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

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 di...

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Vydáno v:	Pediatric allergy and immunology Ročník 36; číslo 10; s. e70209 - n/a
Hlavní autoři:	Palmu, Tiina, Lehtonen, Jussi, Elding Larsson, Helena, Lynch, Kristian F., Jonsdottir, Berglind, Cilio, Corrado, Schatz, Desmond, Rewers, Marian, Hyöty, Heikki, Lönnrot, Maria
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England Wiley Subscription Services, Inc 01.10.2025
Témata:	Allergic rhinitis Asthma Asthma - epidemiology atopic eczema Atopy Child Child, Preschool Clinical Medicine Cohort analysis Cohort Studies Diabetes Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - epidemiology Diabetes Mellitus, Type 1 - genetics Eczema Female Fever Fever - epidemiology Follow-Up Studies Genetic Predisposition to Disease Health risk assessment Humans Hypersensitivity, Immediate - epidemiology Infant Infections Infectious Medicine Infektionsmedicin Klinisk medicin Male Medical and Health Sciences Medicin och hälsovetenskap Prospective Studies Respiration Respiratory tract infection Respiratory Tract Infections - epidemiology Risk Factors Survival analysis infections fever asthma allergic rhinitis atopic eczema
ISSN:	0905-6157, 1399-3038, 1399-3038
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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 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.
AbstractList	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. 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. 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. 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). 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. 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. 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.BACKGROUNDThe 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.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.METHODS3842 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.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).RESULTSThe 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).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.CONCLUSIONSIn 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.
Author	Lehtonen, Jussi Jonsdottir, Berglind Cilio, Corrado Lynch, Kristian F. Palmu, Tiina Schatz, Desmond Hyöty, Heikki Elding Larsson, Helena Rewers, Marian Lönnrot, Maria
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Copyright	2025 The Author(s). published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. 2025 The Author(s). Pediatric Allergy and Immunology published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. 2025. This work is published under Creative Commons Attribution License~https://creativecommons.org/licenses/by/3.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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CorporateAuthor	the TEDDY Study Group TEDDY Study Group Lunds universitet Profile areas and other strong research environments Department of Clinical Sciences, Malmö Lund University Diabetes - Immunovirology Strategiska forskningsområden (SFO) Diabetes - immunovirologi EpiHealth: Epidemiology for Health EXODIAB: Excellence of Diabetes Research in Sweden Faculty of Medicine Strategic research areas (SRA) Medicinska fakulteten Pediatrisk endokrinologi Profilområden och andra starka forskningsmiljöer Institutionen för kliniska vetenskaper, Malmö Paediatric Endocrinology
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Snippet	Background The increased prevalence of atopic diseases may be due to lifestyle changes affecting our exposure to microbes. We investigated the association... The increased prevalence of atopic diseases may be due to lifestyle changes affecting our exposure to microbes. We investigated the association between... Background The increased prevalence of atopic diseases may be due to lifestyle changes affecting our exposure to microbes. We investigated the association... Background: The increased prevalence of atopic diseases may be due to lifestyle changes affecting our exposure to microbes. We investigated the association...
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SubjectTerms	Allergic rhinitis Asthma Asthma - epidemiology atopic eczema Atopy Child Child, Preschool Clinical Medicine Cohort analysis Cohort Studies Diabetes Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - epidemiology Diabetes Mellitus, Type 1 - genetics Eczema Female Fever Fever - epidemiology Follow-Up Studies Genetic Predisposition to Disease Health risk assessment Humans Hypersensitivity, Immediate - epidemiology Infant Infections Infectious Medicine Infektionsmedicin Klinisk medicin Male Medical and Health Sciences Medicin och hälsovetenskap Prospective Studies Respiration Respiratory tract infection Respiratory Tract Infections - epidemiology Risk Factors Survival analysis
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
URI	https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fpai.70209 https://www.ncbi.nlm.nih.gov/pubmed/41036556 https://www.proquest.com/docview/3266092531 https://www.proquest.com/docview/3256395341
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