Can asthma be predicted at birth?

Early life appears optimal for prevention of asthma, but interventions require a target population, and to date asthma cannot be clearly identified at birth.

The study included 614 healthy term babies with lung function measured at birth. There was a 10-year follow-up visit including skin prick test (SPT) for allergens.

The analysis included 37 variables, among them:

- lung function
- cord blood total immunoglobulin E
- soluble CD14

Parental allergic disease was insufficient to identify high-risk populations.

The model predicted a history of asthma correctly in 75% of children. However, it was not good enough - an intervention applied to predicted high-risk children would be started more often in children without asthma.

CD14 is a component of the innate immune system that exists in 2 forms:

- anchored into the membrane by a glycosylphosphatidylinositol (GPI anchor) tail (mCD14)

- soluble form (sCD14)

Innate immune system recognizes LPS via the LPS signal transduction pathway, which has the trimolecular complex of CD14/TLR4/MD2 at the core. CD14 was the first described pattern recognition receptor (PAMP receptor).

In the initial stages of an immune response, the innate immune system recognizes the presence of pathogens and provides the first line of defense. This video is from: Janeway's Immunobiology, 7th Edition Murphy, Travers, & Walport. Source: Garland Science.

References:

Can childhood asthma be predicted at birth? Lødrup Carlsen KC, Mowinckel P, Granum B, Carlsen KH. Clin Exp Allergy. 2010 Oct 6. doi: 10.1111/j.1365-2222.2010.03620.x.
Both low and high levels of cord blood 25(OH) vitamin D were associated with increased aeroallergen sensitization. JACI, 2011.

CD14