Maternal History Of Atopy Research Articles

Factors associated with secretory IgA levels in colostrum and breastmilk

Background Secretory IgA (sIgA) content of breastmilk in the first postpartum month is a reflection of the pregnant woman's immune response to environmental antigen exposure. The role of secretory IgA in breastmilk is to protect and support the development of the neonatal immune response in early life.
 Objective To examine possible factors associated with sIgA levels in breastmilk and colostrum, including environmental exposure, food consumed, maternal history of atopy, and the appearance of allergic symptoms in infants. As a secondary objective, we determined the association between infant factors (IgE, exposure to cigarette smoke) and maternal factors (sIgA, maternal allergies) with infant allergies.
 Methods This prospective cohort study of 80 postpartum mothers and their infants was conducted at Sultan Agung Islamic Hospital, Semarang. We collected maternal colostrum on the second or third postpartum day and mature milk between the 22nd to 25th postpartum day. Exposure factors to mothers and infants in the final trimester of pregnancy up to one month postpartum was recorded through a questionnaire and home visits. The infant’s IgE level was measured at 4 months of age.
 Results Mean colostrum sIgA was 108.9 (SD 16.5) mg/dL (95%CI 97.9 to 121.1 mg/dL) and mean mature milk sIgA was 94.1 (SD 23.9) mg/dL (95%CI 89.1 to 99.2 mg/dL). Mean colostrum sIgA levels were higher in mothers exposed to cigarette smoke [119.1 (SD 1.7) vs. 92.9 (SD 1.5) mg/dL; P=0.026] and frequent infections [128.2 (SD 1.7) vs. 95.9 (SD 1.6) mg/dL; P=0.007] compared to that in unexposed mothers. Mean colostrum sIgA was also higher in mothers with atopic allergy than in those without (136.8 mg/dL vs. 99.3 mg/dL; p=0.017) and in mothers of infants with IgE levels >29 IU/ml than in mothers of infants with IgE levels <29 IU/mL (136.8 vs. 101.2 mg/mg/dL; P=0.045). Elevated colostrum sIgA (>136.8 mg/dL) was not associated with allergies in the infants (P=0.269).
 Conclusions Maternal atopic allergy and frequent infections are associated with increased colostrum sIgA levels. Breastmilk sIgA levels are not associated with allergies in the infant. Maternal exposure to antigens may stimulate the production of specific breastmilk sIgA.

The Association of Prenatal Vitamin D Sufficiency With Aeroallergen Sensitization and Allergic Rhinitis in Early Childhood

The role of prenatal vitamin D sufficiency and supplementation in the development of childhood aeroallergen sensitization and allergic rhinitis remains uncertain. To describe the association of prenatal vitamin D sufficiency with childhood allergic outcomes in participants of the Vitamin D Antenatal Asthma Reduction Trial, a randomized controlled trial of prenatal vitamin D supplementation. We included 414 mother-offspring pairs with offspring aeroallergen sensitization data available at age 6 years in this analysis. We examined the association between prenatal vitamin D sufficiency status, based on vitamin D levels measured in the first and third trimesters, or vitamin D supplementation treatment assignment with the outcomes of aeroallergen sensitization, parent-reported clinical allergic rhinitis, parent-reported clinical allergic rhinitis with aeroallergen sensitization, food sensitization, any sensitization, eczema, and total IgE at ages 3 and 6 years. Compared with early and late insufficiency, early prenatal vitamin D insufficiency with late sufficiency was associated with reduced development of clinical allergic rhinitis with aeroallergen sensitization at 3 years (adjusted odds ratio [aOR]= 0.34; 95% confidence interval [CI], 0.13-0.82; P= .02) and 6 years (aOR= 0.54; 95% CI, 0.29-0.98; P= .05). At 6 years, clinical allergic rhinitis with sensitization was significantly decreased in offspring whose mothers received high-dose vitamin D (aOR= 0.54; 95% CI, 0.32-0.91; P= .02) compared with offspring whose mothers who received low-dose vitamin D. Associations of prenatal vitamin D with aeroallergen sensitization were strengthened among children who also developed asthma or who had a maternal history of atopy. Among mothers with first-trimester vitamin D insufficiency, we detected a protective effect of third-trimester prenatal vitamin D sufficiency on the development of clinical allergic rhinitis with aeroallergen sensitization at ages 3 and 6 years.

