on behalf of the LISA study group Allergens and endotoxin on mothers9 mattresses and total immunoglobulin E in cord blood of neonates. J. Heinrich, G. Bolte, B.Hölscher, J. Douwes, I. Lehmann, B. Fahlbusch, W. Bischof, M. Weiss, M. Borte, H-E. Wichmann, on behalf of the LISA study group. #ERS Journals Ltd 2002. ABSTRACT: The current authors examined whether mite and cat allergen and bacterial endotoxin levels in dust of the mothers9 mattresses were associated with cord blood immunoglobulin (Ig)E (CB-IgE) levels in newborns.Data from 1,332 term and normal weight neonates, from an ongoing birth cohort study, Influences of life-style related factors on the immune system and the development of allergies in childhood (LISA), with complete information on exposure to biocontaminants in mattress dust and CB-IgE were analysed. (4th quartile) were chosen as cut-offs. Nonparametric smoothing (generalised additive models) showed statistically significant confounder-adjusted associations between elevated CB-IgE levels (o0.45 kU?L -1 ) and log-transformed exposures to cat (linear), mite (inverse u-shaped), and endotoxin (u-shaped).After adjustment for covariables, elevated CB-IgE levels (logistic regression using the 1st-4th quartiles of exposure) were positively associated with high cat-allergen exposure and medium exposure to mite allergen, but were inversely associated with exposure to endotoxin. The associations were similar, but somewhat weaker, when 0.35 kU?L -1 was used as cut-off. These results, showing an association between prenatal allergen and endotoxin exposures and immunoglobulin E production, suggest that the development of foetal immune responses may be affected.

+ cord blood T cells are associated with a higher risk for atopic dermatitis during the first 2 yr of life Several risk factors have been shown to be associated with the development of atopic disorders, among them the family atopy history (FAH), cat ownership, smoking during pregnancy and environmental tobacco smoke (ETS) in utero and after birth, the social economic status (SES), family size (absence of siblings), season of birth and exposure to traffic-related air pollutants and the immune status of the child at the time of birth. Some of these risk factors are discussed as predictive factors, pointing already at birth to an increased risk for later allergy development. The genetic background of atopic diseases is the most accepted predictive factor. Beside FAH and cord blood (CB) IgE levels (1, 2) the cytokine production of CB T cells (3, 4) is also discussed to have a predictive value for atopy. + cord blood T cells are associated with a higher risk for atopic dermatitis during the first 2 yr of life.

Background: Various methods exist for statistical inference about a prevalence that consider misclassifications due to an imperfect diagnostic test. However, traditional methods are known to suffer from truncation of the prevalence estimate and the confidence intervals constructed around the point estimate, as well as from under-performance of the confidence intervals' coverage. Methods: In this study, we used simulated data sets to validate a Bayesian prevalence estimation method and compare its performance to frequentist methods, i.e. the Rogan-Gladen estimate for prevalence, RGE, in combination with several methods of confidence interval construction. Our performance measures are (i) error distribution of the point estimate against the simulated true prevalence and (ii) coverage and length of the confidence interval, or credible interval in the case of the Bayesian method. Results: Across all data sets, the Bayesian point estimate and the RGE produced similar error distributions with slight advantages of the former over the latter. In addition, the Bayesian estimate did not suffer from the RGE's truncation problem at zero or unity. With respect to coverage performance of the confidence and credible intervals, all of the traditional frequentist methods exhibited strong under-coverage, whereas the Bayesian credible interval as well as a newly developed frequentist method by Lang and Reiczigel performed as desired, with the Bayesian method having a very slight advantage in terms of interval length. Conclusion: The Bayesian prevalence estimation method should be prefered over traditional frequentist methods. An acceptable alternative is to combine the Rogan-Gladen point estimate with the Lang-Reiczigel confidence interval.

Since differences in the T cell cytokine production of neonates in Munich and Leipzig are independent from FAH our findings may provide evidence for the impact of environmental factors upon the fetal immune system.

Bacteria of the genus Campylobacter are an important cause of human illness worldwide. Campylobacter infections are expressed as gastroenteritis and can lead to severe sequelae like reactive arthritis, Guillain-Barré syndrome, irritable bowel syndrome and inflammatory bowel disease. In Germany, Campylobacter -associated gastroenteritis cases are notifiable but there is no reporting obligation for the sequelaes and the disease burden is clearly underestimated. The aim of our study was to quantify reliably the current disease burden of all Campylobacter spp.-associated diseases for Germany with the method of disability-adjusted life years (DALYs). DALYs combine mortality and morbidity in a single summary measure, whereby one DALY represents the loss of one year in full health. For acute gastroenteritis, we estimated 967 DALYs of which only 484 DALYs were detected within the reporting system. Overall, we estimated that 8811 DALYs were caused by the campylobacter-related diseases known so far. 98% of the DALYs were associated with morbidity and 2% with mortality. Mortality was caused by the health outcomes Gastroenteritis and Guillain-Barré syndrome exclusively.