title: Inflammatory markers predict episodes of wheezing during the first year of life in Bangladesh.
abstract: BACKGROUND
  Environmental factors that influence wheezing in early childhood in the developing world are not well understood and may be useful in predicting respiratory outcomes. Therefore, our objective was to determine the factors that can predict wheezing.
  
  
  METHODS
  Children from Dhaka, Bangladesh were recruited at birth and episodes of wheezing were measured alongside nutritional, immunological and socioeconomic factors over a one-year period. Poisson Regression with variable selection was utilized to determine what factors were associated with wheezing.
  
  
  RESULTS
  Elevated serum IL-10 (rate ratio (RR) = 1.51, 95% confidence interval (CI): 1.22-1.87), IL-1β (RR = 1.55, 95% CI: 1.26-1.93) C-reactive protein (CRP) (RR = 1.41, 95% CI: 1.03-1.93) in early life, and male gender (RR = 1.52, 95% CI: 1.27-1.82) predicted increased wheezing episodes. Conversely, increased fecal alpha-1-antitrypsin (RR = 0.87, 95% CI: 0.76-1.00) and family income (RR = 0.98, 95% CI: 0.97-0.99) were associated with a decreased number of episodes of wheezing.
  
  
  CONCLUSIONS
  Systemic inflammation early in life, poverty, and male sex placed infants at risk of more episodes of wheezing during their first year of life. These results support the hypothesis that there is a link between inflammation in infancy and the development of respiratory illness later in life and provide specific biomarkers that can predict wheezing in a low-income country.
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Burgess
authors.affiliation: Department of Statistics and Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
authors.forename: Miao
authors.initials: M
authors.lastname: Lu
authors.affiliation: Department of Statistics and Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
authors.forename: Jennie Z
authors.initials: JZ
authors.lastname: Ma
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Naylor
authors.affiliation: Division of Pediatric Infectious Diseases, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Donowitz
authors.affiliation: Department of Medicine and Vaccine Testing Center, The University of Vermont College of Medicine, Burlington, VT, USA.
authors.forename: Beth D
authors.initials: BD
authors.lastname: Kirkpatrick
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh, (ICDDR, B), Dhaka, Bangladesh.
authors.forename: Rashidul
authors.initials: R
authors.lastname: Haque
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA. Electronic address: wap3g@virginia.edu.
authors.forename: William A
authors.initials: WA
authors.lastname: Petri
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D015415:Biomarkers / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D016753:Interleukin-10 / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood; D008297:Male; D016012:Poisson Distribution; D012135:Respiratory Sounds; D012307:Risk Factors; D000515:alpha 1-Antitrypsin / Q000032:analysis
chemical_list: D015415:Biomarkers; D053583:Interleukin-1beta; C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin; D016753:Interleukin-10; D002097:C-Reactive Protein
keywords: Bangladesh; Biomarkers; Infant; Inflammation; Wheezing