Key risk factors of asthma-like symptoms are mediated through infection burden in early childhood
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Background: Risk factors of asthma-like symptoms in childhood may act through an increased infection burden because infections often trigger these symptoms. Objective: We sought to investigate whether the effect of established risk factors of asthma-like episodes in early childhood is mediated through burden and subtypes of common infections. Methods: The study included 662 children from the Copenhagen Prospective Studies on Asthma in Childhood 2010 mother-child cohort, in which infections were registered prospectively in daily diaries from age 0 to 3 years. The association between established risk factors of asthma-like episodes and infection burden was analyzed by quasi-Poisson regressions, and mediation analyses were performed for significant risk factors. Results: In the first 3 years of life, the children experienced a median of 16 (interquartile range, 12-23) infectious episodes. We found that the infection burden significantly (PACME <.05) mediated the association of maternal asthma (36.6% mediated), antibiotics during pregnancy (47.3%), siblings at birth (57.7%), an asthma exacerbation polygenic risk score (30.6%), and a bacterial airway immune score (80.2%) with number of asthma-like episodes, whereas the higher number of episodes from male sex, low birth weight, low gestational age, and maternal antibiotic use after birth was not mediated through an increased infection burden. Subtypes of infections driving the mediation were primarily colds, pneumonia, gastroenteritis, and fever, but not acute otitis media or acute tonsillitis. Conclusions: Several risk factors of asthma-like symptoms in early childhood act through an increased infection burden in the first 3 years of life. Prevention of infectious episodes may therefore be beneficial to reduce the burden of asthma-like symptoms in early childhood.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Journal of Allergy and Clinical Immunology |
| Vol/bind | 153 |
| Udgave nummer | 3 |
| Sider (fra-til) | 684-694 |
| Antal sider | 11 |
| ISSN | 0091-6749 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:
The Danish Foundation for Lung Diseases in Children (Børnelungefonden), The Capital Region (A689), and Region Zealand have provided support to the study project. N.B. received funding from The Capital Region Research Foundation (grant no. A7187) and The Lundbeck Foundation (grant no. R381-2021-1428). The funders had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. No pharmaceutical company was involved in the study. All authors had access to the raw data and had final responsibility for the decision to submit for publication. J.S. has received funding from the Danish Council for Independent Research.
Funding Information:
We acknowledge the huge work of late professor Hans Bisgaard, who was the founder of COPSAC and was head of the clinical research center for more than 25 years. Hans was a dedicated, innovative physician-scientist who pushed the asthma research field forward. He contributed immensely to pediatric research through the COPSAC birth cohorts as well as through a vast number of other clinical studies on childhood asthma. Hans’ impressive work and ideas live on in the following studies conducted in the birth cohort. Thank you for being a great inspiration to us all. Furthermore, we express our deepest gratitude to the children and families of the COPSAC 2010 cohort study for all their support and commitment. We acknowledge and appreciate the unique efforts of the COPSAC research team. Lastly, we acknowledge the organizations funding this project: The Danish Foundation for Lung Diseases in Children (Børnelungefonden), The Capital Region, Region Zealand, The Capital Region Research Foundation, and The Lundbeck Foundation.
Funding Information:
The Danish Foundation for Lung Diseases in Children (Børnelungefonden), The Capital Region (A689), and Region Zealand have provided support to the study project. N.B. received funding from The Capital Region Research Foundation (grant no. A7187) and The Lundbeck Foundation (grant no. R381-2021-1428 ). The funders had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. No pharmaceutical company was involved in the study. All authors had access to the raw data and had final responsibility for the decision to submit for publication. J.S. has received funding from the Danish Council for Independent Research.
Publisher Copyright:
© 2023 The Authors
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