Basic and clinical immunology
Influence of early day-care exposure on total IgE levels through age 3 years

https://doi.org/10.1016/j.jaci.2007.07.036Get rights and content

Background

Early day care is inversely associated with asthma and atopy in later childhood, but its association with early immunologic markers of asthma risk is not known.

Objective

We sought to assess the relation of day care by 3 months to total IgE levels through age 3 years.

Methods

Day care was assessed prospectively among 362 nonselected infants enrolled in the Infant Immune Study. Children were categorized based on day-care status by 3 months of age as follows: no day care, day care inside the home with other children, day care outside the home with no other children, or day care outside the home with other children. Total IgE levels were measured in blood obtained at 3, 12, 24, and 36 months. Relations between day care and IgE levels were assessed at each age and longitudinally, with stratification by maternal asthma and atopy.

Results

Day care by 3 months was associated with decreased IgE levels through age 3 years (coefficient: −0.19 log IU/mL, P = .001). The greatest effect was evident for children cared for outside the home. Stratified analyses indicated that the relation existed primarily among children who had atopic or asthmatic mothers. Day-care entry after 3 months showed no relation with IgE levels.

Conclusion

Day-care attendance by 3 months is associated with decreased total IgE levels in the first 3 years of life in children of mothers who are atopic, asthmatic, or both.

Clinical implications

Early day-care exposure can reduce IgE levels, which in turn might reflect a reduced risk of allergic disease in predisposed children.

Section snippets

Study design and population

The Infant Immune Study is a prospective birth cohort study of immune system maturation and its relation to the development of asthma and allergic disease in childhood. Participants were healthy children born to pregnant women who planned to obtain care for their newborns from collaborating pediatricians. Women were contacted at 32 to 35 weeks' gestation to obtain informed consent and to begin data collection on maternal factors.

IgE measurements

Blood specimens were obtained at 3 months (n = 363; mean ± SD age,

Results

IgE levels were assessed at least once in 434 children. Compared with subjects for whom IgE data were not obtained at any age (n = 50), these children were significantly more likely to have received some human milk at 3 months (68.6% vs 31.0%, P < .001), less likely to have smoking mothers at 3 months (7.8% vs 20.0%, P = .022), more likely to have 2 non-Hispanic white parents (60.5% vs 35.4%, P = .001), and more likely to have older parents (mothers' mean age, 29.2 vs 26.2 years [P = .001]

Discussion

This study indicates that day-care exposure by 3 months of age is associated with decreased total and allergen-specific IgE levels through age 3 years. The relation between day care and total IgE level was consistent for each time point assessed (3 months and 1, 2, and 3 years), in longitudinal analysis including all time points, and after adjusting for potential confounders. Day-care attendance outside the home showed a stronger relation to decreased total IgE levels than did exposure to day

References (22)

  • J.C. Celedon et al.

    Day care attendance, respiratory tract illnesses, wheezing, asthma, and total serum IgE level in early childhood

    Arch Pediatr Adolesc Med

    (2002)
  • Cited by (22)

    • Heritable vaginal bacteria influence immune tolerance and relate to early-life markers of allergic sensitization in infancy

      2022, Cell Reports Medicine
      Citation Excerpt :

      Variables were related to this functional data using adonis2 and a P-value threshold of 0.05. For analysis of metagenomic data, total IgE was dichotomized into below normal range (<2 kU/L) and detectable (range: 4.5–14 kU/L), as previously described91 due to sample size limitations (n = 12 dyads). Random forests analysis from the RandomForests package (v4.6.14) was used to identify IgE-discriminatory MetaCyc reactions using classification.

    • Does epigenetics play a role in human asthma?

      2016, Allergology International
      Citation Excerpt :

      Indeed, the link between environmental exposures, epigenetic marks and immune phenotypes appears to be robust.38 Several such birth cohorts [e.g., the Tucson Infant Immune Study (IIS),39 the Wisconsin Childhood Origins of ASThma (COAST) study,40 the Danish Copenhagen Prospective Study of Asthma in Childhood (COPSAC)41 and COPSAC2000,41 the UK Manchester Asthma and Allergy Study (MAAS),42 the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort43] already exist, and research along these lines is already beginning. Because the unique time- and environment-dependent nature of epigenetic marks appears better suited for the analysis of prenatal and early post-natal trajectories to disease than for conventional, static assessments of disease risk, we expect this second generation of epigenetic studies will avoid most of the early pitfalls, and will return exciting results that will begin to highlight the role of epigenetics in asthma and allergic disease pathogenesis.

    • DNA Methylation Biomarkers in Asthma and Allergy

      2016, Epigenetic Biomarkers and Diagnostics
    • Differentiating asthma phenotypes in young adults through polyclonal cytokine profiles

      2014, Annals of Allergy, Asthma and Immunology
      Citation Excerpt :

      The authors consider these results consistent with their finding, although compared with single cytokines, TH1/TH2 cytokine ratios appeared more informative in the present study but were not reported in the Australian study. Others groups also have noted the importance of considering cytokine combination patterns in asthma research.51 In a subsequent report from the same investigative group, a larger population-based cohort of 1,380 Australian teenagers (mean age 14.1 years) was evaluated.27

    • Maternal microchimerism protects against the development of asthma

      2013, Journal of Allergy and Clinical Immunology
    • Effect of prenatal indoor pet exposure on the trajectory of total IgE levels in early childhood

      2011, Journal of Allergy and Clinical Immunology
      Citation Excerpt :

      By using a random-effects model, the Tucson Children’s Respiratory Study showed trends of general increase through childhood that were affected by breast-feeding and maternal total IgE levels, but there was only 1 postnatal data collection point in infancy.26 Most relevant are the results from Rothers et al27 from another Tucson-based birth cohort. Using samples collected at 3 months and 1, 2, and 3 years of age in a cohort of 362 children and again deploying a random-effects model, they reported that day care attendance by age 3 months was associated with decreased total IgE levels, although only among children whose mothers were atopic, asthmatic, or both, another example of effect modification.

    View all citing articles on Scopus

    Supported by grants from the National Institutes of Health (AI 42268 and AI61811) and the Arizona Disease Control Research Commission.

    Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

    View full text