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Melén E, Zar HJ, Siroux V, Shaw D, Saglani S, Koppelman GH, Hartert T, Gern JE, Gaston B, Bush A, Zein J. Asthma Inception: Epidemiologic Risk Factors and Natural History Across the Life Course. Am J Respir Crit Care Med 2024; 210:737-754. [PMID: 38981012 DOI: 10.1164/rccm.202312-2249so] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 07/09/2024] [Indexed: 07/11/2024] Open
Abstract
Asthma is a descriptive label for an obstructive inflammatory disease in the lower airways manifesting with symptoms including breathlessness, cough, difficulty in breathing, and wheezing. From a clinician's point of view, asthma symptoms can commence at any age, although most patients with asthma-regardless of their age of onset-seem to have had some form of airway problems during childhood. Asthma inception and related pathophysiologic processes are therefore very likely to occur early in life, further evidenced by recent lung physiologic and mechanistic research. Herein, we present state-of-the-art updates on the role of genetics and epigenetics, early viral and bacterial infections, immune response, and pathophysiology, as well as lifestyle and environmental exposures, in asthma across the life course. We conclude that early environmental insults in genetically vulnerable individuals inducing abnormal, pre-asthmatic airway responses are key events in asthma inception, and we highlight disease heterogeneity across ages and the potential shortsightedness of treating all patients with asthma using the same treatments. Although there are no interventions that, at present, can modify long-term outcomes, a precision-medicine approach should be implemented to optimize treatment and tailor follow-up for all patients with asthma.
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Affiliation(s)
- Erik Melén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Heather J Zar
- Department of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Valerie Siroux
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Dominic Shaw
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Sejal Saglani
- National Heart and Lung Institute, Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Gerard H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, the Netherlands
| | - Tina Hartert
- Department of Medicine and Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - James E Gern
- Department of Pediatrics, University of Wisconsin, Madison, Wisconsin
| | | | - Andrew Bush
- National Heart and Lung Institute, Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
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Kim BE, Hui-Beckman JW, Nevid MZ, Goleva E, Leung DYM. Air pollutants contribute to epithelial barrier dysfunction and allergic diseases. Ann Allergy Asthma Immunol 2024; 132:433-439. [PMID: 38006973 DOI: 10.1016/j.anai.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 11/27/2023]
Abstract
Air pollution is a global problem associated with various health conditions, causing elevated rates of morbidity and mortality. Major sources of air pollutants include industrial emissions, traffic-related pollutants, and household biomass combustion, in addition to indoor pollutants from chemicals and tobacco. Various types of air pollutants originate from both human activities and natural sources. These include particulate matter, pollen, greenhouse gases, and other harmful gases. Air pollution is linked to allergic diseases, including atopic dermatitis, allergic rhinitis, allergic conjunctivitis, food allergy, and bronchial asthma. These pollutants lead to epithelial barrier dysfunction, dysbiosis, and immune dysregulation. In addition, climate change and global warming may contribute to the exacerbation and the development of allergic diseases related to air pollutants. Epigenetic changes associated with air pollutants have also been connected to the onset of allergic diseases. Furthermore, these changes can be passed down through subsequent generations, causing a higher prevalence of allergic diseases in offspring. Modulation of the aryl hydrocarbon receptor could be a valuable strategy for alleviating air pollutant-induced epidermal barrier dysfunction and atopic dermatitis. A more effective approach to preventing allergic diseases triggered by air pollutants is to reduce exposure to them. Implementing public policies aimed at safeguarding individuals from air pollutant exposure may prove to be the most efficient solution. A pressing need exists for global policy initiatives that prioritize efforts to reduce the production of air pollutants.
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Affiliation(s)
- Byung Eui Kim
- Department of Pediatrics, National Jewish Health, Denver, Colorado
| | | | | | - Elena Goleva
- Department of Pediatrics, National Jewish Health, Denver, Colorado
| | - Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colorado.
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Niu Z, Mohazzab-Hosseinian S, Breton CV. Transgenerational epigenetic inheritance: Perspectives and challenges. J Allergy Clin Immunol 2023; 151:1474-1476. [PMID: 36893860 PMCID: PMC10795545 DOI: 10.1016/j.jaci.2023.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 03/09/2023]
Affiliation(s)
- Zhongzheng Niu
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, Calif
| | - Sahra Mohazzab-Hosseinian
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, Calif
| | - Carrie V Breton
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, Calif.
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Vercelli D, Lynch SV. Interactions between host epigenetics and microbiota: Who does what to whom, when, and why? J Allergy Clin Immunol 2023:S0091-6749(23)00138-0. [PMID: 36720286 DOI: 10.1016/j.jaci.2023.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/07/2023] [Accepted: 01/12/2023] [Indexed: 01/31/2023]
Affiliation(s)
- Donata Vercelli
- Department of Cellular and Molecular Medicine, Tucson, Ariz; Asthma and Airway Disease Research Center, Tucson, Ariz; Arizona Center for the Biology of Complex Diseases, Tucson, Ariz; BIO5 Institute, University of Arizona, Tucson, Ariz.
| | - Susan V Lynch
- Department of Medicine, University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of California San Francisco, San Francisco, Calif; Benioff Center for Microbiome Medicine, University of California San Francisco, San Francisco, Calif.
