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Qi C, Xu CJ, Koppelman GH. The role of epigenetics in the development of childhood asthma. Expert Rev Clin Immunol 2019; 15:1287-1302. [PMID: 31674254 DOI: 10.1080/1744666x.2020.1686977] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: The development of childhood asthma is caused by a combination of genetic factors and environmental exposures. Epigenetics describes mechanisms of (heritable) regulation of gene expression that occur without changes in DNA sequence. Epigenetics is strongly related to aging, is cell-type specific, and includes DNA methylation, noncoding RNAs, and histone modifications.Areas covered: This review summarizes recent epigenetic studies of childhood asthma in humans, which mostly involve studies of DNA methylation published in the recent five years. Environmental exposures, in particular cigarette smoking, have significant impact on epigenetic changes, but few of these epigenetic signals are also associated with asthma. Several asthma-associated genetic variants relate to DNA methylation. Epigenetic signals can be better understood by studying their correlation with gene expression, which revealed higher presence and activation of blood eosinophils in asthma. Strong associations of nasal methylation signatures and atopic asthma were identified, which were replicable across different populations.Expert commentary: Epigenetic markers have been strongly associated with asthma, and might serve as biomarker of asthma. The causal and longitudinal relationships between epigenetics and disease, and between environmental exposures and epigenetic changes need to be further investigated. Efforts should be made to understand cell-type-specific epigenetic mechanisms in asthma.
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Affiliation(s)
- Cancan Qi
- Dept. of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Cheng-Jian Xu
- Dept. of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Gastroenterology, Hepatology and Endocrinology, CiiM, Centre for individualised infection medicine, A joint venture between Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany.,TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture between the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | - Gerard H Koppelman
- Dept. of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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52
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Johnston JD, Cowger AE, Graul RJ, Nash R, Tueller JA, Hendrickson NR, Robinson DR, Beard JD, Weber KS. Associations between evaporative cooling and dust-mite allergens, endotoxins, and β-(1 → 3)-d-glucans in house dust: A study of low-income homes. INDOOR AIR 2019; 29:1005-1017. [PMID: 31463967 DOI: 10.1111/ina.12600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/22/2019] [Accepted: 08/25/2019] [Indexed: 06/10/2023]
Abstract
Recent work suggests that evaporative coolers increase the level and diversity of bioaerosols, but this association remains understudied in low-income homes. We conducted a cross-sectional study of metropolitan, low-income homes in Utah with evaporative coolers (n = 20) and central air conditioners (n = 28). Dust samples (N = 147) were collected from four locations in each home and analyzed for dust-mite allergens Der p1 and Der f1, endotoxins, and β-(1 → 3)-d-glucans. In all sample locations combined, Der p1 or Der f1 was significantly higher in evaporative cooler versus central air conditioning homes (OR = 2.29, 95% CI = 1.05-4.98). Endotoxin concentration was significantly higher in evaporative cooler versus central air conditioning homes in furniture (geometric mean (GM) = 8.05 vs 2.85 EU/mg, P < .01) and all samples combined (GM = 3.60 vs 1.29 EU/mg, P = .03). β-(1 → 3)-d-glucan concentration and surface loads were significantly higher in evaporative cooler versus central air conditioning homes in all four sample locations and all samples combined (P < .01). Our study suggests that low-income, evaporative cooled homes have higher levels of immunologically important bioaerosols than central air-conditioned homes in dry climates, warranting studies on health implications and other exposed populations.
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Affiliation(s)
- James D Johnston
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Ashlin E Cowger
- Department of Microbiology & Molecular Biology, Brigham Young University, Provo, Utah
| | - Robert J Graul
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Ryan Nash
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Josie A Tueller
- Department of Microbiology & Molecular Biology, Brigham Young University, Provo, Utah
| | | | | | - John D Beard
- Department of Public Health, Brigham Young University, Provo, Utah
| | - K Scott Weber
- Department of Microbiology & Molecular Biology, Brigham Young University, Provo, Utah
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53
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Abramson SL. Reducing Environmental Allergic Triggers: Policy Issues. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 6:32-35. [PMID: 29310764 DOI: 10.1016/j.jaip.2017.10.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 10/27/2017] [Accepted: 10/27/2017] [Indexed: 02/03/2023]
Abstract
The implementation of policies to reduce environmental allergic triggers can be an important adjunct to optimal patient care for allergic rhinitis and allergic asthma. Policies at the local level in schools and other public as well as private buildings can make an impact on disease morbidity. Occupational exposures for allergens have not yet been met with the same rigorous policy standards applied for exposures to toxicants by Occupational Safety and Health Administration. Further benefit may be obtained through policies by local, county, state, and national governments, and possibly through international cooperative agreements. The reduction of allergenic exposures can and should be affected by policies with strong scientific, evidence-based derivation. However, a judicious application of the precautionary principle may be needed in circumstances where the health effect of inaction could lead to more serious threats to vulnerable populations with allergic disease. This commentary covers the scientific basis, current implementation, knowledge gaps, and pro/con views on policy issues in reducing environmental allergic triggers.