Trajectories of early-onset rhinitis in the Singapore GUSTO mother-offspring cohort.

The natural history of childhood rhinitis is not well described. This study aimed to identify different rhinitis trajectories in early childhood and their predictors and allergic associations. Rhinitis symptoms were ascertained prospectively from birth until 6years using standardized questionnaires in 772 participants. Rhinitis was defined as one or more episodes of sneezing, runny and/or blocked nose >2weeks duration. Latent trajectories were identified using group-based modelling, and their predictive risk factors and allergic associations were examined. Three rhinitis trajectory groups were identified: 7.6% (n=59) were termed early transient rhinitis, 8.6% (n=66) late transient rhinitis, and 6.6% (n=51) persistent rhinitis. The remaining 77.2% (n=596) were classified as non-rhinitis/reference group. Early transient rhinitis subjects were more likely of Indian ethnicity, had siblings, reported childcare attendance, early wheezing and eczema in the first 3years of life. Late transient rhinitis was associated with antenatal exposure to smoking, higher maternal education levels, andwheezing at age 36-72months. Persistent rhinitis was associated with male gender, paternal and maternal history of atopy, eczema, and house dust mite sensitization. Risk factors for early transient rhinitis involve a combination of genetic and early environmental exposures, whereas late transient rhinitis may relate to maternal factors and early respiratory infections independent of atopy. In contrast, persistent rhinitis is strongly associated with atopic risk and likely represents the typical trajectory associated with allergic disorders. Allergic rhinitis symptoms may commence as early as the first year of life and may inform development of early interventive strategies.

Prenatal exposure to acid suppressant medications and the risk of recurrent wheeze at 3 years of age in children with a history of severe bronchiolitis

Infants diagnosed with severe bronchiolitis are at higher risk for developing recurrent wheeze and asthma. Prior studies from outside the United States (U.S.) suggest that prenatal exposure to acid suppressant medications (ASM), such as proton pump inhibitors and histamine-2 receptor antagonists, may increase the risk of developing asthma. We tested the hypothesis that prenatal exposure to ASM increases the risk of recurrent wheeze among a high-risk population of children with a history of severe bronchiolitis. We enrolled 921 infants hospitalized for bronchiolitis from 2011-2014 in a multi-center, U.S.-based prospective cohort. ASM use during pregnancy was ascertained by parent report. Children were followed for the development of recurrent wheeze by age 3 years (defined by 2007 NIH guidelines). Time-to-event analysis was performed using multivariable Cox-proportional hazards models stratified by age and adjusted for sex, race/ethnicity, income, maternal history of atopy, maternal smoking during pregnancy, use of antibiotics during pregnancy, gestational age at birth, multiple gestation and mode of delivery. Of the 921 infants enrolled in the longitudinal cohort, 900 children with complete data were included in this analysis. Prenatal exposure to ASM occurred in 16% (144/900) of children. Recurrent wheeze developed in 31% (233/756) of unexposed children as compared to 39% (56/144) of exposed children (unadjusted HR 1.38;95%CI, 1.03-1.85). The finding did not change after adjustment (adjusted HR 1.40;95%CI, 1.02 -1.91). In this high-risk cohort of U.S. children with a history of severe bronchiolitis, prenatal exposure to ASM further increased the risk of developing recurrent wheeze by 3 years of age.

Complex relationships between vitamin D and allergic sensitization among Puerto Rican 2-year-old children

