Patterns of Immune Development in Urban Preschoolers with Recurrent Wheeze and/or Atopy

Publication date: Available online 13 January 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): James E. Gern, Agustin Calatroni, Katy F. Jaffee, Henry Lynn, Amy Dresen, William W. Cruikshank, Howard M. Lederman, Hugh A. Sampson, Wayne Shreffler, Leonard B. Bacharier, Peter J. Gergen, Diane R. Gold, Meyer Kattan, George T. O'Connor, Megan T. Sandel, Robert A. Wood, Gordon R. Bloomberg
BackgroundDisadvantaged urban children have high rates of allergic diseases and wheezing, which are diseases associated with Type 2-biased immunity.ObjectiveTo determine whether environmental exposures in early life influence cytokine responses which affect the development of recurrent wheezing illnesses and allergic sensitization.MethodsA birth cohort of 560 urban families was recruited from neighborhoods with high rates of poverty, and 467 (83%) children were followed until 3 years of age. Cytokine responses were measured in blood cell samples obtained at birth (cord blood) and ages 1 and 3 years. Cytokine responses were examined in relation to personal characteristics and environmental exposures to allergens and endotoxin, and also to the development of allergic sensitization and recurrent wheeze assessed at age 3 years.ResultsCytokine responses generally increased with age, but responses at birth were poorly predictive for those at ages 1 and 3 years. Exposure to certain allergens (cockroach, mouse, dust mite) was significantly associated with enhanced cytokine responses at age 3 years, including IFN-α and IL-10 responses to certain stimulants, and responses to phytohemagglutinin. Regarding the clinical outcomes, reduced LPS-induced IL-10 responses at birth was associated with recurrent wheeze. In contrast, reduced RSV-induced IL-8 responses, and increased CpG-induced IL-12p40 and allergen-induced IL-4 responses were associated with atopy.ConclusionsThese findings suggest that diverse biologic exposures, including allergens and endotoxin, in urban homes stimulate the development of cytokine responses in early life, and that cytokine responses to specific microbial and viral stimuli are associated with the development of allergic sensitization and recurrent wheeze.

Teaser

Understanding factors that influence immune development in early life have the potential to offer new preventive strategies for allergic sensitization and recurrent wheeze, two important risk factors for childhood asthma.


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