, social fact ors, or sibship size did not alter these associations. Conclusions: Immunisation against DTP or MMR does not increase the risk of hay fever. The lower confidenc e limit for BCG vaccination contradicts the hypothesised protective effect. The reduced risk of hay fever among children immunised late may be explained by a th ird factor causing both postponement and reduced risk such as intercurrent febri le illnesses.展开更多
Atopy patch testing with Japanese cedar pollen extract has been used to investigate patients with atopic dermatitis whose condition is exacerbated by contact with Japanese cedar pollen.Comparative atopy patch testing,...Atopy patch testing with Japanese cedar pollen extract has been used to investigate patients with atopic dermatitis whose condition is exacerbated by contact with Japanese cedar pollen.Comparative atopy patch testing,scratch tests,and assays for total IgE and specific IgE were performed in 74 patients with atopic dermatitis,5 patients with Japanese cedar pollinosis and 15 control subjects.A skin biopsy was performed on any sites that were positive to Japanese cedar pollen patch test.The results after 48 h of atopy patch testing were compared with the patient’s history,skin scratch test and specific IgE.Twenty-two of the 74 patients(30%)-had a history of exacerbation every spring after contact with Japanese cedar.Of these patients 68%showed a positive reaction to Japanese cedar pollen extract,as did 21%of patientswith atopic dermatitis without a history of exacerbation by Japanese cedar pollen,20%of patients with Japanese cedar pollinosis without eruption and 7%of control subjects.A histological examination revealed eczematous changes and infiltration of lymphocytes and eosinophils in atopy patch testing positive sites.In conclusion,atopy patch testing with Japanese cedar pollen extract is a useful method for investigating trigger factors for eczematous skin lesions in a subgroup of patients with atopic dermatitis.展开更多
文摘Background: Suggestions that immunisation influences allergic disease risk, ei ther positively (pertussis) or negatively (BCG)-are of concern for vaccination policy. Aims: To determine whether DTP, MMR, and BCG vaccination in infancy infl uenced hay fever risk. Methods: Case-control study of 7098 hay fever cases and controls, within two primary care databases. One control per case was matched fo r practice, age, and sex. Odds ratios (OR)were derived using conditional logisti c regression. Results: Compared to those completing in month 5 (base group) (39. 3%), DTP unvaccinated children (4.3%) had a similar risk of hay fever (OR = 0. 94, 95%Cl 0.73 to 1.23). However, those completing after 12months (4.2%) had a reduced risk (OR = 0.60, 95%Cl 0.45 to 0.76) compared to the base group. Compa red to those vaccinated in month 14 (base group) (29.5%), MMR unvaccinated chil dren (2.3%) had an OR of 0.79 (95%Cl 0.58 to 1.08). Completion of MMR after tw o years was associated with reduced hay fever risk (OR = 0.62, 95%Cl 0.48 to 0. 80) compared to the base group. The effects of late immunisation with DTP and MM R were independent. Those vaccinated with BCG by age 2 (2.4%) had an odds ratio of 1.28 (95%Cl 0.96 to 1.70). Adjustment for consulting behaviour, social fact ors, or sibship size did not alter these associations. Conclusions: Immunisation against DTP or MMR does not increase the risk of hay fever. The lower confidenc e limit for BCG vaccination contradicts the hypothesised protective effect. The reduced risk of hay fever among children immunised late may be explained by a th ird factor causing both postponement and reduced risk such as intercurrent febri le illnesses.
文摘Atopy patch testing with Japanese cedar pollen extract has been used to investigate patients with atopic dermatitis whose condition is exacerbated by contact with Japanese cedar pollen.Comparative atopy patch testing,scratch tests,and assays for total IgE and specific IgE were performed in 74 patients with atopic dermatitis,5 patients with Japanese cedar pollinosis and 15 control subjects.A skin biopsy was performed on any sites that were positive to Japanese cedar pollen patch test.The results after 48 h of atopy patch testing were compared with the patient’s history,skin scratch test and specific IgE.Twenty-two of the 74 patients(30%)-had a history of exacerbation every spring after contact with Japanese cedar.Of these patients 68%showed a positive reaction to Japanese cedar pollen extract,as did 21%of patientswith atopic dermatitis without a history of exacerbation by Japanese cedar pollen,20%of patients with Japanese cedar pollinosis without eruption and 7%of control subjects.A histological examination revealed eczematous changes and infiltration of lymphocytes and eosinophils in atopy patch testing positive sites.In conclusion,atopy patch testing with Japanese cedar pollen extract is a useful method for investigating trigger factors for eczematous skin lesions in a subgroup of patients with atopic dermatitis.
