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American Journal of Obstetrics and Gynecology

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Developmental programming for allergy: a secondary analysis of the Mothers, Omega-3, and Mental Health Study - 25/03/13

Doi : 10.1016/j.ajog.2013.01.024 
Vivian C. Romero, MD a, Emily C. Somers, PhD, ScM a, b, c, Valerie Stolberg, MS, MPH f, Chelsea Clinton, MD a, Stephen Chensue, MD, PhD d, Zora Djuric, PhD e, Deborah R. Berman, MD a, Marjorie C. Treadwell, MD a, Anjel M. Vahratian, PhD a, Ellen Mozurkewich, MD, MS a
a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI 
b Division of Rheumatology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 
c Department of Environmental Health Sciences, University of Michigan Medical School, Ann Arbor, MI 
d Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 
e Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI 
f Department of Pathology and Laboratory Medicine, Veterans Affairs Ann Arbor Health System, Ann Arbor, MI 

Résumé

Objective

Fetal dysregulation of T helper cell pathways may predispose to allergy, as high cord blood T helper 2/T helper 1 ratios have been shown to precede development of allergic diseases. We aimed to determine whether prenatal eicosapentaenoic acid and docosahexaenoic acid supplementation reduces T helper 2 to T helper 1-associated chemokine ratios. We also explored the effect of mode of delivery on T helper 2/T helper 1 ratios.

Study Design

We conducted a secondary analysis of a randomized placebo controlled trial initially performed to assess the effects of docosahexaenoic acid or eicosapentaenoic acid supplementation on pregnancy-related depressive symptoms among 126 participants. Cord plasma specimens from 98 newborns were assayed for chemokines associated with T helper 2 (thymus and activation-regulated chemokine [CCL17], macrophage-derived chemokine [CCL22], eotaxin [CCL 11]) and T helper 1 (interferon-inducible protein-10 [CXCL 10]) by enzyme-linked immunosorbent assay and Multiplex immunoassays. Ratios of log-transformed chemokines macrophage-derived chemokine/interferon-inducible protein-10 and thymus and activation-regulated chemokine/interferon-inducible protein-10 were compared between groups by analyses of variance. Multiple linear regression was performed to examine associations between treatments and chemokine ratios, adjusting for covariates.

Results

After adjusting for gestational age at delivery, birthweight, and mode of delivery, both omega-3 supplementation groups were associated with lower macrophage-derived chemokine/interferon-inducible protein-10 ratios than placebo (eicosapentaenoic acid: coefficient −1.8; 95% confidence interval [CI], −3.6 to −0.05; P = .04; docosahexaenoic acid: −2.0; 95% CI, −3.9 to −0.07; P = .04). Similar associations were found for thymus and activation-regulated chemokine/interferon-inducible protein-10 (eicosapentaenoic acid: −1.5; 95% CI, −3.0 to 0.06; P = .06; docosahexaenoic acid −2.2; 95% CI, −3.8 to −0.52; P = .01). Cesarean delivery was associated with higher macrophage-derived chemokine/interferon-inducible protein-10 (1.6; 95% CI, 0.01−3.3; P = .049) and thymus and activation-regulated chemokine/interferon-inducible protein-10 (1.5; 95% CI, 0.1−2.9; P = .042) ratios than vaginal delivery.

Conclusion

Prenatal supplementation with eicosapentaenoic acid and docosahexaenoic acid resulted in decreased cord blood T helper 2/T helper 1 chemokine ratios. Cesarean delivery was associated with a pronounced T helper 2 deviation at birth.

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Key words : allergy, chemokines, fetal, omega-3, programming


Plan


 This project was supported by NIH R21 AT004166-03S1, National Center for Complementary and Alternative Medicine, National Institutes of Health (NIH); a University of Michigan Clinical Research Initiatives grant; the University of Michigan General Clinical Research Center (now the Michigan Clinical Research Unit); the NIH through University of Michigan Cancer Center Support Grant number P30 CA046592; the Department of Obstetrics and Gynecology, University of Michigan Medical School; and the Michigan Institute for Clinical Health Research. Study supplements and placebos were donated by Nordic Naturals Corporation, Watsonville, CA. Nordic Naturals did not participate in the data analysis or interpretation of the results.
 E.M. was an invited speaker for the Global Organization for EPA and DHA Omega-3 at the Nutracon 2012 Conference in March 2012 and received reimbursement for travel expenses. E.C.S. was supported by grant number 1K01ES019909-01 from the National Institute of Environmental Health Sciences. The other authors report no conflict of interest.
 The racing flag logo above indicates that this article was rushed to press for the benefit of the scientific community.
 Reprints are not available from the authors.
 Cite this article as: Romero VC, Somers EC, Stolberg V, et al. Developmental programming for allergy: a secondary analysis of the Mothers, Omega-3, and Mental Health Study. Am J Obstet Gynecol 2013;208:316.e1-6.


© 2013  Mosby, Inc. Tous droits réservés.
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Vol 208 - N° 4

P. 316.e1-316.e6 - avril 2013 Retour au numéro
Article précédent Article précédent
  • The Mothers, Omega-3, and Mental Health Study: a double-blind, randomized controlled trial
  • Ellen L. Mozurkewich, Chelsea M. Clinton, Julie L. Chilimigras, Susan E. Hamilton, Lucy J. Allbaugh, Deborah R. Berman, Sheila M. Marcus, Vivian C. Romero, Marjorie C. Treadwell, Kristie L. Keeton, Anjel M. Vahratian, Ronald M. Schrader, Jianwei Ren, Zora Djuric
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