Elise M A Slob1,2, Bronwyn K Brew3,4, Susanne J H Vijverberg1,2, Chantal J A R Kats1, Cristina Longo1, Mariëlle W Pijnenburg5, Toos C E M van Beijsterveldt6, Conor V Dolan6, Meike Bartels6, Patrick Magnusson3, Paul Lichtenstein3, Tong Gong3, Gerard H Koppelman7,8, Catarina Almqvist3,9, Dorret I Boomsma6, Anke H Maitland-van der Zee1,2. 1. Dept of Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 2. Dept of Paediatric Pulmonology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 3. Dept of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 4. National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health and Dept of Women's and Children's Health, University of New South Wales, Sydney, Australia. 5. Dept of Paediatrics, Division of Respiratory Medicine and Allergology, ErasmusMC, University Medical Center Rotterdam, Rotterdam, The Netherlands. 6. Netherlands Twin Register, Dept of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. 7. Dept of Paediatric Pulmonology and Paediatric Allergology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 8. Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 9. Paediatric Allergy and Pulmonology Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Abstract
RATIONALE: Early-life antibiotic use has been associated with the development of atopic diseases, but the aetiology remains unclear. To elucidate the aetiology, we used a discordant twin design to control for genetic and environmental confounding. METHODS: We conducted a retrospective cohort study in twins aged 3-10 years from the Netherlands Twin Register (NTR, n=35 365) and a replication study in twins aged 9 years from the Childhood and Adolescent Twin Study in Sweden (CATSS, n=7916). Antibiotic use was recorded at age 0-2 years. Doctor-diagnosed asthma and eczema were reported by parents when children were aged 3-12 years in both cohorts. Individuals were included in unmatched analyses and in co-twin control analyses with disease discordant twin pairs. RESULTS: Early-life antibiotic use was associated with increased risk of asthma (NTR OR 1.34, 95% CI 1.28-1.41; CATSS OR 1.45, 95% CI 1.34-1.56) and eczema (NTR OR 1.08, 95% CI 1.03-1.13; CATSS OR 1.07, 95% CI 1.01-1.14) in unmatched analyses. Co-twin analyses in monozygotic and dizygotic twin pairs showed similar results for asthma (NTR OR 1.54, 95% CI 1.20-1.98; CATSS OR 2.00, 95% CI 1.28-3.13), but opposing results for eczema in the NTR (OR 0.99, 95% CI 0.80-1.25) and the CATSS (OR 1.67, 95% CI 1.12-2.49). The risk of asthma increased for antibiotics prescribed for respiratory infections (CATSS OR 1.45, 95% CI 1.34-1.56), but not for antibiotics commonly used for urinary tract/skin infections (CATSS OR 1.02, 95% CI 0.88-1.17). CONCLUSION: Children exposed to early-life antibiotic use, particularly prescribed for respiratory infections, may be at higher risk of asthma. This risk can still be observed when correcting for genetic and environmental factors. Our results could not elucidate whether the relationship between early-life antibiotic use and eczema is confounded by familial and genetic factors.
RATIONALE: Early-life antibiotic use has been associated with the development of atopic diseases, but the aetiology remains unclear. To elucidate the aetiology, we used a discordant twin design to control for genetic and environmental confounding. METHODS: We conducted a retrospective cohort study in twins aged 3-10 years from the Netherlands Twin Register (NTR, n=35 365) and a replication study in twins aged 9 years from the Childhood and Adolescent Twin Study in Sweden (CATSS, n=7916). Antibiotic use was recorded at age 0-2 years. Doctor-diagnosed asthma and eczema were reported by parents when children were aged 3-12 years in both cohorts. Individuals were included in unmatched analyses and in co-twin control analyses with disease discordant twin pairs. RESULTS: Early-life antibiotic use was associated with increased risk of asthma (NTR OR 1.34, 95% CI 1.28-1.41; CATSS OR 1.45, 95% CI 1.34-1.56) and eczema (NTR OR 1.08, 95% CI 1.03-1.13; CATSS OR 1.07, 95% CI 1.01-1.14) in unmatched analyses. Co-twin analyses in monozygotic and dizygotic twin pairs showed similar results for asthma (NTR OR 1.54, 95% CI 1.20-1.98; CATSS OR 2.00, 95% CI 1.28-3.13), but opposing results for eczema in the NTR (OR 0.99, 95% CI 0.80-1.25) and the CATSS (OR 1.67, 95% CI 1.12-2.49). The risk of asthma increased for antibiotics prescribed for respiratory infections (CATSS OR 1.45, 95% CI 1.34-1.56), but not for antibiotics commonly used for urinary tract/skin infections (CATSS OR 1.02, 95% CI 0.88-1.17). CONCLUSION:Children exposed to early-life antibiotic use, particularly prescribed for respiratory infections, may be at higher risk of asthma. This risk can still be observed when correcting for genetic and environmental factors. Our results could not elucidate whether the relationship between early-life antibiotic use and eczema is confounded by familial and genetic factors.
Authors: Mei-Yan Chu; Ming-Jie Wang; Jin Lin; Ge Yang; Ying Ding; Zheng-Chang Liao; Chuan-Ding Cao; Shao-Jie Yue Journal: Zhongguo Dang Dai Er Ke Za Zhi Date: 2022-05-15
Authors: Salvatore Fasola; Laura Montalbano; Giovanna Cilluffo; Benjamin Cuer; Velia Malizia; Giuliana Ferrante; Isabella Annesi-Maesano; Stefania La Grutta Journal: Int J Environ Res Public Health Date: 2021-12-02 Impact factor: 3.390
Authors: Elise M A Slob; Bronwyn K Brew; Susanne J H Vijverberg; Talitha Dijs; Catharina E M van Beijsterveldt; Gerard H Koppelman; Meike Bartels; Conor V Dolan; Henrik Larsson; Sebastian Lundström; Paul Lichtenstein; Tong Gong; Anke H Maitland-van der Zee; Aletta D Kraneveld; Catarina Almqvist; Dorret I Boomsma Journal: Int J Epidemiol Date: 2021-05-17 Impact factor: 7.196