title: Interactions between innate immunity genes and early-life risk factors in allergic rhinitis.
abstract: OBJECTIVE
  Allergic rhinitis (AR) is a common chronic disease. Many factors could affect the development of AR. We investigated early-life factors, such as delivery mode, feeding method, and use of antibiotics during infancy, which could affect the development of AR. In addition, how interactions between these factors and innate gene polymorphisms influence the development of AR was investigated.
  
  
  METHODS
  A cross-sectional study of 1,828 children aged 9-12 years was conducted. Three early-life factors and AR were assessed by a questionnaire. Skin prick tests were done. Polymorphisms of TLR4 (rs1927911) and CD14 (rs2569190) were genotyped.
  
  
  RESULTS
  Use of antibiotics during infancy increased the risk of AR (aOR [95% CI] 1.511 [1.222-2.037]) and atopic AR (aOR [95% CI], 1.565 [1.078-2.272]). There were synergistic interactions between caesarean delivery, formula feeding, and use of antibiotics in the rate of atopic AR (aOR [95% CI], 3.038 [1.256-7.347]). Additional analyses revealed that the risk for the development of AR or atopic AR subjects with the TLR4 CC genotype were highest when all the 3 early-life factors were present (aOR [95% CI], 5.127 [1.265-20.780] for AR; 6.078 [1.499-24.649] for atopic AR). In addition, the risk for the development of AR or atopic AR in subjects with the CD14 TT genotype were highest when all the 3 early-life factors were present (aOR [95% CI], 5.960 [1.421-15.002] for AR; 6.714 [1.440-31.312] for atopic AR).
  
  
  CONCLUSIONS
  Delivery mode, feeding method, and use of antibiotics during infancy appeared to have synergistic interactions in the development of AR. Gene-environment interactions between polymorphism of innate genes and early- life risk factors might affect the development of AR.
authors.affiliation: Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea.
authors.forename: Ju Hee
authors.initials: JH
authors.lastname: Seo
authors.affiliation: Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Hyung Young
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Jung
authors.affiliation: Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Research Center for Standardization of Allergic Diseases, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Eun
authors.initials: E
authors.lastname: Lee
authors.affiliation: Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Research Center for Standardization of Allergic Diseases, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Song I
authors.initials: SI
authors.lastname: Yang
authors.affiliation: Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.
authors.forename: Ho Sung
authors.initials: HS
authors.lastname: Yu
authors.affiliation: Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.
authors.forename: Mi Jin
authors.initials: MJ
authors.lastname: Kang
authors.affiliation: Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.
authors.forename: Ha Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Presbyterian Medical Center, Jeonju, Korea.
authors.forename: Kang Seo
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Kwon
authors.affiliation: Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea.
authors.forename: Byung Ju
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
authors.forename: Hyo Bin
authors.initials: HB
authors.lastname: Kim
authors.affiliation: Allergy TF, Department of Immunology and Pathology, Korea National Institute of Health, Osong, Korea.
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Allergy TF, Department of Immunology and Pathology, Korea National Institute of Health, Osong, Korea.
authors.forename: Joo Shil
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. imipenem@hanmail.net.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Research Center for Standardization of Allergic Diseases, University of Ulsan College of Medicine, Seoul, Korea. sjhong@amc.seoul.kr.
authors.forename: Soo Jong
authors.initials: SJ
authors.lastname: Hong
keywords: Obstetric delivery; antibiotics; gene-environment interaction, allergic rhinitis; infant food
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