Relation Between In-utero Vitamin D and Immune Function in Early Childhood

儿童早期感染和过敏导致大量的发病率和健康成本。越来越多的证据 这表明维生素D在免疫中的重要作用。然而，将维生素D状态与 儿童期的特应性/过敏和感染不一致;有报告称， 根据维生素D状况的健康风险。此外，很少有研究探讨 维生素D受体（VDR）基因型、维生素D状况和儿童免疫之间的相互作用 结果。我们的目的是研究母亲和脐带血维生素D浓度与婴儿VDR遗传的关系， 在一个大型前瞻性出生队列中， study.新罕布什尔州的出生队列目前正在登记1000对母子 研究（NHBCS），一项收集有关营养，医疗，环境和 社会人口因素，以及分娩前后的几个生物标本。NHBCS将 作为生物标本和数据收集的资源，通过问卷调查、后续访谈和 病历审查。作为拟议研究的一部分，我们将测量产妇和脐带血 NHBCS中25-羟基维生素D（25（OH）D）浓度和婴儿VDR基因型。一是 研究25（OH）D浓度与前3年免疫结果之间的关系， 生活特应性/过敏结局将包括特应性/过敏的所有诊断，特别是：特应性皮炎、食物过敏 以及环境过敏、过敏性鼻炎、喘息和哮喘。感染结局将包括所有感染 特别是呼吸道和胃肠道感染。分析将评估潜在的 受分娩时胎龄、肥胖和母乳喂养/配方奶粉喂养等因素的混淆。 接下来，我们将探讨VDR多态性是否与特应性/过敏症独立相关， 感染结果以及它们是否改变了母体血和脐带血25（OH）D之间的关联 集中和这些结果。这项工作的目标是澄清维生素D与 通过向母亲和/或婴儿补充儿童健康， 在相关的环境和遗传因素的背景下的结果。

Early childhood infection and allergies lead to substantial morbidity and health costs. Accumulating evidence suggests an important role of vitamin D in immunity. However, the studies relating vitamin D status to risk of atopy/allergy and infection in childhood are inconsistent; there are reports of both increased and decreased health risks according to vitamin D status. Moreover, there are few studies that explore the potential interaction between Vitamin D Receptor {VDR) genotypes, vitamin D status, and childhood immune outcomes. We aim to study how maternal and cord blood vitamin D concentration and infant VDR genetic profile are associated with immunity in the first three years of life within a large prospective birth cohort study. One thousand mother-child pairs are currently being enrolled in the New Hampshire Birth Cohort Study (NHBCS), a study that collects extensive data on nutritional, medical, environmental, and sociodemographic factors, as well as several biological specimens before and after delivery. The NHBCS will serve as a resource for biospecimen and data collection through questionnaires, follow-up interviews and medical record reviews. As part of the proposed study, we will measure maternal and cord blood concentrations of 25-hydroxyvitamin D (25(OH)D) and infant VDR genotypes in the NHBCS. First, we will study the associations between 25(OH)D concentrations with immune outcomes during the first 3 years of life. Atopy/allergy outcomes will include all diagnoses of atopy/allergy and specifically: atopic dermatitis, food and environmental allergies, allergic rhinitis, wheeze and asthma. Infection outcomes will include all infection diagnoses, and specifically respiratory and gastrointestinal infections. Analyses will evaluate potential confounding by factors such as gestational age at delivery, adiposity, and breast-feeding/formula feeding. Next, we will explore whether VDR polymorphisms are independently associated with the atopy/allergy and infection outcomes and whether they modify the association between maternal and cord blood 25(OH)D concentration and those outcomes. The goal of this work is to clarify the association between vitamin D status, a factor that is highly modifiable through supplementation of mothers and/or infants, with child health outcomes in the context of relevant environmental and genetic factors.