BackgroundIn the United States, Puerto Ricans have a higher prevalence of asthma than other Latino ethnicities. Low vitamin D levels for children living in northern climates could be a factor. ObjectiveTo assess serum 25-hydroxyvitamin D [25(OH)D] distributions (a marker of vitamin D) and associations among vitamin D, allergic sensitization, early wheeze, and home/demographic factors. MethodsPuerto Rican infants born in New York City, with a maternal history of atopy, were enrolled in a birth cohort. Blood was collected at age 2 years (n = 154; 82 males and 72 females). Serum 25(OH)D and immunoglobulin E (IgE) (indoor allergen-specific and total) were determined using immunoassays. Home/demographic characteristics and respiratory symptoms were assessed by questionnaire. ResultsThe median concentration of 25(OH)D was 22.6 ng/mL; 32% were at risk of deficiency or inadequacy (<12 or 12–19 ng/mL). Serum 25(OH)D levels were lower in the heating (a surrogate for less sun exposure in colder months) compared with nonheating (26.1 vs 22.7 ng/mL, P = .02) season, but were not associated with allergen-specific IgE levels or with level of acculturation (measured by maternal birthplace). However, low 25(OH)D levels (below median) were associated with high total IgE >100 IU/mL (P = .01). Also, 25(OH)D concentrations differed between children who attended daycare and those who did not (21.8 vs 24.5 ng/mL; t test, P = .02). Serum 25(OH)D was not associated with wheeze or asthma by 2 years of age (P = .43). ConclusionVitamin D deficiency, possibly linked with allergic pathways, may partially explain the trajectory for disproportionate asthma burden among Puerto Ricans, especially those born and raised in colder climates.

Maternal cytokine status may prime the metabolic profile and increase risk of obesity in children.

The maternal inflammation status during pregnancy has been associated with metabolic imprinting and obesity development in the child. However, the influence of the maternal Th2 cytokines, interleukin-4 (IL4), IL5 and IL13, has not been studied so far. We investigated the relationship between maternal innate (IL6, IL8, IL10 and tumor necrosis factor-α (TNFa)) and adaptive (interferon-γ, IL4, IL5 and IL13) blood cytokine levels at 34 weeks of gestation and children's overweight development until the age of 3 years in 407 children of the German longitudinal LINA (Lifestyle and Environmental Factors and their Influence on Newborns Allergy risk) cohort. Children's body weight and height were measured during the annual clinical visits or acquired from questionnaires. Body mass index (BMI) Z-scores were calculated according to the WHO reference data to adjust for child's age and gender. Cytokine secretion was stimulated with phytohemagglutinin or lipopolysaccharide and measured by cytometric bead assay. Furthermore, we assessed metabolic parameter in blood of 318 children at age 1 using the AbsoluteIDQ p180 Kit (Biocrates LIFE Science AG). Applying logistic regression models, we found that an increase of maternal IL4 and IL13 was associated with a decreased risk for overweight development in 1- and 2-year-old children. This effect was consistent up to the age of 3 years for IL13 and mainly concerns children without maternal history of atopy. Children's acylcarnitine concentrations at 1 year were positively correlated with maternal IL13 levels and inversely associated with the BMI Z-score at age 1. We were able to show for the first time that the maternal Th2 status may be linked inversely to early childhood overweight development accompanied by an altered metabolic profile of the fetus. However, our data do not support a direct mediating role of acylcarnitines on maternal IL13-induced weight development.

Prevalence and associated factors of airway hyper- responsiveness in children with recurrent chronic cough

Background Airway hyper-responsiveness (AH) is a common char-acteristic of asthma. Patient who has recurrent chronic cough withAH is commonly referred as “cough variant asthma”. Histamineprovocation test should be performed to determine whether a pa-tient has “cough variant asthma” or recurrent viral bronchitis.Objective To determine AH prevalence in children with recurrentchronic cough and factors associated with it.Methods A cross sectional study was conducted on 6-12 year-oldchildren with recurrent chronic cough at the Pediatrics OutpatientClinic, Sanglah Hospital Denpasar from September 2002 until June2003Results Twenty one out of 64 (33%) subjects suffering from recur-rent chronic cough without wheezing had AH. Associated factorssignificantly associated with AH were age, allergic rhinitis, pater-nal and maternal history of atopy, passive smoking, use of mos-quito-coil, positive skin prick test, and eosinophilia. Spearman cor-relation analysis between associated factors and AH showed thatpositive skin prick test and passive smoking were moderately cor-related with AH (r=0.56, p&lt;0.0001; r=0.57, p&lt;0.0001, respectively),whereas multivariate regression logistic analysis on associatedfactors found true associated factors, such as positive skin pricktest (p=0.01; OR=14.82), history of atopy in father (p=0.02;OR=22.75), and passive smoking (p=0.03; OR=11.97).Conclusions The prevalence of airway hyper-responsiveness inchildren with recurrent chronic cough without history of wheezingwas 33%. Independent associated factors of AH in recurrent chroniccough children are positive skin prick test, history of atopy in fa-ther, and passive smoking

