Universität zu Köln

Teich, Niels, Mohl, Wolfgang ORCID: 0000-0002-3284-211X, Primas, Christian ORCID: 0000-0001-7632-6742, Novacek, Gottfried ORCID: 0000-0002-0869-0478, Gauss, Annika, Walldorf, Jens ORCID: 0000-0003-1509-4137, Felten, Gisela, Atreya, Raja, Kruis, Wolfgang, Bettenworth, Dominik, Roznowski, Artur Bartosz, Langhorst, Jost, Schmidt, Karen, Bruns, Tony ORCID: 0000-0002-5576-6914 and Stallmach, Andreas (2020). Thumb sucking or nail biting in childhood and adolescence is associated with an increased risk of Crohn's disease: results from a large case-control study. Scand. J. Gastroenterol., 55 (9). S. 1028 - 1035. ABINGDON: TAYLOR & FRANCIS LTD. ISSN 1502-7708

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Abstract

Background The hygiene hypothesis suggests that a reduction in microbial exposure contributes to an impaired immune response later in life and increases the incidence of immune-mediated diseases such as inflammatory bowel diseases (IBD). Thumb sucking and nail biting are two early habits that modulate the oral microbiota composition and antigen load. Objective We hypothesized a lower risk of Crohn's disease (CD) and ulcerative colitis (UC) in adults with prior thumb sucking and nail biting. Methods 918 IBD cases and their 918 siblings without IBD were asked to fill out a survey containing 32 questions on environmental factors in childhood and early adulthood. Prevalence of thumb sucking and/or nail biting at the usually well-remembered time of (1) school enrollment and (2) coming-of-age ceremonies was the predefined combined risk factor of this study. Results 65% of the patients were female and 57% suffered from CD. About 49% of IBD patients but only 44% of their siblings reported thumb sucking/nail biting at the time of school enrollment or coming-of-age (p = .007). Sensitivity analysis revealed that this difference was observed in patients with CD (50% versus 41%; RR= 1.22; 95% CI 1.09-1.37,p = .001) but not in patients with UC (49% versus 48%; RR= 1.02; 95% CI 0.90-1.17;p = .83). Conclusion Contrary to our expectation and challenging the hygiene hypothesis, we found that common oral habits are not protective against IBD. Instead, nail biting at the time of school enrollment and coming-of-age was a statistically significant risk factor for CD in our cohort. Key summary Evidence available before this study:The hygiene hypothesis suggests that a reduction in microbial exposure due to improved health activities has contributed to an immunological imbalance in the intestine and an increased incidence of allergic and autoimmune diseases. A population-based birth cohort study has demonstrated that thumb-sucking and nail biting in children lead to a reduction of the risk of atopic sensitization, asthma, and hay fever. Added value of this study:Contrary to the hypothesis, thumb sucking and nail biting were not associated with a reduced risk of IBD. Instead, thumb sucking and/or nail biting at the usually well-remembered points in time of school enrollment and of religious or secular coming-of-age ceremonies was associated with a higher risk of Crohn's disease but not of ulcerative colitis. Our data did not support the hygiene hypothesis, one pathogenic concept in the context of IBD.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Teich, Niels UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohl, Wolfgang UNSPECIFIED orcid.org/0000-0002-3284-211X UNSPECIFIED Primas, Christian UNSPECIFIED orcid.org/0000-0001-7632-6742 UNSPECIFIED Novacek, Gottfried UNSPECIFIED orcid.org/0000-0002-0869-0478 UNSPECIFIED Gauss, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Walldorf, Jens UNSPECIFIED orcid.org/0000-0003-1509-4137 UNSPECIFIED Felten, Gisela UNSPECIFIED UNSPECIFIED UNSPECIFIED Atreya, Raja UNSPECIFIED UNSPECIFIED UNSPECIFIED Kruis, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Bettenworth, Dominik UNSPECIFIED UNSPECIFIED UNSPECIFIED Roznowski, Artur Bartosz UNSPECIFIED UNSPECIFIED UNSPECIFIED Langhorst, Jost UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Karen UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Tony UNSPECIFIED orcid.org/0000-0002-5576-6914 UNSPECIFIED Stallmach, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-325540
DOI:	10.1080/00365521.2020.1797869
Journal or Publication Title:	Scand. J. Gastroenterol.
Volume:	55
Number:	9
Page Range:	S. 1028 - 1035
Date:	2020
Publisher:	TAYLOR & FRANCIS LTD
Place of Publication:	ABINGDON
ISSN:	1502-7708
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INFLAMMATORY-BOWEL-DISEASE; HYGIENE Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32554