E-drug: Asthma associated with early antibiotic use (cont'd)
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Dear E-druggers,
As discussed, I contacted Christine Johnson to know more about her
study into asthma and antibiotic use. She sent me the conference
abstract below. It does not provide much information on methodology,
and as the paper isn't published yet, she cannot direct us to a
manuscript. I asked her to keep us posted.
Hilbrand Haak
E-drug moderator
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European Respiratory Society Annual Congress 2003
Abstract # 255461 Preview
Title: The Hygiene Hypothesis: Does antibiotic exposure in infancy
increase risk for childhood atopy and asthma?
Christine C Johnson, PhD 1, Sharon H Alford, MPH 1, Edward M
Zoratti, MD 1, Suzanne L Havstad, MA 1, Edward L Peterson, PhD 1,
Christine LM Joseph, PhD 1 and Dennis R Ownby, MD 2.
1. Biostatistics & Research Epidemiology, Henry Ford Health System,
Detroit, Michigan.
2. Section of Allergy-Immunology, Medical College of Georgia,
Augusta, Georgia.
Abstract:
An immunologic model for the Hygiene Hypothesis is that early life
exposure to bacterial infection and bacterial products protects against
atopy and asthma through influence on colonization patterns of the
gut and subsequent impact on the cytokine profile of the maturing
immune system. Antibiotic (AB) use has been shown to affect gut
colonization and in a mouse model increased serum levels of IgE and
IL-4, while decreasing IFN-gamma, all markers suggestive of aTh2
profile. Data on prescribed ABs during the first six months of life was
available from a Detroit area HMO-based birth cohort followed for the
incidence of atopy and asthma through 6-7 years of age (n=445).
Multi-variable analyses revealed that AB use was associated with
atopy (any positive skin prick test) among breastfed children
(OR=2.85, p<0.02) and children with a positive maternal history
(OR=2.33, p<0.04). AB use was associated with atopic asthma
among breastfed children (OR=6.00, p<0.11) and children with a
positive maternal history (OR=3.96, p<0.23). The early use of
antibiotics appears to increase risk for atopy and possibly atopic
asthma.
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