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Impact of early life geohelminths on wheeze, asthma, and atopy in Ecuadorian children at 8 years.
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  • Philip Cooper,
  • Irina Chis Ster,
  • Martha Chico,
  • Maritza Vaca,
  • Yisela Oviedo,
  • Augusto Maldonado,
  • Maurício Barreto,
  • Thomas Platts-Mills,
  • David Strachan
Philip Cooper
St George's University of London
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Irina Chis Ster
St George's University of London
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Martha Chico
Fundacion Ecuatoriana Para Investigación en Salud
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Maritza Vaca
Foundation Ecuatoriana Para Investigación en Salud
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Yisela Oviedo
Foundacion Ecuatoriana Para Investigación en Salud
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Augusto Maldonado
Universidad San Francisco de Quito
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Maurício Barreto
Universidade Federal da Bahia
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Thomas Platts-Mills
University of Virginia Health System
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David Strachan
St George's, University of London
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Background: Early-life exposures to geohelminths may protect against the development of wheeze/asthma and atopy. Objective: Study effect of maternal geohelminths and infections in children during the first 5 years of life on atopy, wheeze/asthma, and airways reactivity/inflammation at 8 years. Methods: Birth cohort of 2,404 neonates followed to 8 years in rural Ecuador. Data on wheeze/asthma were collected by questionnaire and atopy by skin prick test (SPT) reactivity to 9 allergens. We measured airways reactivity to bronchodilator, fractional exhaled nitric oxide (FeNO), and nasal eosinophilia. Stool samples were examined for geohelminths by microscopy. Results: 1,933 (80.4%) children were evaluated at 8 years. Geohelminths were detected in 45.8% of mothers and in 45.5% of children to 5 years. Frequencies of outcomes at 8 years were: wheeze (6.6%), asthma between 5 and 8 years (7.9%), SPT (14.7%), airways reactivity (10%), and elevated FeNO (10.3%) and nasal eosinophilia (9.2%). Any maternal geohelminth was associated with reduced prevalence of SPT (OR 0.72). Childhood T. trichiura infections were associated with reduced wheeze (OR 0.57) but greater parasite burdens with A. lumbricoides were associated with increased wheeze (OR 2.83) and asthma (OR 2.60). Associations between maternal geohelminths and wheeze/asthma were modified by atopy. Parasite-specific effects on wheeze/asthma and airways reactivity and inflammation were observed in non-atopic children. Conclusions: Our data provide novel evidence for persistent effects of in utero geohelminth exposures on childhood atopy but highlight the complex nature of the relationship between geohelminths and the airways. Registered as an observational study (ISRCTN41239086).

Peer review status:IN REVISION

30 Nov 2020Submitted to Allergy
01 Dec 2020Assigned to Editor
01 Dec 2020Submission Checks Completed
09 Dec 2020Reviewer(s) Assigned
07 Jan 2021Review(s) Completed, Editorial Evaluation Pending
07 Jan 2021Editorial Decision: Revise Minor