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Here, we aimed to examine whether the neonatal airway immune composition associates with development of allergy and asthma in childhood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We measured unstimulated levels of 20 immune mediators related to the Type 1, Type 2, Type 17, or regulatory immune pathways in the airway mucosal lining fluid of 620 one\u2010month\u2010old healthy neonates from the COPSAC<jats:sub>2010<\/jats:sub> birth cohort. Allergy and asthma were diagnosed at our research clinic by predefined algorithms and objective assessments at age 6\u00a0years. Principal component analyses were used to describe the airway cytokine and chemokine composition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A neonatal airway immune profile particularly characterized by enhanced IL\u20101\u03b2 and reduced CCL26 was significantly associated with later development of elevated specific IgE to inhaled allergens, a positive skin prick test, and allergic rhinitis, but not with food sensitization. Conversely, reduced Type 17 immune\u2010associated markers, including IL\u20101\u03b2 and CXCL8, showed trend of association with development of early asthma endpoints.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Development of early asthma endpoints and inhalant allergy during the first 6\u00a0years of life seems associated with distinctly perturbed airway immune profiles in neonatal life, which is suggestive of an early origin and different pathogenesis of childhood asthma and allergy. These exploratory findings suggest pre\u2010 and perinatal life as an important window of opportunity for prevention of asthma and inhalant allergy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.14862","type":"journal-article","created":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T06:45:15Z","timestamp":1618641915000},"page":"3713-3722","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Neonatal airway immune profiles and asthma and allergy endpoints in childhood"],"prefix":"10.1111","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6846-6243","authenticated-orcid":false,"given":"Bo L.","family":"Chawes","sequence":"first","affiliation":[{"name":"COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene 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Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilofar","family":"F\u00f8lsgaard","sequence":"additional","affiliation":[{"name":"COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Stokholm","sequence":"additional","affiliation":[{"name":"COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"B\u00f8nnelykke","sequence":"additional","affiliation":[{"name":"COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Brix","sequence":"additional","affiliation":[{"name":"Department of 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