Wurminfestationen reduzieren das Risiko für ein atopisches Ekzem

Abstract

Background

Worm infestations may play a role in preventing allergic diseases. There is a lack of epidemiologic information from western countries on the association between worm infestation and atopic eczema (AE). The aim of this study was to investigate the association between worm infestation and AE in a proper temporal sequence and under consideration of the intrinsic and extrinsic subtype.

Methods

Two surveys were performed in East German schoolchildren. Questionnaire data included the history of AE and worm infestation and their time of onset. Specific IgE antibodies to five common aeroallergens were measured and used to define an intrinsic and extrinsic subtype of AE. Logistic regression analyses were performed to control for relevant confounders (age, sex, parental school education, and history of allergies).

Results

A total of 4,169 children participated (response rate 75% and 76%) who were, on average, 9.2 years old (47% girls). Overall, 15.0% reported a prior worm infestation (Ascaris 44%, Oxyuris 33%) and 18.1% had a history of AE. AE occurred significantly less frequently in children who had a worm infestation (prior to the onset of AE) compared to children without such a history (7.1% vs. 16.5%, adjusted odds ratio [OR_adj.] 0.45; 95% confidence intervall 0.33–0.60). The extrinsic type of AE was more strongly affected by a prior worm infestation (OR_adj 0.31; 0.18–0.56) than the intrinsic type (OR_adj. 0.58; 0.40–0.84).

Conclusion

A worm infestation is associated with a reduced risk of subsequent AE manifestation, especially the extrinsic type. The data support the concept that a lack of immune stimulation by parasitic infections contributes to the development of allergies.