Chowdhury H. R.

Hasan M. I.

Hawlader M. D. H.

Iwata T.

Khan A. F.

Takanashi S.

Takeuchi H.

WAGATSUMA Yukiko

Yunus M.

Zaman K.

Clinical & Experimental Allergy

English

Tsukuba Repository  (Tulips-R)

Comment on IgE responses toAscarisand mitetropomyosins are risk factors for asthma著者別名 我妻 ゆき子journal orpublication titleClinical and experimental allergyvolume 46number 1page range 178-180year 2016-11権利 (C) 2015 The Authors. Clinical & ExperimentalAllergy Published by John Wiley & Sons Ltd.This is an open access article under the termsof the Creative CommonsAttribution-NonCommercial-NoDerivs License,which permits use and distribution in anymedium, provided the original work is properlycited, the use is non-commercial and nomodifications or adaptations are made.URL http://hdl.handle.net/2241/00154087doi: 10.1111/cea.12678Creative Commons : 表示 - 非営利 - 改変禁止http://creativecommons.org/licenses/by-nc-nd/3.0/deed.jadoi: 10.1111/cea.12678 Clinical & Experimental Allergy, 46, 178–180CORRESPONDENCE© 2015 The Authors. Clinical & Experimental Allergy Published by John Wiley & Sons Ltd.Comment on IgE responses to Ascaris and mite tropomyosins are riskfactors for asthmaH. Takeuchi1,2, A. F. Khan3, M. I. Hasan4, M. D. H. Hawlader5, M. Yunus4, K. Zaman4, H. R. Chowdhury6, S. Takanashi7,Y. Wagatsuma8 and T. Iwata91Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan, 2Department ofPediatrics, Funabashi General Hospital, Funabashi, Chiba, Japan, 3Centre for Nutrition and Food Security, International Centre for Diarrheal DiseaseResearch, Bangladesh, Mohakhali, Dhaka, Bangladesh, 4Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research,Bangladesh, Mohakhali, Dhaka, Bangladesh, 5Department of Epidemiology, Bangladesh University of Health Sciences, Mirpur, Dhaka, Bangladesh, 6GlobalBurden of Disease Group, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia, 7Department ofDevelopmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku,, Tokyo, Japan, 8Department of Clinical Trial andClinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan and 9Department of Education for Childcare, Faculty of ChildStudies, Tokyo Kasei University, Sayama, Saitama, JapanWe read with great interest the paper by Ahumadaet al. [1] on the association between asthma symptomsand IgE responses to Ascaris and mites in a populationliving in the tropics. They report for the first time in anationwide case–control study performed in Columbiathat IgE sensitization to house dust mite or Ascaris tro-pomyosin has clinical relevance. They also report thatspecific IgE to tropomyosins from Ascaris and mitesstrongly correlate and speculate that co-exposure toboth mite and Ascaris generates conditions to increasethe allergic symptoms.Anti-Ascaris IgE has been reported to increase therisk of wheezing in low endemic areas, and we demon-strated previously that elevated anti-Ascaris IgE wasassociated with wheezing in children in rural Bangla-desh, where as many as 75% of children were infectedwith Ascaris [2]. A study performed later in the samearea of Bangladesh in 2008, when the infection preva-lence was 17.4%, reported that anti-Ascaris IgE wasassociated with increased risk of ever asthma in 5-year-old children as well [3]. These findings suggest thatanti-Ascaris IgE is associated with increased risk ofwheezing regardless of exposure levels to Ascaris.The prevalence of asthma in Bangladesh has beenincreasing over the years. A nationwide cross-sectionalsurvey in 1999 reported 7.3% of asthma prevalence inthe children aged 5–14 years [4]. A subsequent study con-ducted in 2000 among the schoolchildren aged 6–7 yearsdocumented 9.1% of current wheezing [5]. Our laterresearch reported a further increase to a 16% prevalenceof current wheezing in 2001 among children aged 5–6 years in a rural area [2], while a 2008 study described a19.7% prevalence of current wheezing in the same areaamong 5-year-old children [3]. This sudden increase ofthe prevalence from 2000 to 2001 and the subsequentslow increase between 2001 and 2008 also attracts ourattention. The annual increase in the prevalence ofasthma was reported 0.02% for the Indian subcontinent,which