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Bisgaard H, Chawes B, Stokholm J, Mikkelsen M, Schoos AMM, Bønnelykke K. 25 Years of translational research in the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC). J Allergy Clin Immunol 2023; 151:619-633. [PMID: 36642652 DOI: 10.1016/j.jaci.2022.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/28/2022] [Accepted: 11/04/2022] [Indexed: 01/15/2023]
Abstract
The Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) mother-child cohorts have provided a foundation of 25 years of research on the origins, prevention, and natural history of childhood asthma and related disorders. COPSAC's approach is characterized by clinical translational research with longitudinal deep phenotyping and exposure assessments from pregnancy, in combination with multi-omic data layers and embedded randomized controlled trials. One trial showed that fish oil supplementation during pregnancy prevented childhood asthma and identified pregnant women with the highest benefits from supplementation, thereby creating the potential for personalized prevention. COPSAC revealed that airway colonization with pathogenic bacteria in early life is associated with an increased risk of asthma. Further, airway bacteria were shown to be a trigger of acute asthma-like symptoms, with benefit from antibiotic treatment. COPSAC identified an immature gut microbiome in early life as a risk factor for asthma and allergy and further demonstrated that asthma can be predicted by infant lung function. At a molecular level, COPSAC has identified novel susceptibility genes, early immune deviations, and metabolomic alterations associated with childhood asthma. Thus, the COPSAC research program has enhanced our understanding of the processes causing childhood asthma and has suggested means of personalized prevention and treatment.
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Affiliation(s)
- Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Bo Chawes
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Slagelse Hospital, Slagelse, Denmark
| | - Marianne Mikkelsen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ann-Marie Malby Schoos
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Slagelse Hospital, Slagelse, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
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Pérez Chacón G, Fathima P, Jones M, Barnes R, Richmond PC, Gidding HF, Moore HC, Snelling TL. Pertussis immunisation in infancy and atopic outcomes: A protocol for a population-based cohort study using linked administrative data. PLoS One 2021; 16:e0260388. [PMID: 34874968 PMCID: PMC8651097 DOI: 10.1371/journal.pone.0260388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/06/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The burden of IgE-mediated food allergy in Australian born children is reported to be among the highest globally. This illness shares risk factors and frequently coexists with asthma, one of the most common noncommunicable diseases of childhood. Findings from a case-control study suggest that compared to immunisation with acellular pertussis vaccine, early priming of infants with whole-cell pertussis vaccine may be associated with a lower risk of subsequent IgE-mediated food allergy. If whole-cell vaccination is protective of food allergy and other atopic diseases, especially if protective against childhood asthma, the population-level effects could justify its preferential recommendation. However, the potential beneficial effects of whole-cell pertussis vaccination for the prevention of atopic diseases at a population-scale are yet to be investigated. METHODS AND ANALYSIS Analyses of population-based record linkage data will be undertaken to compare the rates of admissions to hospital for asthma in children aged between 5 and 15 years old, who were born in Western Australia (WA) or New South Wales (NSW) between 1997 and 1999 (329,831) when pertussis immunisation in Australia transitioned from whole-cell to acellular only schedules. In the primary analysis we will estimate hazard ratios and 95% confidence intervals for the time-to-first-event (hospital admissions as above) using Cox proportional hazard models in recipients of a first dose of whole-cell versus acellular pertussis-containing vaccine before 112 days old (~4 months of age). Similarly, we will also fit time-to-recurrent events analyses using Andersen-Gill models, and robust variance estimates to account for potential within-child dependence. Hospitalisations for all-cause anaphylaxis, food anaphylaxis, venom, all-cause urticaria and atopic dermatitis will also be examined in children who received at least one dose of pertussis-containing vaccine by the time of the cohort entry, using analogous statistical methods. Presentations to the emergency departments will be assessed separately using the same statistical approach.
