Allergy Asthma Immunol Res.  2015 Mar;7(2):167-174. 10.4168/aair.2015.7.2.167.

Association Between Antibiotic Exposure, Bronchiolitis, and TLR4 (rs1927911) Polymorphisms in Childhood Asthma

• Lee E
• Kwon JW
• Kim HB
• Yu HS
• Kang MJ
• Hong K
• Yang SI
• Jung YH
• Lee SH
• Choi KY
• Shin HL
• Hong SA
• Kim HY
• Seo JH
• Kim BJ
• Lee SY
• Song DJ
• Kim WK
• Jang GC
• Shim JY
• Hong SJ

• KMID: 2365545
• DOI: http://doi.org/10.4168/aair.2015.7.2.167

Abstract

PURPOSE
The complex interplay between environmental and genetic factors plays an important role in the development of asthma. Several studies have yielded conflicting results regarding the 2 asthma-related risk factors: antibiotic usage during infancy and/or a history of bronchiolitis during early life and the development of asthma. In addition to these risk factors, we also explored the effects of Toll-like receptor 4 (TLR4) polymorphism on the development of childhood asthma.
METHODS
This cross-sectional study involved 7,389 middle school students who were from 8 areas of Seoul, Korea, and completed the International Study of Asthma and Allergies in Childhood questionnaire. The TLR4 polymorphism rs1927911 was genotyped in 1,395 middle school students from two areas using the TaqMan assay.
RESULTS
Bronchiolitis in the first 2 years of life, antibiotic exposure during the first year of life, and parental history of asthma were independent risk factors for the development of asthma. When combined, antibiotic use and a history of bronchiolitis increased the risk of asthma (adjusted odds ratio [aOR]: 4.64, 95% confidence interval [CI]: 3.09-6.97, P value for interaction=0.02). In subjects with CC genotype of TLR4, antibiotic exposure and a history of bronchiolitis during infancy, the risk of asthma was increased, compared to subjects without these risk factors (aOR: 5.72, 95% CI: 1.74-18.87).
CONCLUSIONS
Early-life antibiotic exposures and a history of bronchiolitis are risk factors for asthma in young adolescents. Polymorphisms of TLR4 modified the influence of these environmental factors. Reducing antibiotic exposure and preventing bronchiolitis during infancy may prevent the development of asthma, especially in genetically susceptible subjects.

Keyword

Asthma; antibiotics; bronchiolitis; polymorphism; Toll-like receptor 4

MeSH Terms

Adolescent
Anti-Bacterial Agents
Asthma*
Bronchiolitis*
Cross-Sectional Studies
Genotype
Humans
Hypersensitivity
Korea
Odds Ratio
Parents
Risk Factors
Seoul
Toll-Like Receptor 4
Surveys and Questionnaires
Anti-Bacterial Agents
Toll-Like Receptor 4

Figure

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  Figure Combined effect of TLR4 (rs1927911) genotypes with antibiotics exposure before 1 year of life and bronchiolitis in the first 2 years of life in middle school students for asthma diagnosis. Data were analyzed by using logistic regression and adjusted for age, gender, body mass index, a parental history of any allergic diseases, exposure to tobacco smoking, and household income. *P value <0.05.

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