includes Bangladesh [6].On the other hand, the percentage change of Ascarisinfection in age-standardized prevalence from 1999 to2013 was -44.8%, and the percentage change in age-standardized years lived with disability (YDLs) from1999 to 2013 was -80.1%. This percentage decrease inage-standardized YDLs was the highest among all thelisted 301 acute and chronic diseases and injuries in188 countries between 1990 and 2013 [7]. The infectionprevalence in Bangladesh also declined drastically afterintroduction of the national programme of anti-hel-minthic drug administration for children 24–59 months,initiated in 2004, and an additional programme forprimary school-aged children [2,3]. The high prevalenceof the infection in 2001 and the subsequent sharpdecline until 2008 arrests our attention.WHO has been implementing a programme since2001 for people at risk in endemic areas in order toeliminate soil-transmitted helminthic infections toreduce intensity of infection and to protect infectedindividuals from morbidity related to the worms har-boured [8]. Major soil-transmitted helminths are Ascarislumbricoides, Trichuris trichiura and Ancylostoma duo-denale. The morbidity related to the worms harbouredlisted includes abdominal pain, general malaise andweakness, impaired cognitive and physical development[8]. The people at risk are preschool children andschool-age children, women of child baring age andCorrespondence:Haruko Takeuchi, Department of Community and Global Health, GraduateSchool of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo113-0033, Japan. E-mail: htakeuchi-tky@umin.netThis is an open access article under the terms of the Creative CommonsAttribution-NonCommercial-NoDerivs License, which permits use anddistribution in any medium, provided the original work is properly cited, theuse is non-commercial and no modifications or adaptations are made.adults in certain occupations such as tea-pickers orminers [8]. WHO targets to eliminate the morbidity dueto soil-transmitted helminthiases in children by treatingregularly 75% of the children in endemic areas by 2020[8]. It is anticipated that helminthic infection will beeradicated in the near future. Despite this advance, anunacceptably large number of people suffering from theinfection still remain [8].WHO estimated in 2013 that there were over 270 mil-lion preschool children and 600 million school-age chil-dren in need of treatment of the diseases [8]. Theorganization recommends the target countries in thetropics to treat the children once a year when the infec-tion prevalence of soil-transmitted helminths in the com-munity is between 20% and 50%, and twice a year whenthe prevalence is over 50%. According to the Country Xindicators of soil-transmitted helminthiasis of WHO in2013, national coverage of the preventive treatment ofsoil-transmitted helminthiasis in Bangladesh was 100%among preschool-aged children and 80% among school-age children [9]. The programme coverage is expressedby the fraction using the total number of the annualtreatment children receive in the community as thenumerator, and the population of the children in the tar-get age group as the denominator. In other words, when10 children receive treatment twice a year, the number ofchildren treated is counted as ‘20’. As the treatment ofdeworming is conducted twice a year per child in Bangla-desh, the actual annual number of the children whoreceived treatment should be half of WHO’s estimate.Accordingly, the Bangladesh government is going toreduce the number of annual treatment to one becausethe national coverage of the children treated regularly isapproaching 75%.Ahumada et al. [1] hypothesize that co-exposure toboth mite and Ascaris generates conditions to increasethe allergic symptoms. Hawlader et al. [3] found thatanti-Ascaris IgE was significantly associated with anti-DP IgE in rural Bangladesh, in addition to the fact thatanti-Ascaris IgE is associated with ever asthma. Weagain focus on the high prevalence of Ascaris infectionin 2001 and the subsequent sharp decline until 2008.We also focus on the sudden increase in asthma preva-lence in 2001 followed by the slow increase