Baby med astmainhalator

Blood test reveals infant risk of developing asthma

In a new study, researchers from DTU and the research unit for childhood asthma COPSAC have—as the first in the world—shown that immune system responses in children as young as 18 months can be used to predict the risk of them developing intermittent or persistent asthma.

The method used by the researchers may also be used to predict the risk of developing an array of other lifestyle diseases, including those that typically appear later in life, such as diabetes and inflammatory bowel disease. In the long term, this knowledge might be used to develop early prevention measures.

A well-functioning and well-regulated immune system in infants is not only important for successfully fighting off the first infections, but also important in order to avoid developing diseases later in life.

The reason is that a poorly regulated immune system responds incorrectly to a threat. For example, the immune system may react as if the body is exposed to a bacterial infection, when in fact it is attacked by a virus. This will result in the immune system being unable to combat the threat, causing the body remains to remain in the inflammatory state, which is another term for the immune system response. This continued state of emergency may result in the body later developing immune-related diseases.

The theory behind the study was that by mapping the immune system response in infants, it would be possible to predict their development of diseases later in
life. To test their theory, COPSAC (COpenhagen Prospective Studies of Asthma in Childhood) researchers followed 700 children from their mothers’ pregnancy until the age of 6. In collaboration with DTU Bioengineering researchers, they mapped the functional immune response at 18 months in 541 of these children where blood tests were possible, and compared the results with their medical history at the age of 6. 

"Our results show that the causes of children developing intermittent or persistent asthma are not identical, but originate in various underlying mechanisms. These mechanisms play a role early in life, before the child exhibits symptoms of asthma. "
Professor MSO Susanne Brix Pedersen, DTU Bioengineering

The researchers mapped 186 parameters, including the babies’ functional immune response, which is the specific immune system response to threats. They did so by dividing the blood samples into smaller portions and applying a threat to each of them, such as a virus or bacterium. Based on the immune system response, the researchers determined the response phenotype, which is a categorization of the response.

The response phenotype was then compared with the children’s development of intermittent or persistent asthma at the age of 6, and the results confirmed the researchers’ theory: The immune system was poorly regulated in the children who developed asthma, and the researchers were even able to distinguish between intermittent and persistent asthma in the immune system response at 18 months of age.

Professor Susanne Brix Pedersen, whose research group was responsible for carrying out the laboratory-based analyses on the immune cells, says:

“Our results show that the causes of children developing intermittent or persistent asthma are not identical, but originate in various underlying mechanisms. These mechanisms play a role early in life, before the child exhibits symptoms of asthma. Because the setup of the cohort study is so unique, we have the opportunity to look back into early pregnancy and examine what factors may have been important for the development of the perturbed immune response. Hopefully, this knowledge will eventually lead to the prevention of asthma in children.”

The study also indicates that up to 50-60% of all human immune systems occasionally respond incorrectly to an outside threat, and this is where Professor Hans Bisgaard, founder and Head of COPSAC, where the children in the study were followed clinically, sees specific far-reaching perspectives for the study:

“What really fascinates me is that the disturbance of the immune system that we see in relation to asthma, may also relate to other chronic inflammatory diseases. We see a steady increase in chronic inflammatory diseases such as diabetes, inflammatory bowel disease, and arthritis, and I think that they have a common origin. So it will be very important to not only put our findings in perspective to asthma, but also to other diseases.”

Read the article Distinct immune phenotypes in infants developing asthma during childhood in the journal Science Translational Medicine.

DTU Bioengineering is a department of biotechnology and biomedicine at DTU with approx. 300 employees. The department addresses important societal scientific challenges within biotechnology, food technology, and health through basic research and applied research. A key focus is technological and biological means to detect new bioactive molecules, proteins/enzymes, or biological systems (microorganisms or microbiomes) for biomedical or biotechnology purposes.

COPSAC (Copenhagen Prospective Studies on Asthma in Childhood) is a clinical research unit for asthma studies in children with the aim of developing evidence-based prevention strategies. COPSAC includes a multidisciplinary research cluster with competences in paediatrics, pulmonary disease, allergology, dermatology, microbiology, immunology, genetics, and statistics, and participates in national and international research collaborations. COPSAC was founded and is headed by Professor Hans Bisgaard.