T-helper type 2 polarization among asthmatics during and following pregnancy

• Published in: Clinical and experimental allergy 2006-07, Vol.36 (7), p.892-898
• Main Authors: Rastogi, D., Wang, C., Lendor, C., Rothman, P. B., Miller, R. L.
• Format: Article
• Language: English
• Subjects: Adult; Allergic diseases; asthma; Asthma - immunology; asthma symptoms; Biological and medical sciences; Biomarkers - blood; Chemokine CCL11; Chemokines - biosynthesis; Chemokines, CC - biosynthesis; Cohort Studies; Cytokines - biosynthesis; Female; Fetal Blood - immunology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunopathology; Infant, Newborn - immunology; Influenza Vaccines - immunology; Medical sciences; Postpartum Period - immunology; Pregnancy; Pregnancy Complications - immunology; Respiration - immunology; Severity of Illness Index; T helper chemokines; T helper cytokines; Th2 Cells - immunology
• ISSN: 0954-7894; 1365-2222
• DOI: 10.1111/j.1365-2222.2006.02519.x

Summary Background Asthma is the most common medical condition during pregnancy. While increased production of T helper cytokines has been reported to occur in both asthma and pregnancy, the effect of T‐helper type 2 (Th2) polarization on asthma symptoms during pregnancy has not been well‐characterized. Objective We hypothesized that systemic Th2 cytokine and chemokine polarization occurs among asthmatics to a greater extent during their pregnancy, and is associated with more severe asthma and increased Th2 polarization in the newborn. Methods Fifty‐six pregnant asthmatics were recruited from prenatal clinics affiliated with New York Presbyterian Hospital. Systemic production of interleukin‐4, interferon‐γ, eotaxin and IP10 were measured by intracytoplasmic staining or ELISA at recruitment, peripartum and post‐partum, and in the cord blood. The frequency of asthma symptoms was measured by questionnaires and compared with Th biomarkers. Results The chemokine ratio (IP10/eotaxin) declined over the course of pregnancy (from 3.3±1.3 to 1.4±0.2, P=0.016), but IP10 and eotaxin increased post‐partum. The decrease in the chemokine ratio was associated with more frequent asthma symptoms. A non‐significant trend towards decreased interferon‐γ and increased interleukin‐4 production was detected. Cord blood eotaxin levels correlated with maternal levels (r=0.35, P=0.03). Other peripartum biomarkers were not associated with Th2 polarization nor with subsequent respiratory symptoms in the newborn. Conclusions IP10/eotaxin declined over the course of pregnancy and was associated with worse asthma symptoms. Alterations of Th1/Th2 chemokine balance during pregnancy may identify women prone to more severe asthma during pregnancy.