Basic and Clinical Immunology
IgG antibodies against microorganisms and atopic disease in Danish adults: The Copenhagen Allergy Study,☆☆

https://doi.org/10.1067/mai.2003.1335Get rights and content

Abstract

Background: Seropositivity to food-borne and orofecal microorganisms (hepatitis A virus, Helicobacter pylori , and Toxoplasma gondii ), which are considered to be markers of poor hygiene, has been reported to be associated with a lower prevalence of atopy. In contrast, colonization of the gut with Clostridium difficile , a potential intestinal bacterial pathogen, in early childhood may be associated with a higher prevalence of atopy. Objective: The objective of this study was to investigate the association between atopy and exposure to 2 groups of food-borne and orofecal microorganisms: (1) markers of a poor hygiene and (2) intestinal bacterial pathogens. Methods: A cross-sectional population-based study of 15- to 69-year-olds living in Copenhagen, Denmark, was carried out in 1990 to 1991. Atopy was defined as a positive test result for specific IgE to at least 1 of 6 inhalant allergens. Exposure to microorganisms was assessed as IgG seropositivity to microorganisms. Results: Seropositivity to 2 or 3 markers of poor hygiene (hepatitis A virus, H pylori , and T gondii ) was associated with a lower prevalence of atopy (adjusted odds ratio, 0.5; 95% CI, 0.3 to 0.8). In contrast, seropositivity to 2 or 3 intestinal bacterial pathogens (C difficile , Campylobacter jejuni , and Yersinia enterocolitica ) was associated with a higher prevalence of atopy (adjusted odds ratio, 1.7; 95% CI, 1.2 to 2.6). Conclusion: Exposure to markers of poor hygiene was associated with a lower prevalence of atopy, whereas exposure to intestinal bacterial pathogens was associated with a higher prevalence of atopy. These findings raise the hypothesis that different groups of food-borne and orofecal microorganisms may have different effects on the risk of atopy. (J Allergy Clin Immunol 2003;111:847-53.)

Section snippets

Study population

The study was conducted according to a 2-stage protocol. In the first stage a screening questionnaire on respiratory symptoms was mailed to a sample of 15- to 69-year-olds (n = 8000) living in the western part of Copenhagen, the capital of Denmark. The sample was drawn randomly from the Civil Registration System. A total of 6998 or 87.5% responded to the screening questionnaire. In the second stage, a random group and a symptom group selected among the respondents were invited to a health

Results

The prevalence of IgG seropositivity against each of the microorganisms increased with increasing age (chi-square test, P < .05) (Table I). The prevalence of atopy was negatively associated with seropositivity to HAV and positively associated with seropositivity to C difficile (Table II). Furthermore, the prevalence of atopy decreased with an increasing index of exposure to markers of poor hygiene (HAV, H pylori , and T gondii ). In contrast, the prevalence of atopy increased with an increasing

Discussion

We found a negative association between a cumulative index of exposure to HAV, H pylori , and T gondii and the prevalence of atopy and allergic rhinitis. This is consistent with findings of a nested case-control study in Italian military cadets, aged 17 to 24 years.8 Thus, this association is not due to factors specific to Italian lifestyle, environment, or climate. In contrast, a nested case-control study (85 cases with adult onset wheeze and 190 control subjects) in a general population aged

Acknowledgements

We thank Bente Jensen, Anne Skou, Annette Gregersen, Tanja Hansen, and Sylvia Kaznilsson at the Department of Clinical Microbiology, Rigshospitalet, Denmark, for performing IgG measurements and the Product Development staff at ALK Abelló A/S, Hørsholm, Denmark, for performing IgE measurements.

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    Supported by grants from the Danish Lung Association, the National Association against Tuberculosis and Lung Diseases, The Danish Ministry of the Interior and Health, Research Centre for Environmental Health's Fund (383-31), the Danish Health Insurance Foundation (H11/274-89, H11/264-90), The Danish Medical Research Council, Danish Environmental Protection Agency, and ALK Abelló A/S, Denmark.

    ☆☆

    Reprint requests: Allan Linneberg, MD, PhD, Centre for Preventive Medicine, Glostrup University Hospital, 57 Ndr. Ringvej, Entrance 8, 7th floor, DK-2600 Glostrup, Denmark.

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