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Biomedical subjects

Michael Borte

Publications and source records attributed to Michael Borte.

18 recordsLinked to original sources

Impact of parental education and income inequality on children's food intake.

OBJECTIVE: To analyse the association between socio-economic indicators and diet among 2-year-old children, by assessing the independent contribution of parental education and equivalent income to food intake. DESIGN: The analysis was based on data from a prospective birth cohort study. Information on diet was obtained using a semi-quantitative food-frequency questionnaire. Low and high intake of food was defined according to the lowest and the highest quintile of food consumption frequency, respectively. SETTING: Four German cities (Munich, Leipzig, Wesel, Bad Honnef), 1999-2001. Subjects Subjects were 2637 children at the age of 2 years, whose parents completed questionnaires gathering information on lifestyle factors, including parental socio-economic status, household consumption frequencies and children's diet. RESULTS: Both low parental education and low equivalent income were associated with a low intake of fresh fruit, cooked vegetables and olive oil, and a high intake of canned vegetables or fruit, margarine, mayonnaise and processed salad dressing in children. Children with a low intake of milk and cream, and a high intake of hardened vegetable fat, more likely had parents with lower education. Low butter intake was associated with low equivalent income only. CONCLUSIONS: These findings may be helpful for future intervention programmes with more targeted policies aiming at an improvement of children's diets.

Child Nutrition Sciences↗

Rapid subcutaneous IgG replacement therapy is effective and safe in children and adults with primary immunodeficiencies--a prospective, multi-national study.

Sixty patients (16 children, 44 adults) participated in the study aiming at evaluating: (i) IgG levels when switching patients from intravenous IgG (IVIG) infusions in hospital to subcutaneous (SCIG) self-infusions at home using the same cumulative monthly dose, (ii) protections against infections, and (iii) safety of a new, ready-to-use 16% IgG preparation. All children and 33 adults had received IVIG therapy for >6 months at enrolment. Ten adults who had been on SCIG therapy for many years served as controls. Mean serum IgG trough levels increased in the pre-IVIG children from 7.8 to 9.2 g/L (non-inferiority: p < 0.001) and in the adults from 8.6 to 8.9 g/L (non-inferiority: p < 0.001). Totally 114 respiratory tract infections occurred, 90% of them mild. One serious bacterial infection (pneumonia) was reported for one adult. The annualized rate of serious infections was 0.04 episodes/patient. In total 2297 infusions were given and 28 (1%) systemic adverse reactions occurred, none of them severe. Local tissue reactions declined over time, this being particularly distinct after 8 to 10 weeks. In conclusion, the SCIG administration route was safe. High IgG levels were easily maintained resulting in a very good protection against infections.

Adolescent↗

Margarine and butter consumption, eczema and allergic sensitization in children. The LISA birth cohort study.

It has been hypothesized that margarine intake is associated with allergic diseases. However, the epidemiological evidence in children is limited. The aim of the present study was to assess the relationship between dietary intake of margarine and butter with eczema and allergic sensitization in 2-yr-old children. Data of 2582 children at the age of 2 yr with complete information on exposure to diet and allergic outcome were analyzed in a German prospective birth cohort study (LISA). Margarine and butter intake were estimated from a semiquantitative food frequency questionnaire about general fat use at home combined with questions on the child's spread intake. Multiple logistic regression analysis was applied comparing predominant margarine and predominant butter intake with consumption of both butter and margarine. Predominant margarine intake was positively associated with lifetime prevalence of symptomatic eczema (aOR: 1.71; 95% CI: 1.12-2.61) and doctor-diagnosed eczema (aOR: 2.10; 95% CI: 1.36-3.25) and allergic sensitization against inhalant allergens (aOR: 2.10; 95% CI: 1.01-4.41) at the age of 2 yr. No statistically significant associations were found for butter intake. Stratification for parental history of atopic diseases indicated that children at high risk of atopic diseases have higher effect estimates for margarine intake compared to children without parental history of atopic diseases. Stratification for sex also showed higher effect estimates in boys. Children with predominant margarine consumption had an increased risk for eczema and allergic sensitization, while butter intake was no predictor for allergic diseases. However, we could not determine whether margarine is a causal risk factor or whether other lifestyle factors have influenced this association.

Butter↗

Timing of solid food introduction in relation to atopic dermatitis and atopic sensitization: results from a prospective birth cohort study.

