Abstract

A link between infection, inflammation, neurodevelopment and adult illnesses has been proposed. The objective of this study was to examine the association between infection burden during childhood - a critical period of development for the immune and nervous systems - and subsequent systemic inflammatory markers and general intelligence. In the Avon Longitudinal Study of Parents and Children, a prospective birth cohort in England, we examined the association of exposure to infections during childhood, assessed at seven follow-ups between age 1·5 and 7·5 years, with subsequent: (1) serum interleukin 6 and C-reactive protein (CRP) levels at age 9; (2) intelligence quotient (IQ) at age 8. We also examined the relationship between inflammatory markers and IQ. Very high infection burden (90+ percentile) was associated with higher CRP levels, but this relationship was explained by body mass index (adjusted odds ratio (OR) 1·19; 95% confidence interval (CI) 0·95-1·50), maternal occupation (adjusted OR 1·23; 95% CI 0·98-1·55) and atopic disorders (adjusted OR 1·24; 95% CI 0·98-1·55). Higher CRP levels were associated with lower IQ; adjusted β = -0·79 (95% CI -1·31 to -0·27); P = 0·003. There was no strong evidence for an association between infection and IQ. The findings indicate that childhood infections do not have an independent, lasting effect on circulating inflammatory marker levels subsequently in childhood; however, elevated inflammatory markers may be harmful for intellectual development/function.

Highlights

  • Infection is both a common and burdensome disease globally

  • We have examined the effect of confounding factors on these associations, as for example, both infection and intelligence quotient (IQ) are correlated with socio-economic status

  • The overall pattern of association between infection burden and IL-6/C-reactive protein (CRP) was similar between groups with and without atopic disorders

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Summary

Introduction

The World Health Organization (WHO) estimated that infectious diseases contributed 301. Long-term effects of infection may include subtle changes to the immune and nervous systems that, in turn, have adverse health consequences. Serum concentrations of inflammatory markers, such as interleukin-6 (IL-6) and C-reactive protein (CRP), increase transiently return to baseline after the infection subsides [5]. Prospective cohort studies indicate a correlation between elevated levels of IL-6/CRP and subsequent risk of physical and neuropsychiatric illnesses such as cancers, coronary heart disease, type 2 diabetes, Alzheimer’s disease, depression and psychosis [6,7,8,9,10,11,12]

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