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Alves M, Asbell P, Dogru M, Giannaccare G, Grau A, Gregory D, Kim DH, Marini MC, Ngo W, Nowinska A, Saldanha IJ, Villani E, Wakamatsu TH, Yu M, Stapleton F. TFOS Lifestyle Report: Impact of environmental conditions on the ocular surface. Ocul Surf 2023; 29:1-52. [PMID: 37062427 DOI: 10.1016/j.jtos.2023.04.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Environmental risk factors that have an impact on the ocular surface were reviewed and associations with age and sex, race/ethnicity, geographical area, seasonality, prevalence and possible interactions between risk factors are reviewed. Environmental factors can be (a) climate-related: temperature, humidity, wind speed, altitude, dew point, ultraviolet light, and allergen or (b) outdoor and indoor pollution: gases, particulate matter, and other sources of airborne pollutants. Temperature affects ocular surface homeostasis directly and indirectly, precipitating ocular surface diseases and/or symptoms, including trachoma. Humidity is negatively associated with dry eye disease. There is little data on wind speed and dewpoint. High altitude and ultraviolet light exposure are associated with pterygium, ocular surface degenerations and neoplastic disease. Pollution is associated with dry eye disease and conjunctivitis. Primary Sjögren syndrome is associated with exposure to chemical solvents. Living within a potential zone of active volcanic eruption is associated with eye irritation. Indoor pollution, "sick" building or house can also be associated with eye irritation. Most ocular surface conditions are multifactorial, and several environmental factors may contribute to specific diseases. A systematic review was conducted to answer the following research question: "What are the associations between outdoor environment pollution and signs or symptoms of dry eye disease in humans?" Dry eye disease is associated with air pollution (from NO2) and soil pollution (from chromium), but not from air pollution from CO or PM10. Future research should adequately account for confounders, follow up over time, and report results separately for ocular surface findings, including signs and symptoms.
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Affiliation(s)
- Monica Alves
- Department of Ophthalmology and Otorhinolaryngology, University of Campinas Campinas, Brazil.
| | - Penny Asbell
- Department of Bioengineering, University of Memphis, Memphis, USA
| | - Murat Dogru
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Cantanzaro, Italy
| | - Arturo Grau
- Department of Ophthalmology, Pontifical Catholic University of Chile, Santiago, Chile
| | - Darren Gregory
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, USA
| | - Dong Hyun Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
| | | | - William Ngo
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Anna Nowinska
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Ian J Saldanha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Edoardo Villani
- Department of Clinical Sciences and Community Health, University of Milan, Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Tais Hitomi Wakamatsu
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, Brazil
| | - Mitasha Yu
- Sensory Functions, Disability and Rehabilitation Unit, World Health Organization, Geneva, Switzerland
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
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Chia SL, Kapoor S, Carvalho C, Bajénoff M, Gentek R. Mast cell ontogeny: From fetal development to life-long health and disease. Immunol Rev 2023; 315:31-53. [PMID: 36752151 PMCID: PMC10952628 DOI: 10.1111/imr.13191] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Mast cells (MCs) are evolutionarily ancient innate immune cells with important roles in protective immunity against bacteria, parasites, and venomous animals. They can be found in most organs of the body, where they also contribute to normal tissue functioning, for example by engaging in crosstalk with nerves. Despite this, they are most widely known for their detrimental roles in allergy, anaphylaxis, and atopic disease. Just like macrophages, mast cells were conventionally thought to originate from the bone marrow. However, they are already present in fetal tissues before the onset of bone marrow hematopoiesis, questioning this dogma. In recent years, our view of myeloid cell ontogeny has been revised. We now know that the first mast cells originate from progenitors made in the extra-embryonic yolk sac, and later get supplemented with mast cells produced from subsequent waves of hematopoiesis. In most connective tissues, sizeable populations of fetal-derived mast cells persist into adulthood, where they self-maintain largely independently from the bone marrow. These developmental origins are highly reminiscent of macrophages, which are known to have critical functions in development. Mast cells too may thus support healthy development. Their fetal origins and longevity also make mast cells susceptible to genetic and environmental perturbations, which may render them pathological. Here, we review our current understanding of mast cell biology from a developmental perspective. We first summarize how mast cell populations are established from distinct hematopoietic progenitor waves, and how they are subsequently maintained throughout life. We then discuss what functions mast cells may normally have at early life stages, and how they may be co-opted to cause, worsen, or increase susceptibility to disease.
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Affiliation(s)
- Shin Li Chia
- Institute for Regeneration and Repair, Centre for Inflammation Research & Centre for Reproductive HealthThe University of EdinburghEdinburghUK
| | - Simran Kapoor
- Institute for Regeneration and Repair, Centre for Inflammation Research & Centre for Reproductive HealthThe University of EdinburghEdinburghUK
| | - Cyril Carvalho
- Institute for Regeneration and Repair, Centre for Inflammation Research & Centre for Reproductive HealthThe University of EdinburghEdinburghUK
| | - Marc Bajénoff
- Centre d'Immunologie de Marseille‐Luminy (CIML)MarseilleFrance
| | - Rebecca Gentek
- Institute for Regeneration and Repair, Centre for Inflammation Research & Centre for Reproductive HealthThe University of EdinburghEdinburghUK
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Lu C, Liu Z, Liao H, Yang W, Li Q, Liu Q. Effects of early life exposure to home environmental factors on childhood allergic rhinitis: Modifications by outdoor air pollution and temperature. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 244:114076. [PMID: 36113271 DOI: 10.1016/j.ecoenv.2022.114076] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is growing evidence that allergic rhinitis (AR) is associated with indoor environmental factors, but their role in childhood AR during early life remains unclear. OBJECTIVE To investigate the association of preconceptional, prenatal, early postnatal, and current exposure to home environmental factors with childhood AR, and to further explore whether this association can be interacted by outdoor air pollution and temperature. METHODS A retrospective cohort study of 8689 preschool children was conducted during 2019-2020 in Changsha, China. A standard questionnaire was used to collect data on each family's health outcomes and home environments. We considered home environmental exposures during one year before conception, pregnancy, first year of life, and past year. Associations of indoor air pollution and allergens with AR were assessed by multiple logistic regression models. RESULTS Pre-birth exposure to indoor air pollution emitted by new furniture or redecoration and dampness related allergen derived from mold/damp stains and mold/damp clothes or bedding during 1 year before conception and pregnancy was significantly associated with increased AR, with adjusted ORs (95% CI) ranging from 1.35 (1.05-1.75) to 1.87 (1.55-2.27). Childhood AR was also significantly related with post-birth exposure to dampness related indoor allergen including mold/damp stains and mold/damp clothes or bedding in first year and past year and pollen allergen including total and nonflowing plants in past year, with a range of ORs (95% CI) from 1.20 (1.01-1.42) to 1.79 (1.42-2.27). We identified that pre-birth, particularly in utero exposure to both indoor air pollution from renovation and dampness related allergens, played a key role in AR development compared to post-birth exposures, and accumulative effect was observed with the highest risk of AR. High exposure to traffic-related air pollution (TRAP) including outdoor PM2.5, NO2, CO, and O3, as well as living near traffic road not only significantly increased adverse effect of home environmental factors but also decreased protective effect of household dogs on childhood AR. Early life exposure to low temperature in pregnancy and high temperature in first year significantly increased AR risk of home environmental exposure. Sensitivity analysis indicated that some sub-groups were more susceptible to AR risk of home environmental exposure. CONCLUSION Our study suggests that pre-birth exposure to home environmental factors played an important role in AR development and this effect can be interacted by TRAP and temperature, which supports a hypothesis of "(pre)fetal origin of childhood AR".
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Zijing Liu
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Hongsen Liao
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Wenhui Yang
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Qin Li
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Qin Liu
- XiangYa School of Public Health, Central South University, Changsha, China.
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Abstract
Purpose of Review Climate change is the biggest public health threat of the twenty-first century but its impact on the perinatal period has only recently received attention. This review summarizes recent literature regarding the impacts of climate change and related environmental disasters on pregnancy health and provides recommendations to inform future adaptation and mitigation efforts. Recent Findings Accumulating evidence suggests that the changing climate affects pregnancy health directly via discrete environmental disasters (i.e., wildfire, extreme heat, hurricane, flood, and drought), and indirectly through changes in the natural and social environment. Although studies vary greatly in design, analytic methods, and assessment strategies, they generally converge to suggest that climate-related disasters are associated with increased risk of gestational complication, pregnancy loss, restricted fetal growth, low birthweight, preterm birth, and selected delivery/newborn complications. Window(s) of exposure with the highest sensitivity are not clear, but both acute and chronic exposures appear important. Furthermore, socioeconomically disadvantaged populations may be more vulnerable. Summary Policy, clinical, and research strategies for adaptation and mitigation should be continued, strengthened, and expanded with cross-disciplinary efforts. Top priorities should include (a) reinforcing and expanding policies to further reduce emission, (b) increasing awareness and education resources for healthcare providers and the public, (c) facilitating access to quality population-based data in low-resource areas, and (d) research efforts to better understand mechanisms of effects, identify susceptible populations and windows of exposure, explore interactive impacts of multiple exposures, and develop novel methods to better quantify pregnancy health impacts.
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Mass E, Gentek R. Fetal-Derived Immune Cells at the Roots of Lifelong Pathophysiology. Front Cell Dev Biol 2021; 9:648313. [PMID: 33708774 PMCID: PMC7940384 DOI: 10.3389/fcell.2021.648313] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/05/2021] [Indexed: 12/12/2022] Open
Abstract
Tissue-resident innate immune cells exert a wide range of functions in both adult homeostasis and pathology. Our understanding of when and how these cellular networks are established has dramatically changed with the recognition that many lineages originate at least in part from fetal sources and self-maintain independently from hematopoietic stem cells. Indeed, fetal-derived immune cells are found in most organs and serous cavities of our body, where they reside throughout the entire lifespan. At the same time, there is a growing appreciation that pathologies manifesting in adulthood may be caused by adverse early life events, a concept known as “developmental origins of health and disease” (DOHaD). Yet, whether fetal-derived immune cells are mechanistically involved in DOHaD remains elusive. In this review, we summarize our knowledge of fetal hematopoiesis and its contribution to adult immune compartments, which results in a “layered immune system.” Based on their ontogeny, we argue that fetal-derived immune cells are prime transmitters of long-term consequences of prenatal adversities. In addition to increasing disease susceptibility, these may also directly cause inflammatory, degenerative, and metabolic disorders. We explore this notion for cells generated from erythro-myeloid progenitors (EMP) produced in the extra-embryonic yolk sac. Focusing on macrophages and mast cells, we present emerging evidence implicating them in lifelong disease by either somatic mutations or developmental programming events resulting from maternal and early environmental perturbations.
