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Chen YJ, Lin LZ, Liu ZY, Wang X, Karatela S, Wang YX, Peng SS, Jiang BB, Li XX, Liu N, Jing J, Cai L. Association between maternal gestational diabetes and allergic diseases in offspring: a birth cohort study. World J Pediatr 2023; 19:972-982. [PMID: 37029331 DOI: 10.1007/s12519-023-00710-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/22/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Previous studies have linked gestational diabetes (GDM) with allergies in offspring. However, the effect of specific glucose metabolism metrics was not well characterized, and the role of polyunsaturated fatty acids (PUFAs), a modifier of metabolism and the immune system, was understudied. We aimed to investigate the association between maternal GDM and allergic diseases in children and the interaction between glucose metabolism and PUFAs on allergic outcomes. METHODS This prospective cohort study included 706 mother-child dyads from Guangzhou, China. Maternal GDM was diagnosed via a 75-g oral glucose tolerance test (OGTT), and dietary PUFAs were assessed using a validated food frequency questionnaire. Allergic disease diagnoses and the age of onset were obtained from medical records of children within three years old. RESULTS Approximately 19.4% of women had GDM, and 51.3% of children had any allergic diseases. GDM was positively associated with any allergic diseases (hazard ratio [HR] 1.40; 95% confidence interval (CI) 1.05-1.88) and eczema (HR 1.44; 95% CI 1.02-1.97). A unit increase in OGTT after two hours (OGTT-2 h) glucose was associated with an 11% (95% CI 2%-21%) higher risk of any allergic diseases and a 17% (95% CI 1-36%) higher risk of food allergy. The positive associations between OGTT-2 h glucose and any allergic diseases were strengthened with decreased dietary a-linolenic acid (ALA) and increased n-6 PUFAs, linoleic acid (LA), LA/ALA ratio, and n-6/n-3 PUFA ratio. CONCLUSIONS Maternal GDM was adversely associated with early-life allergic diseases, especially eczema. We were the first to identify OGTT-2 h glucose to be more sensitive in inducing allergy risk and that dietary PUFAs might modify the associations.
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Affiliation(s)
- Yu-Jing Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Li-Zi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Zhao-Yan Liu
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xin Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, People's Republic of China
| | - Shamshad Karatela
- Faculty of Health and Behavioural Sciences, Pharmacy Australia Centre of Excellence, University of Queensland, Woolloongabba, QLD, Australia
- Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, QLD, Australia
| | - Yu-Xuan Wang
- Global Health Research Center, Duke Kunshan University, Kunshan, People's Republic of China
| | - Shan-Shan Peng
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Bi-Bo Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Xiao-Xu Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Nan Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China.
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China.
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Ruan F, Zhang J, Liu J, Sun X, Li Y, Xu S, Xia W. Association between prenatal exposure to metal mixtures and early childhood allergic diseases. ENVIRONMENTAL RESEARCH 2022; 206:112615. [PMID: 34968434 DOI: 10.1016/j.envres.2021.112615] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
The association between prenatal exposure to the metal mixture and allergic diseases is poorly understood. We aimed to explore the individual effect and the combined effect of prenatal exposure to vanadium (V), chromium (Cr), nickel (Ni), arsenic (As), cadmium (Cd), thallium (Tl), and lead (Pb) on early childhood allergic diseases based on a birth cohort study that included 628 mother-infant pairs. Metals were measured in maternal urine samples collected in the first, second, and third trimesters. Children were prospectively followed up at age 4 years to collect information on allergic rhinitis, wheeze, and eczema status. By applying logistic regression models, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR), the different statistical analyses revealed urinary metals were only associated with early childhood allergic rhinitis. The averaged prenatal As exposure was significantly associated with an increased OR for allergic rhinitis in both single-metal (OR = 2.04, 95% CI: 1.35, 3.07) and multiple-metal logistic regression models (OR = 1.78, 95% CI: 1.15, 2.78). The WQS index of mixed metal exposure was positively associated with allergic rhinitis (OR = 1.66, 95% CI: 1.26, 2.19), and As and Tl had the largest weights in the WQS index (weighted 0.51 and 0.29, respectively). The BKMR analysis also showed the overall effect of the metal mixture was significantly associated with allergic rhinitis when all the metals were at their 55th percentile or above, compared to their 50th percentile. The effect of As and Tl on the risk of allergic rhinitis was significant when all of the other metals were fixed at the specific percentiles. Our findings suggest that prenatal co-exposure to higher levels of the seven metals increases the risk of allergic rhinitis in children, and As and Tl may contribute most to the combined risk.
