Maternal plasma total neopterin and kynurenine/tryptophan levels during pregnancy in relation to asthma development in the offspring.

Maria C Magnus, Øystein Karlstad, Øivind Midtun, Siri E Håberg, Gro Tunheim, Christine L Parr, Per Nafstad, Stephanie J London, Roy M Nilsen, Per M Ueland, Wenche Nystad

Journal: The Journal of allergy and clinical immunology 2017;138(5):1319-1325.e4

PMID: 27221136

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Abstract

BACKGROUND

Neopterin levels and kynurenine/tryptophan ratios (KTRs) increase with IFN-γ stimulation, indicating T1 immunity, and thus might be inversely associated with asthma.

OBJECTIVE

We sought to examine the association of maternal neopterin levels and KTRs during pregnancy with asthma in the offspring.

METHODS

We analyzed the associations of maternal plasma total neopterin levels and KTRs in midpregnancy with asthma at age 7 years among 2883 children in the Norwegian Mother and Child Cohort Study. Asthma was classified either based on registered dispensed asthma medications in the Norwegian Prescription Database or maternal report. We calculated adjusted relative risks using log-binomial regression.

RESULTS

The median gestational week of blood sampling was 18 weeks (interquartile range, 17-19 weeks). The risk of dispensed asthma medications at age 7 years was highest among children of mothers in the highest quartile of neopterin levels, whereas the risk was similar in the 3 lowest quartiles. The adjusted relative risk of dispensed asthma medications was 1.66 (95% CI, 1.16-2.38) when comparing children of mothers in the highest quartile with those in the 3 lowest quartiles. A similar association was observed for maternal report of asthma at age 7 years. When we evaluated allergic versus nonallergic asthma, neopterin levels tended to be associated with nonallergic asthma. Maternal KTR was not associated with asthma development.

CONCLUSIONS

Our findings indicate that high maternal levels of neopterin, a marker of cellular immune activation, during pregnancy were positively associated with asthma in offspring. Experimental studies would be needed to further elucidate underlying mechanisms.

Address: Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway. Electronic address: [email protected].; Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.; Bevital AS, Bergen, Norway.; Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.; Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway; Department of Community Medicine, Medical Faculty, University of Oslo, Oslo, Norway.; Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.; Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Science, University of Bergen, Bergen, Norway; Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.

DOI: 10.1016/j.jaci.2016.02.032

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MeSH Terms: Adult, Asthma, Child, Drug Prescriptions, Female, Humans, Interferon-gamma, Kynurenine, Neopterin, Norway, Pregnancy, Tryptophan