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Agnihotri NT, Lei DK, Gupta RS. Managing Younger Siblings of Food Allergic Children. Immunol Allergy Clin North Am 2019; 39:469-480. [PMID: 31563182 DOI: 10.1016/j.iac.2019.07.001] [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] [Indexed: 11/19/2022]
Abstract
Current guidelines state that there is insufficient evidence to recommend testing siblings of food allergic children before introduction of potential allergic foods, but the topic continues to remain controversial. Although the proportion of siblings who are sensitized to a food without clinical reactivity is high in comparison to those with a true food allergy, there is still a known increased risk amongst siblings of children with food allergies that has led to much apprehension about management. The appropriateness of testing and further steps for management of sensitization in the absence of history of clinical reactivity should be discussed with parents.
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Affiliation(s)
- Neha T Agnihotri
- Department of Medicine, Division of Allergy and Immunology, Northwestern University, 211 E. Ontario, 10th Floor, Suite 1000, Chicago, IL 60611, USA
| | - Dawn K Lei
- Department of Medicine, Division of Allergy and Immunology, Northwestern University, 211 E. Ontario, 10th Floor, Suite 1000, Chicago, IL 60611, USA
| | - Ruchi S Gupta
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, 750 North Lake Shore Drive, Suite #680, Chicago, IL 60611, USA.
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55
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Gao X, Ren X, Wang Q, Yang Z, Li Y, Su Z, Li J. Critical roles of regulatory B and T cells in helminth parasite-induced protection against allergic airway inflammation. Clin Exp Immunol 2019; 198:390-402. [PMID: 31397879 DOI: 10.1111/cei.13362] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2019] [Indexed: 12/29/2022] Open
Abstract
The prevalence of allergic asthma and incidences of helminth infections in humans are inversely correlated. Although experimental studies have established the causal relation between parasite infection and allergic asthma, the mechanism of the parasite-associated immunomodulation is not fully elucidated. Using a murine model of asthma and nematode parasite Heligmosomoides polygyrus, we investigated the roles of regulatory B cells (Breg ) and T cells (Treg ) in mediation of the protection against allergic asthma by parasite. H. polygyrus infection significantly suppressed ovalbumin (OVA)-induced allergic airway inflammation (AAI) evidenced by alleviated lung histopathology and reduced numbers of bronchoalveolar inflammatory cell infiltration, and induced significant responses of interleukin (IL)-10+ Breg , IL-10+ Treg and forkhead box protein 3 (FoxP3)+ Treg in mesenteric lymph node and spleen of the mice. Adoptive transfer of IL-10+ Breg and IL-10+ Treg cell prevented the lung immunopathology in AAI mice. Depletion of FoxP3+ Treg cells in FoxP3-diphtheria toxin (DT) receptor transgenic mice by diphtheria toxin (DT) treatment exacerbated airway inflammation in parasite-free AAI mice and partially abrogated the parasite-induced protection against AAI. IL-10+ Breg cells were able to promote IL-10+ Treg expansion and maintain FoxP3+ Treg cell population. These two types of Tregs failed to induce CD19+ B cells to transform into IL-10+ Breg cells. These results demonstrate that Breg , IL-10+ Treg and FoxP3+ Treg cells contribute in A discrepant manner to the protection against allergic airway immunopathology by parasiteS. Breg cell might be a key upstream regulatory cell that induces IL-10+ Treg response and supports FoxP3+ Treg cell population which, in turn, mediate the parasite-imposed immunosuppression of allergic airway inflammation. These results provide insight into the immunological relationship between parasite infection and allergic asthma.
