Indoor mould exposure, cytokines from T2/non-T2/Th17 pathways and asthma: the CONSTANCES cohort

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*Co-last authors No epidemiological study has investigated the intricate relation between cytokines involved in T2/non-T2/Th17 pathways, dwelling mould exposure and asthma. We aimed to study these associations in adults from the French population-based cohort CONSTANCES. Among participants attending the 2019-2021 follow-up, all the 989 with current asthma (CA) and 989 never-asthmatics randomly selected were included in the analyses. CA and mould exposure (Exp) were respectively defined by self-reports in the last 12 months of asthma attacks, symptoms or treatments, and presence of visible mould (yes/no) in the dwelling, leading to 4 groups: NoExp/NoCA (reference), Exp/NoCA, NoExp/CA, Exp/CA. Mouldy area size [0, >0-<0.2, 0.2-1, ≥1m2] was reported. Serum cytokines (n=12) were measured using multiplex technique. Linear and logit models were adjusted for age, sex, smoking status, body mass index, education level and French Deprivation Index. Among the 1,978 adults (mean age 53 years, 54% women, 8% current smokers), 32% reported visible mould, 1.8% with mouldy area size≥1m². Eotaxin-3 was associated with NoExp/CA and Exp/CA (adjusted(a)OR for one interquartile range increase=1.43 [1.23-1.66], 1.32 [1.10-1.59], respectively). Thymic Stromal LymphoPoietin (TSLP) was associated with Exp/NoCA and NoExp/CA (aOR=1.11 [1.00-1.23], 1.14 [1.04-1.24] respectively), with a positive trend with mouldy area size (p-trend=0.004). No other significant associations were observed. TSLP was associated with both mould exposure and asthma, suggesting a mediating role. Further identification of asthma endotypes based on clinical and biological data, including 25 cytokines (T2/non-T2/Th17) measurements, is ongoing.

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