oraz innymi chorobamiPopulation-based cases control study of inflammatory bowel disease risk factors.
Gearry RB, Richardson AK, Frampton CM, Dodgshun AJ, Barclay ML.
Department of Medicine, University of Otago, Christchurch, New Zealand. Richard.gearry@cdhb.govt.nz
Comment in:
* J Gastroenterol Hepatol. 2010 Feb;25(2):227-8.
BACKGROUND AND AIM: The rapid increase in inflammatory bowel disease (IBD) incidence confirms the importance of environment in its etiology. We aimed to assess the role of childhood and other environmental risk factors in IBD.
METHODS: A population-based case-control study was carried out in Canterbury, New Zealand. Participants comprised 638 prevalent Crohn's disease (CD) cases, 653 prevalent ulcerative colitis (UC) cases and 600 randomly-selected sex and age matched controls. Exposure rates to environmental risk factors were compared. Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CI) are presented.
RESULTS: A family history of IBD (CD OR 3.06 [2.18-4.30], UC OR 2.52 [1.90-3.54]), cigarette smoking at diagnosis (CD OR 1.99 [1.48-2.68], UC OR 0.67 [0.48-0.94]), high social class at birth (CD and UC trend, P < 0.001) and Caucasian ethnicity (CD OR 2.04 [1.05-4.38], UC OR 1.47 [1.01-2.14]) were significantly associated with IBD. City living was associated with CD (P < 0.01). Being a migrant was associated with UC (UC OR 1.40 [1.14-2.01]). Having a childhood vegetable garden was protective against IBD (CD OR 0.52 [0.36-0.76], UC OR 0.65 [0.45-0.94]) as was having been breast-fed (CD OR 0.55 [0.41-0.74], UC OR 0.71 [0.52-0.96]) with a duration-response effect. Appendicectomy, tonsillectomy, infectious mononucleosis and asthma were more common in CD patients than controls (P < 0.01).
CONCLUSIONS: The importance of childhood factors in the development of IBD is confirmed. The duration-response protective association between breast-feeding and subsequent development of IBD requires further evaluation, as does the protective effect associated with a childhood vegetable garden.
Może to suche fakty, ale widza na ten temat jest niezbędna i dziwię się stanowisku Ranki.Curr Opin Immunol. 2010 Sep 17. [Epub ahead of print]
Neonatal tolerance under breastfeeding influence.
Verhasselt V.
INSERM, U924, 660, route des Lucioles, Valbonne, F-06560, France; Université de Nice-Sophia-Antipolis, Valbonne, F-06560, France.
Abstract
Diseases due to defect in tolerance induction such as allergy, celiac disease, or Type 1 Diabetes develop mostly in childhood indicating the necessity of early intervention for primary prevention. Epidemiological studies report that breastfeeding could protect from these diseases. However, data are controversial and the mechanisms unclear. Experimental data suggest that breastfeeding-induced protection might rely on tolerance induction as long as some criteria are fulfilled. Thus, the tolerogenic potential of breast milk would depend on maternal exposure to common environmental and dietary antigens and the efficiency of antigen transfer across mammary epithelium. Induction of tolerance upon breast milk-mediated antigen transfer will also depend on the presence of immunomodulatory factors in breast milk and of its impact on neonatal gut and immune system maturation. The better understanding of maternal influence on tolerance induction through breastfeeding should allow the development of new strategies to prevent immune-mediated diseases.
Ranka budesonid w piance, hydrokortyzon we wlewkach nie przenika praktycznie do organizmu i może być stosowany w ciąży bezpiecznie.
Uważa się również, że niewielki dawki sterydów są mniej szkodliwe dla dziecka niż rezygnacja z karmienia.
Rozumiem obawę przyszłych mam i tych, które właśnie urodziły, ale będę powtarzała z uporem maniaka, że nic nie zastąpi karmienia piersią i butelka nie jest wyborem, a ostatecznością.
To jest wasza inwestycja w wasze dziecko.