Das Paracetamol-Dilemma

WELLINGTON – Paracetamol ist einer der weltweit am häufigsten eingesetzten Medikamentenwirkstoffe. Aufgrund seines Sicherheitsprofils ist er das Mittel der Wahl bei Fieber und Schmerzen. Vor zehn Jahren allerdings wurde die Hypothese formuliert, wonach die Anwendung von Paracetamol möglicherweise das Asthma-Risiko erhöht. Es wurde diskutiert, dass der Wechsel von Aspirin zu Paracetamol bei amerikanischen Kindern in den 1980er Jahren zu einer in diesem Zeitraum registrierten Häufung von Asthma bei Kindern beitrug.

Der Einsatz von Paracetamol statt Aspirin, so die Vermutung der Wissenschaftler, könnte zu einer verstärkten allergischen Immunantwort geführt und dabei die Anfälligkeit für Asthma und andere allergische Störungen erhöht haben. Seit damals wurde in einer Reihe epidemiologischer Studien über einen Zusammenhang zwischen Asthma und der Paracetamolexposition im Mutterleib, in der Kindheit und im Erwachsenenalter berichtet. Diese Studien führten zur Annahme, dass der Einsatz von Paracetamol ein bedeutender Risikofaktor für die Entstehung von Asthma sein könnte.

Den jüngsten, diese Hypothese unterstützenden  Nachweis lieferte eine große internationale epidemiologische Studie über Asthma im Kindesalter, die kürzlich in der medizinischen Fachzeitschrift The Lancet veröffentlicht wurde. Diese von der International Study of Asthma and Allergies in Childhood (ISAAC) durchgeführte Untersuchung umfasste über 200.000 Kinder im Alter von sechs bis sieben Jahren, die an  73 medizinischen Zentren in 31 Ländern behandelt werden. Die Eltern oder Erziehungsberechtigten der Kinder beantworteten Fragebögen über aktuelle Asthma-Symptome, Rhinitis (Heuschnupfen), Ekzeme und andere Risikofaktoren wie den Einsatz von Paracetamol bei Fieber während des ersten Lebensjahrs und die Häufigkeit der Paracetamol-Verabreichung in den letzten 12 Monaten.  

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