OBJECTIVE: Prophylactic feeding guidelines recommend a delayed introduction of solid foods for the prevention of atopic diseases. Scientific evidence for this is scarce. This study investigates whether a delayed introduction of solids (past 4 months or 6 months) is protective against the development of atopic dermatitis (AD) and atopic sensitization when considering reverse causality. METHODS: Data from 2612 infants in an ongoing birth cohort study were analyzed at 2 years of age. Information on diet and on symptoms and diagnoses of AD was collected semiannually, and information on specific immunoglobulin E levels was collected at 2 years of age. RESULTS: Solid food introduction past the first 4 months of life decreased the odds of symptomatic AD but not for doctor-diagnosed AD, combined doctor-diagnosed and symptomatic AD, or atopic sensitization. Postponing the introduction beyond the sixth month of life was not protective in relation to either definition of AD or atopic sensitization. There was also no evidence for a protective effect of a delayed introduction of solids on AD and atopic sensitization in children of atopic parents. There was clear evidence for reverse causality between early skin or allergic symptoms and the introduction of solids. CONCLUSIONS: This study does not find evidence supporting a delayed introduction of solids beyond the sixth month of life for the prevention of AD and atopic sensitization. We cannot rule out that delaying the introduction of solids for the first 4 months of life might offer some protection. Measures to avoid reverse causality have to be considered in the conduction, analysis, and interpretation of cohort studies on the topic.

Cohort Studies↗

Entry age into day care and later development of allergic disorders--results from the city of Leipzig cohort of the LISA study.

The situation in early childhood is supposed to be a risk factor for later development of allergic diseases. The birth cohort from the LISA (Lifestyle-Immune System-Allergy) study gave us the opportunity to investigate the relationship between early childhood situation and the development of allergic diseases. This paper describes our findings regarding to the relationship between entry age into day care and obstructive bronchitis as well as allergic rhinitis and atopic eczema. Study was designed as a longitudinal birth cohort study. Children were examined by a physician at birth, 1/2 year, 1 year, 1 1/2 year, 2 years, 3 years and 4 years. Further information was collected using a structured questionnaire which was answered by the parents. Outcomes under investigation were atopic eczema, allergic rhinitis, wheezing (with and without cold), obstructive bronchitis and asthma (after 2nd year of life). Logistic regression analysis adjusted for infectious diseases of the mother during pregnancy, vaccination of the mother during pregnancy, antibiotics, prenatal smoking of the mother or other persons in the apartment and vaccination state showed an significant promoting effect of entry age into day care against obstructive bronchitis over the first three years of life (OR 1/2 year: 8.55; 95%CI: 2.93...24.97; OR 1st year: 4.96; 95% CI: 1.73...14.24; OR 2nd year: 3.06 95% CI: 1...9.37). A further significant effect was found for crowding against asthma in the fourth year of life (OR 25.7; 95%CI: 1.65...400.17). No significant effects were found between the other periods under investigation (1st year until 4th year of life). On the base of our findings we recommend an entry age into day care of more than six months to prevent effects shown.

Age Factors↗

Pharmacoeconomic evaluation of immunoglobulin treatment in patients with antibody deficiencies from the perspective of the German statutory health insurance.

Primary antibody deficiencies are the most common forms of primary immunodeficiencies. Substitution therapy with polyvalent immunoglobulins has been established as the standard therapy for antibody deficiencies for several decades. Until now mainly intravenous immunoglobulins (IVIG) have been used in Germany, and the majority of patients receive treatment in hospital outpatient clinics. In recent years subcutaneous administration of immunoglobulins (SCIG) has been developed which is administered as home self-infusion. Studies indicate no significant differences in immunoglobulin substitution therapy between SCIG and IVIG concerning outcome. We carried out a cost-minimization analysis to compare the two treatment alternatives in Germany. Under base case assumptions the treatment with SCIG is cost saving from the perspective of the German statutory health insurance. The main cost drivers are IVIG and SCIG; the incremental cost of SCIG compared to IVIG is most sensitive to changes in the immunoglobulin price and changes in the body weight of the patient.

Adult↗

The influence of prelabor rupture of the membranes on the levels of oral mucosal immunoglobulins in the neonate.