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Affiliation(s)
- X Gao
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,University of Chinese Academy of Sciences, Beijing, China
| | - X Ren
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Q Wang
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Z Yang
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Y Li
- Department of Public Health, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Z Su
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - J Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
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56
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Farm-like indoor microbiota in non-farm homes protects children from asthma development. Nat Med 2019; 25:1089-1095. [PMID: 31209334 DOI: 10.1038/s41591-019-0469-4] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 04/25/2019] [Indexed: 01/04/2023]
Abstract
Asthma prevalence has increased in epidemic proportions with urbanization, but growing up on traditional farms offers protection even today1. The asthma-protective effect of farms appears to be associated with rich home dust microbiota2,3, which could be used to model a health-promoting indoor microbiome. Here we show by modeling differences in house dust microbiota composition between farm and non-farm homes of Finnish birth cohorts4 that in children who grow up in non-farm homes, asthma risk decreases as the similarity of their home bacterial microbiota composition to that of farm homes increases. The protective microbiota had a low abundance of Streptococcaceae relative to outdoor-associated bacterial taxa. The protective effect was independent of richness and total bacterial load and was associated with reduced proinflammatory cytokine responses against bacterial cell wall components ex vivo. We were able to reproduce these findings in a study among rural German children2 and showed that children living in German non-farm homes with an indoor microbiota more similar to Finnish farm homes have decreased asthma risk. The indoor dust microbiota composition appears to be a definable, reproducible predictor of asthma risk and a potential modifiable target for asthma prevention.
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Carpaij OA, Burgess JK, Kerstjens HAM, Nawijn MC, van den Berge M. A review on the pathophysiology of asthma remission. Pharmacol Ther 2019; 201:8-24. [PMID: 31075356 DOI: 10.1016/j.pharmthera.2019.05.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/02/2019] [Indexed: 01/28/2023]
Abstract
Asthma is a chronic respiratory condition, which is highly prevalent worldwide. Although no cure is currently available, it is well recognized that some asthma patients can spontaneously enter remission of the disease later in life. Asthma remission is characterized by absence of symptoms and lack of asthma-medication use. Subjects in asthma remission can be divided into two groups: those in clinical remission and those in complete remission. In clinical asthma remission, subjects still have a degree of lung functional impairment or bronchial hyperresponsiveness, while in complete asthma remission, these features are no longer present. Over longer periods, the latter group is less likely to relapse. This remission group is of great scientific interest due to the higher potential to find biomarkers or biological pathways that elicit or are associated with asthma remission. Despite the fact that the definition of asthma remission varies between studies, some factors are reproducibly observed to be associated with remitted asthma. Among these are lower levels of inflammatory markers, which are lowest in complete remission. Additionally, in both groups some degree of airway remodeling is present. Still, the pathological disease state of asthma remission has been poorly investigated. Future research should focus on at least two aspects: further characterisation of the small airways and airway walls in order to determine histologically true remission, and more thorough biological pathway analyses to explore triggers that elicit this phenomenon. Ultimately, this will result in pharmacological targets that provide the potential to steer the course of asthma towards remission.
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Affiliation(s)
- Orestes A Carpaij
- University of Groningen, University Medical Center Groningen, Groningen, Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, the Netherlands.
| | - Janette K Burgess
- University of Groningen, University Medical Center Groningen, Groningen, Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
| | - Huib A M Kerstjens
- University of Groningen, University Medical Center Groningen, Groningen, Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, the Netherlands
| | - Martijn C Nawijn
- University of Groningen, University Medical Center Groningen, Groningen, Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
| | - Maarten van den Berge
- University of Groningen, University Medical Center Groningen, Groningen, Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, the Netherlands
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58
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Kumar S, Jeong Y, Ashraf MU, Bae YS. Dendritic Cell-Mediated Th2 Immunity and Immune Disorders. Int J Mol Sci 2019; 20:ijms20092159. [PMID: 31052382 PMCID: PMC6539046 DOI: 10.3390/ijms20092159] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/29/2019] [Accepted: 04/29/2019] [Indexed: 12/24/2022] Open
Abstract
Dendritic cells (DCs) are the professional antigen-presenting cells that recognize and present antigens to naïve T cells to induce antigen-specific adaptive immunity. Among the T-cell subsets, T helper type 2 (Th2) cells produce the humoral immune responses required for protection against helminthic disease by activating B cells. DCs induce a Th2 immune response at a certain immune environment. Basophil, eosinophil, mast cells, and type 2 innate lymphoid cells also induce Th2 immunity. However, in the case of DCs, controversy remains regarding which subsets of DCs induce Th2 immunity, which genes in DCs are directly or indirectly involved in inducing Th2 immunity, and the detailed mechanisms underlying induction, regulation, or maintenance of the DC-mediated Th2 immunity against allergic environments and parasite infection. A recent study has shown that a genetic defect in DCs causes an enhanced Th2 immunity leading to severe atopic dermatitis. We summarize the Th2 immune-inducing DC subsets, the genetic and environmental factors involved in DC-mediated Th2 immunity, and current therapeutic approaches for Th2-mediated immune disorders. This review is to provide an improved understanding of DC-mediated Th2 immunity and Th1/Th2 immune balancing, leading to control over their adverse consequences.
