SPC
21-05-2008, 08:21
I think the general gist is that dust is bad, but worrying about dust is worse!
May 19, 2008 (Toronto, Ontario) — Mothers who have increased stressed levels, even when not exposed to high levels of dust in their homes, were found to have elevated levels of a particular asthma marker, putting their unborn children at greater risk of having asthma when they entered the world.
Investigators presented data here at the American Thoracic Society 2008 International Conference that explored the association of prenatal maternal stress, dust-mite exposure, and cord blood immunglobulin (Ig)E on 387 infants. The subjects were enrolled in a large prospective investigation of prenatal and early-life exposures and asthma risk, known as the Asthma Coalition on Community, Environment, and Social Stress (ACCESS).
"We wanted to see if there were any markers of an immune response," said Junenette Peters, DSc, a postdoctoral fellow at the Harvard School of Public Health in Boston, Massachusetts, who presented the study results during an oral presentation session. "It doesn't mean that you are going to have asthma, but it puts you at increased risk."
A total of 61% of subjects in the study were Hispanic and the rest were African-American. The mean age of subjects was 26.6 years, and 69% had not completed high school.
Investigators controlled for factors such as age, education, race, smoking status, and atopic history. Dr. Peters defined high dust-mite exposure as 2 mg/g and above, medium exposure as between 0.02 and 2 mg/g, and low exposure as 2 mg/g and below. Dust was collected from the bedrooms of pregnant mothers and quantified. Cord blood total IgE assays were performed using the CAP-FEIA system.
Researchers used CRISYS (a 63-item questionnaire) and a perceived stress scale to evaluate the subjects' levels of stress. The total sum of negative life events was 0.04 (P = .06), and the number of domains with reported life events was 0.08 (P = .02).
Interestingly, the impact of stress, such as financial problems or relationship issues, was more pronounced in the group with low dust-mite-allergen exposure, according to investigators. Dr. Peters suggested that high dust-mite exposure likely overwhelms the effect of stress.
"The stress is having an indirect effect [with low dust-mite exposure], making the cells more sensitive and permeable or susceptible," said Dr. Peters. "Just minimizing dust mites won't be enough to give you the results you want.
"The idea is to follow the children prospectively to see if they have developed intermediate asthma markers, such as wheeze, and then to continue to follow them to see if they develop asthma," she said in an interview. "We are already beginning to measure the mothers' exposure to allergens postnatally, and we are beginning to look at her stress postnatally."
Dr. Jerry Krishnan, MD, PhD, associate professor of medicine, associate professor of health studies (epidemiology), and director of the asthma and COPD Center at the University of Chicago in Illinois, said the research highlights the impact that stress can have on health.
"We are recognizing that stress may act through mechanisms independent of biology, so those with stress may be more nonadherent, and that may lead to worse morbidity and poorer health," said Dr. Krishnan, who acted as one of the moderators of the oral session. "This research provides interesting evidence that there may be some very specific biology at play where stress increases the body's immunologic response to environmental conditions."
The study's researchers need to go 1 step further and look at the relation between stress in pregnant mothers and a range of allergens other than dust, added Dr. Krishnan.
"There is a question of whether this finding is limited to dust alone or whether there are other things at play," he said. "If it is not consistent across different allergens, it either means this is a spurious finding or in fact that there is something very specific about dust allergens. If this is consistent across allergens, it is a very important finding that needs to be pursued."
He added that the findings require validation in another cohort, and that IgE level alone does not necessarily result in worse health outcomes.
Neither Dr. Peters nor Dr. Krishnan had any relevant financial relationships. The National Heart Lung and Blood Institute funded the study.
American Thoracic Society 2008 International Conference: Abstract A231. Presented May 18, 2008.
http://www.medscape.com/viewarticle/574729?sssdmh=dm1.353152&src=nldne
May 19, 2008 (Toronto, Ontario) — Mothers who have increased stressed levels, even when not exposed to high levels of dust in their homes, were found to have elevated levels of a particular asthma marker, putting their unborn children at greater risk of having asthma when they entered the world.
Investigators presented data here at the American Thoracic Society 2008 International Conference that explored the association of prenatal maternal stress, dust-mite exposure, and cord blood immunglobulin (Ig)E on 387 infants. The subjects were enrolled in a large prospective investigation of prenatal and early-life exposures and asthma risk, known as the Asthma Coalition on Community, Environment, and Social Stress (ACCESS).
"We wanted to see if there were any markers of an immune response," said Junenette Peters, DSc, a postdoctoral fellow at the Harvard School of Public Health in Boston, Massachusetts, who presented the study results during an oral presentation session. "It doesn't mean that you are going to have asthma, but it puts you at increased risk."
A total of 61% of subjects in the study were Hispanic and the rest were African-American. The mean age of subjects was 26.6 years, and 69% had not completed high school.
Investigators controlled for factors such as age, education, race, smoking status, and atopic history. Dr. Peters defined high dust-mite exposure as 2 mg/g and above, medium exposure as between 0.02 and 2 mg/g, and low exposure as 2 mg/g and below. Dust was collected from the bedrooms of pregnant mothers and quantified. Cord blood total IgE assays were performed using the CAP-FEIA system.
Researchers used CRISYS (a 63-item questionnaire) and a perceived stress scale to evaluate the subjects' levels of stress. The total sum of negative life events was 0.04 (P = .06), and the number of domains with reported life events was 0.08 (P = .02).
Interestingly, the impact of stress, such as financial problems or relationship issues, was more pronounced in the group with low dust-mite-allergen exposure, according to investigators. Dr. Peters suggested that high dust-mite exposure likely overwhelms the effect of stress.
"The stress is having an indirect effect [with low dust-mite exposure], making the cells more sensitive and permeable or susceptible," said Dr. Peters. "Just minimizing dust mites won't be enough to give you the results you want.
"The idea is to follow the children prospectively to see if they have developed intermediate asthma markers, such as wheeze, and then to continue to follow them to see if they develop asthma," she said in an interview. "We are already beginning to measure the mothers' exposure to allergens postnatally, and we are beginning to look at her stress postnatally."
Dr. Jerry Krishnan, MD, PhD, associate professor of medicine, associate professor of health studies (epidemiology), and director of the asthma and COPD Center at the University of Chicago in Illinois, said the research highlights the impact that stress can have on health.
"We are recognizing that stress may act through mechanisms independent of biology, so those with stress may be more nonadherent, and that may lead to worse morbidity and poorer health," said Dr. Krishnan, who acted as one of the moderators of the oral session. "This research provides interesting evidence that there may be some very specific biology at play where stress increases the body's immunologic response to environmental conditions."
The study's researchers need to go 1 step further and look at the relation between stress in pregnant mothers and a range of allergens other than dust, added Dr. Krishnan.
"There is a question of whether this finding is limited to dust alone or whether there are other things at play," he said. "If it is not consistent across different allergens, it either means this is a spurious finding or in fact that there is something very specific about dust allergens. If this is consistent across allergens, it is a very important finding that needs to be pursued."
He added that the findings require validation in another cohort, and that IgE level alone does not necessarily result in worse health outcomes.
Neither Dr. Peters nor Dr. Krishnan had any relevant financial relationships. The National Heart Lung and Blood Institute funded the study.
American Thoracic Society 2008 International Conference: Abstract A231. Presented May 18, 2008.
http://www.medscape.com/viewarticle/574729?sssdmh=dm1.353152&src=nldne