T-helper type 2 polarization among asthmatics during and following pregnancy.
BACKGROUND
Asthma is the most common medical condition during pregnancy. While increased production of T helper cytokines has been reported to occur in both asthma and pregnancy, the effect of T-helper type 2 (Th2) polarization on asthma symptoms during pregnancy has not been well-characterized.


OBJECTIVE
We hypothesized that systemic Th2 cytokine and chemokine polarization occurs among asthmatics to a greater extent during their pregnancy, and is associated with more severe asthma and increased Th2 polarization in the newborn.


METHODS
Fifty-six pregnant asthmatics were recruited from prenatal clinics affiliated with New York Presbyterian Hospital. Systemic production of interleukin-4, interferon-gamma, eotaxin and IP10 were measured by intracytoplasmic staining or ELISA at recruitment, peripartum and post-partum, and in the cord blood. The frequency of asthma symptoms was measured by questionnaires and compared with Th biomarkers.


RESULTS
The chemokine ratio (IP10/eotaxin) declined over the course of pregnancy (from 3.3 +/- 1.3 to 1.4 +/- 0.2, P = 0.016), but IP10 and eotaxin increased post-partum. The decrease in the chemokine ratio was associated with more frequent asthma symptoms. A non-significant trend towards decreased interferon-gamma and increased interleukin-4 production was detected. Cord blood eotaxin levels correlated with maternal levels (r = 0.35, P = 0.03). Other peripartum biomarkers were not associated with Th2 polarization nor with subsequent respiratory symptoms in the newborn.


CONCLUSIONS
IP10/eotaxin declined over the course of pregnancy and was associated with worse asthma symptoms. Alterations of Th1/Th2 chemokine balance during pregnancy may identify women prone to more severe asthma during pregnancy.
Rastogi
D
D
Division of Pulmonary, Allergy, Critical Care, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Wang
C
C
Lendor
C
C
Rothman
P B
PB
Miller
R L
RL
D000328:Adult; D001249:Asthma / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D054413:Chemokine CCL11; D018925:Chemokines / Q000096:biosynthesis; D019742:Chemokines, CC / Q000096:biosynthesis; D015331:Cohort Studies; D016207:Cytokines / Q000096:biosynthesis; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D006801:Humans; D007231:Infant, Newborn / Q000276:immunology*; D007252:Influenza Vaccines / Q000276:immunology; D049590:Postpartum Period / Q000276:immunology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology*; D012119:Respiration / Q000276:immunology; D012720:Severity of Illness Index; D018418:Th2 Cells / Q000276:immunology*
D015415:Biomarkers; C515456:CCL11 protein, human; D054413:Chemokine CCL11; D018925:Chemokines; D019742:Chemokines, CC; D016207:Cytokines; D007252:Influenza Vaccines