Oral mucosal immunoglobulins play an important role in the human immune system as a first-line defense against viral and bacterial infection. Secretory immunoglobulin A (sIgA), IgD and the free secretory component (FSC) can be determined in the first days of life; however, it is yet unknown which events influence the local synthesis of the immunoglobulins. The aim of this study was to evaluate the influence of prelabor rupture of the membranes (PROM) within a period of 24 h on the synthesis of oral mucosal sIgA, IgD, FSC and albumin of neonates in their first day of life. Comparison of 35 neonates with a history of PROM with a control group of 44 term neonates revealed no significant differences neither with respect to sIgA, IgD, FSC nor to albumin. The results indicate that PROM within a period of 24 h does not significantly increase the synthesis of oral mucosal immunoglobulins in neonates in the first day of life.

Albumins↗

Children and adults with primary antibody deficiencies gain quality of life by subcutaneous IgG self-infusions at home.

BACKGROUND: A large number of children and adults with primary antibody deficiencies need lifelong IgG replacement therapy. It is mostly unknown what effect the choice of replacement therapy has on the patients' health-related quality of life (HRQOL) and treatment satisfaction (TS). OBJECTIVE: To investigate whether a switch from hospital-based intravenous IgG (IVIG) to home-based subcutaneous IgG (SCIG) therapy would improve the HRQOL and TS. METHODS: Fifteen children (<14 years; hospital-based IVIG therapy at enrollment) and 32 adults (> or =14 years; 22 on hospital-based IVIG and 10 on home-based SCIG therapy at enrollment) were included. Questionnaires were completed at baseline and at 6 and 10 months: the Child Health Questionnaire-Parental Form 50 (children) or Short Form 36 (adults), the Life Quality Index, and questions regarding therapy preferences. RESULTS: The SCIG home therapy was reported to give better health (P=.001) and improved school/social functioning (P=.02) for the children, reduced emotional distress (P=.02) and limitations on personal time for the parents (P=.004), and fewer limitations on family activities (P=.002). Adults switching therapy reported improved vitality (P=.04), mental health ( P=.05), and social functioning ( P=.01). Adults already on SCIG home therapy at enrollment retained high HRQOL and TS scores. The SCIG home therapy improved TS because it led to greater independence and better therapy convenience ( P <.05). The patients preferred the SCIG administration route and having the treatment at home. CONCLUSIONS: Home-based SCIG therapy improves several important aspects of HRQOL and provides the patients with primary antibody deficiencies and their families with greater independence and better control of the therapy situation and daily life. SCIG home therapy is an appreciated therapeutic alternative for adults and children in need of lifelong IgG replacement therapy.

Adolescent↗

Mode of delivery and development of atopic disease during the first 2 years of life.

It has been hypothesized that cesarean delivery might have an impact on the development of atopic diseases because of its gut flora modulating properties. In the present study, we analysed the association between cesarean delivery and atopic diseases using data of 2500 infants enrolled in the LISA-Study, a German prospective multicenter birth cohort study. Data on symptoms and physician-diagnosed atopic diseases were gathered by questionnaires shortly after birth and at infant's age 6, 12, 18, and 24 months. In addition, sensitization to common food and inhalant allergens was assessed by measuring specific immunoglobulin E (IgE) using the CAP-RAST FEIA method at the age of 2 yr. Confounder-adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated by multiple logistic regression. We found a positive association between cesarean delivery and occurrence of at least one episode of wheezing [aOR 1.31 (95% CI 1.02-1.68)] and of recurrent wheezing [1.41 (1.02-1.96)] during the first 2 yr of life. Furthermore, effect estimates for allergic sensitization defined as at least one specific IgE >/=0.70 kU/l against any allergen [1.48 (0.98-2.24)], against food allergens [1.64 (1.03-2.63)], and against inhalant allergens [1.75 (0.98-3.12)] were increased. Symptoms of atopic dermatitis [1.21 (0.92-1.59)], physician-diagnosed atopic dermatitis [1.04 (0.79-1.39)], and symptoms of allergic rhinoconjunctivitis [1.40 (0.80-2.44)] were only marginally increased in children delivered by cesarean section. In conclusion, our results suggest that cesarean delivery may be an additional risk factor for wheezing and allergic sensitization at least to food allergens up to the age of 2 yr. This should be considered when cesarean section is done for other than medical reasons.

Cesarean Section↗

Establishment of age-dependent reference values for IgA subclasses.

