Date of Award

1-1-2012

Document Type

Campus Access Thesis

Department

Epidemiology and Biostatistics

Sub-Department

Epidemiology

First Advisor

Wilfred Karmaus

Abstract

Eczema among children and its relation to maternal whey and serum immune markers are considered to either de- or increase risk of the skin disorder. We conducted a prospective study to contrast the role of different maternal immune markers (MIMs) in maternal serum and whey on the development of eczema symptoms in infancy. Pregnant women were recruited in Columbia and Charleston, South Carolina, and provided blood and milk samples before delivery and 1-6 weeks thereafter, respectively. The concentrations of interferon (IFN)-gamma, IFN gamma-induced protein 10 (IP-10 or CXCL10), CCL11, and interleukin (IL) 1beta, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, and, IL-13 in maternal serum and breast milk whey were assayed in duplicates using bioplex multiplex kits. Other ELISA kits were used to assay transforming growth factor (TGF)-beta1 and immunoglobulin A (IgA). Eczema-like disorders were ascertained at ages 6 and 12 months by telephone interviews. Generalized estimating equations were used to estimate the effect of immune marker on repeated eczema information at ages 6 and 12 months adjusting for confounders. False discovery rate was used to penalize multiple testing. Of 178 women, 161 provided blood and 115 breast milk samples. Immune markers IL-4, IL-10, IL-12, IL-1beta, and CCL11 in maternal serum and whey were not further considered for statistical analyses since the proportion of non-detectable values were high. Higher levels of IL-6, IL-5, and IL-13 in maternal serum increased the risk of infant scratching (RR = 1.73, 1.61 and 1.84, respectively; p< 0.002). A similar association was detected for infant scratching and higher levels of IL-13 in breast milk whey (RR= 1.47). Surprisingly, IL-6 and IL-13 in breast milk whey were found to reduce the risk of reported eczema diagnosis (RR = 0.25 and 0.27, respectively; p = 0.04). Children exposed to the higher level of IL-6 in whey also had a significantly lower relative risk for eczema-like manifestations such as cradle cap, cheek-eczema, eczema on other sites of the head and body, ear eczema, small reddish itchy areas lasting for at least 4 weeks, swollen lips, sore nappy-area (RR = 0.36; p = 0.014).

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