Centre of Research for Immunology and Breastfeeding (CIBF), Medical School and School of Biomedical Science, University of Western Australia, Perth, WA 6009, Australia.
Immunology and Breastfeeding Group, Neonatal and Life Course Health Program, Telethon Kids Institute, Perth, WA 6009, Australia.
Nutrients. 2022 May 17;14(10):2095. doi: 10.3390/nu14102095.
Allergies are major noncommunicable diseases associated with significant morbidity, reduced quality of life, and high healthcare costs. Despite decades of research, it is still unknown if early-life exposure to indoor allergens plays a role in the development of IgE-mediated allergy and asthma. The objective of this study is to contribute to the identification of early-life risk factors for developing allergy. We addressed whether two different sources of house dust mite Der p 1 allergen exposure during early life, i.e., human milk and dust, have different relationships with IgE levels and asthma outcomes in children. We performed longitudinal analyses in 249 mother−child pairs using data from the PIAMA birth cohort. Asthma symptoms and serum total and specific IgE levels in children were available for the first 16 years of life. Der p 1 levels were measured in human milk and dust samples from infant mattresses. We observed that infant exposure to Der p 1 through human milk was associated with an increased risk of having high levels of serum IgE (top tertile > 150 kU/mL) in childhood as compared to infants exposed to human milk with undetectable Der p 1 [adjusted OR (95% CI) 1.83 (1.05−3.20) p = 0.0294]. The Der p 1 content in infant mattress dust was not associated with increased IgE levels in childhood. The risk of asthma and Der p 1 sensitization was neither associated with Der p 1 in human milk nor with Der p 1 in dust. In conclusion, high levels of IgE in childhood were associated with Der p 1 exposure through human milk but not exposure from mattress dust. This observation suggests that human milk is a source of Der p 1 exposure that is relevant to allergy development and fosters the need for research on the determinants of Der p 1 levels in human milk.
过敏是与较高发病率、生活质量降低和高医疗保健费用相关的主要非传染性疾病。尽管已经进行了数十年的研究，但仍然不清楚生命早期接触室内过敏原是否会导致 IgE 介导的过敏和哮喘的发生。本研究的目的是确定生命早期发生过敏的危险因素。我们研究了生命早期来自两个不同尘螨过敏原来源（人乳和灰尘）的 Der p 1 过敏原暴露是否与儿童 IgE 水平和哮喘结局有不同的关系。我们对 PIAMA 出生队列中的 249 对母婴进行了纵向分析。在儿童生命的前 16 年，我们可以获得哮喘症状和血清总 IgE 及特异性 IgE 水平的数据。从婴儿床垫的人乳和灰尘样本中测量了 Der p 1 水平。我们发现，与接触人乳中未检出 Der p 1 的婴儿相比，婴儿通过人乳接触 Der p 1 与儿童时期血清 IgE 水平较高（血清 IgE 水平最高三分位数（> 150 kU/mL））的风险增加有关[校正比值比（95%可信区间）1.83（1.05-3.20），p = 0.0294]。婴儿床垫灰尘中的 Der p 1 含量与儿童时期 IgE 水平升高无关。Der p 1 在人乳和灰尘中的含量与哮喘和 Der p 1 致敏风险均无关联。总之，儿童时期 IgE 水平较高与通过人乳接触 Der p 1 有关，而与床垫灰尘接触 Der p 1 无关。这一观察结果表明，人乳是 Der p 1 暴露的来源，与人过敏的发生有关，并促使人们需要研究人乳中 Der p 1 水平的决定因素。
