Immunological Trajectories of White Blood Cells from Adolescence to Adulthood: Description and Determinants

Abstract

Background: The immune system gradually matures early in life in the face of internal and external stimuli. Whether the immune responses are lasting and stable during the course of life is still unclear. Methods: As part of the EPITeen cohort, 1183 adolescents were prospectively evaluated at the ages of 13, 17, 21, 24 and 27. Sociodemographic, behavioral and clinical data were collected by self- and face-to-face-administered questionnaires, along with a physical examination comprising anthropometric measurements and blood sample collections. Mixed-effects models were used to identify individual trajectories of white blood cells (WBC) and finite Gaussian mixture models were used to identify the clusters of individual trajectories. Results: Participants were allocated into six clusters based on the individual trajectories of WBC distribution. Higher Inflammatory Activation Cluster (11.4%) had the highest total WBC count and neutrophils percentage, as well as the lowest percentage of lymphocytes. These participants had significantly higher odds of being overweight [OR = 2.44, 95%CI:1.51–3.92]. Lowest Levels of WBC Cluster (24.1%) had the lowest total WBC count, being characterized by a higher participation on sports [OR = 1.54, 95%CI:1.12–2.13]. Highest Proportion of Eosinophils Cluster (20.1%) had the highest eosinophils percentage and the highest likelihood of having been diagnosed with a chronic disease [OR = 2.11, 95%CI:1.43–3.13], namely “asthma or allergies” [OR = 14.0 (1.73, 112.2]. Lowest Proportion of Eosinophils Cluster (29.1%) had the lowest percentage of eosinophils and basophils, as well as the highest lymphocyte proportion. Participants in the Undefined Cluster (13.8%) showed the highest percentage of monocytes and basophils and were also characterized by significant lower odds of having parents with 7–9 years of schooling [OR = 0.56, (0.32, 0.99]. Conclusions: In this study we identified distinct immunological trajectories of WBC from adolescence to adulthood that were associated with social, clinical and behavioral determinants. These results suggest that these immunological trajectories are defined early in life, being dependent on the exposures.

How the metabolic phenotype in adulthood is affected by long-lasting immunological trajectories since adolescence

“…To have a summary measure on the exposure overtime, as well as to reduce the random error associated at each measurement, we classified participants according to the pattern of evolution of the WBCs from 13 to 27 years old. Individual trajectories for total and differential WBCs were evaluated and participants were allocated into six clusters 22 . One of the clusters was composed only by 17 participants and was not considered for further analyses since they were considered probable outliers due to extreme values in at least one of the evaluations.…”

“…The results were adjusted for sex (model 1), and for sex and sports practice (model 2). The selection of confounders was based on the characteristics that are different between trajectories 22 and rely on prior knowledge that support whether those variables could also be a cause for metabolic features. Additionally, we performed a model adjusting to hs -CRP levels (model 3), in order to evaluate a possible mediator effect.…”