Effect of Antibiotic Use and Mold Exposure in Infancy on Allergic Rhinitis in Susceptible Adolescents

Abstract

To explore the risk of allergic rhinitis (AR) in adolescents with the independent and combined effect of antibiotic use and mold exposure in infancy.The study population consisted of 7389 students recruited from 8 middle schools in Seoul, Korea.The International Study of Asthma and Allergies in Childhood written questionnaire was obtained from 7389 adolescents. Interleukin 13 (IL-13) (rs20541) and toll-like receptor 4 (rs1927911) polymorphisms were performed on TaqMan genotyping in 1395 randomly selected adolescents.Of the total 7286 completed surveys, almost one-third used antibiotics, and 10.3% were exposed to mold in infancy. The data showed age, parental history of AR, antibiotic use in infancy, and pet ownership during pregnancy or infancy were linked with an increased risk of current AR. The presence of an older sibling was noted to have a protective effect. Increased odds ratio for current AR was seen with combined antibiotic use and mold exposure in infancy. Antibiotic use had an adjusted odds ratio of 1.25, whereas mold exposure had an adjusted odds ratio of 0.99 when considered independently. Patients also had increased risk of current AR with IL-13 (rs20541) GA or AA genotype and CT + TT genotype of toll-like receptor 4 (rs1927911).In genetically susceptible adolescents, with specific IL-13 polymorphisms, antibiotic use and mold exposure in infancy have additive effects on the risk of current AR.Certain genetic polymorphisms may increase the risk of different types of atopic disease. Studies such as this aim to identify future risk factors of development of atopy. AR is a common diagnosis in childhood. Unfortunately, as is often noted, AR appears to be a multifactorial condition and, as such, is difficult to isolate single or even combined risk factors. Although recall bias is a potential limitation of the study, the information collected appears important. Limitation of mold exposure and judicious use of antibiotics in children appear to be even more important than previously thought, to prevent the development of allergic rhinitis in some adolescents later in life.