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Affiliation(s)
- Elvira Mass
- Developmental Biology of the Immune System, Life & Medical Sciences (LIMES) Institute, University of Bonn, Bonn, Germany
| | - Rebecca Gentek
- Centre for Inflammation Research & Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
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Gao X, Yin M, Yang P, Li X, Di L, Wang W, Cui H, Yan X, Liu J. Effect of Exposure to Cats and Dogs on the Risk of Asthma and Allergic Rhinitis: A Systematic Review and Meta-analysis. Am J Rhinol Allergy 2020; 34:703-714. [PMID: 32564683 DOI: 10.1177/1945892420932487] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Controversies persist regarding whether exposure to cat or dog increases the risk of asthma and allergic rhinitis. OBJECTIVE This meta-analysis aimed to assess the associations between exposure to cats or dogs and the development of asthma and allergic rhinitis. METHODS A systematic review was performed to identify case-control and cohort studies before May 2019, evaluating the association between exposure to cats and dogs and the risk of asthma and rhinitis. The risk of bias was assessed using the Newcastle-Ottawa Scale. The odds ratios (ORs) and risk ratios (RRs) were pooled for case-control and cohort studies, respectively. Subgroup analyses were performed on prespecified study-level characteristics. RESULTS The meta-analysis of 34 cohort studies showed a protective role of exposure to cats [RR: 0.88, 95% confidence interval (CI): 0.77-0.99] or dogs (RR: 0.85, 95% CI: 0.73-0.97) in the development of asthma. The subgroup analysis of birth cohort (RR: 0.74, 95% CI: 0.56-0.93) and children population (RR: 0.83, 95% CI: 0.70-0.96) also suggested a favorable role of exposure to dogs in the development of asthma. Pooled evidence from 13 case-control studies indicated no significant impact of cats (OR: 1.66, 95% CI: 0.39-2.94) and dogs (OR: 1.22, 95% CI: 0.92-1.52) on the development of asthma. A pooled analysis of five cohort studies showed a favorable effect of exposure to cats (RR: 0.60, 95% CI: 0.33-0.86) or dogs (RR: 0.68, 95% CI 0.44-0.90) on the development of allergic rhinitis. CONCLUSION The findings indicated a protective effect of exposure to cats and dogs, especially ownership, on the development of asthma and allergic rhinitis.
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Affiliation(s)
- Xiaoping Gao
- Department of Otorhinolaryngology Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Mei Yin
- Department of Respiratory and Critical Care Medicine, the Cardiovascular and Cerebrovascular Disease, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Pei Yang
- Department of Otorhinolaryngology Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xia Li
- Department of Otolaryngology, The Third People's Hospital of Yinchuan, Yinchuan, China
| | - Lingling Di
- Department of Otorhinolaryngology Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Wei Wang
- Department of Otorhinolaryngology Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Hua Cui
- Department of Respiratory and Critical Care Medicine, the Cardiovascular and Cerebrovascular Disease, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xiaohui Yan
- Department of Otorhinolaryngology Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Jing Liu
- Department of Otorhinolaryngology Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, China
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Almqvist C, Ekberg S, Rhedin S, Fang F, Fall T, Lundholm C. Season of birth, childhood asthma and allergy in a nationwide cohort-Mediation through lower respiratory infections. Clin Exp Allergy 2019; 50:222-230. [PMID: 31782836 DOI: 10.1111/cea.13542] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/26/2019] [Accepted: 11/15/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies have suggested an association between season of birth and risk of childhood asthma and allergic disease. The association may be modified by birth year and region, or mediated by respiratory tract infections. OBJECTIVE We aimed to estimate the association between season of birth and risk of childhood asthma/wheeze or allergic rhinoconjunctivitis in a population-based setting, and the mediating effect of lower respiratory infections. METHODS Two population-based cohorts were identified from the nationwide Swedish Medical Birth, Patient and Prescribed Drug Registers. The association between birth month/season and asthma/wheeze incidence was analysed using Cox proportional regression in the younger cohort born 2005-2010 (n = 582 494) and asthma/allergic rhinoconjunctivitis prevalence during the 7th year of life using log-binomial models in the older cohort born 2001-2004 (n = 367 583). Interactions were formally tested. Mediation analyses to address the effect of lower respiratory infections were performed in the older cohort using the R package "medflex." RESULTS Children born during fall and winter had an increased risk of asthma/wheeze after 2 years of age in the younger cohort: hazard ratio 1.24 (95% confidence interval, CI 1.17, 1.33) for winter and risk of prevalent asthma during their 7th year of life in the older cohort; prevalence ratio (PR) 1.12 (95% CI 1.08, 1.16) for winter. These estimates were partly mediated by lower respiratory infections; the indirect effect for winter compared with summer was PR 1.03 (95% CI 1.03, 1.04). The association was similar for allergic rhinoconjunctivitis in the 7th year of life, but not mediated by respiratory infections. CONCLUSION We found that the association between season of birth and risk of childhood asthma/wheeze, but not allergic rhinoconjunctivitis, is partly mediated through lower respiratory infections. CLINICAL RELEVANCE This has important implications for patient care, such as asthma management programmes to notify timing of seasonality for viral respiratory tract infections.
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Affiliation(s)
- Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Sara Ekberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Samuel Rhedin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tove Fall
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Cecilia Lundholm
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Lambert KA, Lodge C, Lowe AJ, Prendergast LA, Thomas PS, Bennett CM, Abramson MJ, Dharmage SC, Erbas B. Pollen exposure at birth and adolescent lung function, and modification by residential greenness. Allergy 2019; 74:1977-1984. [PMID: 30934123 DOI: 10.1111/all.13803] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/10/2019] [Accepted: 02/26/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Exposure to high levels of pollen in infancy is a risk factor for allergic respiratory diseases in later childhood, but effects on lung function are not fully understood. We aim to examine associations between grass pollen exposure in the first months of life and lung function at 12 and 18 years, and explore potential modification. METHODS Using the Melbourne Atopy Cohort Study, a birth cohort of children with a family history of allergic diseases, we modeled the association between cumulative grass pollen exposure up to 3 months after birth, on FEV1 , FVC, and FEV1 /FVC ratio at 12 and 18 years. We also assessed modifying effects of residential greenness levels (derived from satellite imagery), asthma, and early life sensitization to ryegrass. RESULTS Grass pollen exposure in the first 7 days was associated with a reduction in FEV1 (-15.5 mL; 95% CI: -27.6, -3.3 per doubling of pollen count) and FVC (-20.8 mL; -35.4, -6.1) at 12 years, but not at 18 years. Increase in cumulative grass pollen exposure up to 3 months was negatively associated with FVC at 12 and 18. Exposure to high residential greenness modified the association at 18 years. CONCLUSION Early exposure to grass pollen was associated with decreased lung function in children and adolescents. Targeted interventions for pollen avoidance strategies that take into account local topography could be implemented alongside other clinical interventions such as immunotherapy.
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Affiliation(s)
- Katrina A. Lambert
- Department of Public Health, School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
| | - Caroline Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health The University of Melbourne Melbourne Victoria Australia
| | - Adrian J. Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health The University of Melbourne Melbourne Victoria Australia
| | - Luke A. Prendergast
- Department of Mathematics and Statistics, School of Engineering and Mathematical Sciences La Trobe University Melbourne Victoria Australia
| | - Paul S. Thomas
- Prince of Wales' Hospital Clinical School and School of Medical Sciences, Faculty of Medicine University of New South Wales Sydney New South Wales Australia
| | - Catherine M. Bennett
- Centre for Population Health Research Deakin University Melbourne Victoria Australia
| | - Michael J. Abramson
- School of Public Health & Preventive Medicine Monash University Melbourne Victoria Australia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health The University of Melbourne Melbourne Victoria Australia
| | - Bircan Erbas
- Department of Public Health, School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
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9
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Susanto NH, Schoos AMM, Standl M, Lowe AJ, Dharmage SC, Svanes C, Salim A, von Berg A, Lehmann I, Rasmussen MA, Werchan M, Bergmann KC, Lodge C, Abramson MJ, Heinrich J, Bisgaard H, Erbas B. Environmental grass pollen levels in utero and at birth and cord blood IgE: Analysis of three birth cohorts. ENVIRONMENT INTERNATIONAL 2018; 119:295-301. [PMID: 29990949 DOI: 10.1016/j.envint.2018.06.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 06/26/2018] [Accepted: 06/26/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Early life factors are associated with allergic respiratory diseases, but the role of high grass pollen concentrations during pregnancy and shortly after birth is not known. OBJECTIVE To assess outdoor levels of grass pollen during the intrauterine period and at birth during peak pollen season on cord blood IgE in birth cohorts. METHODS Three birth cohorts were included: MACS (n = 429), Australia; COPSAC2000 (n = 200), Denmark; and LISA (n = 1968), Germany. Cord blood IgE was categorized (<0.5 kU/L, 0.5-1 kU/L, >1 kU/L) and dichotomized (high IgE ≥ 0.5 kU/L). Birth during the grass pollen season months and cumulative exposure to outdoor grass pollen counts during pregnancy with cord blood IgE were analysed using multinomial regression and analysed in meta-analysis using binomial regression adjusted for potential confounders. RESULTS Birth during the grass pollen season had higher pooled odds of cord blood IgE >0.5 kU/L 1.37 (95% CI 1.06, 1.77) in a meta-analysis with little heterogeneity between the three cohorts. Cumulative exposure to outdoor grass pollen counts during the entire pregnancy was associated with slightly lower pooled odds but significant (OR = 0.98, 95% CI: 0.96 to 0.99). CONCLUSIONS Birth during grass pollen seasons were associated with increased risk of high cord blood IgE in cities from both hemispheres, but high pollen loads in the environment during the entire pregnancy appeared protective. As IgE responses develop during the first months of life, our study findings provide new insights into the mechanisms of grass pollen exposure at birth and shortly after on possible allergic respiratory diseases.
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Affiliation(s)
- Nugroho Harry Susanto
- School of Pyschology and Public Health, La Trobe University, Melbourne, Australia; Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia; Epidemiology and Biostatistics Division, Public Health Department, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
| | - Ann-Marie Malby Schoos
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen & Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Denmark
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Adrian J Lowe
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Cecilie Svanes
- Centre for International Health, University of Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Norway
| | - Agus Salim
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Andrea von Berg
- Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - Irina Lehmann
- Department of Environmental Immunology/Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Morten Arendt Rasmussen
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen & Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Denmark
| | | | | | - Caroline Lodge
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Ludwig Maximilians University, Munich, Comprehensive Pneumology Centre (LMU), Munich, German Centre for Lung Research, Germany
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen & Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Denmark
| | - Bircan Erbas
- School of Pyschology and Public Health, La Trobe University, Melbourne, Australia.
