儿童环境暴露与炎症性肠病

炎症性肠病(IBD)常见于青春期，在美国影响了140万人。环境暴露，特别是空气污染和天气，已被认为有助于IBD疾病活动。我们开始使用考虑地理位置的新数据源评估环境暴露与儿童IBD患病率和疾病活动度之间的关系。研究人员在一家儿科医疗中心进行了为期6个月的随访，发现1999-2015年期间被诊断患有IBD的青少年，该中心服务于100万儿童。健康对照(HC)通过ehr识别，并按年龄和性别匹配IBD青年。记录所有患者在每次临床就诊时的家庭住址，并使用ArcGIS接近工具集计算从家庭到最近的主要道路和高速公路的距离。使用Wilcoxon秩和检验进行组间比较(IBD vs . HC和诊断后有疾病爆发的IBD vs .没有疾病爆发的IBD)，家与主要道路之间以及家与高速公路之间的距离。天气数据(温度、湿度、风速和风向、大气压力和太阳辐射)根据家庭位置从WiFire数据服务中提取。进行互信息分析(MIA)，并使用机器学习对模型进行训练/交叉验证，以确定天气数据是否可以预测IBD诊断和/或IBD疾病活动以及MIA。我们的研究包括320名青年IBD患者(161 M: 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).