title: Evaluation of airway reactivity and immune characteristics as risk factors for wheezing early in life.
abstract: BACKGROUND
  Childhood asthma is most often characterized by recurrent wheezing, airway hyperreactivity, and atopy; however, our understanding of these relationships from early in life remains unclear. Respiratory tract illnesses and atopic sensitization early in life might produce an interaction between innate and acquired immune responses, leading to airway inflammation and heightened airway reactivity.
  
  
  OBJECTIVE
  We hypothesized that premorbid airway reactivity and immunologic characteristics of infants without prior episodes of wheezing would be associated with subsequent wheezing during a 1-year follow-up.
  
  
  METHODS
  One hundred sixteen infants with chronic dermatitis were enrolled before episodes of wheezing. Airway reactivity, allergen-specific IgE levels, cytokine production by stimulated PBMCs, and percentages of dendritic cells were measured on entry, and airway reactivity was reassessed at the 1-year follow-up. Linear regression models were used to evaluate a predictor's effect on continuous outcomes.
  
  
  RESULTS
  Milk sensitization, egg sensitization, or both were associated with heightened airway reactivity before wheezing and after the onset of wheezing; however, these factors were not associated with an increased risk of wheezing. There was an interaction between initial airway reactivity and wheezing as a determinant of airway reactivity at follow-up. In addition, cytokine production by stimulated PBMCs was a risk factor for wheezing, whereas increased percentages of conventional dendritic cells were protective against wheezing.
  
  
  CONCLUSIONS
  Our data in a selected cohort of infants support a model with multiple risk factors for subsequent wheezing that are independent of initial airway reactivity; however, the causative factors that produce wheezing very early in life might contribute to heightened airway reactivity.
authors.affiliation: Department of Pediatrics, James Whitcomb Riley Hospital for Children, Herman B Wells Center for Pediatric Research, Indianapolis, Ind 46202-5225, USA.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Yao
authors.forename: Florencia M
authors.initials: FM
authors.lastname: Barbé-Tuana
authors.forename: Conrado J
authors.initials: CJ
authors.lastname: Llapur
authors.forename: Marcus H
authors.initials: MH
authors.lastname: Jones
authors.forename: Christina
authors.initials: C
authors.lastname: Tiller
authors.forename: Risa
authors.initials: R
authors.lastname: Kimmel
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kisling
authors.forename: Evelyn T
authors.initials: ET
authors.lastname: Nguyen
authors.forename: James
authors.initials: J
authors.lastname: Nguyen
authors.forename: Zhangsheng
authors.initials: Z
authors.lastname: Yu
authors.forename: Mark H
authors.initials: MH
authors.lastname: Kaplan
authors.forename: Robert S
authors.initials: RS
authors.lastname: Tepper
mesh_terms: D017668:Age of Onset; D001249:Asthma / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D016207:Cytokines / Q000276:immunology; D003713:Dendritic Cells / Q000166:cytology / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000276:immunology*; D012307:Risk Factors
chemical_list: D016207:Cytokines; D007073:Immunoglobulin E
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