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Weinberger KR, Kinney PL, Robinson GS, Sheehan D, Kheirbek I, Matte TD, Lovasi GS. Levels and determinants of tree pollen in New York City. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:119-124. [PMID: 28000684 PMCID: PMC5479752 DOI: 10.1038/jes.2016.72] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/28/2016] [Indexed: 05/08/2023]
Abstract
Exposure to allergenic tree pollen is a risk factor for multiple allergic disease outcomes. Little is known about how tree pollen levels vary within cities and whether such variation affects the development or exacerbation of allergic disease. Accordingly, we collected integrated pollen samples at uniform height at 45 sites across New York City during the 2013 pollen season. We used these monitoring results in combination with adjacent land use data to develop a land use regression model for tree pollen. We evaluated four types of land use variables for inclusion in the model: tree canopy, distributed building height (a measure of building volume density), elevation, and distance to water. When included alone in the model, percent tree canopy cover within a 0.5 km radial buffer explained 39% of the variance in tree pollen (1.9% increase in tree pollen per one-percentage point increase in tree canopy cover, P<0.0001). The inclusion of additional variables did not improve model fit. We conclude that intra-urban variation in tree canopy is an important driver of tree pollen exposure. Land use regression models can be used to incorporate spatial variation in tree pollen exposure in studies of allergic disease outcomes.
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Affiliation(s)
- Kate R. Weinberger
- Institute at Brown for Environment and Society, Brown University, Providence, RI, 02912, USA
| | - Patrick L. Kinney
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Guy S. Robinson
- Louis Calder Center Biological Field Station, Fordham University, Armonk, New York, 10504, USA
- Department of Natural Sciences, Fordham College at Lincoln Center, New York, NY, 10023, USA
| | - Daniel Sheehan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Iyad Kheirbek
- New York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, NY, 10012, USA
| | - Thomas D. Matte
- New York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, NY, 10012, USA
| | - Gina S. Lovasi
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
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11
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Pyrhönen K, Kulmala P, Näyhä S. Coincidence of pollen season with the first fetal trimester together with early pet exposure is associated with sensitization to cat and dog allergens in early childhood: A Finnish population-based study. Clin Exp Allergy 2017; 48:306-316. [DOI: 10.1111/cea.13067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 11/15/2017] [Accepted: 11/18/2017] [Indexed: 01/18/2023]
Affiliation(s)
- K. Pyrhönen
- Center for Life Course Health Research; University of Oulu; Oulu Finland
| | - P. Kulmala
- PEDEGO Research Unit and MRC Oulu; University of Oulu and Oulu University Hospital; Oulu Finland
- Biomedicine Research Unit; Medical Microbiology and Immunology; University of Oulu; Oulu Finland
| | - S. Näyhä
- Faculty of Medicine; University of Oulu; Oulu Finland
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12
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Bjerg A. Putting prevalence trends in allergic conditions under the magnifying glass. Acta Paediatr 2017; 106:9-11. [PMID: 27943441 DOI: 10.1111/apa.13638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Anders Bjerg
- Astrid Lindgren Children's Hospital; Karolinska University Hospital Solna; Stockholm Sweden
- Department of Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
- Krefting Research Centre; Department of Internal Medicine and Clinical Nutrition; Sahlgrenska Academy; University of Gothenburg, Göteborg Sweden
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13
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Pazderska A, Fichna M, Mitchell AL, Napier CM, Gan E, Ruchała M, Santibanez-Koref M, Pearce SH. Impact of Month of Birth on the Risk of Development of Autoimmune Addison's Disease. J Clin Endocrinol Metab 2016; 101:4214-4218. [PMID: 27575942 PMCID: PMC5095257 DOI: 10.1210/jc.2016-2392] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
CONTEXT The pathogenesis of autoimmune Addison's disease (AAD) is thought to be due to interplay of genetic, immune, and environmental factors. A month-of-birth effect, with increased risk for those born in autumn/winter months, has been described in autoimmune conditions such as type 1 diabetes and autoimmune thyroid disease. OBJECTIVE Month-of-birth effect was investigated in 2 independent cohorts of AAD subjects. DESIGN, SETTING, AND PATIENTS The monthly distribution of birth in AAD patients was compared with that of the general population using the cosinor test. A total of 415 AAD subjects from the United Kingdom cohort were compared with 8 180 180 United Kingdom births, and 231 AAD subjects from the Polish cohort were compared with 2 421 384 Polish births. MAIN OUTCOME MEASURES Association between month of birth and the susceptibility to AAD. RESULTS In the entire cohort of AAD subjects, month-of-birth distribution analysis showed significant periodicity with peak of births in December and trough in May (P = .028). Analysis of the odds ratio distribution based on month of birth in 2 cohorts of patients with AAD versus the general population revealed a December peak and May trough, and January peak and July trough, in the United Kingdom and Polish cohorts, respectively. CONCLUSION For the first time, we demonstrate that month of birth exerts an effect on the risk of developing AAD, with excess risk in individuals born in winter months and a protective effect when born in the summer. Exposure to seasonal viral infections in the perinatal period, coupled with vitamin D deficiency, could lead to dysregulation of innate immunity affecting the risk of developing AAD.
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Affiliation(s)
- Agnieszka Pazderska
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Marta Fichna
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Anna L Mitchell
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Catherine M Napier
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Earn Gan
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Marek Ruchała
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Mauro Santibanez-Koref
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Simon H Pearce
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
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14
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Thysen AH, Rasmussen MA, Kreiner-Møller E, Larsen JM, Følsgaard NV, Bønnelykke K, Stokholm J, Bisgaard H, Brix S. Season of birth shapes neonatal immune function. J Allergy Clin Immunol 2015; 137:1238-1246.e13. [PMID: 26581916 DOI: 10.1016/j.jaci.2015.08.041] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 07/05/2015] [Accepted: 08/27/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND Birth season has been reported to be a risk factor for several immune-mediated diseases. We hypothesized that this association is mediated by differential changes in neonatal immune phenotype and function with birth season. OBJECTIVE We sought to investigate the influence of season of birth on cord blood immune cell subsets and inflammatory mediators in neonatal airways. METHODS Cord blood was phenotyped for 26 different immune cell subsets, and at 1 month of age, 20 cytokines and chemokines were quantified in airway mucosal lining fluid. Multivariate partial least squares discriminant analyses were applied to determine whether certain immune profiles dominate by birth season, and correlations between individual cord blood immune cells and early airway immune mediators were defined. RESULTS We found a birth season-related fluctuation in neonatal immune cell subsets and in early-life airway mucosal immune function. The seasonal airway immune pattern was associated with the number of activated and regulatory T cells in cord blood whereas it was independent of concomitant presence of pathogenic airway microbes. Specifically, summer newborns presented with the lowest levels of all cell types and mediators; fall newborns displayed high levels of activated T cells and mucosal IL-12p70, TNF-α, IL-13, IL-10, and IL-2; and winter newborns had the highest levels of innate immune cells, IL-5, type 17-related immune mediators, and activated T cells. CONCLUSION Birth season fluctuations seem to affect neonatal immune development and result in differential potentiation of cord blood immune cells and early airway mucosal immune function.
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Affiliation(s)
- Anna Hammerich Thysen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Denmark
| | - Morten Arendt Rasmussen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Spectroscopy and Chemometrics, Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | - Eskil Kreiner-Møller
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jeppe Madura Larsen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Denmark
| | - Nilofar Vahman Følsgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Susanne Brix
- Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Denmark
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15
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Bousquet J, Anto JM, Wickman M, Keil T, Valenta R, Haahtela T, Lodrup Carlsen K, van Hage M, Akdis C, Bachert C, Akdis M, Auffray C, Annesi-Maesano I, Bindslev-Jensen C, Cambon-Thomsen A, Carlsen KH, Chatzi L, Forastiere F, Garcia-Aymerich J, Gehrig U, Guerra S, Heinrich J, Koppelman GH, Kowalski ML, Lambrecht B, Lupinek C, Maier D, Melén E, Momas I, Palkonen S, Pinart M, Postma D, Siroux V, Smit HA, Sunyer J, Wright J, Zuberbier T, Arshad SH, Nadif R, Thijs C, Andersson N, Asarnoj A, Ballardini N, Ballereau S, Bedbrook A, Benet M, Bergstrom A, Brunekreef B, Burte E, Calderon M, De Carlo G, Demoly P, Eller E, Fantini MP, Hammad H, Hohman C, Just J, Kerkhof M, Kogevinas M, Kull I, Lau S, Lemonnier N, Mommers M, Nawijn M, Neubauer A, Oddie S, Pellet J, Pin I, Porta D, Saes Y, Skrindo I, Tischer CG, Torrent M, von Hertzen L. Are allergic multimorbidities and IgE polysensitization associated with the persistence or re-occurrence of foetal type 2 signalling? The MeDALL hypothesis. Allergy 2015; 70:1062-78. [PMID: 25913421 DOI: 10.1111/all.12637] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2015] [Indexed: 12/22/2022]
Abstract
Allergic diseases [asthma, rhinitis and atopic dermatitis (AD)] are complex. They are associated with allergen-specific IgE and nonallergic mechanisms that may coexist in the same patient. In addition, these diseases tend to cluster and patients present concomitant or consecutive diseases (multimorbidity). IgE sensitization should be considered as a quantitative trait. Important clinical and immunological differences exist between mono- and polysensitized subjects. Multimorbidities of allergic diseases share common causal mechanisms that are only partly IgE-mediated. Persistence of allergic diseases over time is associated with multimorbidity and/or IgE polysensitization. The importance of the family history of allergy may decrease with age. This review puts forward the hypothesis that allergic multimorbidities and IgE polysensitization are associated and related to the persistence or re-occurrence of foetal type 2 signalling. Asthma, rhinitis and AD are manifestations of a common systemic immune imbalance (mesodermal origin) with specific patterns of remodelling (ectodermal or endodermal origin). This study proposes a new classification of IgE-mediated allergic diseases that allows the definition of novel phenotypes to (i) better understand genetic and epigenetic mechanisms, (ii) better stratify allergic preschool children for prognosis and (iii) propose novel strategies of treatment and prevention.
