Abstract
Background: Early life exposure to microbial agents may have an effect on the development of the immune system and on respiratory health later in life. Inflammation is a key factor in the pathogenesis of respiratory diseases. Aims: To evaluate the associations between early life microbial exposures, and the fractional exhaled nitric oxide (FeNO), a biomarker of eosinophilic airway inflammation, at school age. Methods: In homes of participants of three prospective European birth cohorts (LISA, n=182; PIAMA, n=244; and INMA, n=355), endotoxin, EPS and ?(1,3)-D-glucan were measured in living room dust collected at 2-3 months of age. Home dampness and pet ownership were periodically reported by the parents through questionnaires. FeNO was measured at age 8 for PIAMA and at age 10/11 for LISA and INMA. Cohort-specific associations between the indoor microbial exposures and FeNO were evaluated using multivariable regression analyses. Estimates were combined using random-effects meta-analyses. Results: FeNO at school age was significantly lower in children exposed to endotoxin at age 2-3 months (? -0.054, 95% confidence interval (CI) -0.97;-0.01) and in children with reported dog ownership during the first two years of life (GM ratio 0.82, CI 0.70-0.96). FeNO was not significantly associated with early life exposure to EPS, ?(1,3)-D-glucan, indoor dampness and cat ownership. Conclusion: Early life exposure to bacterial endotoxin and early life dog ownership are associated with lower FeNO at school age. Further studies have to unravel the underlying effect mechanisms and possible clinical relevance of this finding.
Published Version
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