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Affiliation(s)
- Gladymar Pérez Chacón
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Faculty of Health Science, Curtin School of Population Health, Curtin University, Bentley, WA, Australia
| | - Parveen Fathima
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Mark Jones
- Faculty of Medicine and Health, Health and Clinical Analytics Lab, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Rosanne Barnes
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Peter C. Richmond
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Division of Paediatrics, University of Western Australia, Perth, WA, Australia
| | - Heather F. Gidding
- Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
- Women and Babies Health Research, Kolling Institute, Northern Sydney Local Health District, Sydney, NSW, Australia
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children’s Hospital at Westmead, Sydney, NSW, Australia
| | - Hannah C. Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Faculty of Health Science, Curtin School of Population Health, Curtin University, Bentley, WA, Australia
| | - Thomas L. Snelling
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Faculty of Health Science, Curtin School of Population Health, Curtin University, Bentley, WA, Australia
- Faculty of Medicine and Health, Health and Clinical Analytics Lab, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
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Chawes BL, Wolsk HM, Carlsson CJ, Rasmussen MA, Følsgaard N, Stokholm J, Bønnelykke K, Brix S, Schoos AM, Bisgaard H. Neonatal airway immune profiles and asthma and allergy endpoints in childhood. Allergy 2021; 76:3713-3722. [PMID: 33864271 DOI: 10.1111/all.14862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/11/2021] [Accepted: 03/31/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The immune system plays a key role in the pathogenesis of asthma and allergy, but the role of the airway cytokine and chemokine composition in vivo in early life prior to symptom development has not been described previously. Here, we aimed to examine whether the neonatal airway immune composition associates with development of allergy and asthma in childhood. METHODS We measured unstimulated levels of 20 immune mediators related to the Type 1, Type 2, Type 17, or regulatory immune pathways in the airway mucosal lining fluid of 620 one-month-old healthy neonates from the COPSAC2010 birth cohort. Allergy and asthma were diagnosed at our research clinic by predefined algorithms and objective assessments at age 6 years. Principal component analyses were used to describe the airway cytokine and chemokine composition. RESULTS A neonatal airway immune profile particularly characterized by enhanced IL-1β and reduced CCL26 was significantly associated with later development of elevated specific IgE to inhaled allergens, a positive skin prick test, and allergic rhinitis, but not with food sensitization. Conversely, reduced Type 17 immune-associated markers, including IL-1β and CXCL8, showed trend of association with development of early asthma endpoints. CONCLUSIONS Development of early asthma endpoints and inhalant allergy during the first 6 years of life seems associated with distinctly perturbed airway immune profiles in neonatal life, which is suggestive of an early origin and different pathogenesis of childhood asthma and allergy. These exploratory findings suggest pre- and perinatal life as an important window of opportunity for prevention of asthma and inhalant allergy.
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Affiliation(s)
- Bo L. Chawes
- COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Helene M. Wolsk
- COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Christian J. Carlsson
- COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Morten A. Rasmussen
- COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
- Department of Food Science University of Copenhagen Frederiksberg C Denmark
| | - Nilofar Følsgaard
- COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Jakob Stokholm
- COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Klaus Bønnelykke
- COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Susanne Brix
- Department of Biotechnology and Biomedicine Technical University of Denmark Lyngby Denmark
| | - Ann‐Marie M. Schoos
- COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Hans Bisgaard
- COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
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Sigurdardottir ST, Jonasson K, Clausen M, Lilja Bjornsdottir K, Sigurdardottir SE, Roberts G, Grimshaw K, Papadopoulos NG, Xepapadaki P, Fiandor A, Quirce S, Sprikkelman AB, Hulshof L, Kowalski ML, Kurowski M, Dubakiene R, Rudzeviciene O, Bellach J, Yürek S, Reich A, Erhard SM, Couch P, Rivas MF, van Ree R, Mills C, Grabenhenrich L, Beyer K, Keil T. Prevalence and early-life risk factors of school-age allergic multimorbidity: The EuroPrevall-iFAAM birth cohort. Allergy 2021; 76:2855-2865. [PMID: 33934363 PMCID: PMC8453757 DOI: 10.1111/all.14857] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/04/2021] [Accepted: 02/22/2021] [Indexed: 01/01/2023]
Abstract
Background Coexistence of childhood asthma, eczema and allergic rhinitis is higher than can be expected by chance, suggesting a common mechanism. Data on allergic multimorbidity from a pan‐European, population‐based birth cohort study have been lacking. This study compares the prevalence and early‐life risk factors of these diseases in European primary school children. Methods In the prospective multicentre observational EuroPrevall‐iFAAM birth cohort study, we used standardized questionnaires on sociodemographics, medical history, parental allergies and lifestyle, and environmental exposures at birth, 12 and 24 months. At primary school age, parents answered ISAAC‐based questions on current asthma, rhinitis and eczema. Allergic multimorbidity was defined as the coexistence of at least two of these. Results From 10,563 children recruited at birth in 8 study centres, we included data from 5,572 children (mean age 8.2 years; 51.8% boys). Prevalence estimates were as follows: asthma, 8.1%; allergic rhinitis, 13.3%; and eczema, 12.0%. Allergic multimorbidity was seen in 7.0% of the whole cohort, ranging from 1.2% (Athens, Greece) to 10.9% (Madrid, Spain). Risk factors for allergic multimorbidity, identified with AICc, included family‐allergy‐score, odds ratio (OR) 1.50 (95% CI 1.32–1.70) per standard deviation; early‐life allergy symptoms, OR 2.72 (2.34–3.16) for each symptom; and caesarean birth, OR 1.35 (1.04–1.76). Female gender, OR 0.72 (0.58–0.90); older siblings, OR 0.79 (0.63–0.99); and day care, OR 0.81 (0.63–1.06) were protective factors. Conclusion Allergic multimorbidity should be regarded as an important chronic childhood disease in Europe. Some of the associated early‐life factors are modifiable and may be considered for prevention strategies.
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Affiliation(s)
- Sigurveig T. Sigurdardottir
- Landspitali University Hospital Reykjavik Iceland
- Faculty of Medicine University of Iceland Reykjavik Iceland
| | - Kristjan Jonasson
- Department of Computer Science University of Iceland Reykjavík Iceland
| | - Michael Clausen
- Children's Hospital Reykjavik Reykjavik Iceland
- Department of Allergy Landspitali University Hospital Reykjavik Iceland
| | | | | | - Graham Roberts
- Human Development and Health & Clinical and Experimental Sciences Faculty of Medicine University of Southampton UK
- NIHR Southampton Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
- The David Hide Asthma and Allergy Research Centre St Mary’s Hospital Isle of Wight UK
| | - Kate Grimshaw
- Dietetic Department Salford Royal NHS Foundation Trust UK
- Clinical and Experimental Sciences Faculty of Medicine University of Southampton UK
- Division of Infection, Immunity and Respiratory Medicine School of Biological Sciences Manchester Institute of Biotechnology University of Manchester Manchester UK
| | - Nikolaos G. Papadopoulos
- Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
- Division of Infection, Immunity & Respiratory Medicine University of Manchester Manchester UK
| | - Paraskevi Xepapadaki
- Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
| | - Ana Fiandor
- Department of Allergy La Paz University Hospital IdiPAZ Madrid Spain
| | - Santiago Quirce