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Affiliation(s)
- J. Bousquet
- University Hospital; Montpellier France
- MACVIA-LR; Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon; European Innovation Partnership on Active and Healthy Ageing Reference Site; Paris France
- INSERM; VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, U1168; Paris France
- UVSQ; UMR-S 1168; Université Versailles St-Quentin-en-Yvelines; Versailles France
| | - J. M. Anto
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- Hospital del Mar Research Institute (IMIM); Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP); Barcelona Spain
- Department of Experimental and Health Sciences; University of Pompeu Fabra (UPF); Barcelona Spain
| | - M. Wickman
- Sachs’ Children's Hospital; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - T. Keil
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
- Institute for Clinical Epidemiology and Biometry; University of Wuerzburg; Wuerzburg Germany
| | - R. Valenta
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - T. Haahtela
- Skin and Allergy Hospital; Helsinki University Hospital; Helsinki Finland
| | - K. Lodrup Carlsen
- Department of Paediatrics; Oslo University Hospital; Oslo Norway
- Faculty of Medicine; Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - M. van Hage
- Clinical Immunology and Allergy Unit; Department of Medicine Solna; Karolinska Institutet and University Hospital; Stockholm Sweden
| | - C. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - C. Bachert
- ENT Department; Ghent University Hospital; Gent Belgium
| | - M. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - C. Auffray
- European Institute for Systems Biology and Medicine; Lyon France
| | - I. Annesi-Maesano
- EPAR U707 INSERM; Paris France
- EPAR UMR-S UPMC; Paris VI; Paris France
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Centre; Odense University Hospital; Odense Denmark
| | - A. Cambon-Thomsen
- UMR Inserm U1027; Université de Toulouse III Paul Sabatier; Toulouse France
| | - K. H. Carlsen
- Department of Paediatrics; Oslo University Hospital; Oslo Norway
- University of Oslo; Oslo Norway
| | - L. Chatzi
- Department of Social Medicine; Faculty of Medicine; University of Crete; Heraklion Crete Greece
| | - F. Forastiere
- Department of Epidemiology; Regional Health Service Lazio Region; Rome Italy
| | - J. Garcia-Aymerich
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- Hospital del Mar Research Institute (IMIM); Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP); Barcelona Spain
- Department of Experimental and Health Sciences; University of Pompeu Fabra (UPF); Barcelona Spain
| | - U. Gehrig
- Julius Center of Health Sciences and Primary Care; University Medical Center Utrecht; University of Utrecht; Utrecht the Netherlands
| | - S. Guerra
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
| | - J. Heinrich
- Institute of Epidemiology; German Research Centre for Environmental Health; Helmholtz Zentrum München; Neuherberg Germany
| | - G. H. Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology; GRIAC Research Institute; University Medical Center Groningen; Beatrix Children's Hospital; University of Groningen; Groningen the Netherlands
| | - M. L. Kowalski
- Department of Immunology, Rheumatology and Allergy; Medical University of Lodz; Lodz Poland
| | - B. Lambrecht
- VIB Inflammation Research Center; Ghent University; Ghent Belgium
| | - C. Lupinek
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | | | - E. Melén
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - I. Momas
- Department of Public Health and Biostatistics, EA 4064; Paris Descartes University; Paris France
- Paris Municipal Department of Social Action, Childhood, and Health; Paris France
| | - S. Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations; Brussels Belgium
| | - M. Pinart
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
| | - D. Postma
- Department of Respiratory Medicine; GRIAC Research Institute; University Medical Center Groningen; Beatrix Children's Hospital; University of Groningen; Groningen the Netherlands
| | | | - H. A. Smit
- Julius Center of Health Sciences and Primary Care; University Medical Center Utrecht; University of Utrecht; Utrecht the Netherlands
| | - J. Sunyer
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- Hospital del Mar Research Institute (IMIM); Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP); Barcelona Spain
- Department of Experimental and Health Sciences; University of Pompeu Fabra (UPF); Barcelona Spain
| | - J. Wright
- Bradford Institute for Health Research; Bradford Royal Infirmary; Bradford UK
| | - T. Zuberbier
- Allergy-Centre-Charité at the Department of Dermatology; Charité - Universitätsmedizin Berlin; Berlin Germany
- Secretary General of the Global Allergy and Asthma European Network (GA2LEN); Berlin Germany
| | - S. H. Arshad
- David Hide Asthma and Allergy Research Centre; Isle of Wight UK
| | - R. Nadif
- INSERM; VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, U1168; Paris France
- UVSQ; UMR-S 1168; Université Versailles St-Quentin-en-Yvelines; Versailles France
| | - C. Thijs
- Department of Epidemiology; CAPHRI School of Public Health and Primary Care; Maastricht University; Maastricht the Netherlands
| | - N. Andersson
- Sachs’ Children's Hospital; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - A. Asarnoj
- Sachs’ Children's Hospital; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - N. Ballardini
- Sachs’ Children's Hospital; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - S. Ballereau
- European Institute for Systems Biology and Medicine; Lyon France
| | - A. Bedbrook
- MACVIA-LR; Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon; European Innovation Partnership on Active and Healthy Ageing Reference Site; Paris France
| | - M. Benet
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
| | - A. Bergstrom
- Sachs’ Children's Hospital; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - B. Brunekreef
- Julius Center of Health Sciences and Primary Care; University Medical Center Utrecht; University of Utrecht; Utrecht the Netherlands
| | - E. Burte
- INSERM; VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, U1168; Paris France
- UVSQ; UMR-S 1168; Université Versailles St-Quentin-en-Yvelines; Versailles France
| | - M. Calderon
- National Heart and Lung Institute; Imperial College London; Royal Brompton Hospital NHS; London UK
| | - G. De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients' Associations; Brussels Belgium
| | - P. Demoly
- Department of Respiratory Diseases; Montpellier University Hospital; Montpellier France
| | - E. Eller
- Department of Dermatology and Allergy Centre; Odense University Hospital; Odense Denmark
| | - M. P. Fantini
- Department of Medicine and Public Health; Alma Mater Studiorum - University of Bologna; Bologna Italy
| | - H. Hammad
- VIB Inflammation Research Center; Ghent University; Ghent Belgium
| | - C. Hohman
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - J. Just
- Allergology Department; Centre de l'Asthme et des Allergies; Hôpital d'Enfants Armand-Trousseau (APHP); Paris France
- Institut Pierre Louis d'Epidémiologie et de Santé Publique; Equipe EPAR; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136; Paris France
| | - M. Kerkhof
- Department of Respiratory Medicine; GRIAC Research Institute; University Medical Center Groningen; Beatrix Children's Hospital; University of Groningen; Groningen the Netherlands
| | - M. Kogevinas
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- Hospital del Mar Research Institute (IMIM); Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP); Barcelona Spain
- Department of Experimental and Health Sciences; University of Pompeu Fabra (UPF); Barcelona Spain
| | - I. Kull
- Sachs’ Children's Hospital; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - S. Lau
- Department for Pediatric Pneumology and Immunology; Charité Medical University; Berlin Germany
| | - N. Lemonnier
- European Institute for Systems Biology and Medicine; Lyon France
| | - M. Mommers
- Department of Epidemiology; CAPHRI School of Public Health and Primary Care; Maastricht University; Maastricht the Netherlands
| | - M. Nawijn
- Department of Pediatric Pulmonology and Pediatric Allergology; GRIAC Research Institute; University Medical Center Groningen; Beatrix Children's Hospital; University of Groningen; Groningen the Netherlands
| | | | - S. Oddie
- Bradford Institute for Health Research; Bradford Royal Infirmary; Bradford UK
| | - J. Pellet
- European Institute for Systems Biology and Medicine; Lyon France
| | - I. Pin
- Département de pédiatrie; CHU de Grenoble; Grenoble Cedex 9 France
| | - D. Porta
- Department of Epidemiology; Regional Health Service Lazio Region; Rome Italy
| | - Y. Saes
- VIB Inflammation Research Center; Ghent University; Ghent Belgium
| | - I. Skrindo
- Department of Paediatrics; Oslo University Hospital; Oslo Norway
- Faculty of Medicine; Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - C. G. Tischer
- Institute of Epidemiology; German Research Centre for Environmental Health; Helmholtz Zentrum München; Neuherberg Germany
| | - M. Torrent
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- Area de Salut de Menorca, ib-salut; Illes Balears Spain
| | - L. von Hertzen
- Skin and Allergy Hospital; Helsinki University Hospital; Helsinki Finland
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Kinney PL, Matte T, Knowlton K, Madrigano J, Petkova E, Weinberger K, Quinn A, Arend M, Pullen J. New York City Panel on Climate Change 2015 Report. Chapter 5: Public health impacts and resiliency. Ann N Y Acad Sci 2015; 1336:67-88. [PMID: 25688947 PMCID: PMC4749144 DOI: 10.1111/nyas.12588] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Patrick L Kinney
- Mailman School of Public Health, Columbia University, New York, NY
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17
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Lowe AJ, Olsson D, Bråbäck L, Forsberg B. Pollen exposure in pregnancy and infancy and risk of asthma hospitalisation - a register based cohort study. Allergy Asthma Clin Immunol 2012; 8:17. [PMID: 23134739 PMCID: PMC3499234 DOI: 10.1186/1710-1492-8-17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 11/01/2012] [Indexed: 11/25/2022] Open
Abstract
Background A seasonal effect of month of birth and risk of allergic disease has been suggested by numerous studies. Few studies have directly measured pollen exposures at different points during pregnancy and in early life, and assessed their effects on risk of respiratory disease outcomes. Methods Pollen exposure was calculated for the first and last 12 weeks of pregnancy and the first 12 weeks of infancy for all children conceived by women residing in Stockholm, Sweden, between 1988 and 1995. Hospital admission data for respiratory conditions in the first year of life was also collected. Results Out of 110,381 children, 940 had been hospitalised for asthma by 12-months of age. Pollen levels showed both marked seasonal variations and between year differences. Exposure to high levels of pollen in the last 12 weeks of pregnancy was associated with an increased risk of asthma hospitalisation (aOR = 1.35, 95% CI = 1.07-1.71 for highest quartile versus remaining infants). Exposure to high levels of pollen in the first three months of life was associated with a reduced risk (aOR = 0.76, 95% CI = 0.59-0.98) but only in children of heavy smoking mothers. Conclusions High levels of pollen exposure during late pregnancy were somewhat unexpectedly associated with an elevated risk of hospitalisation for asthma within the first year of life.
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Affiliation(s)
- Adrian J Lowe
- Occupational & Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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18
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Carpe N, Mandeville I, Kho AT, Qiu W, Martin JG, Tantisira KG, Raby BA, Weiss ST, Kaplan F. Maternal allergen exposure reprograms the developmental lung transcriptome in atopic and normoresponsive rat pups. Am J Physiol Lung Cell Mol Physiol 2012; 303:L899-911. [PMID: 22983352 DOI: 10.1152/ajplung.00179.2012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The "fetal origins hypothesis" argued that physiological changes consequent to in utero exposures ultimately contribute to disease susceptibility in later life. The dramatic increase in asthma prevalence is attributed to early exposures acting on preexisting asthma-susceptible genotypes. We showed previously that distinct transcriptome signatures distinguish the developmental respiratory phenotype of atopic (Brown Norway, BN) and normoresponsive (Lewis) rats. We aimed to determine whether maternal allergen exposure would influence asthma pathogenesis by reprogramming primary patterns of developmental lung gene expression. Postnatal offspring of dams sensitized to ovalbumin before mating and challenged during pregnancy were assessed for lung function, inflammatory biomarkers, and respiratory gene expression. Although maternal ovalbumin exposure resulted in characteristic features of an allergic response (bronchoalveolar lavage neutrophils, IgE, methacholine-induced lung resistance) in offspring of both strains, substantial strain-specific differences were observed in respiratory gene expression. Of 799 probes representing the top 5% of transcriptomic variation, only 112 (14%) were affected in both strains. Strain-specific gene signatures also exhibited marked differences in enrichment for gene ontologies, with immune regulation and cell proliferation being prominent in the BN strain, cell cycle and microtubule assembly gene sets in the Lewis strain. Multiple ovalbumin-specific probes in both strains were also differentially expressed in lymphoblastoid cell lines from human asthmatic vs. nonasthmatic sibling pairs. Our data point to the existence of distinct, genetically programmed responses to maternal exposures in developing lung. These different response patterns, if recapitulated in human fetal development, can contribute to long-term pulmonary health including interindividual susceptibility to asthma.
