| Sažetak | Cilj istraživanja: utvrditi utjecaj rizičnih čimbenika i infekcije RSV-om u ranoj životnoj dobi te istražiti mogućnost uporabe periostina i vitamina D kao biomarkera za razvoj atopijskih bolesti u djece do 10. godine života. Nacrt studije: istraživanje je opažajno, kohortno i prospektivno. Od rođenja je praćeno 127 djece: u dobi od godinu dana evaluirano je 127 djece, do dvije godine 92 djece, a 72 djece je praćeno do 10. godine života. Ispitanici i metode: u djece koja su do druge godine imala pozitivna RSV-specifična IgG protutijela (RSV-IgG), praćen je razvoj RSV-IgE, RSV-IgG3 i RSV-IgG4, alergijske senzibilizacije i atopijskih bolesti. Analizirani su periostin i vitamin D kao mogući biomarkeri za razvoj atopijskih bolesti u djece. Rezultati: Pozitivna RSV-IgE protutijela u jednogodišnje djece povećavaju šanse za pojavu recidivirajućih bronhoopstrukcija za 5,94 puta (OR=5,94, 95% CI=1,05-33,64; p=0,044) i za pojavu alergijskog rinitisa (AR) za više od 15 puta (OR=15,03, 95% CI=2,08-108,72; p=0,007) do 10. godine života. Veće koncentracije periostina u serumu imala su djeca s bronhoopstrukcijama u posljednjih 12 mjeseci (35,53 nasuprot 29,60 ng/mL, p=0,016) i djeca koja su imala recentne simptome AR (35,53 nasuprot 29,60 ng/mL, p=0,025) u odnosu na djecu bez simptoma. Povezanost periostina s recidivirajućim bronhoopstrukcijama prisutna je u djece neatopičara (tau_b=0,512, p=0,005). RSV-IgG4 u jednogodišnje djece pokazala su značajno predviđanje razvoja alergijske senzibilizacije (OR 2,73, 95% CI 1,07-7,00, p=0,036), pozitivnu povezanost s nutritivnom alergijom (tau_b=0,205, p=0,023) i atopijskim dermatitisom (AD) (tau_b=0,201, p=0,025) do druge godine života, AD do 10. godine (tau_b=0,211, p=0,049) i recentnim simptomima AD (tau_b=0,269, p=0,012). Razina RSV-IgE pozitivno je povezana s AR do 10. godine (tau_b=0,290, p=0,012) i recentnim simptomima AR (tau_b= 0,260, p=0,025). Pozitivna obiteljska anamneza povećava šanse za pojavu recidivirajućih bronhoopstrukcija za 5,49 puta (OR=5,49, 95% CI=1,01-30,07; p=0,049), a dulje trajanje isključivog dojenja smanjuje šansu za njihovu pojavu (OR=0,63, 95% CI=0,45-0,89; p=0,008) u djece do 10. godine života. Pušenje majke u trudnoći povećava šanse za pojavu AR tijekom praćenja za 7,63 puta (OR=7,63, 95% CI=1,59-36,53; p=0,011). Zaključak: RSV specifična-IgE protutijela mogu biti povezana s razvojem atopijskih bolesti u djece. Veća koncentracija periostina nađena je u djece neatopičara s recidivirajućim bronhoopstrukcijama i u djece s AR. |
| Sažetak (engleski) | Objectives: to determine the influence of risk factors and RSV infection in early life and explore the possibility of using periostin and vitamin D as biomarkers for the development of allergic sensitization and atopic diseases in 10-year-old children. Study Design: the research is observational, a cohort and prospective follow-up of 127 children born in Požeško-slavonska County: 127 children have been evaluated at the age of one, 92 at the age of two and 72 were monitored until the age of 10. Participants and methods: children who had positive RSV-specific IgG antibodies (RSV-IgG) during the first two years of life, had been monitored for development of RSV-IgE, RSV-IgG3 and RSV-IgG4, allergic sensitization and atopic diseases. Periostin and vitamin D have been analysed as possible biomarkers for development of atopic diseases in children. Results: Positive RSV-IgE in one-year-old children increase the chances of recurrent wheezing occurrence in children by 5.94 times (OR=5.94, 95% CI=1.05-33.64; p=0.044) and also for the occurrence of allergic rhinitis (AR) more than 15 times (OR=15.03, 95% CI=2.08-108.72; p=0.007) by the age of 10. Ten-year-old children with current wheezing showed significantly higher periostin serum concentrations (35.53 vs. 29.60 ng/mL, p=0.016) as well as children with current AR symptoms (35.53 vs. 29.60 ng/mL, p=0.025), compared to children who were symptom-free in the previous year. Correlation of periostin serum concentration with recurrent wheezing is present in non-atopic children (tau_b=0.512, p=0.005). RSV-IgG4 in one-year-old children showed significant prediction of increased total and/or allergen-specific IgE (OR= 2.73, 59% CI 1.07-7.00, p=0.036), positive correlation with development of nutritive allergy (tau_b=0.205, p=0.023) and atopic dermatitis (AD) (tau_b 0.201, p=0.025) in the first two years of age, significant positive correlation with AD until the age of 10 (tau_b 0.211, p=0.049) and current AD (tau_b 0.269, p=0.012). RSV-IgE showed positive correlation with AR in children until the age of 10 (tau_b=0.290, p=0.012) and current AR (tau_b=0.260, p=0.025). A positive family history increases the chances of recurrent wheezing by 5.49 times (OR=5.49, 95% CI=1.01-30.07; p=0.049), and a longer duration of exclusive breastfeeding significantly reduces the chances of recurrent wheezing occurrence (OR=0.63, 95% CI=0.45-0.89; p=0.008). Maternal smoking during pregnancy increases the chances of developing AR during follow-up, by 7.63 times (OR=7.63, 95% CI=1.59-36.53; p=0.011). Conclusion: RSV-IgE may be associated with development of atopic diseases in children. A higher concentration of periostin was found in serum of non-atopic children with recurrent wheezing and in children with AR. |