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Wheatley LM, Holloway JW, Svanes C, Sears MR, Breton C, Fedulov AV, Nilsson E, Vercelli D, Zhang H, Togias A, Arshad SH. The role of epigenetics in multi-generational transmission of asthma: An NIAID workshop report-based narrative review. Clin Exp Allergy 2022; 52:1264-1275. [PMID: 36073598 PMCID: PMC9613603 DOI: 10.1111/cea.14223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 01/26/2023]
Abstract
There is mounting evidence that environmental exposures can result in effects on health that can be transmitted across generations, without the need for a direct exposure to the original factor, for example, the effect of grandparental smoking on grandchildren. Hence, an individual's health should be investigated with the knowledge of cross-generational influences. Epigenetic factors are molecular factors or processes that regulate genome activity and may impact cross-generational effects. Epigenetic transgenerational inheritance has been demonstrated in plants and animals, but the presence and extent of this process in humans are currently being investigated. Experimental data in animals support transmission of asthma risk across generations from a single exposure to the deleterious factor and suggest that the nature of this transmission is in part due to changes in DNA methylation, the most studied epigenetic process. The association of father's prepuberty exposure with offspring risk of asthma and lung function deficit may also be mediated by epigenetic processes. Multi-generational birth cohorts are ideal to investigate the presence and impact of transfer of disease susceptibility across generations and underlying mechanisms. However, multi-generational studies require recruitment and assessment of participants over several decades. Investigation of adult multi-generation cohorts is less resource intensive but run the risk of recall bias. Statistical analysis is challenging given varying degrees of longitudinal and hierarchical data but path analyses, structural equation modelling and multilevel modelling can be employed, and directed networks addressing longitudinal effects deserve exploration as an effort to study causal pathways.
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Affiliation(s)
- Lisa M. Wheatley
- National Institute of Allergy and Infectious DiseaseNational Institutes of HealthBethesdaMarylandUSA
| | - John W. Holloway
- Faculty of Medicine, Human Development and HealthUniversity of SouthamptonSouthamptonUK
| | - Cecilie Svanes
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
| | | | - Carrie Breton
- University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Alexey V. Fedulov
- Warren Alpert Medical School of Brown University, Rhode Island HospitalProvidenceRhode IslandUSA
| | - Eric Nilsson
- Washington State University PullmanPullmanWashingtonUSA
| | | | - Hongmei Zhang
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public HealthUniversity of MemphisMemphisTennesseeUSA
| | - Alkis Togias
- National Institute of Allergy and Infectious DiseaseNational Institutes of HealthBethesdaMarylandUSA
| | - Syed Hasan Arshad
- Clinical and Experimental Sciences, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- The David Hide Asthma and Allergy CentreSt Mary's HospitalNewportUK
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Rebuzzini P, Fabozzi G, Cimadomo D, Ubaldi FM, Rienzi L, Zuccotti M, Garagna S. Multi- and Transgenerational Effects of Environmental Toxicants on Mammalian Reproduction. Cells 2022; 11:cells11193163. [PMID: 36231124 PMCID: PMC9563050 DOI: 10.3390/cells11193163] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 11/21/2022] Open
Abstract
Environmental toxicants (ETs) are an exogenous chemical group diffused in the environment that contaminate food, water, air and soil, and through the food chain, they bioaccumulate into the organisms. In mammals, the exposure to ETs can affect both male and female fertility and their reproductive health through complex alterations that impact both gametogeneses, among other processes. In humans, direct exposure to ETs concurs to the declining of fertility, and its transmission across generations has been recently proposed. However, multi- and transgenerational inheritances of ET reprotoxicity have only been demonstrated in animals. Here, we review recent studies performed on laboratory model animals investigating the effects of ETs, such as BPA, phthalates, pesticides and persistent contaminants, on the reproductive system transmitted through generations. This includes multigenerational effects, where exposure to the compounds cannot be excluded, and transgenerational effects in unexposed animals. Additionally, we report on epigenetic mechanisms, such as DNA methylation, histone tails and noncoding RNAs, which may play a mechanistic role in a nongenetic transmission of environmental information exposure through the germline across generations.
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Affiliation(s)
- Paola Rebuzzini
- Laboratory of Developmental Biology, Department of Biology and Biotechnology “Lazzaro Spallanzani”, Via Ferrata 9, University of Pavia, 27100 Pavia, Italy
- Correspondence: (P.R.); (M.Z.); (S.G.); Tel.: +39-0382-986323 (P.R. & M.Z. & S.G.)
| | - Gemma Fabozzi
- Clinica Valle Giulia, GeneraLife IVF, Via De Notaris 2B, 00197 Rome, Italy
| | - Danilo Cimadomo
- Clinica Valle Giulia, GeneraLife IVF, Via De Notaris 2B, 00197 Rome, Italy
| | | | - Laura Rienzi
- Clinica Valle Giulia, GeneraLife IVF, Via De Notaris 2B, 00197 Rome, Italy
- Department of Biomolecular Sciences, University of Urbino “Carlo Bo”, Via Sant’Andrea 34, 61029 Urbino, Italy
| | - Maurizio Zuccotti
- Laboratory of Developmental Biology, Department of Biology and Biotechnology “Lazzaro Spallanzani”, Via Ferrata 9, University of Pavia, 27100 Pavia, Italy
- Centre for Health Technologies (CHT), University of Pavia, Via Ferrata 5, 27100 Pavia, Italy
- Correspondence: (P.R.); (M.Z.); (S.G.); Tel.: +39-0382-986323 (P.R. & M.Z. & S.G.)
| | - Silvia Garagna
- Laboratory of Developmental Biology, Department of Biology and Biotechnology “Lazzaro Spallanzani”, Via Ferrata 9, University of Pavia, 27100 Pavia, Italy
- Centre for Health Technologies (CHT), University of Pavia, Via Ferrata 5, 27100 Pavia, Italy
- Correspondence: (P.R.); (M.Z.); (S.G.); Tel.: +39-0382-986323 (P.R. & M.Z. & S.G.)
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