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Affiliation(s)
- Nicole Carpe
- Departments of Human Genetics, Montreal Children’s Hospital Research Institute, McGill University, Montreal, Quebec, Canada
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Different implications of paternal and maternal atopy for perinatal IgE production and asthma development. Clin Dev Immunol 2012; 2012:132142. [PMID: 22272211 PMCID: PMC3261469 DOI: 10.1155/2012/132142] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 10/03/2011] [Indexed: 12/16/2022]
Abstract
Asthma is a hereditary disease associated with IgE-mediated reaction. Whether maternal atopy and paternal atopy have different impacts on perinatal IgE production and asthma development remains unclear. This paper reviews and summarizes the effects of maternal and paternal atopy on the developmental aspects of IgE production and asthma. Maternal atopy affects both pre- and postnatal IgE production, whereas paternal atopy mainly affects the latter. Maternally transmitted genes GSTP1 and FceRI-beta are associated with lung function and allergic sensitization, respectively. In IgE production and asthma development, the maternal influence on gene-environment interaction is greater than paternal influence. Maternal, paternal, and/or postnatal environmental modulation of allergic responses have been linked to epigenetic mechanisms, which may be good targets for early prevention of asthma.
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20
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Rigato PO, Fusaro AE, Victor JR, Sato MN. Maternal immunization to modulate the development of allergic response and pathogen infections. Immunotherapy 2011; 1:141-56. [PMID: 20635979 DOI: 10.2217/1750743x.1.1.141] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This article reviews recent experimental approaches of preventive strategies regarding allergy and infections by pathogens, particularly in early childhood, by targeting maternal immunomodulation. Basic research is essential to understand maternal vaccination as a strategy to control allergic disease and bacterial and viral infections; thus, providing support for future translational research. The environmental stimuli and host genetic factors, along with maternal influences in early life when immune systems are developing and during postnatal life, are essential for the decision between tolerance induction or allergen sensitization. Maternal immunomodulation strategies should serve as a challenge when attempting to halt the spread of allergy responses and viral infections, until the innate and adaptive arms of the immune system of the neonates are competent.
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Affiliation(s)
- Paula Ordonhez Rigato
- Laboratório de Dermatologia e Imunodeficiências - LIM56, Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical - Prédio II, Av Dr Enéas de Carvalho Aguiar, 500, 3 masculine andar, 05403-05000, São Paulo, Brazil
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Yang HJ, Jeon YH, Min TK, Son BS, Park KJ, Moon JY, Pyun BY. The impact of climate change on aeroalleregen and pediatric allergic diseases. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2011. [DOI: 10.5124/jkma.2011.54.9.971] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hyeon Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Seoul, Korea
| | - You Hoon Jeon
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Seoul, Korea
| | - Taek Ki Min
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Seoul, Korea
| | - Bu Soon Son
- Department of Environmental Health Science, Soonchunhyang University, Asan, Korea
| | - Kwan Jun Park
- Research Institute for Healthy Cities and Health Impact Assessment, Soonchunhyang University, Cheonan, Korea
| | - Jong Youn Moon
- Research Institute for Healthy Cities and Health Impact Assessment, Soonchunhyang University, Cheonan, Korea
| | - Bok Yang Pyun
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Seoul, Korea
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Sheffield PE, Weinberger KR, Kinney PL. Climate change, aeroallergens, and pediatric allergic disease. THE MOUNT SINAI JOURNAL OF MEDICINE, NEW YORK 2011; 78:78-84. [PMID: 21259264 PMCID: PMC3075981 DOI: 10.1002/msj.20232] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The degree to which aeroallergens are contributing to the global increase in pediatric allergic disease is incompletely understood. We review the evidence that links climate change to changes in aeroallergens such as pollen and outdoor mold concentrations and, subsequently, aeroallergen association with pediatric allergic disease. We specifically explore the evidence on both the exacerbation and the development of allergic disease in children related to outdoor pollen and mold concentrations. Pediatric allergic diseases include atopic dermatitis or eczema, allergic rhinitis or hay fever, and some types of asthma in children, typically defined as < 18 years of age. We discuss how the timing of aeroallergen exposure both in utero and in childhood could be associated with allergies. We conclude that the magnitude and type of health impacts due to climate change will depend on improved understanding of the relationship between climatic variables, multiple allergen factors, and allergic disease. Improved public-health strategies such as adequate humidity control, optimum air filtration and ventilation, and improved anticipatory public-health messaging will be critical to adaptation.
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Affiliation(s)
- Perry E Sheffield
- Departments of Pediatrics and Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA.
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23
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Shao H, Tachibana H, Cheng X. Can IgE-mediated allergic diseases be prevented by using allergen-specific IgG antibodies? Med Hypotheses 2010; 76:271-3. [PMID: 21041032 DOI: 10.1016/j.mehy.2010.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2010] [Accepted: 10/12/2010] [Indexed: 11/28/2022]
Abstract
The prevalence of allergic disease has increased significantly over the past few decades, especially in children. Prenatal period may represent an ideal time for the implementation of interventions to prevent allergy and allergic diseases. In this hypothesis, allergen-specific immunoglobulin G (IgG) antibodies may combine with maternal allergens as blocking antibodies with immunoglobulin E (IgE) or mask antigenic determinants in their binding to prevent the sensitization of the fetus. It may also modify fetal immune response to prevent the production of allergen-specific IgE antibodies and the further development of allergic diseases. Recent epidemiological, immunological and intervention studies supporting the hypothesis were summarized. Anti-mite human IgG Fabs (antigen binding fragments) were prepared from two immunoglobulin genes libraries and they were confirmed to have a specific binding blocking property by an in vitro mastocyte degranulation inhibition test. Allergen-specific human IgG antibodies may have a potential use in the prenatal immunoprophylaxis or the prevention of allergic diseases after birth.
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Affiliation(s)
- Hongxia Shao
- Department of Medical Microbiology and Parasitology, Shanghai Medical College of Fudan University, China
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Keski-Nisula L, Lappalainen MHJ, Mustonen K, Hirvonen MR, Pfefferle PI, Renz H, Pekkanen J, Roponen M. Production of interleukin-5, -10 and interferon-γ in cord blood is strongly associated with the season of birth. Clin Exp Allergy 2010; 40:1658-68. [PMID: 20825427 DOI: 10.1111/j.1365-2222.2010.03601.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The effect of labour and different labour-related factors on the cord blood (CB) cell cytokine production is still relatively unknown. OBJECTIVE To study the relationships between the production of IL-5, IL-10 and IFN-γ in CB samples and maternal, early neonatal and birth-related factors. METHODS Whole-blood samples were collected after birth (n=423) and they were stimulated for 24 and 48 h with a combination of phorbol ester and ionomycin. Production of IL-5, IL-10 and IFN-γ was determined using ELISA. Maternal, early neonatal and birth-related variables were recorded prospectively during pregnancy, and during and after delivery. RESULTS After multivariable adjustment for confounders, the strongest predictor of IL-5, IL-10 and IFN-γ production in CB cell samples was the season of birth. Children born in the spring had significantly lower cytokine responses compared with those born in the fall. IL-5 production was inversely associated with female gender of the child and maternal smoking. If corrections for white blood cell (WBC) counts were not performed, IL-5 production was also significantly associated with the mode of delivery. Respectively, the production of IL-10 and IFN-γ was inversely associated with prostaglandin induction before birth. CONCLUSION Environmental exposure to pollen and ultraviolet irradiation during gestation may have an effect on the cytokine profile of the offspring in CB because children born in the spring or winter showed the lowest IL-5, IL-10 and IFN-γ responses. The production of IL-10 and IFN-γ was also inversely associated with prostaglandin labour induction before birth. Other labour-related factors were not significantly associated with production of IL-5, IL-10 and IFN-γ after WBC count correction.
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Affiliation(s)
- L Keski-Nisula
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland.
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25
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Cecchi L, D'Amato G, Ayres JG, Galan C, Forastiere F, Forsberg B, Gerritsen J, Nunes C, Behrendt H, Akdis C, Dahl R, Annesi-Maesano I. Projections of the effects of climate change on allergic asthma: the contribution of aerobiology. Allergy 2010; 65:1073-81. [PMID: 20560904 DOI: 10.1111/j.1398-9995.2010.02423.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Climate change is unequivocal and represents a possible threat for patients affected by allergic conditions. It has already had an impact on living organisms, including plants and fungi with current scenarios projecting further effects by the end of the century. Over the last three decades, studies have shown changes in production, dispersion and allergen content of pollen and spores, which may be region- and species-specific. In addition, these changes may have been influenced by urban air pollutants interacting directly with pollen. Data suggest an increasing effect of aeroallergens on allergic patients over this period, which may also imply a greater likelihood of the development of an allergic respiratory disease in sensitized subjects and exacerbation of symptomatic patients. There are a number of limitations that make predictions uncertain, and further and specifically designed studies are needed to clarify current effects and future scenarios. We recommend: More stress on pollen/spore exposure in the diagnosis and treatment guidelines of respiratory and allergic diseases; collection of aerobiological data in a structured way at the European level; creation, promotion and support of multidisciplinary research teams in this area; lobbying the European Union and other funders to finance this research.
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Affiliation(s)
- L Cecchi
- Interdepartmental Centre of Bioclimatology, University of Florence, Florence, Italy.