- Department of Allergy La Paz University Hospital IdiPAZ Madrid Spain
| | - Aline B. Sprikkelman
- Department of Pediatric Pulmonology and Pediatric Allergology University Medical Center Groningen University of Groningen The Netherlands
| | - Lies Hulshof
- Department of Pediatric Pulmonology and Pediatric Allergology Emma Children's Hospital Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
| | - Marek L. Kowalski
- Department of Immunology, Allergy and Rheumatology Medical University of Lodz Lodz Poland
| | - Marcin Kurowski
- Department of Immunology, Allergy and Rheumatology Medical University of Lodz Lodz Poland
| | - Ruta Dubakiene
- Medical Faculty Clinic of Chest Diseases, Allergology and Immunology Vilnius University Vilnius Lithuania
| | - Odilija Rudzeviciene
- Faculty of Medicine Clinic of Children’s Diseases Vilnius University Vilnius Lithuania
| | - Johanna Bellach
- Department of Paediatric Pneumology and Immunology Charité – Universitätsmedizin Berlin Berlin Germany
| | - Songül Yürek
- Department of Paediatric Pneumology and Immunology Charité – Universitätsmedizin Berlin Berlin Germany
| | - Andreas Reich
- Epidemiology Unit German Rheumatism Research Centre Berlin Germany
| | - Sina Maria Erhard
- Institute of Social Medicine, Epidemiology and Health Economics Charité – Universitätsmedizin Berlin Berlin Germany
| | - Philip Couch
- Centre for Health Informatics School of Health Sciences The University of Manchester Manchester UK
| | | | - Ronald van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Clare Mills
- Institute of Inflammation and Repair University of Manchester Manchester UK
| | - Linus Grabenhenrich
- Department for Infectious Disease Epidemiology Robert Koch‐Institut Berlin Germany
| | - Kirsten Beyer
- Department of Paediatric Pneumology and Immunology Charité – Universitätsmedizin Berlin Berlin Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics Charité – Universitätsmedizin Berlin Berlin Germany
- Institute of Clinical Epidemiology and Biometry University of Würzburg Würzburg Germany
- State Institute of Health Bavarian Health and Food Safety Authority Bad Kissingen Germany
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Carlsson CJ, Rasmussen MA, Pedersen SB, Wang N, Stokholm J, Chawes BL, Bønnelykke K, Bisgaard H. Airway immune mediator levels during asthma-like symptoms in young children and their possible role in response to azithromycin. Allergy 2021; 76:1754-1764. [PMID: 33150590 DOI: 10.1111/all.14651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Asthma-like symptoms in young children are orchestrated by the local airway immune response, but current knowledge largely relies on in vitro airway models. Azithromycin has been shown to reduce the duration of episodes with asthma-like symptoms, but efficacy may depend on the individual child's immune response. OBJECTIVES To investigate in vivo upper airway immune mediator levels during episodes with asthma-like symptoms in young children and their ability to predict the clinical response to azithromycin treatment. METHODS A total of 535 children aged 0-3 years from the Copenhagen Prospective Studies of Asthma in Childhood-2010 mother-child cohort were examined for immune mediator levels in samples of nasal epithelial lining fluid during episodes with asthma-like symptoms as well as in the asymptomatic state. In a sub-study, children with recurrent asthma-like symptoms were randomized to either a 3-day course of oral azithromycin (10 mg/kg; n = 32) or placebo (n = 38). In the current study, we compared the pretreatment immune mediator levels with the clinical response to treatment with azithromycin in an exploratory post hoc analysis. RESULTS The immune mediator concentrations during vs outside episodes were significantly upregulated for IFN-ɣ (ratio 1.73), TNF-α (ratio 2.05), IL-1β (ratio 1.45), IL-10 (ratio 1.97), while CCL22 (ratio 0.65) was downregulated. Low levels of TNF-α and IL-10 and high levels of CCL22 predicted better treatment response to azithromycin (P-values < .05). CONCLUSION Upper airway immune mediator levels were altered during episodes of asthma-like symptoms, and levels of TNF-α, CCL22, and IL-10 may predict the response to azithromycin treatment.
