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Clinical & Experimental Allergy

T-helper type 2 polarization among asthmatics during and following pregnancy

Authors

  • D. Rastogi,

    1. Division of Pulmonary, Allergy, Critical Care, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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    • 1Present address: Children's Hospital at Montefiore, Albert Einstein College of Medicine.

  • C. Wang,

    1. Division of Pulmonary, Allergy, Critical Care, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • C. Lendor,

    1. Division of Pulmonary, Allergy, Critical Care, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • P. B. Rothman,

    1. Department of Medicine, University of Iowa, IA, USA
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  • R. L. Miller

    1. Division of Pulmonary, Allergy, Critical Care, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • This work was funded by 1 P01 AI50514 Asthma and Allergic Diseases Research Center, and Grant No. RR00645 from the General Clinical Research Center

Correspondence:
Rachel L. Miller MD, PH8C, College of Physicians and Surgeons, Columbia University, 630 W. 168th St., New York, New York, 10032. E-mail: rlm14@columbia.edu

Summary

Background Asthma is the most common medical condition during pregnancy. While increased production of T helper cytokines has been reported to occur in both asthma and pregnancy, the effect of T-helper type 2 (Th2) polarization on asthma symptoms during pregnancy has not been well-characterized.

Objective We hypothesized that systemic Th2 cytokine and chemokine polarization occurs among asthmatics to a greater extent during their pregnancy, and is associated with more severe asthma and increased Th2 polarization in the newborn.

Methods Fifty-six pregnant asthmatics were recruited from prenatal clinics affiliated with New York Presbyterian Hospital. Systemic production of interleukin-4, interferon-γ, eotaxin and IP10 were measured by intracytoplasmic staining or ELISA at recruitment, peripartum and post-partum, and in the cord blood. The frequency of asthma symptoms was measured by questionnaires and compared with Th biomarkers.

Results The chemokine ratio (IP10/eotaxin) declined over the course of pregnancy (from 3.3±1.3 to 1.4±0.2, P=0.016), but IP10 and eotaxin increased post-partum. The decrease in the chemokine ratio was associated with more frequent asthma symptoms. A non-significant trend towards decreased interferon-γ and increased interleukin-4 production was detected. Cord blood eotaxin levels correlated with maternal levels (r=0.35, P=0.03). Other peripartum biomarkers were not associated with Th2 polarization nor with subsequent respiratory symptoms in the newborn.

Conclusions IP10/eotaxin declined over the course of pregnancy and was associated with worse asthma symptoms. Alterations of Th1/Th2 chemokine balance during pregnancy may identify women prone to more severe asthma during pregnancy.

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