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26
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Yang KD, Chang JC, Chuang H, Liang HM, Kuo HC, Lee YS, Hsu TY, Ou CY. Gene-gene and gene-environment interactions on IgE production in prenatal stage. Allergy 2010; 65:731-9. [PMID: 19968631 DOI: 10.1111/j.1398-9995.2009.02260.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Prevalence of allergic diseases in children has increased worldwide over the past decades. Allergy sensitization may occur in fetal life. This study investigated whether gene-gene and gene-environment interactions affected cord blood IgE (CBIgE) levels. METHODS A total of 575 cord blood DNA samples were subjected to a multiplex microarray for 384 single nucleotide polymorphisms (SNPs) in 159 allergy candidate genes. Genetic association was initially assessed by univariate and multivariate analyses. Multifactor dimensionality reduction (MDR) was used to identify gene-gene and gene-environment interactions. Environmental factors for analysis included maternal atopy, paternal atopy, parental smoking, gender, and prematurity. RESULTS Twenty-one SNPs in 14 genes were associated with CBIgE elevation (>or =0.5 KU/l) in univariate analysis. Multivariate analysis identified eleven genes (IL13, IL17A, IL2RA, CCL17, CXCL1, PDGFRA, FGF1, HAVCR1, GNAQ, C11orf72, and ADAM33) which were significantly associated with CBIgE elevation. MDR analyses of gene-gene interactions identified IL13 interacted with IL17A and/or redox genes on CBIgE elevation with the prediction accuracy of 62.52%. Analyses of gene-environment interactions identified that maternal atopy combined with IL13, rs1800925 and CCL22, rs170359 SNPs had the highest prediction accuracy of 67.15%. All the high and low risk classifications on gene-gene and gene-environment interactions by MDR analyses could be validated by Chi-square test. CONCLUSIONS Gene-gene (e.g. immune and redox genes) and gene-environment (e.g. maternal atopy and FGF1or redox genes) interactions on IgE production begin in prenatal stage, suggesting that prevention of IgE-mediated diseases may be made possible by control of maternal atopy and redox responses in prenatal stage.
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Affiliation(s)
- K D Yang
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University, No. 123 Ta-Pei Road, Kaohsiung, Taiwan
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Pucheu-Haston CM, Copeland LB, Haykal-Coates N, Ward MDW. Maternal respiratory sensitization and gestational allergen exposure does not affect subsequent pup responses to homologous or heterologous allergen. J Immunotoxicol 2010; 7:57-67. [PMID: 19916739 DOI: 10.3109/15476910903373440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Evidence suggests that the predisposition towards atopy begins early in life. Maternal allergy has been associated with an increased risk of the development of allergic disease in offspring. Some studies suggest that the development of childhood atopy may also be influenced by prenatal allergen exposure. In this study, a respiratory allergen exposure model was used to determine the impact of maternal sensitization (with or without additional exposures during pregnancy) on subsequent pup responses to homologous or heterologous allergen. Female BALB/c mice received two intratracheal aspiration (IA) exposures to Metarhizium anisopliae crude antigen (MACA) or Hank's buffered salt solution (HBSS) prior to breeding. Some mice also received three additional exposures during pregnancy. Control mothers did not receive treatment. Young adult offspring received three IA exposures to MACA, house dust mite extract (HDM) or HBSS. Offspring sensitized as young adults to either HDM or MACA developed an airway inflammatory response, including increased bronchoalveolar lavage fluid lactate dehydrogenase activity, total protein and total and differential cell counts compared to offspring exposed to HBSS. Increased airway responsiveness to methacholine was observed in pups treated with HDM but not with MACA. Maternal sensitization status (with or without gestational allergen exposure) had no effect on offspring response to either MACA or HDM. In conclusion, this study demonstrates that IA administration of MACA or HDM extract to young adult BALB/c mice induces the development of an inflammatory airway response. In contrast to previous reports, neither maternal sensitization nor gestational allergen exposure could be demonstrated to have a clear effect on offspring sensitization. This discrepancy may be a function of the respiratory sensitization and exposure protocol used in this study, which mimics natural sensitization more closely than do parenteral routes of exposure.
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Affiliation(s)
- Cherie M Pucheu-Haston
- Curriculum in Toxicology, University of North Carolina-Chapel Hill, Chapel Hill, NC 27711, USA
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Carpe N, Mandeville I, Ribeiro L, Ponton A, Martin JG, Kho AT, Chu JH, Tantisira K, Weiss ST, Raby BA, Kaplan F. Genetic influences on asthma susceptibility in the developing lung. Am J Respir Cell Mol Biol 2010; 43:720-30. [PMID: 20118217 DOI: 10.1165/rcmb.2009-0412oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Asthma is the leading serious pediatric chronic illness in the United States, affecting 7.1 million children. The prevalence of asthma in children under 4 years of age has increased dramatically in the last 2 decades. Existing evidence suggests that this increase in prevalence derives from early environmental exposures acting on a pre-existing asthma-susceptible genotype. We studied the origins of asthma susceptibility in developing lung in rat strains that model the distinct phenotypes of airway hyperresponsiveness (Fisher rats) and atopy (brown Norway [BN] rats). Postnatal BN rat lungs showed increased epithelial proliferation and tracheal goblet cell hyperplasia. Fisher pups showed increased lung resistance at age 2 weeks, with elevated neutrophils throughout the postnatal period. Diverse transcriptomic signatures characterized the distinct respiratory phenotypes of developing lung in both rat models. Linear regression across age and strain identified developmental variation in expression of 1,376 genes, and confirmed both strain and temporal regulation of lung gene expression. Biological processes that were heavily represented included growth and development (including the T Box 1 transcription factor [Tbx5], the epidermal growth factor receptor [Egfr], the transforming growth factor beta-1-induced transcript 1 [Tgfbr1i1]), extracellular matrix and cell adhesion (including collagen and integrin genes), and immune function (including lymphocyte antigen 6 (Ly6) subunits, IL-17b, Toll-interacting protein, and Ficolin B). Genes validated by quantitative RT-PCR and protein analysis included collagen III alpha 1 Col3a1, Ly6b, glucocorticoid receptor and Importin-13 (specific to the BN rat lung), and Serpina1 and Ficolin B (specific to the Fisher lung). Innate differences in patterns of gene expression in developing lung that contribute to individual variation in respiratory phenotype are likely to contribute to the pathogenesis of asthma.
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Affiliation(s)
- Nicole Carpe
- Department of Human Genetics, McGill University, 4060 Saint Catherine West, Montreal, PQ, Canada
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Analysis of airborne betula pollen in Finland; a 31-year perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:1706-23. [PMID: 19578456 PMCID: PMC2705213 DOI: 10.3390/ijerph6061706] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Accepted: 05/20/2009] [Indexed: 11/21/2022]
Abstract
In this 31-year retrospective study, we examined the influence of meteorology on airborne Betula spp. (birch) pollen concentrations in Turku, Finland. The seasonal incidence of airborne birch pollen in Turku occurred over a brief period each year during spring (April 30 – May 31). Mean peak concentrations were restricted to May (May 5 to 13). Statistically significant increases in the annual accumulated birch pollen sum and daily maximum values were observed over the study period. Birch pollen counts collected in April were retrospectively shown to increase over the duration of the study. Increases in April temperature values were also significantly associated with the earlier onset of the birch pollen season. Furthermore, the number of days where daily birch pollen concentrations exceeded 10 and 1,000 grains/m3 also increased throughout the study period. These data demonstrate that increases in temperature, especially during months preceding the onset of the birch pollen season, favor preseason phenological development and pollen dispersal. Birch pollen derived from other geographical locations may also contribute to the aerospora of Turku, Finland. To date, the public health burden associated with personal exposure to elevated birch pollen loads remains unclear and is the focus of future epidemiological research.
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Harley KG, Macher JM, Lipsett M, Duramad P, Holland NT, Prager SS, Ferber J, Bradman A, Eskenazi B, Tager IB. Fungi and pollen exposure in the first months of life and risk of early childhood wheezing. Thorax 2009; 64:353-8. [PMID: 19240083 DOI: 10.1136/thx.2007.090241] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Many studies have found that the risk of childhood asthma varies by month of birth, but few have examined ambient aeroallergens as an explanatory factor. A study was undertaken to examine whether birth during seasons of elevated ambient fungal spore or pollen concentrations is associated with risk of early wheezing or blood levels of Th1 and Th2 type cells at 24 months of age. METHODS 514 children were enrolled before birth and followed to 24 months of age. Early wheezing was determined from medical records, and Th1 and Th2 type cells were measured in peripheral blood using flow cytometry. Ambient aeroallergen concentrations were measured throughout the study period and discrete seasons of high spore and pollen concentrations were defined. RESULTS A seasonal pattern was observed, with birth in autumn to winter (the spore season) associated with increased odds of early wheezing (adjusted odds ratio 3.1; 95% confidence interval 1.3 to 7.4). Increasing mean daily concentrations of basidiospores and ascospores in the first 3 months of life were associated with increased odds of wheeze, as were increasing mean daily concentrations of total and specific pollen types. Levels of Th1 cells at age 24 months were positively associated with mean spore concentrations and negatively associated with mean pollen concentrations in the first 3 months of life. CONCLUSIONS Children with higher exposure to spores and pollen in the first 3 months of life are at increased risk of early wheezing. This association is independent of other seasonal factors including ambient levels of particulate matter of aerodynamic diameter <or=2.5 microm and lower respiratory infections.
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Affiliation(s)
- K G Harley
- Center for Children's Environmental Health Research, School of Public Health, University of California, Berkeley, 2150 Shattuck Ave, Suite 600, Berkeley, CA 94704, USA.
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Polte T, Hennig C, Hansen G. Allergy prevention starts before conception: maternofetal transfer of tolerance protects against the development of asthma. J Allergy Clin Immunol 2008; 122:1022-1030.e5. [PMID: 19000583 DOI: 10.1016/j.jaci.2008.09.014] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Revised: 09/05/2008] [Accepted: 09/08/2008] [Indexed: 11/13/2022]
Abstract
BACKGROUND Allergy prevention must start early because environmental exposures during pregnancy and young life determine disease risk. OBJECTIVE In this study we analyzed whether prevention can start even earlier before conception by transfer of immunologic tolerance from the mother to the offspring preventing the offspring from having asthma. METHODS BALB/c mice were orally tolerized with ovalbumin before conception by means of oral application of antigen. The offspring of tolerized and naive mothers were immunized with ovalbumin at 6 weeks and 4 months of age and analyzed in our murine asthma model. RESULTS Although the offspring of naive mothers had an asthma-like phenotype, the offspring of tolerized mice were completely protected, even when immunized as late as 8 months after birth. Critically involved in the tolerance transfer was allergen-specific IgG, levels of which were increased in the sera of the mother, fetus, and pup and breast milk. FcRn(-/-) mice, which cannot transport IgG through the placenta, transferred tolerance to the offspring only when the missing diaplacental IgG transfer was compensated by IgG transfer through breast milk from tolerant mothers but not when weaned by naive wet nurses. Inhibition of IFN-gamma, produced by memory T cells in the offspring, abrogated the protective effect of maternal tolerance, demonstrating a crucial role for IFN-gamma in the maintenance of allergen-specific tolerance. CONCLUSION Our data show that maternal immunologic memory has a significant and persistent effect on the immune response of the offspring.
