Environmental exposures in early life, including breastfeeding and NICU admission, appeared to impact the risk for developing eosinophilic esophagitis by interacting with particular gene variants, according to new research.
“With replication, these results suggest the potential for modifying risk of developing disease in genetically-susceptible individuals,” Elizabeth T. Jensen, MPH, PhD, of the Wake Forest School of Medicine, told Healio Gastroenterology and Liver Disease.
Of note, children with the susceptibility gene variant known as CAPN14 who were breastfed showed a 92% lower risk for developing eosinophilic esophagitis (EoE), and children without the susceptibility gene variant LOC283710/KLF13 who were admitted to the NICU showed a significantly higher risk for developing EoE.
“While the underlying mechanism for how breastfeeding and CAPN14 may interact and protect against EoE is unknown, CAPN14 is associated with barrier function in the gut,” Jensen said in a press release. “Thus, breastmilk, in the setting of altered barrier function, may be critical to disease prevention.”
Jensen and colleagues performed a case-control study of 127 children with EoE and 121 controls recruited from the Cincinnati Center for Eosinophilic Disorders at Cincinnati Children’s Hospital Medical Center. They evaluated for interactions between certain genetic susceptibility variants and reported early-life environmental exposures, such as antibiotic use, cesarean delivery, breastfeeding, NICU admission and exposure to pets.
Initial case-only analyses showed interactions between rs6736278 within CAPN14 and breastfeeding, and between rs17815905 in the LOC283710/KLF13 region and NICU admission (P = .02 for both). Further, case-control analyses showed the risk for EoE could be modifiable in genetically susceptible individuals, and specifically they found EoE risk was significantly reduced in those with the susceptibility variant at CAPN14 who were breastfed (adjusted OR = 0.08; 95% CI, 0.01-0.59), and significantly increased in those with the susceptibility variant at LOC283710/KLF13 who were admitted to the NICU (aOR = 4.83; 95% CI, 1.49-15.66).
“We are in the process of identifying funding resources for building on this research in a larger sample, exploring interaction between early life factors and other susceptibility genes associated with EoE and atopic disease,” Jensen told Healio Gastroenterology and Liver Disease. – by Adam Leitenberger
Disclosures: Jensen reports she received grants from the ACG and NIH. Please see the study for a full list of all other authors’ relevant financial disclosures.