title: Clinical markers of asthma and IgE assessed in parents before conception predict asthma and hayfever in the offspring.
abstract: BACKGROUND
  Mice models suggest epigenetic inheritance induced by parental allergic disease activity. However, we know little of how parental disease activity before conception influences offspring's asthma and allergy in humans.
  
  
  OBJECTIVE
  We aimed to assess the associations of parental asthma severity, bronchial hyperresponsiveness (BHR), and total and specific IgEs, measured before conception vs. after birth, with offspring asthma and hayfever.
  
  
  METHODS
  The study included 4293 participants (mean age 34, 47% men) from the European Community Respiratory Health Survey (ECRHS) with information on asthma symptom severity, BHR, total and specific IgEs from 1991 to 1993, and data on 9100 offspring born 1972-2012. Adjusted relative risk ratios (aRRR) for associations of parental clinical outcome with offspring allergic disease were estimated with multinomial logistic regressions.
  
  
  RESULTS
  Offspring asthma with hayfever was more strongly associated with parental BHR and specific IgE measured before conception than after birth [BHR: aRRR = 2.96 (95% CI: 1.92, 4.57) and 1.40 (1.03, 1.91), respectively; specific IgEs: 3.08 (2.13, 4.45) and 1.83 (1.45, 2.31), respectively]. This was confirmed in a sensitivity analysis of a subgroup of offspring aged 11-22 years with information on parental disease activity both before and after birth.
  
  
  CONCLUSIONS
  Parental BHR and specific IgE were associated with offspring asthma and hayfever, with the strongest associations observed with clinical assessment before conception as compared to after birth of the child. If the hypothesis is confirmed in other studies, parental disease activity assessed before conception may prove useful for identifying children at risk for developing asthma with hayfever.
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway.|Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: R J
authors.identifier: http://orcid.org/0000-0001-5319-525X
authors.initials: RJ
authors.lastname: Bertelsen
authors.affiliation: INSERM U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.|UMR-S 1168, Univ Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France.|Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Rava
authors.affiliation: ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|Universitat Pompeu Fabra, Barcelona, Spain.|CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: A E
authors.initials: AE
authors.lastname: Carsin
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Accordini
authors.affiliation: Medical Faculty, University of Iceland, Reykjavík, Iceland.
authors.forename: B
authors.initials: B
authors.lastname: Benediktsdóttir
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Dratva
authors.affiliation: Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
authors.forename: K A
authors.initials: KA
authors.lastname: Franklin
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany.|Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig Maximilians University Munich, Munchen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Heinrich
authors.affiliation: Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Holm
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: C
authors.identifier: http://orcid.org/0000-0001-5093-6980
authors.initials: C
authors.lastname: Janson
authors.affiliation: Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.|Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Johannessen
authors.affiliation: Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: D L
authors.initials: DL
authors.lastname: Jarvis
authors.affiliation: Tartu University Hospital, Lung Clinic, Tartu, Estonia.
authors.forename: R
authors.initials: R
authors.lastname: Jogi
authors.affiliation: Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Epidemiology Team, Paris, France.|UMR 1152, University Paris Diderot Paris 7, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Leynaert
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Norback
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway.|Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
authors.forename: E R
authors.initials: ER
authors.lastname: Omenaas
authors.affiliation: INSERM U897 Bordeaux University, Bordeaux Cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Raherison
authors.affiliation: Department of Nursing, University of Huelva, Huelva, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Sánchez-Ramos
authors.affiliation: Department of Public Health, Aarhus University, Aarhus, Denmark.|National Research Centre for the Working Environment, Copenhagen, Denmark.
authors.forename: V
authors.initials: V
authors.lastname: Schlünssen
authors.affiliation: Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Sigsgaard
authors.affiliation: Allergy and Lung Health Unit, Melbourne School of Population Health, The University of Melbourne, Melbourne, Vic., Australia.
authors.forename: S C
authors.initials: SC
authors.lastname: Dharmage
authors.affiliation: Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.|Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
authors.forename: C
authors.initials: C
authors.lastname: Svanes
mesh_terms: D000328:Adult; D001249:Asthma / Q000097:blood* / Q000453:epidemiology / Q000235:genetics*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D006255:Rhinitis, Allergic, Seasonal / Q000097:blood* / Q000453:epidemiology / Q000235:genetics*
chemical_list: D015415:Biomarkers; D007073:Immunoglobulin E
keywords: European Community Respiratory Health Survey; IgE; asthma; clinical immunology; epidemiology; offspring; preconception; rhinitis