title: Effect of antibiotic use and mold exposure in infancy on allergic rhinitis in susceptible adolescents.
abstract: BACKGROUND
  Antibiotic use in infancy induces alteration in intestinal microbiota and is associated with the development of allergic diseases. Mold exposure is also associated with allergic diseases. Genetic susceptibility may interact with specific environmental factors in allergic disease development.
  
  
  OBJECTIVE
  To investigate independent and combined effects of antibiotic use and mold exposure in infancy on the risk of allergic rhinitis (AR) in adolescents.
  
  
  METHODS
  Data on AR and environmental factors were collected using the International Study of Asthma and Allergies in Childhood questionnaire from 7,389 adolescents from Seoul, Korea. TaqMan genotyping was performed for interleukin 13 (IL-13) (rs20541) and Toll-like receptor 4 (rs1927911) polymorphisms in 1,395 adolescents.
  
  
  RESULTS
  Age, parental history of AR, antibiotic use in infancy, and pet ownership during pregnancy or infancy were associated with an increased risk of current AR (diagnosis of AR and symptoms of AR within the preceding 12 months). Having older siblings was a protective effect. The adjusted odds ratio (aOR) for current AR for combined antibiotic use and mold exposure in infancy was 1.45 (95% confidence interval [CI], 1.01-2.09). For each factor separately, aORs were 1.25 (95% CI, 1.04-1.50) and 0.99 (95% CI, 0.75-1.31), respectively. Antibiotic and mold exposure in infancy, GA or AA genotypes of IL-13 (rs20541) (aOR 4.53; 95% CI, 1.66-12.38; P for interaction = .05), and CT+TT genotype of Toll-like receptor 4 (rs1927911) (aOR, 3.20; 95% CI, 1.24-8.26; P for interaction = .18) increased the risk of current AR.
  
  
  CONCLUSIONS
  Antibiotic use and mold exposure in infancy have additive effects on the risk of current AR in genetically susceptible adolescents. Gene-environment interactions between IL-13 (rs20541) and antibiotics or mold may play a role in AR.
authors: Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Song-I
authors: SI
authors: Yang
authors: Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Eun
authors: E
authors: Lee
authors: Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Young-Ho
authors: YH
authors: Jung
authors: Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors: Hyung Young
authors: HY
authors: Kim
authors: Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
authors: Ju-Hee
authors: JH
authors: Seo
authors: Department of Pediatrics, Seoul National University Bundang Hospital, Seungnam, Korea.
authors: Ji-Won
authors: JW
authors: Kwon
authors: Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea.
authors: Byoung-Ju
authors: BJ
authors: Kim
authors: Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
authors: Hyo-Bin
authors: HB
authors: Kim
authors: Department of Pediatrics, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
authors: So-Yeon
authors: SY
authors: Lee
authors: Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
authors: Gwang Cheon
authors: GC
authors: Jang
authors: Department of Pediatrics and the Allergy and Respiratory Research Laboratory, Inje University Seoul Paik Hospital, Seoul, Korea.
authors: Woo-Kyung
authors: WK
authors: Kim
authors: Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jung Yeon
authors: JY
authors: Shim
authors: Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Mi-Jin
authors: MJ
authors: Kang
authors: Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Ho-Sung
authors: HS
authors: Yu
authors: Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: sjhong@amc.seoul.kr.
authors: Soo-Jong
authors: SJ
authors: Hong
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005658:Fungi; D059647:Gene-Environment Interaction; D020022:Genetic Predisposition to Disease; D006801:Humans; D018793:Interleukin-13 / Q000235:genetics; D007422:Intestines / Q000382:microbiology; D008297:Male; D064307:Microbiota / Q000187:drug effects; D020641:Polymorphism, Single Nucleotide; D056910:Republic of Korea; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D012307:Risk Factors; D011795:Surveys and Questionnaires; D051197:Toll-Like Receptor 4 / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D018793:Interleukin-13; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4