title: Prenatal T cell immunity to Wuchereria bancrofti and its effect on filarial immunity and infection susceptibility during childhood.
abstract: BACKGROUND
  Antenatal immune experience with Wuchereria bancrofti due to maternal filariasis may influence susceptibility to infection. We tested the hypothesis that filarial-specific T cell responses at birth that are indicative of in utero tolerance or sensitization affect the evolution of filarial-specific immunity and susceptibility to W. bancrofti infection during childhood.
  
  
  METHODS
  A birth-cohort study of 159 Kenyan newborns was performed. Cord blood and peripheral blood were obtained annually to age 7 years and were assayed for filarial infection and filarial antigen-driven interferon (IFN)- gamma , interleukin (IL)-2, IL-5, and IL-13 production by lymphocytes.
  
  
  RESULTS
  There was a 12.9-fold (95% confidence interval [CI], 2.5-107.2-fold) and a 4.8-fold (95% CI, 1.7-12.9-fold) increased risk of infection for immune-tolerant newborns (maternal infection present during gestation, with no filarial antigen-driven cord blood T cell response [n = 25]), compared with immune-sensitized (maternal infection present with cord blood T cell response [n = 24]) and unexposed (maternal infection absent [n = 110]) newborns. Cytokine responses developed at a later age in tolerant newborns, were characterized by impaired IFN-gamma responses, and contrasted with those of filarial-sensitized newborns, who had sustained and elevated IL-5 and IL-13 responses to age 7 years.
  
  
  CONCLUSIONS
  Prenatal immune experience, as determined by whether in utero priming to filarial antigen occurs, is a major determinant of childhood susceptibility to W. bancrofti infection.
authors.affiliation: Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio 44106-7286, USA.
authors.forename: Indu
authors.initials: I
authors.lastname: Malhotra
authors.forename: Peter L
authors.initials: PL
authors.lastname: Mungai
authors.forename: Alex N
authors.initials: AN
authors.lastname: Wamachi
authors.forename: Daniel
authors.initials: D
authors.lastname: Tisch
authors.forename: John M
authors.initials: JM
authors.lastname: Kioko
authors.forename: John H
authors.initials: JH
authors.lastname: Ouma
authors.forename: Eric
authors.initials: E
authors.lastname: Muchiri
authors.forename: James W
authors.initials: JW
authors.lastname: Kazura
authors.forename: Christopher L
authors.initials: CL
authors.lastname: King
mesh_terms: D000818:Animals; D002648:Child; D002675:Child, Preschool; D004198:Disease Susceptibility; D005260:Female; D005368:Filariasis / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance; D007223:Infant; D007231:Infant, Newborn; D007371:Interferon-gamma / Q000096:biosynthesis; D018793:Interleukin-13; D007376:Interleukin-2 / Q000096:biosynthesis; D015848:Interleukin-5 / Q000096:biosynthesis; D018512:Parasitemia; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology*; D014958:Wuchereria bancrofti / Q000276:immunology*
chemical_list: D018793:Interleukin-13; D007376:Interleukin-2; D015848:Interleukin-5; D007371:Interferon-gamma