Childhood atopy and allergic disease and skin test responses to environmental mycobacteria in rural Crete: a cross‐sectional survey

Bibakis, I; Zekveld, C; Dimitroulis, J.; Pedioti, A; Gerakianaki, T.; Fanourgiaki, S.; Kokiadi, I.; Iliakou-Bibakis, V.; Taylor, A J Newman; Stanford, Cynthia; Stanford, J. L.; Cullinan, Paul

doi:10.1111/j.1365-2222.2005.02230.x

Cited by 15 publications

(9 citation statements)

References 26 publications

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“…On the contrary, Ota et al. (20) found no inverse relation of TST positivity and atopy in Gambian children as was found in several other studies (18, 21–23).…”

Section: Discussionmentioning

confidence: 78%

No association between tuberculin skin test and atopy in a bacillus Calmette‐Guérin vaccinated birth cohort

Eifan

Akkoç

Özdemir

et al. 2009

Pediatric Allergy Immunology

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Previously, an inverse association was suggested between mycobacterial infection and atopy. We aimed to determine the association between tuberculin skin test (TST) and allergic manifestations in a birth cohort where all infants were vaccinated with bacillus Calmette-Guérin (BCG) at birth. Newborns were enrolled randomly and prospectively followed up for a period of 5 yr. Information on family history and environmental factors was obtained at birth, International Study of Asthma and Allergies in Childhood asthma questionnaire, physical examination, skin prick test to common inhalant and food allergens and TST were performed at 2 and 5 yr of age. Positive TST reactivity was defined as an induration of > or = 10 mm. A total of 399 newborns were enrolled, 293 and 125 were available for a followup visit at 2 and 5 yr of age respectively. The prevalence of ever asthma, rhinitis and allergen sensitization tended to increase while eczema decreased with time. No significant association was found between TST reactivity and ever and current wheeze, doctor diagnosed asthma or atopic sensitization both at 2 and 5 yr of age. This prospectively designed birth cohort study did not confirm the previously suggested inverse correlation between TST reactivity and atopic sensitization or any allergic manifestations in Turkish children vaccinated with BCG at birth.

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“…On the contrary, Ota et al. (20) found no inverse relation of TST positivity and atopy in Gambian children as was found in several other studies (18, 21–23).…”

Section: Discussionmentioning

confidence: 78%

No association between tuberculin skin test and atopy in a bacillus Calmette‐Guérin vaccinated birth cohort

Eifan

Akkoç

Özdemir

et al. 2009

Pediatric Allergy Immunology

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“…Table 1 summarizes the characteristics of studies. Of the 23 studies 19 were cross‐sectional, three case–control and one prospective cohort (13, 16–37). Table 2 shows the type of Mycobacterium infection studied and methods used to define mycobacterial exposure or infection and atopic disease outcome.…”

Section: Resultsmentioning

confidence: 99%

Mycobacterial infection and atopy in childhood: A systematic review

Obihara

Bollen

Beyers

et al. 2007

Pediatric Allergy Immunology

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The epidemiological relation between mycobacterial infection and the prevalence of atopic disease in humans is still unclear. This is in contrast to studies in murine models in which a clear suppression of atopic symptoms was observed after exposure to mycobacteria or mycobacterial products. We therefore wanted to provide a systematic overview of the published literature on the relationship between mycobacterial infection and atopic disease and to evaluate the causal relationship in a meta-analysis. The EMBASE and MEDLINE databases were searched systematically for papers published in the English literature (1966-2005) on the relation between mycobacterial infection and atopic disease. Original observational or interventional studies involving the paediatric population were included. Two authors independently reviewed articles for data on mycobacterial exposure and atopic disease outcome. Any differences were resolved by discussion. Of a total of 1201 hits, 23 studies (19 cross-sectionals, three case-controls and one prospective cohort) met the inclusion criteria. Only a minority of studies (40%) observed an association between mycobacterial infection and the prevalence of atopic disease outcome. In the meta-analysis, only studies containing data on mycobacterial exposure and atopic disease outcome variables were included. Only cross-sectional studies, in which the relation between a positive tuberculin skin test and allergic symptoms was studied, observed statistically significant negative correlation (odds ratio 0.63; 95% confidence interval: 0.51-0.79). The results of this review show that the evidence of the relationship of mycobacterial infection and atopic disease is based on observations of cross-sectional studies. In a meta-analysis, calculations showed a high level of heterogeneity (I(2)) within studies with similar design making it difficult to pool effects. This may partly be explained by differences in the type and definition of mycobacterial infection and lack of uniformity in the definition of atopy. The results show that only a minority of studies in the literature shows any evidence of inverse relationship between mycobacterial exposure and atopic disease outcome. The fact that the present epidemiological evidence on the relationship between mycobacterial infection and the development of atopic disease is based mainly on cross-sectional observational studies indicates the need for population-based prospective studies to address this issue. This issue needs to be addressed in view of recent suggestions to developing mycobacterial-based vaccines against atopic disease in the future.

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“…The 1 mg dose of SRP299 administered in this study was the same as the dose of killed M. vaccae suspension SRL172 used in a previous study on AD study in [5][6][7][8][9][10][11][12][13][14][15][16][17][18] year olds, and used extensively in tuberculosis, cancer and allergy studies. The intradermal route of administration was chosen as this delivers M. vaccae to the antigenpresenting cells in the skin.…”

Section: Discussionmentioning

confidence: 99%

“…A study of Japanese schoolchildren in 1997 showed a strong inverse association between delayed hypersensitivity to Mycobacterium tuberculosis and asthma [10] and prompted increased recent interest in this potential area. An independent study of 418 South African children showed a similarly strong negative association between tuberculin reactivity and allergic rhinitis [11], although another large study of 606 children in Crete found no significant association between mycobacterial skin reactivity and atopic diseases [12]. Some of these epidemiological studies may suggest a link between mycobacterial reactivity and atopic disease, but they do not address the question as to whether administration of mycobacterial antigens can modify the clinical course of these conditions.…”

Section: Introductionmentioning

confidence: 99%

Killed Mycobacterium vaccae suspension in children with moderate‐to‐severe atopic dermatitis: a randomized, double‐blind, placebo‐controlled trial

Berth‐Jones

Arkwright

Marasović

et al. 2006

Clin Experimental Allergy

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Childhood atopy and allergic disease and skin test responses to environmental mycobacteria in rural Crete: a cross‐sectional survey

Abstract: Our findings, in a population of BCG-immunized children, do not lend support to the suggestion that infection with atypical mycobacteria is protective against childhood allergic disease.

Cited by 15 publications

References 26 publications

No association between tuberculin skin test and atopy in a bacillus Calmette‐Guérin vaccinated birth cohort

No association between tuberculin skin test and atopy in a bacillus Calmette‐Guérin vaccinated birth cohort

Mycobacterial infection and atopy in childhood: A systematic review

Killed Mycobacterium vaccae suspension in children with moderate‐to‐severe atopic dermatitis: a randomized, double‐blind, placebo‐controlled trial

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