Supplementary Material for: Anti-<b><i>Ascaris</i></b> IgE as a Risk Factor for Asthma Symptoms among 5-Year-Old Children in Rural Bangladesh with Even Decreased <b><i>Ascaris</i></b> Infection Prevalence

<b><i>Background:</i></b> Epidemiological studies have indicated that anti-<i>Ascaris</i> IgE enhances asthma and allergies under specific conditions although the association between them is still controversial. The association of anti-<i>Ascaris</i> IgE with increased asthma symptoms among children from a general population with a mild to moderate <i>Ascaris</i> infection prevalence was investigated. <b><i>Methods:</i></b> A total of 126 children aged 5 years with wheezing during the previous year and 110 children who did not have wheezing were selected randomly from the rural service area of the International Centre for Diarrhoeal Disease Research, Bangladesh. Serum levels of total, anti-<i>Ascaris</i>, anti-<i>Dermatophagoides pteronyssinus</i>, and anti-cockroach IgEs were tested, and their risks for wheezing were analyzed. The wheezing children were then classified by hierarchical cluster analysis to investigate the contribution of anti-<i>Ascaris</i> IgE to wheezing. <b><i>Results:</i></b> The anti-<i>Ascaris</i> IgE levels in wheezing and never-wheezing children were 1.07 and 0.65 U_A/mL, and it contributed to 11% of wheezing in children. Anti-<i>Ascaris</i> IgE was significantly associated with wheezing (odds ratio [OR] per log_e increment: 1.37 [95% CI: 1.01–1.87], <i>p</i> = 0.046). The ORs, which were adjusted for sex, parental asthma, pneumonia history, helminth infections, <i>Haemophilus influenzae</i> type B combination vaccination, antibiotic use during infancy, and total and specific IgE levels, increased even when only children with more specific symptoms of asthma were included in the analysis. Namely, the ORs for wheezing with sleep disturbance, four or more attacks, and wheezing with speech difficulties during the previous 1 year were OR = 1.44/log_e increment [95% CI: 1.01–2.07], OR = 1.90/log_e increment [95% CI: 1.11–3.25], and OR = 1.78/log_e increment [95% CI: 1.01–3.14], respectively. <b><i>Conclusions:</i></b> The anti-<i>Ascaris</i> IgE levels in wheezing and never-wheezing children in the current study significantly decreased concurrently with <i>Ascaris</i> infection prevalence compared with their corresponding values in 2001. The contribution of anti-<i>Ascaris</i> IgE to wheezing also dropped from 26% in 2001 to 11% in the current study. Despite significant decreases in the levels and the seroprevalence and its contribution to wheezing, anti-<i>Ascaris</i> IgE remained significantly associated with increased risk of wheezing. Anti-<i>Ascaris</i> IgE significantly increased the risk of wheezing in a general population with a mild to moderate <i>Ascaris</i> infection prevalence, suggesting robustness as a risk factor and a possible dose-response relationship.

<b><i>背景：</i></b> 流行病学研究表明，抗蛔虫（Ascaris）免疫球蛋白E（IgE）在特定条件下会加重哮喘与过敏症状，但二者间的关联仍存在争议。本研究针对轻至中度蛔虫感染流行率的普通人群中儿童群体，探究抗蛔虫IgE与哮喘症状加重之间的关联。
<b><i>方法：</i></b> 本研究从孟加拉国国际腹泻病研究中心（International Centre for Diarrhoeal Disease Research, Bangladesh）的农村服务区域中随机选取126名在过去一年出现过喘息症状的5岁儿童，以及110名无喘息症状的5岁儿童。检测受试者血清中总IgE、抗蛔虫IgE、抗屋尘螨（Dermatophagoides pteronyssinus）IgE以及抗蟑螂IgE的水平，并分析其与喘息症状的风险关联。随后通过系统聚类分析（hierarchical cluster analysis）对喘息儿童进行分类，以探究抗蛔虫IgE对喘息症状的贡献度。
<b><i>结果：</i></b> 出现喘息症状与从未出现喘息症状的儿童，其抗蛔虫IgE水平分别为1.07和0.65 U_A/mL，该抗体可解释11%的儿童喘息病例。抗蛔虫IgE与喘息症状存在显著关联（自然对数每增加1个单位的比值比（odds ratio, OR）为1.37，95%置信区间（CI）：1.01~1.87，<i>p</i> = 0.046）。在对性别、父母哮喘史、肺炎病史、蠕虫感染（helminth infections）、B型流感嗜血杆菌（Haemophilus influenzae type B）联合疫苗接种史、婴儿期抗生素使用情况以及总IgE和特异性IgE水平进行校正后，该关联依然显著；当仅将具有更典型哮喘症状的儿童纳入分析时，OR值进一步升高。具体而言，过去一年中出现伴随睡眠障碍的喘息、发作次数≥4次的喘息，以及伴随言语困难的喘息，其对应的OR值分别为1.44/自然对数增量[95% CI: 1.01~2.07]、1.90/自然对数增量[95% CI: 1.11~3.25]，以及1.78/自然对数增量[95% CI: 1.01~3.14]。
<b><i>结论：</i></b> 本研究中出现喘息与从未出现喘息的儿童，其抗蛔虫IgE水平相较于2001年的对应数值，均随蛔虫感染流行率的下降而显著降低。抗蛔虫IgE对儿童喘息的贡献度也从2001年的26%降至本研究中的11%。尽管该抗体的水平、血清阳性率（seroprevalence）及其对喘息的贡献度均出现显著下降，但其仍与喘息风险升高存在显著关联。在轻至中度蛔虫感染流行率的普通人群中，抗蛔虫IgE可显著升高儿童出现喘息的风险，提示其作为风险因素的稳定性及潜在的剂量-反应关系。

搜集汇总

背景与挑战

背景概述

该数据集是孟加拉国农村5岁儿童哮喘症状与抗蛔虫IgE关联性研究的补充材料，包含236名儿童（126名有喘息症状，110名无喘息症状）的血清IgE测试数据和分析结果。研究发现抗蛔虫IgE水平与喘息风险显著相关（OR=1.37），即使在蛔虫感染率下降的背景下，这种关联性依然存在，表明抗蛔虫IgE是哮喘症状的稳健风险因素。