BACKGROUND: Recently, subclass-specific antisera have been introduced for application in a nephelometric assay. The aim of this study was to establish age-dependent reference values for serum concentrations of the two IgA subclasses in children and adults. METHODS: Serum levels of IgA1 and IgA2 were measured by automated immunonephelometry in samples from 235 clinically healthy children between 6 months and 18 years of age and 36 healthy adults. RESULTS: Both IgA1 and IgA2 were detectable in all samples, and both IgA1 and IgA2 increased with increasing age. In adults, the mean value for IgA1 is 1.46 g/l for IgA2 0.21 g/l and for total IgA 1.94 g/l. Individual IgA2 values correlate significantly (p < 0.0001) with IgA1 values (r(2) = 0.5433). In addition, there was a highly significant (p < 0.0001) correlation (r(2) = 0.9530) between the measured total IgA and the sum of the two IgA subclasses indicating that immunonephelometry using highly specific polyclonal antisera might be superior to other methods. CONCLUSIONS: These results and the availability of age-dependent reference values make it worthwhile to reassess the role of IgA subclasses in immunodeficiency and autoimmune diseases where conventional methods have led to conflicting results.

Adult↗

Redecoration of apartments promotes obstructive bronchitis in atopy risk infants--results of the LARS Study.

Findings by other authors indicate that exposure to chemical emissions from indoor paint is related to asthma symptoms in adults. In their first years of life children are receptive to obstructive airway diseases. The aim of this study was to investigate the influence of redecoration of the apartment on airway symptoms in infants during the first two years of life. The Leipzig Allergy Risk Children Study (LARS) is a birth cohort study with the following inclusion criteria: double positive family atopy anamnesis, cord blood IgE > 0.9 kU/l, or low birth weight between 1500-2500 g. Within the context of LARS, 186 parents of risk children completed a questionnaire on the respiratory symptoms of their children and the redecoration of their apartment at the end of the first and second year of life. A total 22% of the children suffered from obstructive bronchitis once or more during their first year, and 11% experienced this condition during their second year of life. Redecoration of the apartment had a significant influence on the appearance of obstructive bronchitis in the first (OR 4.1 95% CI 1.4-11.9) and in the second year of life (OR 4.2 95% CI 1.4-12.9). (The OR are adjusted for cord blood-IgE > 0.9 kU/l, birth weight < or = 2500 g, male sex and double positive parental atopy anamnesis, dampness, smoking or pet in the apartment). Simultaneous contamination from redecoration activities and additional exposures such as smoking, a pet or dampness in the apartment increased the risk for obstructive bronchitis in the first year (OR 9.1; 95% CI 2.3-34.8) as well as in the second year (OR 5.1; 95% CI 1.6-15.6). Our data suggest that redecoration of the apartment is associated with the development of acute inflammations, but not with a chronic influence on the airways in atopy risk infants. At an exposure to more than one environmental factor, pronounced effects were seen.

Air Pollution, Indoor↗

Levels of antibodies specific to tetanus toxoid, Haemophilus influenzae type b, and pneumococcal capsular polysaccharide in healthy children and adults.

Antibody levels specific for capsular polysaccharides of Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) and for tetanus toxoid were measured in serum samples of 386 age-stratified subjects. The study group consists of healthy adult blood donors and hospitalized children undergoing elective surgery, excluding individuals with a history of infection. In children, anti-tetanus toxoid antibody levels displayed two peaks of 1.20 IU/ml (20.4 mg/liter) and 1.65 IU/ml (28.1 mg/liter) related to the schedule of routine childhood immunization in the first year and at 8 years of age. Eighty percent of the antibodies are of the immunoglobulin G1 (IgG1) isotype. For pneumococcal capsular polysaccharide (PCP), the specific antibody levels represent the acquisition of natural immunity. The initial concentration of 9.2 mg/liter was low in infancy (0.5 to 1 years of age) and remained low until 3 to 4 years of age (14.6 mg/liter). During this period PCP antibodies were almost 100% of the IgG2 subclass. Thereafter, IgG anti-PCP antibody titers increased steadily to adult levels (59.5 mg/liter). The data are intended to provide reference ranges to aid in the interpretation of specific antibody determinations in the clinical setting.

Adolescent↗

IgG subclass concentrations in certified reference material 470 and reference values for children and adults determined with the binding site reagents.