Epidemiological and genetic characteristics associated with the severity of acute viral bronchiolitis by respiratory syncytial virus

Objectiveto assess the epidemiological and genetic factors associated with severity of acute viral bronchiolitis (AVB) by respiratory syncytial virus (RSV). Data source: the key words “bronchiolitis”, “risk factor”, “genetics” and “respiratory syn-cytial virus”, and all combinations among them were used to perform a search in the PubMed,SciELO, and Lilacs databases, of articles published after the year 2000 that included individualsyounger than 2 years of age. Data synthesis: a total of 1,259 articles were found, and their respective summaries were read. Of these, 81 were selected, which assessed risk factors for the severity of AVB, and were read in full; the 60 most relevant studies were included. The epidemiologic factors associated with AVB severity by RSV were prematurity, passive smoking, young age, lack of breastfeeding, chronic lung disease, congenital heart disease, male gender, ethnicity, viral coinfection, low weight at admission, maternal smoking during pregnancy, atopic dermatitis, mechanical ventilation in the neonatal period, maternal history of atopy and/or asthma during pregnancy, season of birth, low socioeconomic status, Down syndrome, environmental pollution, living at an altitude > 2,500 meters above sea level, and cesarean section birth. Conversely, some children with severe AVB did not present any of these risk factors. In this regard, recent studies have verified the influence of genetic factors on the severity of AVB by RSV. Polymorphisms of the TLRs, RANTES, JUN, IFNA5, NOS2, CX3CR1, ILs, and VDR genes have been shown to be associated with more severe evolution of AVB by RSV. Conclusionthe severity of AVB by RSV is a phenomenon that depends on the varying degrees of interaction among epidemiological, environmental, and genetic variables.

Epidemiological and genetic characteristics associated with the severity of acute viral bronchiolitis by respiratory syncytial virus

Objectiveto assess the epidemiological and genetic factors associated with severity of acute viral bronchiolitis (AVB) by respiratory syncytial virus (RSV). Data sourcethe key words “bronchiolitis”, “risk factor”, “genetics” and “respiratory syncytial virus”, and all combinations among them were used to perform a search in the PubMed, SciELO, and Lilacs databases, of articles published after the year 2000 that included individuals younger than 2 years of age. Data synthesisa total of 1,259 articles were found, and their respective summaries were read. Of these, 81 were selected, which assessed risk factors for the severity of AVB, and were read in full; the 60 most relevant studies were included. The epidemiologic factors associated with AVB severity by RSV were prematurity, passive smoking, young age, lack of breastfeeding, chronic lung disease, congenital heart disease, male gender, ethnicity, viral coinfection, low weight at admission, maternal smoking during pregnancy, atopic dermatitis, mechanical ventilation in the neonatal period, maternal history of atopy and/or asthma during pregnancy, season of birth, low socioeconomic status, Down syndrome, environmental pollution, living at an altitude > 2,500 meters above sea level, and cesarean section birth. Conversely, some children with severe AVB did not present any of these risk factors. In this regard, recent studies have verified the influence of genetic factors on the severity of AVB by RSV. Polymorphisms of the TLRs, RANTES, JUN, IFNA5, NOS2, CX3CR1, ILs, and VDR genes have been shown to be associated with more severe evolution of AVB by RSV. Conclusionthe severity of AVB by RSV is a phenomenon that depends on the varying degrees of interaction among epidemiological, environmental, and genetic variables.

