Maternal and paternal tuberculosis is associated with increased asthma and respiratory symptoms in their offspring: a study from Northern Europe

Sanjay Gyawali; Juan Pablo López-Cervantes; Ane Johannessen; Thorarinn Gislason; Mathias Holm; Christer Janson; Rain Jögi; Lars Modig; Vivi Schlünssen; Tehmina Mustafa; Cecilie Svanes

doi:10.3389/falgy.2023.1193141

Maternal and paternal tuberculosis is associated with increased asthma and respiratory symptoms in their offspring: a study from Northern Europe

Front Allergy. 2023 Jun 8:4:1193141. doi: 10.3389/falgy.2023.1193141. eCollection 2023.

Authors

Sanjay Gyawali^{1

2}, Juan Pablo López-Cervantes^{1

2}, Ane Johannessen¹, Thorarinn Gislason^{3

4}, Mathias Holm⁵, Christer Janson⁶, Rain Jögi⁷, Lars Modig⁸, Vivi Schlünssen⁹, Tehmina Mustafa^{1

10}, Cecilie Svanes^{1

2}

Affiliations

¹ Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway.
² Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
³ Faculty of Medical, University of Iceland, Reykjavik, Iceland.
⁴ Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland.
⁵ Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁶ Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
⁷ Lung Clinic, Tartu University Hospital, Tartu, Estonia.
⁸ Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden.
⁹ Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark.
¹⁰ Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.

Abstract

Background: Given the profound impact of tuberculosis (TB) on immunity and given murine studies suggesting that infections may influence immunity across generations, we hypothesize that parental TB might impact health and disease in future offspring.

Objective: This study investigated the impact of maternal and paternal TB on offspring asthma and respiratory symptoms.

Methods: We included data from the third follow-up of the Respiratory Health in Northern Europe study (RHINE). Information on own asthma status, asthma-like symptoms and other respiratory symptoms, as well as information about parental TB and asthma, were collected using standardized questionnaires. The associations between parental TB and RHINE participants' asthma and respiratory symptoms were analyzed using multiple logistic regression, with adjustment for parental education, smoking habits and asthma.

Results: Of 8,323 study participants, 227 (2.7%) reported only paternal TB, 282 (3.4%) only maternal TB, and 33 (0.4%) reported that both parents had TB. We found a higher risk of asthma (aOR: 1.29, 95% CI: 1.05-1.57) in offspring with a history of parental TB as compared to offspring without parental TB., Parental TB was significantly associated with allergic asthma in offspring (aOR: 1.58, 95% CI: 1.29-2.05), while no significant association between parental TB and asthma without allergy (aOR: 1.00, 95% CI: 0.76-1.32) in offspring was observed.

Conclusion: Results from this study indicate that parental TB might be a risk factor for offspring's asthma and respiratory symptoms. We raise the hypothesis that the immunological impact of infections might be transmitted to influence offspring phenotype in humans.

Keywords: asthma; epigenetic; generational study; offspring asthma; tuberculosis.

Grants and funding

The RHINE study received funding from the Norwegian Research Council, Norwegian Asthma and Allergy Association, Danish Lung Association, Swedish Heart and Lung Foundation, Vårdal Foundation for Health Care Healthcare Science and Allergy Research, Swedish Asthma and Allergy Association, Icelandic Research Council, and Estonian Science Foundation. The RHINE IV ongoing study has received funding from the Research Council of Norway project Life-GAP grant no. 300 765.