Abstract
Prenatal exposures may be critical for immune system development, with consequences for allergic disease susceptibility. We examined associations of prenatal exposures (nutrient intakes and air pollutants) with allergic disease biomarkers in adolescence. We used data from 857 mother-child pairs in Project Viva, a Massachusetts-based pre-birth cohort. Outcomes of interest at follow-up (median age 12.9 years) were fractional exhaled nitric oxide (FeNO) and total serum IgE. We applied Bayesian Kernel Machine Regression analyses to estimate multivariate exposure-response functions, allowing for exposure interactions. Exposures were expressed as z-scores of log-transformed data and we report effects in % change in FeNO or IgE z-score per increase in exposure from the 25th to 75th percentile. FeNO levels were lower with higher intakes of prenatal vitamin D (−16.15%, 95% CI: −20.38 to −2.88%), folate from foods (−3.86%, 95% CI: −8.33 to 0.83%) and n-3 PUFAs (−9.21%, 95% CI −16.81 to −0.92%). Prenatal air pollutants were associated with higher FeNO and IgE, with the strongest associations detected for PM2.5 with IgE (25.6% increase, 95% CI 9.34% to 44.29%). We identified a potential synergistic interaction (p = 0.02) between vitamin E (food + supplements) and PM2.5; this exposure combination was associated with further increases in FeNO levels.
Highlights
Exposures encountered during prenatal life have been shown to have either adverse or, in some cases, protective associations with asthma and allergic disease in later childhood[3,4]
In adolescent children followed since the prenatal period, we examined multiple components from two prenatal exposure types, air pollution and maternal nutrient intakes, to determine their associations with IgE and fractional exhaled nitric oxide (FeNO) measured in adolescence
We used a state of the art, non-parametric statistical methodology, Bayesian Kernel Machine Regression (BKMR), to identify potential relationships between exposures mixtures encountered in prenatal life and biomarkers of allergic disease in adolescence
Summary
Exposures encountered during prenatal life have been shown to have either adverse or, in some cases, protective associations with asthma and allergic disease in later childhood[3,4]. In adolescent children followed since the prenatal period, we examined multiple components from two prenatal exposure types, air pollution and maternal nutrient intakes, to determine their associations with IgE and FeNO measured in adolescence. We examined the potential for sexual dimorphism in the effects of mixtures of exposures on outcomes in adolescence, when the influences of sex on allergy and allergic airway inflammatory responses may be in transition. To investigate these hypotheses, we applied Bayesian Kernel Machine Regression (BKMR)[20], a recently developed approach for estimating the health effects of multi-exposure mixtures. We applied BKMR methodology to data from Project Viva, a longitudinal pre-birth cohort study of prenatal exposures and chronic disease outcomes, with follow-up through adolescence
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