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Affiliation(s)
- Christian J. Carlsson
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Morten A. Rasmussen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
- Department of Food Science University of Copenhagen Frederiksberg Denmark
| | - Susanne B. Pedersen
- Department of Biotechnology and Biomedicine Technical University of Denmark Lyngby Denmark
| | - Ni Wang
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Bo L. Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
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Vu K, Lou W, Tun HM, Konya TB, Morales-Lizcano N, Chari RS, Field CJ, Guttman DS, Mandal R, Wishart DS, Azad MB, Becker AB, Mandhane PJ, Moraes TJ, Lefebvre DL, Sears MR, Turvey SE, Subbarao P, Scott JA, Kozyrskyj AL. From Birth to Overweight and Atopic Disease: Multiple and Common Pathways of the Infant Gut Microbiome. Gastroenterology 2021; 160:128-144.e10. [PMID: 32946900 DOI: 10.1053/j.gastro.2020.08.053] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/23/2020] [Accepted: 08/31/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Few studies, even those with cohort designs, test the mediating effects of infant gut microbes and metabolites on the onset of disease. We undertook such a study. METHODS Using structural equation modeling path analysis, we tested directional relationships between first pregnancy, birth mode, prolonged labor and breastfeeding; infant gut microbiota, metabolites, and IgA; and childhood body mass index and atopy in 1667 infants. RESULTS After both cesarean birth and prolonged labor with a first pregnancy, a higher Enterobacteriaceae/Bacteroidaceae ratio at 3 months was the dominant path to overweight; higher Enterobacteriaceae/Bacteroidaceae ratios and Clostridioides difficile colonization at 12 months were the main pathway to atopic sensitization. Depletion of Bifidobacterium after prolonged labor was a secondary pathway to overweight. Influenced by C difficile colonization at 3 months, metabolites propionate and formate were secondary pathways to child outcomes, with a key finding that formate was at the intersection of several paths. CONCLUSIONS Pathways from cesarean section and first pregnancy to child overweight and atopy share many common mediators of the infant gut microbiome, notably C difficile colonization.
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Affiliation(s)
- Khanh Vu
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Hein M Tun
- School of Public Health, University of Hong Kong, Hong Kong
| | - Theodore B Konya
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Radha S Chari
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - David S Guttman
- Centre for the Analysis of Genome Evolution and Function, University of Toronto, Toronto, Ontario, Canada
| | - Rupasri Mandal
- The Metabolomics Innovation Centre, Edmonton, Alberta, Canada
| | - David S Wishart
- The Metabolomics Innovation Centre, Edmonton, Alberta, Canada
| | - Meghan B Azad
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Allan B Becker
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Piush J Mandhane
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Theo J Moraes
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Diana L Lefebvre
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Malcolm R Sears
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stuart E Turvey
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - James A Scott
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Anita L Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada; Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada; School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
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Ziyab AH, Karmaus W, AlShatti KA, Al-Kandari M, Hussein SH, Ali YM. Psoriasis Among Adolescents in Kuwait and the Role of Siblings, Breastfeeding, and Household Cat and Secondhand Smoke Exposure: A Cross-Sectional Study. Dermatol Ther (Heidelb) 2020; 10:1137-1153. [PMID: 32844373 PMCID: PMC7477028 DOI: 10.1007/s13555-020-00437-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION Globally, the epidemiology of psoriasis is poorly understood, and most countries lack essential epidemiologic data regarding disease burden and its determinants. This study sought to estimate the prevalence of psoriasis among adolescents in Kuwait and assess its association with different risk factors, including obesity, sibship size, breastfeeding, and exposure to household secondhand smoke (SHS) and pets. METHODS Schoolchildren aged 11-14 years (n = 3864) were enrolled in a cross-sectional study. Lifetime and current (past 12 months) prevalence of psoriasis were ascertained according to ever having a history of doctor-diagnosis plus current active lesion(s) and/or current use of treatment of psoriasis. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were estimated. RESULTS The lifetime and current prevalence of psoriasis were estimated to be 3.6% (136/3806) and 1.1% (42/3806), respectively. Commonly reported anatomical sites affected by psoriasis included scalp (47.6%) and the extensor surface of the knees (50%) and elbows (38.1%). Household SHS exposure was associated with increased lifetime psoriasis (aPR = 1.41, 95% CI 1.07-1.98), and showed a trend for association with current psoriasis (1.77, 0.89-3.53). Similarly, cat-keeping during infancy was associated with lifetime psoriasis (1.96, 1.14-3.37), and demonstrated a trend for association with current psoriasis (1.49, 0.52-1.98). In contrast, breastfeeding was associated with a decreased lifetime psoriasis (0.62, 0.44-0.89), but was not associated with current psoriasis. Trend analyses showed that the prevalence of lifetime and current psoriasis increased with increasing numbers of total, older, and younger siblings. CONCLUSIONS Psoriasis affects a considerable proportion of schoolchildren in Kuwait. Interestingly, psoriasis prevalence was related to risk factors also found in allergic diseases, such as exposure to SHS, cat-keeping in infancy, breastfeeding, and sibship size, possibly suggesting a role of immune dysregulation.