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Affiliation(s)
- Tobias Polte
- Department of Pediatrics, Division of Pediatric Pulmonology and Neonatology, Hannover Medical School, Hannover, Germany
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Abstract
The prevalence of atopic diseases has increased abruptly in recent years in most Westernized societies, making the question why this happened the topic of a heated debate. The best paradigm available to date to explain this steep rise, the 'hygiene hypothesis', supports that it is the excess 'cleanliness' of our environments that has led to the decline in the number of infectious stimuli that are necessary for the proper development of our immune system. Recent findings support that it is the combined effect that not only pathogenic, but also non-pathogenic microorganisms, and even their structural components,can exert on the immune system that deters from the development of atopic responses. Adding to these results are intriguing new findings on the effect different gene polymorphisms can have on an individual's predisposition to allergic diseases. The most important linkages produced, to date, include those among the genes for IL-4, IL-13, HLA-DRB, TNF, LTA,FCER1B, IL-4RA, ADAM33, TCR alpha/delta, PHF11, GPRA, TIM, p40, CD14, DPP10, T-bet, GATA-3, and FOXP3 and allergic disorders. The two parallel research efforts, epidemiologic and genetic, are only recently starting to converge,producing fascinating results on the effect particular gene-environment interactions might have in the development of atopy.The most important lesson learned through this tremendous research effort is that not only a small number but thousands and millions of separate risk factors act in concordance in the production of the allergic phenotype.
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Knudsen TB, Thomsen SF, Ulrik CS, Fenger M, Nepper-Christensen S, Backer V. Season of birth and risk of atopic disease among children and adolescents. J Asthma 2007; 44:257-60. [PMID: 17530522 DOI: 10.1080/02770900701246832] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Season of birth (SOB) has been regarded as a risk factor for atopy. The aim of this study was to explore the relationship between season of birth (SOB) and later development of atopic disease in children and adolescents. METHODS A total of 1,007 randomly selected subjects, 7 to 17 years of age, who were living in urban Copenhagen, Denmark were studied. All participants were interviewed about respiratory symptoms and possible risk factors for atopic disease. Skin test reactivity, serum total immunoglobulin E (IgE), and airway responsiveness were measured using standard techniques. RESULTS The overall risk of atopy, as judged by skin test reactivity and serum total IgE, was the same regardless of SOB. On the contrary, asthma was more common in subjects born in the autumn compared with subjects born during the remaining part of the year (12.4% vs. 5.6%), OR = 2.40, 95% CI (1.56-3.94), p < 0.001. This was observed both for atopic asthma OR = 2.41, 95% CI (1.25-4.64), p = 0.007, non-atopic asthma, OR = 2.35, 95% CI (1.14-4.83), p = 0.02, and house dust mite (HDM) sensitive airway hyperresponsiveness, OR = 3.00, 95% CI (1.44-6.24), p = 0.002. Rhinitis and pollen allergy were not significantly related to SOB. CONCLUSIONS Atopy itself is independent of season of birth, whereas asthma is more prevalent among subjects born during the autumn. Regarding asthma, these results suggest that the first months of life enclose a period of particular vulnerability towards environmental risk factors, especially exposure to aeroallergens like HDM.
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Rowe J, Kusel M, Holt BJ, Suriyaarachchi D, Serralha M, Hollams E, Yerkovich ST, Subrata LS, Ladyman C, Sadowska A, Gillett J, Fisher E, Loh R, Soderstrom L, Ahlstedt S, Sly PD, Holt PG. Prenatal versus postnatal sensitization to environmental allergens in a high-risk birth cohort. J Allergy Clin Immunol 2007; 119:1164-73. [PMID: 17412403 DOI: 10.1016/j.jaci.2007.02.016] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Revised: 01/24/2007] [Accepted: 02/15/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND The timing of allergen sensitization is controversial, with conflicting evidence suggesting transplacental priming versus exclusively postnatal priming. Resolution of this question is important in relation to rational design of allergy prevention strategies, particularly the issue of allergen avoidance during pregnancy. OBJECTIVE To elucidate the kinetics of sensitization in high-risk children during their first 2 years of life. METHODS We prospectively studied house dust mite (HDM)-specific IgE and IgG(4) antibody production and associated T-cell immunity in a cohort of 200 high-risk infants. Parallel antibody studies tracked responses against a broader panel of inhalant and dietary allergens including peanut. RESULTS HDM-induced T(H)2 responses in PBMC from 6 months onward, particularly IL-4 and IL-5, correlated increasingly strongly with sensitization outcomes at 2 years, and a contrasting negative relationship was observed with IFN-gamma response capacity. HDM-induced T-cell responses in cord blood, although common, were unrelated to subsequent sensitization. Transient HDM-IgE (and IgG(4)) production frequently peaked at 6 or 12 months before returning to baseline, which suggests the onset of protective tolerance. This finding contrasted with progressively increasing HDM-IgE titers in children sensitized by 2 years of age. Comparably contrasting patterns were observed in peanut-specific responses in sensitized versus nonsensitized children. CONCLUSION Priming of T(H)2 responses associated with persistent HDM-IgE production occurs entirely postnatally, as HDM reactivity in cord blood seems nonspecific and is unrelated to subsequent development of allergen-specific T(H)2 memory or IgE. CLINICAL IMPLICATIONS These findings question the scientific basis for existing recommendations for allergen avoidance by high-risk women during pregnancy.
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Affiliation(s)
- Julie Rowe
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia
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Abstract
Allergic diseases continue to increase in prevalence, and now affect over a third of the population in many countries. There is evidence that the increase in such diseases has its origins in early life exposures. Pregnancy or early childhood may therefore be critical periods for preventing the onset of allergic disease, and prenatal interventions are an attractive possibility for a population-based preventive approach. Here we review the data suggesting that prenatal exposures are important in the development of allergic disease, and that interventions during this time might be effective in prevention. We find evidence from both animal and human studies that prenatal interventions can influence the future development of allergic disease. There are a number of mechanisms through which such interventions may act to prevent allergic sensitization. We conclude that prenatal interventions have the potential to reduce the burden of allergic disease, and merit continued investigation. Further research in this area may lead to significant public health initiatives.
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Affiliation(s)
- R J Boyle
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC., Australia
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Ghunaim N, Wickman M, Almqvist C, Söderström L, Ahlstedt S, van Hage M. Sensitization to different pollens and allergic disease in 4-year-old Swedish children. Clin Exp Allergy 2006; 36:722-7. [PMID: 16776672 DOI: 10.1111/j.1365-2222.2006.02489.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although the relationship between sensitization to different inhalant allergens in adolescents and adults has been intensively studied, information concerning sensitization in children is scarce in particular to pollens. OBJECTIVES In 4-year-old children to elucidate the pollen immunoglobulin (IgE) antibody profile (birch only, timothy only and combinations of three pollens (birch, timothy or mugwort) and to relate the results to other inhalant and food allergens, as well as the presence of allergic diseases. METHODS A total of 2551 4-year-old children belonging to a prospective birth cohort, which has been followed longitudinally (BAMSE), were investigated with respect to IgE antibodies to pollen and other inhalant and food allergens, and expression of allergic disease, based on questionnaire data. RESULTS Eleven percent (n=285) of the children were sensitized to pollen. Birch was the dominating cause of pollen sensitization (birch sensitization only, n=133); followed by timothy grass pollen (n=56) and a combination of two (n=64) or three (n=30) pollens. A remarkably high proportion of the children sensitized only to birch was also sensitized to other inhalant allergens. This was not seen for children sensitized only to timothy. The highest frequencies of IgE reactivity to food were found in the group of children sensitized to the combination of birch, timothy and mugwort pollen. Children sensitized to timothy only, exhibited symptoms of allergic disease significantly less frequently compared with children sensitized to birch only. Sensitization to birch pollen was found to be closely associated with rhinitis and eczema compared with asthma. The highest frequency of asthma and/or rhinitis and/or eczema was reported in children sensitized to at least two pollens. CONCLUSION Our results demonstrate that birch is the dominating source of pollen sensitization at the age of four in Sweden. This might associate with the pattern of sensitization to other inhalant and food allergens as well as influence on the expression of allergic disease in this particular age group.
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Affiliation(s)
- N Ghunaim
- Clinical Immunology and Allergy Unit, Department of Medicine, Karolinska Institutet and University Hospital, Stockholm, Sweden
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Prescott SL. Maternal allergen exposure as a risk factor for childhood asthma. Curr Allergy Asthma Rep 2006; 6:75-80. [PMID: 16476199 DOI: 10.1007/s11882-006-0014-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The role of early allergen exposure has been a central focus in the effort to curtail the rising rates of allergic disease. Exposures in pregnancy have been of interest because the first signs of disease are often seen in early infancy. However, so far, strategies to avoid or reduce allergen exposure in pregnancy have had disappointing results in reducing disease. Although there is growing evidence that the fetus is exposed to allergens, this appears to be physiologic and not a risk factor for allergic disease. It is still not clear if this exposure has some role in the context of normal tolerance. Although infants who later develop allergic disease show some differences in neonatal allergen-specific responses, these are not consistent. Furthermore, the magnitude and frequency of responses do not correlate well with maternal allergen exposure, and it now seems likely that these responses do not reflect true immunologic "memory." Despite this, there is accumulating evidence that a number of other exposures in pregnancy have the capacity to significantly influence immune development and alter the risk for allergic responses to allergens. This underscores the importance of further defining the events in this early period, to determine causal pathways and better strategies for prevention.
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Affiliation(s)
- Susan L Prescott
- UWA School of Pediatrics and Child Health, Princess Margaret Hospital, Perth, WA, Australia.
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Vance GHS, Lewis SA, Grimshaw KEC, Wood PJ, Briggs RA, Thornton CA, Warner JO. Exposure of the fetus and infant to hens' egg ovalbumin via the placenta and breast milk in relation to maternal intake of dietary egg. Clin Exp Allergy 2006; 35:1318-26. [PMID: 16238791 DOI: 10.1111/j.1365-2222.2005.02346.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Maternally derived allergens may be transferred to the developing infant during pregnancy and lactation. However, it is not known how manipulation of environmental allergen levels might impact on this early-life exposure. OBJECTIVE To measure dietary egg allergen (ovalbumin (OVA)) in gestation-associated environments, in relation to maternal dietary egg intake. METHOD OVA was measured by allergen-specific ELISA in maternal blood collected throughout pregnancy, infant blood at birth (umbilical cord) and in breast milk at 3 months post-partum. Samples derived from pregnant women undergoing diagnostic amniocentesis at 16-18 weeks gestation who were not subject to any dietary intervention, and from pregnant women, with personal or partner atopy, randomized to complete dietary egg exclusion or an unmodified healthy diet before 20 weeks gestation as a primary allergy prevention strategy. Maternal dietary egg intake was monitored closely throughout the study period by diary record and serial measurement of OVA-specific immunoglobulin G concentration. RESULTS Circulating OVA was detected throughout pregnancy in 20% of women and correlated with both presence (P<0.001) and concentration (r=0.754, P<0.001) of infant OVA at birth (umbilical cord). At 3 months post-partum OVA was detected in breast milk samples of 35% women, in higher concentrations than measured in blood. Blood and breast milk OVA were not related to maternal dietary intake or atopic pre-disposition. CONCLUSIONS Rigorous dietary egg exclusion does not eliminate trans-placental and breast milk egg allergen passage. This early-life exposure could modulate developing immune responses.