during2001 and 2008. Wheezing illness in this area might bepart of the morbidity related to the worms harboured.However, if it is part of the morbidity, there shouldhave been a decline in the prevalence of wheezing after2001. Similarly, if Ascaris infection suppresses asthma,there should have been a continuing increase in theprevalence of asthma. These findings mentioned above,together with the results of the studies including ours,have led us to speculate that the subsequent increase inthe asthma prevalence after 2001 had been suppressedby the national deworming programme. Bangladeshmight have been in the era of co-exposure to both miteand Ascaris in 2001. Although the national coverage ofthe children treated regularly is approaching 75%,the programme is for severe infection and morbidity.There still remain a large number of lightly infectedchildren without symptoms. It is, therefore, of extremeimportance to examine the impact of Ascaris infectionon the development of asthma, in addition to thedescribed morbidity, among the children at risk, test-ing the immunological status in Bangladesh in itsrapid transition in the prevalence of both asthma andAscaris infection. We would hope to see children copewell with wheezing illnesses in Bangladesh based onthe scientific findings, including the findings in thepresent study.AcknowledgementsThe authors thank the children who participated in ourprevious studies and offered us their precious blood andstool, and their guardians who accompanied the chil-dren. We thank the field research staffs for vigorousdata collection, too. We also thank Dr. Tariq Anwar,Mr. Joytsnamoy Chakraborty, Dr. Mahbubur Rahman,Dr. Shams El Arifeen, Dr. Abdullar Baqui, ProfessorDavid Sack, former Executive Director of ICDDR, B, Dr.Hirotsgu Kano, Dr. Shinji Nakahara and Dr ShizueSunami for overall encouragement.Conflict of interestThe authors declare no conflict of interest.References1 Ahumada V, Garcıa E, Dennis R et al. IgEresponses to Ascaris and mitetropomyosins are risk factors for asthma.Clin Exp Allergy 2015; 45:1189–200.2 Takeuchi H, Zaman K, Takahashi J et al.High titre of anti-Ascaris immunoglob-ulin E associated with bronchial asthmasymptoms in 5-year-old rural Banglade-shi children. Clin Exp Allergy 2008;38:276–82.3 Hawlader MD, Ma E, Noguchi E et al.Ascaris lumbricoids infection as a riskfactor for asthma and atopy in ruralBangladeshi children. Trop Med Health2014; 42:77–85.4 Hassan MR, Kabir AR, Mahmud AMet al. Self-reported asthma symptoms inchildren and adults of Bangladesh: find-ings of the National Asthma PrevalenceStudy. Int J Epidemiol 2002; 31:483–8.5 Kabir ML, Rahman F, Hassan MQ,Ahamed F, Mridha MA. Asthma, atopiceczema and allergic rhino-conjunctivitisin school children. Mymensingh Med J2005; 14:41–5.6 Pearce N, Ait-Khaled N, Beasley R et al.Worldwide trends in the prevalence ofasthma symptoms: phase III of the© 2015 The Authors. Clinical & Experimental Allergy Published by John Wiley & Sons Ltd., 46 : 178–180Correspondence 179International Study of Asthma andAllergies in Childhood (ISAAC). Thorax2007; 62:758–66.7 Global Burden of Disease Study 2013Collaborators. Global, regional, andnational incidence, prevalence, and yearslived with disability for 301 acute andchronic diseases and injuries in 188countries, 1990-2013: a systematic anal-ysis for the GlobalBurden of DiseaseStudy 2013. Lancet 2015; pii: S0140-6736(15)60692-4.8 Media centre Soil-transmitted helminthinfections. Fact sheet N336 UpdatedMay 2015. http://www.who.int/media-centre/factsheets/fs336/en/.9 Soil-transmitted helminthiasis. CountryX indicators. http://www.who.int/neglected_diseases/preventive_chemotherapy/sth/db/?units=minimal&region=all&country=bgd&countries=bgd&year=2013 (Lastaccessed 2 December 2015).© 2015 The Authors. Clinical & Experimental Allergy Published by John Wiley & Sons Ltd., 46 : 178–180180 Correspondence

Comment on IgE responses toAscarisand mite tropomyosins are risk factors for asthma

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Comment on IgE responses toAscarisand mite tropomyosins are risk factors for asthma

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