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Affiliation(s)
- Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | | | - Manal Al-Kandari
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Shaimaa H Hussein
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Yaser M Ali
- Department of Internal Medicine, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
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Barcik W, Boutin RCT, Sokolowska M, Finlay BB. The Role of Lung and Gut Microbiota in the Pathology of Asthma. Immunity 2020; 52:241-255. [PMID: 32075727 PMCID: PMC7128389 DOI: 10.1016/j.immuni.2020.01.007] [Citation(s) in RCA: 303] [Impact Index Per Article: 75.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/30/2019] [Accepted: 01/20/2020] [Indexed: 02/08/2023]
Abstract
Asthma is a common chronic respiratory disease affecting more than 300 million people worldwide. Clinical features of asthma and its immunological and molecular etiology vary significantly among patients. An understanding of the complexities of asthma has evolved to the point where precision medicine approaches, including microbiome analysis, are being increasingly recognized as an important part of disease management. Lung and gut microbiota play several important roles in the development, regulation, and maintenance of healthy immune responses. Dysbiosis and subsequent dysregulation of microbiota-related immunological processes affect the onset of the disease, its clinical characteristics, and responses to treatment. Bacteria and viruses are the most extensively studied microorganisms relating to asthma pathogenesis, but other microbes, including fungi and even archaea, can potently influence airway inflammation. This review focuses on recently discovered connections between lung and gut microbiota, including bacteria, fungi, viruses, and archaea, and their influence on asthma.
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Affiliation(s)
- Weronika Barcik
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada; Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
| | - Rozlyn C T Boutin
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada; Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland; Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - B Brett Finlay
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada; Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada; Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada.
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Testa D, DI Bari M, Nunziata M, Cristofaro GDE, Massaro G, Marcuccio G, Motta G. Allergic rhinitis and asthma assessment of risk factors in pediatric patients: A systematic review. Int J Pediatr Otorhinolaryngol 2020; 129:109759. [PMID: 31734564 DOI: 10.1016/j.ijporl.2019.109759] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/07/2019] [Accepted: 10/26/2019] [Indexed: 01/02/2023]
Abstract
Allergic rhinitis (AR) is the most prevalent allergic disease in children and can be associated with asthma (A); this association can have significant effect on child's quality of life. The objective of this work was to systematically review existing literature on the risk factors of AR and A in children to better understand the link between these two diseases. We performed a literature search over the last 25 years in PubMed and Medline. Inclusion criteria comprised English language papers containing original human data with greater than 30 subjects and papers that statistically analyze the relationship between AR and A and the risk factor(s), in children population. A statistically significant correlation was found between children with AR and A and ambient Polycyclic Aromatic Hydrocarbons exposure, live in an industrialized city with elevated traffic, dampness and moulds exposure, electric cooking, male gender, single nucleotide polymorphisms in PTNP22 gene and CTLA-4 gene, fast food and margarine products consumption, use of paracetamol in last year, history of tuberculosis, parental atopy, high total serum IgE, antibiotics in uterus and infections in uterus exposure, history of formula feeding and caesarian section. A strong and complex link between AR and A was accounted: A represents a major risk factor for the onset of AR, that correlates with more severe asthmatic symptoms. Even the onset of A in a child with AR worsen it. The interaction of genetic and environmental risk factors and the consequent epigenetic, microbiota and immunological changes, were found to led to the development of AR and A in children, with both atopic and non-atopic pathways. Close monitoring of evidenced risk factors may help with an early recognize and treat A in patients with AR.