A systematic review of the importance of milk TGF‐β on immunological outcomes in the infant and young child

Cytokines in milk like transforming growth factor-beta (TGF-beta) have been shown to induce oral tolerance in experimental animal studies. However, human studies are less consistent with these findings. The primary objective of this review was to conduct a systematic review of published studies on the association between TGF-beta identified in human milk and immunological outcomes in infancy and early childhood. Human prospective clinical studies were identified through MEDLINE, CAB Abstracts, Biological Abstracts and Scopus. Selection criteria included: well described populations of mothers and infants, time of milk sampling, immunological outcome measures and analytical methods of TGF-beta determination. We considered a wide range of immunological outcomes in infancy and early childhood, such as wheeze, atopy, eczema and the immunoglobulin switch. Twelve human studies were included in the review and 67% showed a positive association with TGF-beta1 or TGF-beta2 demonstrating protection against allergy-related outcomes in infancy and early childhood. High variability in concentrations of TGF-beta was noted between and within studies, some of it explained by maternal history of atopy or by consumption of probiotics. Human milk TGF-beta appears to be essential in developing and maintaining appropriate immune responses in infants and may provide protection against adverse immunological outcomes, corroborating findings from experimental animal studies. Further large clinical studies in diverse human populations are indicated to confirm these results.

Effect of Probiotic Supplementation for the First 6 Months of Life on Allergen- and Vaccine-Specific Immune Responses

Taylor AL, Hale J, Wiltschut J, Lehmann H, Dunstan JA, Prescott SL. Clin Exp Allergy. 2006;36:1227–1235 PURPOSE OF THE STUDY. To determine if probiotic dietary supplementation in the first 6 months of life could modify allergen- and vaccine-specific immune responses. STUDY POPULATION. One hundred seventy-eight term infants born to women with a history of allergic disease and a positive prick-skin test result were enrolled in Australia between July 2002 and March 2005. METHODS. In a randomized double-blind, placebo-controlled design, 3 × 109 colony-forming units of Lactobacillus acidophilus (LARVI-A1; Probiomics, Eveleigh, New South Wales, Australia) was administered daily to term infants for the first 6 months of life. Peripheral blood mononuclear cell cytokine responses to tetanus toxoid (TT), house dust mite (HDM), ovalbumin, β-lactoglobulin, Staphylococcus enterotoxin B, and phytohemagglutinin were measured at 6 months of age. RESULTS. Of the 178 infants who completed the study, blood samples were available from 118 children (60 placebo treated, 58 probiotic treated). Infants treated with probiotics had significantly lower interleukin 10 (IL-10) production to TT vaccine antigen than those in the placebo group (P = .03). Infants treated with probiotics had no significant differences in the levels of T-helper 1 and T-helper 2 cell responses to foods (ovalbumin or β-lactoglobulin) or inhalant allergens (HDM). However, the number of infants who had detectable tumor necrosis factor α and IL-10 responses to HDM were less than those who had received probiotics (P = .046 and 0.014, respectively). In addition, children who received probiotics had decreased productions of IL-5 and transforming growth factor β in response to Staphylococcus enterotoxin B (P = .044 and 0.015, respectively). CONCLUSIONS. Although there were no consistent effects on allergen-specific responses, children treated with probiotics may have immunomodulatory effects on TT responses. The clinical ramifications of this have yet to be determined. REVIEWER COMMENTS. It is interesting to note that the TT vaccine-specific responses in IL-10 were significant, whereas the allergen-specific responses were not. However, the clinical implication of this is not known. The authors pointed out that the types of probiotics selected and dosing regimen may be important in regard to immunologic outcomes. Some studies have shown a protective effect of probiotic supplementation on outcomes of atopic dermatitis (some have not), and the effect on allergen-specific responses, if any, remains unclear. This study began to tease out the allergen-specific outcomes. Although clinical atopic dermatitis evaluations were not made during this study, the immunologic effects of probiotics in infants with a maternal history of atopy are seemingly not allergen specific.