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Affiliation(s)
- Sunil Kumar
- Science Research Center (SRC) for Immune Research on Non-Lymphoid Organ (CIRNO), Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
| | - Yideul Jeong
- Science Research Center (SRC) for Immune Research on Non-Lymphoid Organ (CIRNO), Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
- Department of Biological Sciences, Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
| | - Muhammad Umer Ashraf
- Science Research Center (SRC) for Immune Research on Non-Lymphoid Organ (CIRNO), Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
- Department of Biological Sciences, Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
| | - Yong-Soo Bae
- Science Research Center (SRC) for Immune Research on Non-Lymphoid Organ (CIRNO), Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
- Department of Biological Sciences, Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
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59
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Cooper PJ, Chico ME, Vaca MG, Sandoval CA, Loor S, Amorim LD, Rodrigues LC, Barreto ML, Strachan DP. Effect of Early-Life Geohelminth Infections on the Development of Wheezing at 5 Years of Age. Am J Respir Crit Care Med 2019; 197:364-372. [PMID: 28957644 DOI: 10.1164/rccm.201706-1222oc] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
RATIONALE Exposures to geohelminths during gestation or early childhood may reduce risk of wheezing illness/asthma and atopy during childhood in tropical regions. OBJECTIVES To investigate the effect of maternal and early childhood geohelminths on development of wheeze/asthma and atopy during the first 5 years of life. METHODS A cohort of 2,404 neonates was followed to 5 years of age in a rural district in coastal Ecuador. Data on wheeze were collected by questionnaire and atopy was measured by allergen skin prick test reactivity to 10 allergens at 5 years. Stool samples from mothers and children were examined for geohelminths by microscopy. MEASUREMENTS AND MAIN RESULTS A total of 2,090 (86.9%) children were evaluated at 5 years. Geohelminths were observed in 45.5% of mothers and in 34.1% of children by 3 years. Wheeze and asthma were reported for 12.6% and 5.7% of children, respectively, whereas 14.0% had skin test reactivity at 5 years. Maternal geohelminths were associated with an increased risk of wheeze (adjusted odds ratio, 1.41; 95% confidence interval, 1.06-1.88), whereas childhood geohelminths over the first 3 years of life were associated with reduced risk of wheeze (adjusted odds ratio, 0.70; 95% confidence interval, 0.52-0.96) and asthma (adjusted odds ratio, 0.60; 95% confidence interval, 0.38-0.94) but not skin prick test reactivity. The effects on wheeze/asthma were greatest with later age of first infection, were observed only in skin test-negative children, but were not associated with parasite burden or specific geohelminths. CONCLUSIONS Although maternal exposures to geohelminths may increase childhood wheeze, childhood geohelminths during the first 3 years may provide protection through a nonallergic mechanism. Registered as an observational study (ISRCTN41239086).
