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Association of fever and infections with the subsequent risk of atopic diseases in children with genetic susceptibility for T1D : Results from the TEDDY cohort study

Palmu, Tiina ; Lehtonen, Jussi ; Elding Larsson, Helena LU orcid ; Lynch, Kristian F. ; Jonsdottir, Berglind ; Cilio, Corrado LU ; Schatz, Desmond ; Rewers, Marian ; Hyöty, Heikki and Lönnrot, Maria (2025) In Pediatric Allergy and Immunology 36(10).
Abstract

Background: The increased prevalence of atopic diseases may be due to lifestyle changes affecting our exposure to microbes. We investigated the association between infections, fever, and atopic diseases in a large international birth cohort setting. Methods: 3842 children at genetic risk for type 1 diabetes were followed prospectively for the first 10 years for the occurrence of infections and atopic diseases within The Environmental Determinants of Diabetes in the Young (TEDDY) study. A time-discrete survival analysis was carried out to evaluate the association of self-reported febrile and non-febrile infections (respiratory, gastrointestinal, other, fever alone) and the risk of subsequent atopic eczema, allergic rhinitis, asthma, and... (More)

Background: The increased prevalence of atopic diseases may be due to lifestyle changes affecting our exposure to microbes. We investigated the association between infections, fever, and atopic diseases in a large international birth cohort setting. Methods: 3842 children at genetic risk for type 1 diabetes were followed prospectively for the first 10 years for the occurrence of infections and atopic diseases within The Environmental Determinants of Diabetes in the Young (TEDDY) study. A time-discrete survival analysis was carried out to evaluate the association of self-reported febrile and non-febrile infections (respiratory, gastrointestinal, other, fever alone) and the risk of subsequent atopic eczema, allergic rhinitis, asthma, and allergies. Results: The rate of respiratory infections was positively associated with the subsequent risk of asthma (HR 1.30, 95% CI 1.25–1.35, p <.001). Febrile respiratory infections increased the risk of asthma more than non-febrile ones (febrile respiratory infection HR 1.50, 95% CI 1.42–1.59, p <.001; non-febrile respiratory infection HR 1.24, 95% CI 1.18–1.30, p <.001). In contrast, fever decreased the positive association of infections with the risk of other atopic diseases. Episodes of fever as the only reported symptom had a negative association particularly with the risk of atopic eczema (HR 0.53, 95% CI 0.39–0.71, p <.001). Conclusions: In a longitudinal cohort study, fever shows a clear impact on how infections associate with subsequent atopic diseases. Understanding the modifying role of fever on risk offers new possibilities to explore the mechanisms that mediate the effect of infections in the atopic process.

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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
allergic rhinitis, asthma, atopic eczema, fever, infections
in
Pediatric Allergy and Immunology
volume
36
issue
10
article number
e70209
publisher
Blackwell Munksgaard
external identifiers
  • pmid:41036556
  • scopus:105017562993
ISSN
0905-6157
DOI
10.1111/pai.70209
language
English
LU publication?
yes
id
70ab51ad-a5af-4d2b-afac-82f59b8591c0
date added to LUP
2025-11-26 10:44:02
date last changed
2025-12-24 13:48:16
@article{70ab51ad-a5af-4d2b-afac-82f59b8591c0,
  abstract     = {{<p>Background: The increased prevalence of atopic diseases may be due to lifestyle changes affecting our exposure to microbes. We investigated the association between infections, fever, and atopic diseases in a large international birth cohort setting. Methods: 3842 children at genetic risk for type 1 diabetes were followed prospectively for the first 10 years for the occurrence of infections and atopic diseases within The Environmental Determinants of Diabetes in the Young (TEDDY) study. A time-discrete survival analysis was carried out to evaluate the association of self-reported febrile and non-febrile infections (respiratory, gastrointestinal, other, fever alone) and the risk of subsequent atopic eczema, allergic rhinitis, asthma, and allergies. Results: The rate of respiratory infections was positively associated with the subsequent risk of asthma (HR 1.30, 95% CI 1.25–1.35, p &lt;.001). Febrile respiratory infections increased the risk of asthma more than non-febrile ones (febrile respiratory infection HR 1.50, 95% CI 1.42–1.59, p &lt;.001; non-febrile respiratory infection HR 1.24, 95% CI 1.18–1.30, p &lt;.001). In contrast, fever decreased the positive association of infections with the risk of other atopic diseases. Episodes of fever as the only reported symptom had a negative association particularly with the risk of atopic eczema (HR 0.53, 95% CI 0.39–0.71, p &lt;.001). Conclusions: In a longitudinal cohort study, fever shows a clear impact on how infections associate with subsequent atopic diseases. Understanding the modifying role of fever on risk offers new possibilities to explore the mechanisms that mediate the effect of infections in the atopic process.</p>}},
  author       = {{Palmu, Tiina and Lehtonen, Jussi and Elding Larsson, Helena and Lynch, Kristian F. and Jonsdottir, Berglind and Cilio, Corrado and Schatz, Desmond and Rewers, Marian and Hyöty, Heikki and Lönnrot, Maria}},
  issn         = {{0905-6157}},
  keywords     = {{allergic rhinitis; asthma; atopic eczema; fever; infections}},
  language     = {{eng}},
  number       = {{10}},
  publisher    = {{Blackwell Munksgaard}},
  series       = {{Pediatric Allergy and Immunology}},
  title        = {{Association of fever and infections with the subsequent risk of atopic diseases in children with genetic susceptibility for T1D : Results from the TEDDY cohort study}},
  url          = {{http://dx.doi.org/10.1111/pai.70209}},
  doi          = {{10.1111/pai.70209}},
  volume       = {{36}},
  year         = {{2025}},
}