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Affiliation(s)
- Domenico Testa
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Matteo DI Bari
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Michele Nunziata
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Generoso DE Cristofaro
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Massaro
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppina Marcuccio
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Gaetano Motta
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania "Luigi Vanvitelli", Naples, Italy
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10
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Infant airway microbiota and topical immune perturbations in the origins of childhood asthma. Nat Commun 2019; 10:5001. [PMID: 31676759 PMCID: PMC6825176 DOI: 10.1038/s41467-019-12989-7] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 10/14/2019] [Indexed: 12/24/2022] Open
Abstract
Asthma is believed to arise through early life aberrant immune development in response to environmental exposures that may influence the airway microbiota. Here, we examine the airway microbiota during the first three months of life by 16S rRNA gene amplicon sequencing in the population-based Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010) cohort consisting of 700 children monitored for the development of asthma since birth. Microbial diversity and the relative abundances of Veillonella and Prevotella in the airways at age one month are associated with asthma by age 6 years, both individually and with additional taxa in a multivariable model. Higher relative abundance of these bacteria is furthermore associated with an airway immune profile dominated by reduced TNF-α and IL-1β and increased CCL2 and CCL17, which itself is an independent predictor for asthma. These findings suggest a mechanism of microbiota-immune interactions in early infancy that predisposes to childhood asthma. Here, Thorsen et al. examine the microbiota during the first three months of life in a cohort of 700 children and find that microbial diversity and the relative abundances of Veillonella and Prevotella in the airways at one month of age are associated with topical immune mediators and asthma by age 6 years.
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11
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Lunjani N, Satitsuksanoa P, Lukasik Z, Sokolowska M, Eiwegger T, O'Mahony L. Recent developments and highlights in mechanisms of allergic diseases: Microbiome. Allergy 2018; 73:2314-2327. [PMID: 30325537 DOI: 10.1111/all.13634] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/11/2018] [Accepted: 10/05/2018] [Indexed: 12/13/2022]
Abstract
All body surfaces are exposed to a wide variety of microbes, which significantly influence immune reactivity within the host. This review provides an update on some of the critical novel findings that have been published on the influence of the microbiome on atopic dermatitis, food allergy and asthma. Microbial dysbiosis has consistently been observed in the skin, gut and lungs of patients with atopic dermatitis, food allergy and asthma, respectively, and the role of specific microbes in allergic disorders is being intensively investigated. However, many of these discoveries have yet to be translated into routine clinical practice.
