title: Chronic caregiver stress and IgE expression, allergen-induced proliferation, and cytokine profiles in a birth cohort predisposed to atopy.
abstract: BACKGROUND
  Psychologic stress modifies immune function and cytokine production.
  
  
  OBJECTIVE
  We examined relationships between caregiver stress on the following markers of early childhood immune response: (1) IgE expression (n=215); (2) mitogen-induced and allergen-specific (Dermatophagoides farinae [Der f 1] and cockroach [Bla g 2]) proliferative response (n=114); and (3) subsequent cytokine expression (INF-gamma, TNF-alpha, IL-10, and IL-13) in a prospective birth cohort predisposed to atopy.
  
  
  METHODS
  Caregiver stress was measured at 2-month intervals for the first 2 years of life and yearly thereafter by using the Perceived Stress Scale. A subsequent blood sample obtained from the children (median age, 2.1 years; range, 18-32 months) was analyzed for total serum IgE level and allergen-induced proliferation quantified as the stimulation index (SI; mean thymidine incorporation of the stimulated sample divided by that of the unstimulated sample). The relationship between stress and the proliferative response (SI >3 vs SI < or =3), and total IgE level (< or =100 IU/mL vs >100 IU/mL) was examined by using logistic regression. The relationship between cytokine levels and stress was analyzed by using linear regression.
  
  
  RESULTS
  In adjusted analyses higher caregiver stress in the first 6 months after birth was associated with a Der f 1 SI of greater than 3 (odds ratio [OR], 1.5; 95% CI, 1.0-2.3) and nominally associated with a Bla g 2 SI of greater than 3 (OR, 1.13; 95% CI, 0.7-1.8). Higher stress between ages 6 and 18 months was associated with a high total IgE level (OR, 2.03; 95% CI, 1.1-3.6). Higher stress was significantly associated with increased production of TNF-alpha, with a suggested trend between higher stress and reduced INF-gamma production.
  
  
  CONCLUSIONS
  Increased stress in early childhood was associated with an atopic immune profile in these children predisposed to atopy-asthma.
authors.affiliation: Channing Laboratory, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA. rosalind.wright@channing.harvard.edu
authors.forename: Rosalind J
authors.initials: RJ
authors.lastname: Wright
authors.forename: Patricia
authors.initials: P
authors.lastname: Finn
authors.forename: Johanna Paola
authors.initials: JP
authors.lastname: Contreras
authors.forename: Sheldon
authors.initials: S
authors.lastname: Cohen
authors.forename: Robert O
authors.initials: RO
authors.lastname: Wright
authors.forename: John
authors.initials: J
authors.lastname: Staudenmayer
authors.forename: Matthew
authors.initials: M
authors.lastname: Wand
authors.forename: David
authors.initials: D
authors.lastname: Perkins
authors.forename: Scott T
authors.initials: ST
authors.lastname: Weiss
authors.forename: Diane R
authors.initials: DR
authors.lastname: Gold
mesh_terms: D000485:Allergens / Q000276:immunology*; D039741:Antigens, Dermatophagoides / Q000276:immunology; D052179:Antigens, Plant; D060829:Arthropod Proteins; D017028:Caregivers; D002908:Chronic Disease; D003546:Cysteine Endopeptidases; D016207:Cytokines / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D007073:Immunoglobulin E / Q000097:blood*; D007223:Infant; D007371:Interferon-gamma / Q000096:biosynthesis; D016015:Logistic Models; D008213:Lymphocyte Activation; D008297:Male; D013315:Stress, Psychological / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis
chemical_list: D000485:Allergens; D039741:Antigens, Dermatophagoides; D052179:Antigens, Plant; D060829:Arthropod Proteins; D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; C105482:allergen Bla g 1; D007073:Immunoglobulin E; D007371:Interferon-gamma; D003546:Cysteine Endopeptidases; C451159:Dermatophagoides farinae antigen f 1