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Early-life allergic sensitization and respiratory infection-Two hits on lung function?
Vikas Wadhwa1, Shyamali C Dharmage1, Danielle Wurzel1,2
1Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Summary
Early childhood allergic sensitization and respiratory infections interact to affect adult lung function. Respiratory infections negatively impacted lung function in sensitized individuals but improved it in non-sensitized individuals up to age 25.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Epidemiology
Background:
- Allergic sensitization and respiratory infections are common in childhood, with potential links to asthma development via the 'two-hit' hypothesis.
- Previous research has not explored the long-term impact of these combined factors on adult lung function.
Purpose of the Study:
- To investigate the interaction between early-life allergic sensitization and respiratory infections.
- To determine the association of these factors with lung function outcomes in adulthood.
Main Methods:
- A birth cohort study assessed allergic sensitization via skin prick testing at 24 months.
- Respiratory infections were monitored through questionnaires up to 24 months.
- Regression models analyzed interactions and associations with lung function at ages 12, 18, and 25 years.
Main Results:
- At age 25, early sensitization was linked to reduced lung function (FEV1) with increased respiratory infections.
- Conversely, non-sensitized individuals showed improved lung function with more respiratory infections.
- Significant interactions were observed for FEV1/FVC ratio and FEF25-75, with stronger evidence at later ages (18 and 25 years).
Conclusions:
- The study supports the 'two-hit' hypothesis, demonstrating interactions between early allergic sensitization and respiratory infections impacting lung function into adulthood.
- The impact of early respiratory infections on lung function is contingent on the presence or absence of allergic sensitization.
- Findings highlight the differential long-term effects of childhood exposures on respiratory health.
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