Abstract
This study investigated the effect of attending pre-school on mucosal immunity. Children 3.5 to 5 years of age who attended pre-school were observed for a 10 month period. Demographic information was collected on previous childcare experiences, the home environment and clinical information relating to the child and the family. A daily illness log was kept for each child. A multivariate longitudinal analysis of the relation between immunoglobulins in saliva and age, gender, childcare experience, pre-school exposure, number of siblings, environmental tobacco smoke (ETS), atopy and hospitalisation was conducted. There was a positive association of higher IgA levels with the winter season and with children being older than 4 years (P < .001), having attended childcare prior to commencing pre-school (P < .05), and having been exposed to ETS at home (P < .05). Lower IgA levels were associated with being atopic (P < .05). Higher IgG levels were associated with exposure to ETS (P < .001), while lower levels were associated to having atopy. Higher IgM levels were associated with previous childcare experience (P < .01) whilst having been hospitalised was associated with having low salivary IgM levels (P < .01). Lagged analyses demonstrated that immunological parameters were affected by the number of respiratory infections in the preceding 2 months.
Highlights
The mucosal immune system begins to develop shortly after conception, and whilst structurally complete at birth, it is functionally immature [1]
Whilst some have shown that salivary immunoglobulin levels continue to increase throughout the childhood years [3], others have found that adult levels are reached by seven years [4,5,6,7,8] and even as early as 12 to 18 months of age [9, 10]
This study of 37 children aged 3.5–5 years attending a single Australian pre-school for one school year establishes longitudinal data on (1) the development of total salivary immunoglobulins IgA, IgG, and IgM, and IgA antibody specific against E. coli O antigen; (2) the influence of age on these parameters; (3) the impact of season and infection on immune parameters; (4) environmental factors which affect the pattern of immunoglobulin ontogeny and antibody production
Summary
The mucosal immune system begins to develop shortly after conception, and whilst structurally complete at birth, it is functionally immature [1]. Functional development is rapidly stimulated after birth by the ingestion and inhalation of bacterial and food antigens and mitogens. Numerous studies have looked at the development of the mucosal immune system in the early years of childhood in order to gain some insight into the maturation of the host mucosal defences in children. Whilst some have shown that salivary immunoglobulin levels continue to increase throughout the childhood years [3], others have found that adult levels are reached by seven years [4,5,6,7,8] and even as early as 12 to 18 months of age [9, 10]. The literature is not conclusive on the postnatal ontogeny, what is clear is that the timing and pattern of the increase from infant to adult levels appear to depend on environmental influences [11,12,13,14]
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