1
|
Caputo M, Raupach-Rosin H, Karch A, Borte M, Lehmann I, Liebert UG, Standl M, Heinrich J, Mikolajczyk RT. Vaccinations and Infections Are Associated With Unrelated Antibody Titers: An Analysis From the German Birth Cohort Study LISA. Front Pediatr 2019; 7:254. [PMID: 31294004 PMCID: PMC6603196 DOI: 10.3389/fped.2019.00254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 06/04/2019] [Indexed: 11/13/2022] Open
Abstract
The evidence for non-specific effects (NSE) of vaccinations on all-cause morbidity and mortality among children is growing. However, our understanding of the underlying mechanisms is still limited. One hypothesis is that NSE are mediated by antibody titers. We used data of 2,123 children from the population-based birth cohort study LISA conducted in Germany to explore whether routine childhood vaccinations and the individual infection history in the first 2 years of life are associated with unrelated antibody titers. We selected 19 exposures (infections and vaccinations) and investigated their association with levels of 12 IgG antibody titers at the age of 2 years. Based on univariable analyses (ANOVA), we identified 21 crude associations between exposures and titers (p < 0.05), while 11 (95%-CI: 6, 17) spurious associations were expected due to multiple testing. In exploratory multivariable analyses, we observed associations between seven investigated IgG titers and 10 exposures; either administered vaccines [e.g., higher anti-hRSV IgG titer in BCG-vaccinated children (regression-coefficient in standard-deviation-units: 0.38; 95%-CI: 0.12, 0.65)] or infections [e.g., higher anti-measles IgG titer in children with reported chickenpox (0.44; 95%-CI: 0.08, 0.80)]. Our results indicate the existence of associations between immunogenic exposures and unrelated antibody titers. Further studies investigating the underlying immunological mechanisms are required.
Collapse
Affiliation(s)
- Mahrrouz Caputo
- Department of Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany.,PhD Programme "Epidemiology," Brunswick, Germany
| | - Heike Raupach-Rosin
- Department of Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany
| | - André Karch
- Department of Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany.,German Centre for Infection Research (DZIF), Site Brunschwick-Hannover, Brunswick, Germany.,Institute for Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Michael Borte
- Children's Hospital, Municipal Hospital St. Georg Leipzig, Academic Teaching Hospital of the University of Leipzig, Leipzig, Germany
| | - Irina Lehmann
- Department of Environmental Immunology, Core Facility Studies, Helmholtz Centre for Environmental Research- UFZ, Leipzig, Germany.,Charitè - Universitätsmedizin Berlin and Berlin Institute of Health (BIH), Berlin, Germany
| | | | - Marie Standl
- Helmholtz Zentrum München- German Research Center for Environmental Health, Institute of Epidemiology, Munich, Germany
| | - Joachim Heinrich
- Helmholtz Zentrum München- German Research Center for Environmental Health, Institute of Epidemiology, Munich, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Rafael T Mikolajczyk
- German Centre for Infection Research (DZIF), Site Brunschwick-Hannover, Brunswick, Germany.,Institute for Medical Epidemiology, Biometry, and Informatics (IMEBI), Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| |
Collapse
|
2
|
Krämer U, Schmitz R, Ring J, Behrendt H. What can reunification of East and West Germany tell us about the cause of the allergy epidemic? Clin Exp Allergy 2015; 45:94-107. [PMID: 25412814 DOI: 10.1111/cea.12458] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The increase of allergies in East Germany--reaching West German prevalence shortly after the reunification--is considered a model for the allergy epidemic in the western world. Whether such a pattern was observed in all comparison studies and for all allergic manifestations is not known because a complete overview is missing. Hints about possible causal factors for the allergy epidemic could be gained by identifying known risk factors, which explain the observed pattern of allergy development in Germany. Again, an overview about these efforts is missing. We identified 14 cross-sectional studies conducted after 1989 and calculated prevalence ratios (West/East) for asthma, hayfever, eczema and allergic sensitization. Additionally, a tabular overview about the explanatory power of risk factors hypothesized in the nineties and covering outdoor exposure, indoor factors, early childhood influences, nutrition as well as awareness is given. At the time of the German reunification, the prevalence ratio West/East was largest for hayfever and sensitization to birch pollen, less pronounced for the other phenotypes and even less than one for atopic eczema. Hayfever and sensitization to birch pollen also showed the steepest increase in East Germany afterwards. Single-room heating with fossil fuels and living as only child in a family were identified as explaining up to 23.5% of the excess trend in East compared to the trend in West. Hayfever as most typical atopic disease showed the difference in allergy pattern between East and West Germany clearest. Risk factors identified for these phenotypes are completely different (single child) or even act in the opposite direction (single-room heating) from classical risk factors for airway diseases. This might be the most important lesson from the West/East German experience. It already stimulated many other studies focussing on protective factors such as microbial stimulation.
Collapse
Affiliation(s)
- U Krämer
- IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | | | | | | |
Collapse
|
3
|
Eczema, respiratory allergies, and traffic-related air pollution in birth cohorts from small-town areas. J Dermatol Sci 2009; 56:99-105. [DOI: 10.1016/j.jdermsci.2009.07.014] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 06/10/2009] [Accepted: 07/24/2009] [Indexed: 11/23/2022]
|