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Affiliation(s)
- Fengyu Ruan
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Jingjing Zhang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Juan Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Xiaojie Sun
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
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Kim BE, Hui-Beckman J, Lyubchenko T, Hall CF, Fallahi S, Brull A, Goleva E, Leung DY. Transient Receptor Potential Vanilloid 1 Plays a Major Role in Low Temperature-Mediated Skin Barrier Dysfunction. J Allergy Clin Immunol 2022; 150:362-372.e7. [PMID: 35189126 DOI: 10.1016/j.jaci.2022.01.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/23/2021] [Accepted: 01/26/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Children born in the fall and winter are at increased risk for developing atopic dermatitis (AD) and food allergy (FA). Since these seasons are associated with low temperature, we hypothesized that low temperature exposure may compromise keratinocyte differentiation and contribute to skin barrier dysfunction. OBJECTIVE To examine whether low temperature causes skin barrier dysfunction. METHODS Primary human epidermal keratinocytes (HEKs) were differentiated in 1.3mM CaCl2 media and cultured at different temperatures. The cells were transfected with transient receptor potential cation channel subfamily V member 1 (TRPV1) or signal transducer and activator of transcription (STAT) 3 small-interfering RNA (siRNA) to examine the effects of these gene targets in HEKs exposed to low temperature. Gene expression of TRPV1, epidermal barrier proteins, and keratinocyte-derived cytokines were evaluated. Organotypic skin equivalents were generated using HEKs transfected with control or TRPV1 siRNA and grown at 25oC or 37oC. Transepidermal water loss (TEWL) and levels of epidermal barrier proteins were evaluated. RESULTS Filaggrin (FLG) and loricrin (LOR) expression, but not keratin (KRT)-1 and KRT-10 expression, was downregulated in HEKs incubated at 25oC while TRPV1 silencing increased intracellular Ca2+ influx (keratinocyte differentiation signal) and enhanced the expression of epidermal differentiation proteins. Interleukin (IL)-1β and thymic stromal lymphopoietin (TSLP) induced by low temperature inhibited FLG expression in keratinocytes through the TRPV1/STAT3 pathway. Moreover, low temperature-mediated inhibition of FLG and LOR was recovered, and TEWL was decreased in organotypic skin transfected with TRPV1 siRNA. CONCLUSION TRPV1 is critical in low temperature-mediated skin barrier dysfunction. Low temperature exposure induced TSLP, an alarmin implicated in epicutaneous allergen sensitization. CLINICAL IMPLICATIONS Low temperature causes skin barrier dysfunction through TRPV1 and TSLP, which may explain the pathways involved in promoting allergic sensitization through the skin.
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Affiliation(s)
- Byung Eui Kim
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206
| | | | - Taras Lyubchenko
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206; Department of Biological Science, University of Denver, Denver, CO, 80208
| | - Clifton F Hall
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206
| | - Sahand Fallahi
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206; Department of Biological Science, University of Denver, Denver, CO, 80208
| | - Amelia Brull
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206
| | - Elena Goleva
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206
| | - Donald Ym Leung
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206
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Hui-Beckman J, Kim BE, Leung DY. Origin of Allergy From In Utero Exposures to the Postnatal Environment. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2022; 14:8-20. [PMID: 34983104 PMCID: PMC8724834 DOI: 10.4168/aair.2022.14.1.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/28/2021] [Accepted: 07/11/2021] [Indexed: 04/28/2023]
Abstract
As the incidence of atopic conditions continues to increase, emphasis has been placed on understanding the origin of allergy with hope that prevention measures can be achieved. The perinatal environment is important for this understanding, given that both the immune system and microbiome start forming prenatally. Maternal exposure can greatly impact on fetal health. Additionally, the dysfunctional epithelial barrier is influential in allowing allergens and irritants to penetrate the skin or mucosa, leading to the release of proinflammatory cytokines and mediators to drive type 2 tissue inflammation and the onset of allergy. There are numerous factors related to skin, airway, and gut epithelial barriers dysfunction, and genetic predispositions are also present. Comprehensive birth cohort studies and further mechanistic studies will be keys to understanding the origin of allergy.
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Affiliation(s)
| | - Byung Eui Kim
- Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA
| | - Donald Ym Leung
- Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA.
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Leung DYM. Advances in cutaneous allergy. Ann Allergy Asthma Immunol 2021; 126:1-2. [PMID: 33292968 DOI: 10.1016/j.anai.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colorado.
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Leung DYM. Origins of allergy: Scratching below the surface. Ann Allergy Asthma Immunol 2020; 125:497-498. [PMID: 33097164 DOI: 10.1016/j.anai.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colorado.
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