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Background  The elucidation of factors that trigger the development of transient wheezing in early childhood may be an important step toward understanding the pathogenesis of asthma and other allergic diseases later in life. Transient wheezing has been mainly attributed to viral infections, although sensitisation to aeroallergens and food allergens may occur at an early age. In developing countries, intestinal helminthic infections have also been associated with allergy or atopy-related disorders.    Objective  The aim of this study was to explore the association of  Trichuris trichiura  and  Ascaris lumbricoides  infections with wheezing and atopy in early childhood.    Study design  A cross-sectional study using a Portuguese-language ISAAC phase I questionnaire, adapted for preschool-aged children, nested in a cohort study of childhood diarrhoea, was conducted on 682 children. Two faecal samples per child were examined for the presence of intestinal helminthic infection. IgE antibodies against three allergenic preparations  (Dermatophagoides pteronyssinus, Blomia tropicalis  and common child food), as well as against  A. lumbricoides  antigens, were measured in a sub-sample of these children, whose parents allowed the procedure. Atopy was defined by the presence of levels of serum IgE antibodies ≥0.35 kU/L against at least one of the three tested allergenic preparations.    Results  Active  T. trichiura  infection but not  A. lumbricoides  infection was positively associated with wheezing in the total studied children population [adjusted OR = 2.60; CI = 1.54;4.38] and in the atopic children sub-population [adjusted OR = 3.07; CI = 1.00;9.43]. The association with atopy was also positive and statistically significant only in the brute analysis [OR = 2.13; CI = 1.03;4.40]. Anti- A. lumbricoides  IgE antibodies, but not current  A. lumbricoides  infection, were positively associated with wheezing in atopic children [adjusted OR = 2.01; CI = 1.00;4.50] and in non-atopic children [adjusted OR = 3.07; CI = 1.13;8.35] and it was also associated with atopy [adjusted OR = 7.29; CI = 3.90; 13.4]. On the other hands, reports of wheezing were not significantly associated with atopy.    Conclusions  These data corroborate previous studies showing that wheezing is predominantly associated with infection in early childhood and shows that anti- A. lumbricoides  IgE antibodies, but not active  Ascaris  infections, are associated with wheezing and atopy. Additionally, the data demonstrate that  T. trichiura  infection may play a role in the pathogenesis of atopic wheezing in early childhood.

respiratory research

The presence of serum anti-Ascaris lumbricoides IgE antibodies and of Trichuris trichiura infection are risk factors for wheezing and/or atopy in preschool-aged Brazilian children