Effect of Neonatal Sepsis on the Development of Allergies and Asthma in Later Childhood

Abstract

Background: Exposure to large amounts of endotoxins and other bacterial products in early childhood may protect against the development of allergic diseases later in childhood. The aim of this study was to investigate the effects of neonatal sepsis on subsequent development of asthma, allergic rhinitis, and atopic dermatitis in children. Methods: We recruited 85 children (mean age 48.67 ± 12.88 months) who had been hospitalized for sepsis in their neonatal period and their siblings (n = 85) as controls (mean age 61.81 ± 21.34 months) to investigate the prevalences of asthma, atopic dermatitis and allergic rhinitis. After asking the questions in the International Study of Asthma and Allergies in Children (ISAAC) questionnaires to the parents, total IgE levels in sera were measured and skin prick tests were performed. Results: Children with neonatal sepsis had lower total IgE levels and less sensitivity to Dermatophagoides pteronyssinus than controls (25.9 vs. 9.4%, p = 0.003). In addition, wheeze ever, wheeze in the last 12 months, physician-diagnosed asthma, and use of asthma drugs were less common in these subjects. Prevalences of allergic rhinitis and atopic dermatitis were equal in both groups. Conclusion: Exposure to severe infections such as sepsis in the neonatal period may decrease sensitization to environmental allergens and prevalence of asthma in later childhood.

Meta‐analysis shows that infants who have suffered neonatal sepsis face an increased risk of mortality and severe complications

“…This meant that 12 articles were available for the final review. These studies included a total of 3669 infants with neonatal sepsis and 24 723 infants without sepsis, who were considered as controls . Of the 12 papers we included, nine investigated infants born before 34 weeks of gestational age or with a birthweight of less than 1500 g , including 3484 infants with neonatal sepsis and 23 912 infants without neonatal sepsis.…”

“…Of the 12 papers we included, nine investigated infants born before 34 weeks of gestational age or with a birthweight of less than 1500 g , including 3484 infants with neonatal sepsis and 23 912 infants without neonatal sepsis. A further three studies investigated infants born after at least 34 weeks of gestational age or with a birthweight of up to 1500 g, including 185 infants with neonatal sepsis and 811 infants without neonatal sepsis . Only one of the 12 studies investigated the short‐term outcome of term infants , while the other studies described long‐term outcomes.…”

“…Growth impairment was defined as weight, length or head circumference below the 10th percentile for sex and age . For atopic diseases, either a clinical diagnosis of asthma, allergic rhinitis or atopic dermatitis, or the use of the International Study of Asthma and Allergies in Childhood questionnaire, had to be documented .…”

Polymorphisms in the myosin light chain kinase gene that confer risk of severe sepsis are associated with a lower risk of asthma

“…This notion is partially supported by studies demonstrating that children who survived neonatal sepsis were less likely to develop asthma. 39,40 MYLK plays a pivotal role in regulating both smooth muscle contractile activity and numerous functions in nonmuscle cells, 41 including leukocyte recruitment to the airways, 22 and is therefore an attractive candidate gene for atopic asthma. MLC phosphorylation is associated with smooth muscle contraction via maintenance of tight junction permeability at the apices of lung epithelial cells.…”

Estradiol and thermoregulation in adult endotoxemic rats exposed to lipopolysaccharide in neonatal life

“…Endotoxin exposure during the post-natal period has been shown to program permanent alterations in immune system in animals that have a new contact with LPS in adult life (Ellis et al 2005, Roponen et al 2005, Kato et al 2006, Cetinkaya et al 2007). Many studies demonstrated that this exposure at low doses produces an attenuation of the febrile response in adults.…”