Breast-feeding and atopic disease: A cohort study from childhood to middle age

The literature regarding the association between breast-feeding and atopic diseases has been contradictory. We have assessed the relationship between breast-feeding and atopic disorders in a cohort followed into middle age. The Tasmanian Asthma Study is a population-based prospective cohort study that has followed participants from the age of 7 to 44 years. Exclusive breast-feeding in the first 3 months of life was examined as a risk factor for atopic diseases by using multiple logistic regression and generalized estimating equation analyses. At age 7 years, exclusively breast-fed children with a maternal history of atopy had a marginally lesser risk of current asthma than those not exclusively breast-fed (odds ratio [OR], 0.8; 95% CI, 0.6-1.0). However, after age 7 years, the risk reversed, and exclusively breast-fed children had an increased risk of current asthma at 14 (OR, 1.46; 95% CI, 1.02-2.07), 32 (OR, 1.84; 95% CI, 1.06-3.3), and 44 (OR, 1.57; 95% CI, 1.15-2.14) years. Exclusively breast-fed children also had a reduced risk of food allergy at age 7 years but an increased risk of food allergy (OR, 1.26; 95% CI, 1.1-1.5) and allergic rhinitis (OR, 1.2; 95% CI, 1.0-1.3) at 44 years. Exclusively breast-fed babies with a maternal history of atopy were less likely to develop asthma before the age of 7 years, but more likely to develop asthma after the age of 7 years. The current recommendation to breast-feed high-risk infants for protection against early wheezing illness can be confirmed. However, the recommendation should be reconsidered for protection against allergic asthma and atopy in the longer term.

N‐3 Polyunsaturated Fatty Acids and Atopy in Korean Preschoolers

Atopy is a growing problem for Korean children. Since eicosapentaenoic acid is a precursor of less active inflammatory eicosanoids, n-3 polyunsaturated fatty acids (PUFA) may have a protective effect on atopy. This study was undertaken to determine whether n-3 PUFA in red blood cells (RBC) is lower in atopic than in non-atopic preschoolers. Three hundred and eight Korean children aged 4-6 years were enrolled. Total RBC fatty acid composition was measured by gas chromatography. The prevalence of atopic dermatitis, allergic rhinitis, or asthma was 29%. Total RBC n-3 PUFA were lower in preschoolers with atopy than controls (9.8 +/- 1.2 vs. 11.4 +/- 1.6%; P<0.05), while n-6 PUFA (33.0 +/- 1.4 vs. 32.2 +/- 1.0%; P<0.05) and n-6/n-3 PUFA ratio (3.4 +/- 0.6 vs. 2.8 +/- 0.5; P<0.05) were greater. The following factors were also associated with an increase in atopy: higher saturated fatty acids (39.6 +/- 1.4 vs. 40.6 +/- 1.9; P<0.05) and arachidonic acid (15.3 +/- 1.6 vs. 16.0 +/- 2.9; P<0.05), and lower total PUFA (43.8 +/- 0.7 vs. 42.8 +/- 1.4; P<0.05) and omega-3 index (EPA + DHA; 9.1 +/- 0.8 vs. 7.8 +/- 0.5; P<0.05) in RBC. Maternal history of atopy was a significant (P<0.05) risk factor, while lactation was not. The results suggest that a reduced content of n-3 PUFA in the RBC membrane could play a role in early children atopy.

Prenatal Environmental Tobacco Smoke and Null Genotypes of Glutathione S-Transferase T1 were Associated with Fetal Cord Blood IgE

P-120 Introduction: Elevated cord blood IgE (cbIgE) is a predictor for atopic diseases. Environmental tobacco smoke (ETS) exposure are known associated with cbIgE levels. However, interactive effects on cbIgE is unclear between ETS and genotypes of glutathione s-transferase (GST) T1. A birth-cohort study was conducted to assess the association between gene-environmental interaction and cbIgE. Methods: Between July 2001 and July 2005, 1080 mother-infant pairs are recruited from 8 maternity hospitals in Taiwan. Questionnaires were completed by mothers prior to and immediately following birth. CAP system were used to measure maternal IgE, specific IgE to common allergens, and cbIgE levels. GSTT1/M1 (null/non-null) was determined by polymerase chain reaction (PCR). Results: A total of 745 mother-infant pairs had all measurements satisfactorily completed. The prevalence of elevated cbIgE (≥ 0.35 IU/ml) and maternal prenatal ETS exposure was 23.7% and 39.3%, respectably. The frequency of null GSTT1, M1 genotype was 48.0% and 57.0%, respectively. Male infants (p=0.0002), birth season in Spring (p=0.019), maternal history of atopy (p=0.0008), elevated maternal total IgE (p<0.0001) were associated with elevated cbIgE. Birth weight, gestational age, birth order, parental socioeconomical status, paternal atopy history, and GSTM1 genotype was not associated with cbIgE. Both maternal prenatal ETS exposure (OR=0.48, 95% CI =0.28∼0.80) and GSTT1 null genotype (OR=0.54, 95% CI=0.33∼0.86) were negatively associated with high cbIgE, while OR for those with both GSTT1 null genotype and ETS exposure were 0.30 (95% CI=0.16∼0.54) after adjusting for the above variables. Discussion and Conclusions: Our study found maternal prenatal ETS exposure and GSTT1 null genotype associated with lower cbIgE, adjusting for confounding factors. When both ETS and GSTT1 null genotypes were present, the OR for high IgE were even lower. This finding is somewhat different from previous studies about ETS effects on asthma occurrence. Further follow-up of these children on their development of asthma, allergic rhinitis, or atopic dermatitis will provide valuable information about the prenatal and early childhood risk factors for atopic diseases.

