title: Atopy, cytokine production, and airway reactivity as predictors of pre-school asthma and airway responsiveness.
abstract: BACKGROUND
  Childhood asthma is often characterized by recurrent wheezing, airway hyper-reactivity, atopy, and altered immune characteristics; however, our understanding of the development of these relationships from early in life remains unclear. The aim of our study was to evaluate whether atopy, cytokine production by peripheral blood mononuclear cells (PBMCs), and airway responsiveness, assessed in infants and toddlers, are associated with asthma and airway responsiveness at 4-years of age.
  
  
  METHODS
  Infants with eczema (N = 116), enrolled prior to wheezing, were assessed at entry (mean age of 10.7 months), at 1-year follow-up (N = 112), and at 4-years of age (N = 94). Total serum IgE, specific IgE to allergens, and cytokines produced by stimulated PBMCs, were assessed at entry and 1-year follow-up. Spirometry was obtained at all 3-visits, while airway reactivity to methacholine was assessed at entry and 1-year follow-up, and bronchodilator (BD) responsiveness, as well as current asthma was assessed at 4-years of age.
  
  
  RESULTS
  We found that pre-school children with asthma had lower spirometry and a greater BD-response. Serum IgE, particularly to egg and/or milk, and altered cytokine production by PBMCs at entry to the study were associated with asthma, lower spirometry, and greater airway responsiveness at 4-years of age. In addition, we found that airway responsiveness, as well as spirometry, tracked from infancy to 4-years of age.
  
  
  CONCLUSIONS
  While spirometry and airway responsiveness track longitudinally from early in life, atopy and cytokine production by PBMCs are associated not only with an increased risk of pre-school asthma, but also lower spirometry and increased airway responsiveness.
authors: Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, Indiana; Centro Infant-Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
authors: Edgar E
authors: EE
authors: Sarria
authors: Rita
authors: R
authors: Mattiello
authors: Weiguo
authors: W
authors: Yao
authors: Valentina
authors: V
authors: Chakr
authors: Christina J
authors: CJ
authors: Tiller
authors: Jeffrey
authors: J
authors: Kisling
authors: Rebeka
authors: R
authors: Tabbey
authors: Zhangsheng
authors: Z
authors: Yu
authors: Mark H
authors: MH
authors: Kaplan
authors: Robert S
authors: RS
authors: Tepper
mesh_terms: D001249:Asthma / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D001985:Bronchial Provocation Tests; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D003876:Dermatitis, Atopic / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007223:Infant; D016015:Logistic Models; D008297:Male; D012135:Respiratory Sounds; D018570:Risk Assessment; D012307:Risk Factors; D013147:Spirometry
chemical_list: D015415:Biomarkers; D016207:Cytokines; D007073:Immunoglobulin E
keywords: airway reactivity; bronchodilator response; infants; pre-school children; spirometry
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