{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:55:20Z","timestamp":1789102520770,"version":"build-2803163510"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2009,9,15]],"date-time":"2009-09-15T00:00:00Z","timestamp":1252972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Background: <\/jats:bold> Observational evidence suggests that infection with helminths protects against allergic disease and allergen skin sensitization. It is postulated that such effects are mediated by helminth\u2010induced cytokine responses, in particular IL\u201010.<\/jats:p><jats:p><jats:bold>Objective: <\/jats:bold> We tested this hypothesis in a rural area of central Vietnam where hookworm infection is endemic.<\/jats:p><jats:p><jats:bold>Methods: <\/jats:bold> One thousand five hundred and sixty\u2010six schoolchildren aged 6\u201317 were randomly allocated to receive either anti\u2010helminthic therapy or a placebo at 0, 3, 6, and 9 months. We compared changes in the prevalence of exercise\u2010induced bronchoconstriction, allergen skin sensitization, flexural eczema on skin examination, questionnaire\u2010reported allergic disease (wheeze and rhinitis symptoms), and immunological parameters (hookworm\u2010induced IFN\u2010\u03b3, IL\u20105, IL\u201010) between 0 and 12 months.<\/jats:p><jats:p><jats:bold>Results: <\/jats:bold> One thousand four hundred and eighty\u2010seven children (95% of these randomized) completed the study. The most common helminth infections were hookworm (65%) and <jats:italic>Ascaris lumbricoides<\/jats:italic> (7%). There was no effect of the therapy on the primary outcome, exercise\u2010induced bronchoconstriction (within\u2010participant mean percent fall in peak flow from baseline after anti\u2010helminthic treatment 2.25 (SD 7.3) vs. placebo 2.19 (SD 7.8, <jats:italic>P<\/jats:italic>=0.9), or on the prevalence of questionnaire\u2010reported wheeze [adjusted odds ratio (OR)=1.16, 95% confidence interval (CI) 0.35\u20133.82, <jats:italic>P<\/jats:italic>=0.8] and rhinitis (adjusted OR=1.39, 0.89\u20132.15, <jats:italic>P<\/jats:italic>=0.1), or flexural dermatitis on skin examination (adjusted OR=1.15, 0.39\u20133.45, <jats:italic>P<\/jats:italic>=0.8). However, anti\u2010helminthic therapy was associated with a significantly higher allergen skin sensitization risk (adjusted OR=1.31, 1.02\u20131.67, <jats:italic>P<\/jats:italic>=0.03). This effect was particularly strong for children infected with <jats:italic>A. lumbricoides<\/jats:italic> at baseline (adjusted OR=4.90, 1.48\u201316.19, <jats:italic>P<\/jats:italic>=0.009). Allergen skin sensitization was inversely related to hookworm\u2010specific IL\u201010 at baseline (adjusted OR=0.76, 0.59\u20130.99, <jats:italic>P<\/jats:italic>=0.04). No cytokine tested, including IL\u201010, changed significantly after the anti\u2010helminthic therapy compared with the placebo.<\/jats:p><jats:p><jats:bold>Conclusion: <\/jats:bold> A significant reduction in worm burden over a 12\u2010month period in helminth\u2010infected children increases the risk of allergen skin sensitization but not of clinical allergic disease. The effect on skin sensitization could not be fully explained by any of the immunological parameters tested.<\/jats:p><jats:p> <jats:italic>Cite this as<\/jats:italic>: C. Flohr, L. N. Tuyen, R. J. Quinnell, S. Lewis, T. T. Minh, J. Campbell, C. Simmons, G. Telford, A. Brown, T. T. Hien, J. Farrar, H. Williams, D. I. Pritchard and J. Britton, <jats:italic>Clinical &amp; Experimental Allergy<\/jats:italic>, 2010 (40) 131\u2013152.<\/jats:p>","DOI":"10.1111\/j.1365-2222.2009.03346.x","type":"journal-article","created":{"date-parts":[[2009,9,15]],"date-time":"2009-09-15T07:20:58Z","timestamp":1252999258000},"page":"131-142","source":"Crossref","is-referenced-by-count":93,"title":["Reduced helminth burden increases allergen skin sensitization but not clinical allergy: a randomized, double\u2010blind, placebo\u2010controlled trial in Vietnam"],"prefix":"10.1111","volume":"40","author":[{"given":"C.","family":"Flohr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. N.","family":"Tuyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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