BACKGROUND: There is currently no international reference preparation for IgG subclass (IgGSc) quantification. This situation has led to calibration differences among assays and a variety of reference interval values with consequential difficulties in comparing results. We therefore evaluated IgGSc concentrations in Certified Reference Material 470 (CRM 470). METHODS: Pure, polyclonal IgG1, -2, -3, and -4 were prepared from a large serum pool for use as primary standards. The IgG mass in each preparation was calculated from amino-acid analysis data. IgGSc concentrations were assessed in CRM 470 by nephelometry with modern analytical techniques, using these reference preparations. Subsequently, IgGSc concentrations were measured in 380 healthy individuals (250 males and 130 females), and age-dependent reference intervals were established. RESULTS: IgGSc concentrations in CRM 470 were as follows: IgG1, 5028 mg/L; IgG2, 3418 mg/L; IgG3, 579 mg/L, and IgG4, 381 mg/L, with a total IgG concentration of 9406 mg/L, 2.83% below the certified total IgG value of 9680 mg/L. Age-dependent percentile curves for the four IgGSc were constructed using a Box-Cox transformation. Maximum median values were as follows: IgG1, 6.02 g/L at 11 years; IgG2, 3.45 g/L at 31 years; IgG3, 0.63 g/L at 17 years; and IgG4, 0.48 g/L at 14 years. No significant sex-related differences were observed. CONCLUSIONS: The correlation between the summation of individual IgGSc and separate measurements of total IgG concentrations was good and supports the accuracy of the results. The results are based on The Binding Site assays and should not be considered appropriate for other assays unless so demonstrated.

Adolescent↗

Increased incidence of allergic sensitisation and respiratory diseases due to mould exposure: results of the Leipzig Allergy Risk children Study (LARS).

To investigate mould effects on health, the concentration of mould spores in air and dust was determined during a prospective cohort study. Clinical outcome was estimated by questionnaires and determination of specific IgE antibodies and intracellular cytokine production of T cells. A significant association was observed between the incidence of respiratory tract infections and exposure to Penicillium spores. Moreover, Aspergillus exposure was found to be associated with allergic rhinitis or related symptoms. In addition, T cells of children exposed to Aspergillus showed a significantly lower content of TH1 cytokines (IFN-gamma, TNF-alpha, IL-2) producing cells. Our data suggest that mould exposure is associated with several effects on health, depending on the species involved.

Aspergillus↗

Natural history of serum immunoglobulin concentrations in low birth weight infants and association with respiratory tract infections.

UNLABELLED: Infections are a significant cause of morbidity and mortality among low birth weight (LBW) infants. THE AIMS OF OUR STUDY WERE: (1) to investigate whether serum antibody concentrations in 62 LBW infants (1,500-2,500 g) were normalized by 1 year of life, and (2) to determine the clinical relevance of humoral immaturity in these children during the 1st year compared to 20 appropriate-for-gestational-age (AGA) term infants. At 1 year of life, immunoglobulin serum concentrations in LBW infants were comparable to those of the control group. The incidence of respiratory tract infections during the 1st year of life was not significantly different between LBW and AGA term infants. Interestingly, we demonstrated that LBW infants with a higher frequency of reported febrile upper respiratory tract infections had more elevated serum total IgG, IgG(1), IgG(3), total IgA, and IgA(1) concentrations. Thus, infants with a birth weight of 1,500-2,500 g do not appear to have an increased risk of respiratory tract infections compared to AGA term children during the 1st year of life. Furthermore, our data suggest that especially febrile infections induce higher serum immunoglobulin concentrations in LBW infants.

Birth Weight↗

Passive smoking, excretion of metabolites, and health effects: results of the Leipzig's Allergy Risk Study (LARS).

Over a 5-yr period, the Leipzig's Allergy Risk Study (LARS) investigated the influence of typical indoor-contaminant burdens on the development of allergies and upper respiratory tract infections in allergy-prone children. Typical indoor volatile organic compounds (VOCs) and excretion of certain VOC metabolites in urine were measured in children 3 yr of age. Data analyses were based on parent-completed questionnaires, exposure measurements, and medical examinations. Evaluation of passive smoking was of special interest. Generally, residences with a high burden of passive smoking had higher benzene concentrations than residences inhabited by nonsmokers. Obstructive bronchitis was observed more frequently in children exposed to increased concentrations of benzene, as well as toluene, styrene, and m,p-xylene. In addition, atopic symptoms were associated with excretion of certain VOC metabolites. For example, the authors found an association between eczema and exposure to toluene and between eczema and increased excretion of the toluene metabolite S-benzylmercapturic acid. The results suggest that if an association with certain health effects is to be demonstrated, evaluation of external exposures should be supplemented with evaluations of internal exposure.

Child Welfare↗