Association between antenatal cytokine production and the development of atopy and asthma at age 6 years

C Macaubas1, N H de Klerk, B J Holt

  • 1Telethon Institute for Child Health Research, and Centre for Child Health Research, Faculty of Medicine and Dentistry, University of Western Australia, Western Australia, Perth, Australia.

Lancet (London, England)
|October 22, 2003
PubMed

Insights

Antenatal cytokine levels, specifically interleukin 4 and interferon gamma in cord blood, are linked to a reduced risk of childhood asthma and atopy. Maternal smoking negatively impacts these protective cytokine levels, highlighting a target for asthma prevention.

Area of Science:

  • Immunology
  • Pediatric Allergy
  • Environmental Health

Background:

  • Antenatal factors influence susceptibility to atopy and asthma.
  • Cytokines play a crucial role in placental immunological homeostasis.
  • Investigating antenatal cytokine profiles offers insights into early-life allergy development.

Purpose of the Study:

  • To examine the association between cord-blood cytokine concentrations and atopy/asthma outcomes at age 6.
  • To explore the influence of family, antenatal, and perinatal factors on these associations.
  • To assess the impact of maternal smoking on cord-blood cytokines and asthma risk.

Main Methods:

  • Assayed cord-blood serum from 407 children for key interleukins (IL-4, IL-5, IL-6, IL-10, IL-12, IL-13), interferon gamma, and TNF-alpha.
  • Utilized logistic regression to analyze associations between factors, cytokines, and outcomes.
  • Employed propensity scores to estimate causal effects of cytokines on outcomes.

Main Results:

  • Detectable cord-blood IL-4 and interferon gamma were associated with significantly lower risks of physician-diagnosed asthma, current asthma, current wheeze, and atopy at age 6.
  • High tumor necrosis factor alpha (TNFalpha) concentrations correlated with reduced atopy risk.
  • Maternal smoking was linked to increased wheeze risk and decreased levels of IL-4 and interferon gamma.

Conclusions:

  • The fetoplacental unit's cytokine production mechanism, similar to that in high-risk children, appears crucial for immune regulation.
  • This mechanism is vulnerable to disruption by maternal smoking, suggesting it's a key target for antenatal asthma prevention strategies.
Abstract

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