Beyond Our Pages

Beyond Our Pages

High Levels of Cord Serum Eosinophil Cationic Protein Predict the Risk of Atopy

Background: Transient tachypnoea of the newborn is a transient respiratory disturbance characterized by tachypnoea shortly after birth, which resolves within 2 to 5 days. The basic pathogenetic mechanism is the delayed resorption of the alveolar fluid of which the exact triggering mechanism still remains unknown. An etiological link associated with parenteral history of atopy was proposed by several studies. Some laboratory studies also revealed that serum IgE, eosinophil cationic protein (ECP) and cord IgE were higher among infants with maternal history of atopy. Objective: The purpose of this study was to investigate the possible association of parental history of atopy with cord blood ECP and IgE concentrations in infants with transient tachypnoea of the newborn. Methods: ECP and IgE levels were quantified in cord blood samples of 30 infants who were diagnosed as having transient tachypnoea of the newborn. The control group (N = 30) was selected among healthy newborns with similar birth weight and gestational age. Results: Cord blood ECP concentrations were significantly higher in the study group (17.6 µcg/L) than in healthy control subjects (7.89 µcg/L). In addition, transient tachypnoea of the newborn was more frequent in infants with a family history of atopic disease (p < 0.01). Cord blood IgE concentrations were also higher in the study group than the controls (4.1 versus 3.28 mg/L) but the difference was not statistically significant (p > 0.05). Conclusion: Family history of atopy and elevated levels of cord blood ECP are risk factors for transient tachypnoea of the newborn. In addition cord blood ECP level is a useful marker for predicting the risk of atopy.

Effects of maternal allergen-specific IgG in cord blood on early postnatal development of allergen-specific T-cell immunity.

A wide body of epidemiologic evidence indicates that as yet unknown maternal factor(s) can influence susceptibility to allergic disease in the offspring. It is also well established that the induction of allergen-specific T-cell memory is frequently initiated in utero, and it is likely that maternal factors exert their influence during this period. This study examines the relationship between maternally derived allergen-specific IgG subclass antibodies and cellular immune responses (lymphoproliferation and cytokine production) against the same allergens in 49 subjects tested at birth and at 2 years of age. Polyclonal production of the Th1 cytokine IFN-gamma was also examined in the cord-blood samples. At birth, there were positive correlations between both house-dust mite (HDM)- and ovalbumin (OVA)-specific IgG subclass levels in cord blood, maternal atopy, and the magnitude of perinatal lymphoproliferative responses to respective allergens. Inverse relationships were also observed between cord-blood IgG antibody titres and allergen-specific production of some Th2 cytokines. However, there were no consistent relationships between cord-blood allergen-specific IgG antibodies and subsequent immune responses to allergens when the same subjects were retested at 2 years of age. An inverse relationship was observed between maternal history of atopy and perinatal IFN-gamma production capacity. Our results suggest that transplacental transfer of allergen-specific IgG antibody is unlikely to be a major mechanism for maternal regulation of allergen-specific immunity in infancy. An alternative possibility is that maternal effects may operate by influencing IFN-gamma production by T cells in the offspring.