Asthma diagnosis and treatmentChronic caregiver stress and IgE expression, allergen-induced proliferation, and cytokine profiles in a birth cohort predisposed to atopy
Section snippets
Methods
Participants in the Home Allergen and Asthma Study include infants and their 499 families with a history of asthma or allergy recruited within 48 hours of delivery between September 1994 and July 1996, as previously reported.19 The Brigham and Women's Hospital Human Studies Committee approved the study, and written parental informed consent was obtained.
At the home visit, when the index child was 2 to 3 months old, data were collected on environmental exposures, including dust samples analyzed
Results
Table 1 shows the distribution of sociodemographic factors, maternal asthma, and whether the child had a cold within a week of the blood draw relative to total IgE levels and allergen-specific SIs. Fig 1 contains estimates of the stress curves for the families stratified by IgE level (IgE > 100 IU/mL vs IgE ≤ 100 IU/mL) or Der f 1 SI (SI > 3 vs SI ≤ 3). In these data IgE level (mean ± SD, 40.2 ± 95.2 IU/mL; range, 2-1247 IU/mL) and Der f 1 SI (5.5 ± 6.2; range, 0.4-34.0) showed considerable
Discussion
These data demonstrate that higher early-life chronic caregiver stress was associated with increased total IgE expression and an enhanced allergen-specific proliferative response at age 2 to 3 years. Moreover, higher-level stress was associated with increased TNF-α levels by stimulated PBMCs and reduced IFN-γ levels. Exposure to stress in early development might result in functional changes in immune reactivity in susceptible children, potentiating the inflammatory response.
Serial measurement
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During preparation of the manuscript, Dr Wright was the recipient of the Edward and Amalie Kass Fellowship at the Harvard Medical School and a Mentored Clinical Scientist Development Award from the National Heart, Lung, and Blood Institute, K08 HL04187. These analyses were also supported by the Fetzer Institute and NIH R01 #AI/EHS35786.