环境因素和炎症性肠病的童年

炎症性肠病(IBD)经常出现在青春期和影响> 140万人在美国。环境因素,尤其是空气污染和天气,已经提出为炎症性肠病的疾病活动。我们评估环境因素之间的关系和小儿炎症性肠病的患病率和疾病活动使用新颖的数据来源,考虑到地理位置。青年从1999 - 2015年诊断出患有IBD > = 6个月随访发现儿科医疗中心服务集水面积> 100万名儿童。健康对照组(HC) EHR-identified,年龄和性别匹配的IBD青年。家庭住址在每个临床遇到的所有病人记录和距离计算从房屋到最近的主要道路和高速公路利用ArcGIS接近工具集。组比较(IBD诉HC和IBD诉没有疾病爆发后诊断)和主要道路和家之间的距离和高速公路使用Wilcoxon等级和执行测试。气象数据(温度、湿度、风速和风向,大气压力,和太阳辐射)提取根据WiFire家里位置随着时间的推移,数据服务。互信息分析(MIA)和模型进行训练/旨在使用机器学习来确定天气数据预测炎症性肠病诊断和/或炎症性肠病的疾病活动和米娅。我们的研究包括320名青年与炎症性肠病(161:159 F; mean (SD) age: 11 (4) y) were identified with 320 age-and-sex matched HC. IBD youth lived statistically significantly further away from freeways (median (IQR): 5,286 (2,406, 11,281) v. 3,914 (1,682, 7,161) ft, IBD v. HC, p=0.0006) and major roads (844 (360, 1,805) v. 610 (181, 1,083) ft, IBD v. HC, p<0.0001) than HC. On average, youth with IBD who flared (N=133) lived closer to freeways (5,017 (2,207, 11,146) v. 5,800 (2,516, 11,977) ft, flare v. non flare, p=0.52) and major roads (718 (386, 2,034) v. 932 (329, 1.775) ft, flare v. non flare, p=0.82) than youth with IBD who did not flare (N=187), but this did not reach statistical significance. Models created using weather data in cross-validation did not demonstrate accuracy greater than chance (average AUC 0.58 - 0.60) in predicting presence of IBD and whether an IBD disease flare occurred. From our results, we concluded that traffic pollution may play a role in the development of IBD in children. Reduced exposure to antigens (i.e., traffic pollution) may lead to underdevelopment of the control pathways of the immune system leading to dysregulation with subsequent antigen exposures (hygiene hypothesis).