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Affiliation(s)
- Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- University of Cape Town; Cape Town South Africa
| | | | - Zuzanna Lukasik
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - Thomas Eiwegger
- Program in Translational Medicine; The Hospital for Sick Children; Toronto Ontario Canada
- Department of Immunology; The University of Toronto; Toronto Ontario Canada
- Division of Immunology and Allergy; Food allergy and Anaphylaxis Program; The Department of Paediatrics; The Hospital for Sick Children; Toronto Ontario Canada
| | - Liam O'Mahony
- Departments of Medicine and Microbiology; APC Microbiome Ireland; National University of Ireland; Cork Ireland
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12
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Thwaites RS, Jarvis HC, Singh N, Jha A, Pritchard A, Fan H, Tunstall T, Nanan J, Nadel S, Kon OM, Openshaw PJ, Hansel TT. Absorption of Nasal and Bronchial Fluids: Precision Sampling of the Human Respiratory Mucosa and Laboratory Processing of Samples. J Vis Exp 2018. [PMID: 29443104 PMCID: PMC5908664 DOI: 10.3791/56413] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The methods of nasal absorption (NA) and bronchial absorption (BA) use synthetic absorptive matrices (SAM) to absorb the mucosal lining fluid (MLF) of the human respiratory tract. NA is a non-invasive technique which absorbs fluid from the inferior turbinate, and causes minimal discomfort. NA has yielded reproducible results with the ability to frequently repeat sampling of the upper airway. By comparison, alternative methods of sampling the respiratory mucosa, such as nasopharyngeal aspiration (NPA) and conventional swabbing, are more invasive and may result in greater data variability. Other methods have limitations, for instance, biopsies and bronchial procedures are invasive, sputum contains many dead and dying cells and requires liquefaction, exhaled breath condensate (EBC) contains water and saliva, and lavage samples are dilute and variable. BA can be performed through the working channel of a bronchoscope in clinic. Sampling is well tolerated and can be conducted at multiple sites in the airway. BA results in MLF samples being less dilute than bronchoalveolar lavage (BAL) samples. This article demonstrates the techniques of NA and BA, as well as the laboratory processing of the resulting samples, which can be tailored to the desired downstream biomarker being measured. These absorption techniques are useful alternatives to the conventional sampling techniques used in clinical respiratory research.
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Affiliation(s)
- Ryan S Thwaites
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Hannah C Jarvis
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Nehmat Singh
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Akhilesh Jha
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | | | - Hailing Fan
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Tanushree Tunstall
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Joan Nanan
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Simon Nadel
- St Mary's Hospital, Imperial College Healthcare Trust
| | - Onn Min Kon
- St Mary's Hospital, Imperial College Healthcare Trust
| | - Peter J Openshaw
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Trevor T Hansel
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital;
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13
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Wolsk HM, Chawes BL, Thorsen J, Stokholm J, Bønnelykke K, Brix S, Bisgaard H. Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels. J Vis Exp 2017. [PMID: 28809842 DOI: 10.3791/55800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
This protocol describes noninvasive sampling of undisturbed upper airway mucosal lining fluid. It also details the extraction procedure used prior to the analysis of immune mediators in fluid eluates for the study of the airway topical immune signature, without the need for stimulation procedures (often used by other techniques). The mucosal lining fluid is sampled on a strip of filter paper placed at the anterior part of the inferior turbinate and left for 2 min of absorption. Analytes are eluted from the filter papers, and the extracted protein-based eluates are analyzed by an electrochemiluminescence-based immunoassay, allowing for the high-sensitivity quantification of low- and high-level analytes in the same sample. We measured the in vivo levels of 20 preselected immune mediators related to specific immune signaling pathways in the upper airway mucosa, but the technique is not limited to that specific panel or sampling site. The technique was first implemented in 7-year-old children from the Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000) cohort with allergic rhinitis. It was thereafter used in the longitudinal COPSAC2010 birth cohort, sampled at 1 month, 2 years, and 6 years of age and at instances of acute respiratory symptoms. We successfully obtained and analyzed samples from 620 (89%) of 700 1-month-old children; a few samples were below the assay detection limit (reported as the median (Inter-Quartile Range (IQR)). The number of samples below the detection limit (i.e. from 0 to the set point for the lower limit of detection) for each mediator was 29 (7.25 - 119.5). This technique enables the quantification of the in vivo airway mucosal immune profile from birth, can be applied longitudinally, and can be applied to studies on the effect of genetics and early-life environmental exposures, pathophysiology, endotyping, and monitoring of respiratory diseases, and development and evaluation of novel therapeutics.
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Affiliation(s)
- Helene M Wolsk
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen
| | - Bo L Chawes
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen
| | - Jonathan Thorsen
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen
| | - Susanne Brix
- Department of Biotechnology and Biomedicine, Technical University of Denmark
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen;
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