Chronic caregiver stress and IgE expression, allergen-induced proliferation, and cytokine profiles in a birth cohort predisposed to atopy.

BACKGROUND Psychologic stress modifies immune function and cytokine production. OBJECTIVE We examined relationships between caregiver stress on the following markers of early childhood immune response: (1) IgE expression (n=215); (2) mitogen-induced and allergen-specific (Dermatophagoides farinae [Der f 1] and cockroach [Bla g 2]) proliferative response (n=114); and (3) subsequent cytokine expression (INF-gamma, TNF-alpha, IL-10, and IL-13) in a prospective birth cohort predisposed to atopy. METHODS Caregiver stress was measured at 2-month intervals for the first 2 years of life and yearly thereafter by using the Perceived Stress Scale. A subsequent blood sample obtained from the children (median age, 2.1 years; range, 18-32 months) was analyzed for total serum IgE level and allergen-induced proliferation quantified as the stimulation index (SI; mean thymidine incorporation of the stimulated sample divided by that of the unstimulated sample). The relationship between stress and the proliferative response (SI >3 vs SI < or =3), and total IgE level (< or =100 IU/mL vs >100 IU/mL) was examined by using logistic regression. The relationship between cytokine levels and stress was analyzed by using linear regression. RESULTS In adjusted analyses higher caregiver stress in the first 6 months after birth was associated with a Der f 1 SI of greater than 3 (odds ratio [OR], 1.5; 95% CI, 1.0-2.3) and nominally associated with a Bla g 2 SI of greater than 3 (OR, 1.13; 95% CI, 0.7-1.8). Higher stress between ages 6 and 18 months was associated with a high total IgE level (OR, 2.03; 95% CI, 1.1-3.6). Higher stress was significantly associated with increased production of TNF-alpha, with a suggested trend between higher stress and reduced INF-gamma production. CONCLUSION Increased stress in early childhood was associated with an atopic immune profile in these children predisposed to atopy-asthma.