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Affiliation(s)
- G H S Vance
- Child Health, Infection, Inflammation & Repair Division, University of Southampton, Southampton, UK.
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Kihlström A, Hedlin G, Pershagen G, Troye-Blomberg M, Härfast B, Lilja G. Immunoglobulin G4-antibodies to rBet v 1 and risk of sensitization and atopic disease in the child. Clin Exp Allergy 2005; 35:1542-9. [PMID: 16393319 DOI: 10.1111/j.1365-2222.2005.02373.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND In 1993 extremely high levels of birch-pollen were recorded in Stockholm, Sweden. This provided an opportunity to evaluate the effects of aeroallergen exposure (exp.) on the early immune response. OBJECTIVE To assess the influence of exp. to birch-pollen during pregnancy and infancy on the allergen-specific IgE- and IgG4-antibody (ab) response and the development of atopic disease in children. METHODS A total of 970 children with atopic heredity and born in Stockholm 1992, 1993 or 1994 were investigated at age 4.5-5 years. They were divided into five groups; high-dose exp. at 1 year of age, high-dose exp. at 0-3 months, low-dose exp. at 0-3 months, high-dose exp. during pregnancy and low-dose exp. during pregnancy. The children were examined and skin prick tested with inhalant and food allergens. IgE abs (against birch-pollen and recombinant Bet v 1(rBet v1)) and IgG4 abs (against rBet v 1) were analysed in serum. All children were assembled in one group to assess the effects of different ab responses (IgE/IgG4) on the development of atopic disease. RESULTS Children exposed to high doses of birch-pollen during the first 3 months of life more often had detectable levels of IgG4 abs to rBet v 1 than the children in the other groups (P < 0.001), independent of sensitization to birch. Overall, the risk of allergic rhinoconjunctivitis was increased among children sensitized to birch-pollen and appeared more pronounced in children without detectable levels of IgG4 ab to rBet v 1 (Odds ratio 9.4; 95% Confidence interval: 5.5-16.1). IgE sensitization to birch-pollen seemed to have a stronger influence on the development of atopic disease than the IgG4-ab response. CONCLUSION Exposure to high doses of inhalant allergens during the early postnatal period is associated with detectable levels of allergen-specific IgG4 ab even at 5 years of age. An immune modulating effect by IgG4 on symptoms of allergic rhinoconjunctivitis is suggested in children sensitized to birch.
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MESH Headings
- Air Pollutants/immunology
- Allergens/immunology
- Betula
- Chi-Square Distribution
- Child, Preschool
- Conjunctivitis, Allergic/diagnosis
- Conjunctivitis, Allergic/immunology
- Environmental Exposure
- Female
- Humans
- Hypersensitivity, Immediate/diagnosis
- Hypersensitivity, Immediate/immunology
- Immunoglobulin E/blood
- Immunoglobulin G/blood
- Infant
- Infant, Newborn
- Logistic Models
- Male
- Pollen
- Pregnancy
- Prenatal Exposure Delayed Effects
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/immunology
- Seasons
- Skin Tests
- Sweden
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Affiliation(s)
- A Kihlström
- Department of Paediatrics, B57, Karolinska University Hospital, Huddinge, S-14186 Stockholm, Sweden.
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Salvatore S, Keymolen K, Hauser B, Vandenplas Y. Intervention during pregnancy and allergic disease in the offspring. Pediatr Allergy Immunol 2005; 16:558-66. [PMID: 16238580 DOI: 10.1111/j.1399-3038.2005.00315.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The etiology of allergy is multifactorial, with many variables contributing to the final expression of atopic disease. Three breeding grounds are needed to develop allergic disease: the appropriate genetic background, contact with the allergen(s) and environmental factors. Timing and dosing of allergen(s) are of major importance. Contact with (dietary) allergens and various agents such as tobacco smoke and infections occur not only during post-natal life, but also perinatally and even pre-natally. A critical review of published evidence regarding the impact of maternal exposure to antigens during pregnancy on later development of allergy in the offspring can only conclude that more research is urgently needed. Contact with multiple dietary allergens should be in general of benefit to the fetus to develop tolerance. Current knowledge suggests that pregnant women should have a normal diversified diet, avoiding toxic agents such as tobacco and alcohol. The role of maternal intake of poly-unsaturated fatty acids on the development of atopy in the infants needs to be further evaluated. If parental history would be insufficient to determine the fetal risk, preventive measurements would be advisable for all fetuses.
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Affiliation(s)
- S Salvatore
- Clinica Pediatrica di Varese, Università dell'Insubria, Varese, Italy
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Scheinmann P, Paty E, De Blic J. Quelles mesures d’environnement faut-il prendre pour le traitement de la dermatite atopique de l’enfant et pour la prévention des autres manifestations atopiques ? Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)86144-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Kihlström A, Lilja G, Pershagen G, Hedlin G. Maternal pollen allergy may be more important than birch pollen exposure during pregnancy for atopic airway disease in the child. Pediatr Allergy Immunol 2004; 15:497-505. [PMID: 15610362 DOI: 10.1111/j.1399-3038.2004.00194.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In 1993 extremely high levels of birch pollen were recorded in Stockholm, Sweden. We investigated the effects of this exposure on sensitization and development of atopic airway disease in children. The aim of this study was to assess the influence of maternal birch sensitization and symptoms of pollen allergy, as well as exposure to birch pollen during pregnancy, on sensitization and development of atopic airway disease in children. A total of 387 children with atopic heredity (70% had atopic mothers) and born in Stockholm 1993 or 1994 were investigated at age 4.5-5 yr. The children were examined and skin prick tested with inhalant and food allergens. IgE-antibodies against birch pollen and recombinant birch pollen allergen were analyzed in serum. The same tests were performed on the mothers. Children of mothers with symptoms of pollen allergy more often showed symptoms of rhinoconjunctivitis at age 4.5-5, after both high dose [Odds ratio (OR) 5.3; 95% confidence interval (CI): 2.0-13.7] and low dose (OR 4.0; 95% CI: 1.5-10.9) exposure to birch pollen during pregnancy. Similar tendencies were noted for children of mothers sensitized to birch, where stronger effects were suggested in boys (OR 3.8; 95% CI: 1.3-11.5) than in girls (OR 1.2; 95% CI: 0.2-5.5) in the high-dose exposed group. For asthma symptoms and sensitization to birch in the children the results were less consistent. It may be concluded that, maternal pollen allergy seems to have a stronger influence on the development of rhinoconjunctivitis in children with a family history of atopy than the degree of allergen exposure during pregnancy.
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Affiliation(s)
- Anne Kihlström
- Department of Paediatrics, Huddinge University Hospital, Stockholm, Sweden.
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Abstract
PURPOSE OF REVIEW Asymptomatic skin sensitization to aeroallergens is frequently encountered in epidemiological studies and in everyday clinical life. Correct management of the condition is essential to avoid both progression into allergic disease and unnecessary intervention. Understanding immunological mechanisms in asymptomatic skin sensitization might provide new insights into the natural history and treatment of respiratory allergy. RECENT FINDINGS Research on asymptomatic skin sensitization is rare, and the present review unites previous studies with recent findings. It is a common condition affecting 8-30% of the population when using a local standard panel of aeroallergens. Clinically, immediate but not late-phase reactions are induced by allergen challenge. Absent eosinophil stimulation and migration and low IL-5 levels appear to be sentinel mechanisms. Prospective studies show that 30-60% become allergic, depending on allergens and follow-up period. No prospective intervention studies have been performed; however, allergen avoidance seems efficacious in reducing allergy development to occupational and domestic allergens. Asymptomatic skin sensitization due to an erroneously positive skin test must be ruled out before allergen avoidance measures are initiated. SUMMARY Surprisingly few papers exist on asymptomatic skin sensitization epidemiology and immunology, despite the intriguing question as to why symptoms do not develop in IgE-sensitized patients. It is a common condition and a risk factor for later development of respiratory allergic disease. Cross-sectional intervention studies suggest that allergy development is reduced by allergen avoidance. Immunologically, control of eosinophil stimulation and migration seems to be pivotal. How this control is maintained remains to be elucidated.
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Affiliation(s)
- Uffe Bodtger
- Allergy Clinic, National University Hospital, Copenhagen, Denmark.
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van Gool CJAW, Thijs C, Dagnelie PC, Henquet CJM, van Houwelingen AC, Schrander J, Menheere PPCA, van den Brandt PA. Determinants of neonatal IgE level: parity, maternal age, birth season and perinatal essential fatty acid status in infants of atopic mothers. Allergy 2004; 59:961-8. [PMID: 15291904 DOI: 10.1111/j.1398-9995.2004.00528.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The hygiene hypothesis suggests that the protective 'siblings effect' against atopic diseases such as atopic dermatitis, allergic asthma and hay fever is a result of recurrent infections during early childhood. A recent study and review have indicated that this protective effect may already arise in utero. Lower n-3 essential fatty acid (EFA) status is associated with increased parity, and EFA status has also been related to atopy. The present study confirms the negative association between parity and neonatal immunoglobulin E (IgE) levels and further unravel the role of perinatal EFA status. METHODOLOGY In a prospective cohort study in 184 atopic mothers and their neonates, we simultaneously measured serum total IgE and EFA levels in plasma phospholipids, both in the mother at 34-36 weeks of gestation and in the neonate at the age of 1 week. Linear regression analysis was used to estimate the effect of parity on maternal and neonatal IgE and EFA status, and the independent effects of parity and EFA status on IgE, controlling for confounding factors such as maternal age and birth season. RESULTS Parity was associated with lower neonatal IgE level (P < 0.01), as well as with lower docosahexanoic acid (DHA, 22:6n-3) status of the mother (P = 0.01) but not of the neonate (P > 0.69). In the multivariate analysis, higher parity, higher maternal IgE, lower maternal age and birth in the first 3 months of the year were independently associated with neonatal IgE level. No association was detected between maternal or neonatal EFA status and neonatal IgE. CONCLUSIONS As neonatal total serum IgE is predictive of later atopy, our results support the hypothesis that the sibling effect in atopy is already being programmed in utero. Our data also confirm earlier findings that DHA status is lower in multiparous women, but this did not confound the relation between parity and neonatal IgE.
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Affiliation(s)
- C J A W van Gool
- Department of Epidemiology, Nutrition and Toxicology Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
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Muñoz-López F. Prevenir desde el embarazo. Allergol Immunopathol (Madr) 2004. [DOI: 10.1016/s0301-0546(04)79226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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