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Parental TB associated with offspring asthma and rhinitis

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BACKGROUND: Infections in early life are associated with asthma and allergies in one-generation settings; however, the link between parental infection and offspring phenotype is rarely investigated. We aim to study the association of parental TB before conception of the offspring with offspring asthma and rhinitis.

METHODS: We included 2,965 offspring born in 1985–2004 and registered in the Norwegian prescription database to 1,790 parents born after 1960 with a history of TB, and included in the Norwegian TB registry. Offspring asthma (n = 582) and rhinitis (n = 929) were defined based on diagnosis, type of medication and prescribed medication ≥1 year. Associations of parental TB <8 years, ≥8 years but before offspring´s birth year and after birth (reference category) with offspring asthma and rhinitis were analysed using logistic regression.

RESULTS: Asthma risk was higher in persons with parental TB in childhood (OR 1.73, 95% CI 1.20–2.50) or later preconception (OR 1.38, 95% CI 1.00–1.91) than in persons with parental TB after offspring´s birth; this was significant only in the maternal line (childhood: OR 1.95, 95% CI 1.13–3.37; later preconception: OR 1.74, 95% CI 1.08–2.80). Associations with rhinitis were not identified.

CONCLUSIONS: Parental childhood TB was associated with higher asthma risk in future offspring. We speculate that TB impacts maternal immunity and dysregulates the offspring´s type 2 immunity, and that TB-induced epigenetic reprograming of immune defences are transferred to the offspring.

Keywords: NCDs; infections; intergenerational; preconception

Document Type: Research Article

Affiliations: 1: Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway, Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway 2: Department of Clinical Science, University of Bergen, Bergen, Norway 3: Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy 4: Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway 5: Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden 6: Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa, Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK

Publication date: June 1, 2022

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