The development of TH2 responses from infancy to 4 years of age and atopic sensitization in areas endemic for helminth infections

BACKGROUND: Helminth infections and allergies are associated with TH(2) responses. Whereas the development of TH(2) responses and allergic disorders in pediatric populations has been examined in affluent countries, no or little data exist from low income regions of the world. The aim of this study is to examine factors influencing the development of TH(2) responses of children born in areas endemic for helminth infections and to relate these factors to atopic sensitization at 4 years of age. METHODS: Data were collected from pregnant mothers on helminth infections, education and socioeconomic status (SES). Total IgE, IL-5 in response to mitogen, and helminth antigens were measured in children at 2, 5, 12, 24 and 48 months of age. Skin prick testing (SPT) and allergen-specific IgE were determined at 4 years of age. RESULTS: Strong TH(2) responses were seen at 5 months of age and increased with time. Although maternal filarial infection was associated with helminth-antigen specific TH(2) responses, it was low maternal education or SES but not helminth infection, which was associated with the development of high total IgE and PHA-induced IL-5. At 4 years of age when allergen reactivity was assessed by SPT, the high general TH(2) responses did not translate into higher prevalence of SPT. The risk factor for SPT reactivity was low maternal education which decreased the risk of SPT positivity to allergens (adjusted OR, 0.32; 95% CI, 0.12 – 0.87) independently of maternal filarial infection which tended to reduce the child’s risk for being SPT positive (adjusted OR, 0.35; 95% CI, 0.07 – 1.70). CONCLUSIONS: In areas endemic for helminths, potent TH(2) responses were seen early in life, but did not translate into a higher SPT reactivity to allergens. Therefore, in many parts of the world TH(2) responses in general and IgE in particular cannot be used for diagnosis of allergic diseases

Race-specific relationship of birth weight and renal function among healthy young children

BACKGROUND: Low birth weight is associated with diminished renal function. However, despite African Americans being at increased risk of low birth weight and chronic kidney disease, little is known about the association between birth weight and renal function in diverse groups. We examined racial differences in the relationship of birth weight and renal function among healthy, young children. METHODS: Birth weight and serum creatinine were available on 152 children (61.8% African American; 47.4% female) from a birth cohort. Estimated glomerular filtration rate (eGFR) was calculated using the bedside Schwartz equation and gender- and gestational-age adjusted birth weight Z-scores using the US population as a reference. Race-specific linear regression models were fit to estimate the association between birth weight Z-score and eGFR. RESULTS: Mean age was 1.5±1.3 years at first eGFR measurement. African Americans had lower eGFR than non-African Americans (median eGFR= 82 vs. 95 mL/min per 1.73m(2); P=0.06). Birth weight was significantly and positively associated with eGFR among African-American (P=0.012) but not non-African-American children (P=0.33). CONCLUSIONS: We provide, for the first time, evidence suggesting birth weight is associated with renal function in African-American children. Future work is needed to determine if prenatal programming helps explain racial disparities in adult health

Does Pet-Keeping Modify the Association of Delivery Mode with Offspring Body Size?

OBJECTIVES: Caesarean-section (CS) delivery increases risk of childhood obesity, and is associated with a distinct early-life gut microbiome, which may contribute to obesity. Household pets may alter human gut microbiome composition. We examined if pet-keeping modified the association of CS with obesity at age 2 years in 639 Wayne County Health, Environment, Allergy and Asthma Longitudinal Study (WHEALS) birth cohort participants. METHODS: Pet-keeping was defined as having a dog or cat (indoors ≥1 hour/day) at child age 2 years. We used logistic regression to test for an interaction between CS and pet-keeping with obesity (BMI≥95(th) percentile) at age 2 years, adjusted for maternal obesity. RESULTS: A total of 328 (51.3%) children were male; 367 (57.4%) were African American; 228 (35.7%) were born by CS; and 55 (8.6%) were obese. After adjusting for maternal obesity, CS-born children had a non-significant (P=0.25) but elevated 1.4 (95% CI: 0.8, 2.5) higher odds of obesity compared to those born vaginally. There was evidence of effect modification between current pet-keeping and delivery mode with obesity at age 2 years (interaction P=0.054). Compared to children born vaginally without a pet currently in the home, children born via CS without a pet currently in the home had a statistically significant (P=0.043) higher odds (odds ratio=2.00; 95% CI: 1.02, 3.93) of being obese at age 2 years. CONCLUSIONS: Pets modified the CS-BMI relationship; whether the underlying mechanism is through effects on environmental or gut microbiome requires specific investigation

Companion Animal Ethics: A Special Area of Moral Theory and Practice?

Considerations of ethical questions regarding pets should take into account the nature of human-pet relationships, in particular the uniquely combined features of mutual companionship, quasi-family-membership, proximity, direct contact, privacy, dependence, and partiality. The approaches to ethical questions about pets should overlap with those of animal ethics and family ethics (and, for veterinary issues, with healthcare ethics), and so need not represent an isolated field of enquiry, but rather the intersection of those more established fields. This intersection, and the questions of how we treat our pets, present several unique concerns and approaches for focused examination