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Affiliation(s)
- Philip J Cooper
- 1 Facultad de Ciencias Medicas, de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador.,2 Laboratorio de Investigaciones FEPIS, Quininde, Esmeraldas Province, Ecuador.,3 Institute of Infection and Immunity and
| | - Martha E Chico
- 2 Laboratorio de Investigaciones FEPIS, Quininde, Esmeraldas Province, Ecuador
| | - Maritza G Vaca
- 2 Laboratorio de Investigaciones FEPIS, Quininde, Esmeraldas Province, Ecuador
| | - Carlos A Sandoval
- 2 Laboratorio de Investigaciones FEPIS, Quininde, Esmeraldas Province, Ecuador
| | - Sofia Loor
- 2 Laboratorio de Investigaciones FEPIS, Quininde, Esmeraldas Province, Ecuador
| | - Leila D Amorim
- 4 Instituto de Saude Coletiva, Universidade Federal da Bahia, Salvador, Brazil; and
| | - Laura C Rodrigues
- 5 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mauricio L Barreto
- 4 Instituto de Saude Coletiva, Universidade Federal da Bahia, Salvador, Brazil; and
| | - David P Strachan
- 6 Population Health Research Institute, St. George's University of London, London, United Kingdom
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Liu S, Wolters PJ, Zhang Y, Zhao M, Liu D, Wang L, Zhao G, Mao S, Wu L, Zhao H, Wang X. Association between greenhouse working exposure and bronchial asthma: A pilot, cross-sectional survey of 5,420 greenhouse farmers from northeast China. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2019; 16:286-293. [PMID: 30822226 DOI: 10.1080/15459624.2019.1574973] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Long-term exposure to greenhouse environments exposes greenhouse workers to inhalation of antigens that can cause respiratory diseases. This study was conducted to investigate the prevalence and potential risk factors for bronchial asthma among the Chinese greenhouse workers based on questionnaire and spirometry data. This was an observational cross-sectional study, performed via stratified-cluster-random sampling. It was conducted in Liaoning Province from the northeast of People's Republic of China, using a population-based sample of 5,880 workers at 835 plastic film greenhouses. All subjects were interviewed using a standardized questionnaire and underwent pulmonary function tests. Multiple logistic regression analysis was conducted to assess associations between self-reported factors of greenhouse worker exposure and bronchial asthma and to identify potential risk factors for this disease. A total of 5,420 questionnaires were completed. The overall prevalence of asthma in greenhouse workers was 19.2% (1040/5420). Multiple logistic regression analysis revealed that the use of multiple pesticides (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.03-1.49), bad odors in the greenhouse (OR = 1.26, 95% CI = 1.07-1.49), and report of the onset of cough when entering the greenhouse (OR = 1.25, 95% CI = 1.09-1.44) were associated with the development of asthma. In contrast, a higher body mass index (BMI >18.5 kg/m2, OR = 0.93, 95% CI = 0.90-0.95), planting flowers (OR = 0.92, 95% CI = 0.87-0.98), open sidewall to outside (natural ventilation) for at least 30 min per event (OR = 0.82, 95% CI = 0.69-0.96), living in greenhouse (OR = 0.85, 95% CI = 0.73-0.99), and experiencing cough before 14 years old (OR = 0.61, 95% CI = 0.43-0.84) were protective factors to the presentation of asthma among greenhouse workers. Our results suggest that asthma is a major public health problem among Chinese greenhouse workers and more attention should be devoted to preventive measures and management of this disease.
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Affiliation(s)
- Shuo Liu
- a Department of Respiratory Medicine , The First Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
- b Department of Respiratory Medicine , The Fourth Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
- c Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine , University of California , San Francisco, San Francisco , California, USA
| | - Paul J Wolters
- c Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine , University of California , San Francisco, San Francisco , California, USA
| | - Yibing Zhang
- d Department of Scientific Research , The General Hospital of Shenyang Military Command , Shenyang , Liaoning , People's Republic of China
| | - Mingjing Zhao
- b Department of Respiratory Medicine , The Fourth Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Dan Liu
- b Department of Respiratory Medicine , The Fourth Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Lingling Wang
- b Department of Respiratory Medicine , The Fourth Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Guangdan Zhao
- b Department of Respiratory Medicine , The Fourth Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Shitao Mao
- b Department of Respiratory Medicine , The Fourth Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Lijian Wu
- b Department of Respiratory Medicine , The Fourth Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Hongwen Zhao
- a Department of Respiratory Medicine , The First Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Xiaoge Wang
- b Department of Respiratory Medicine , The Fourth Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
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61
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Korhonen L, Oikarinen S, Lehtonen J, Mustonen N, Tyni I, Niemelä O, Honkanen H, Huhtala H, Ilonen J, Hämäläinen AM, Peet A, Tillmann V, Siljander H, Knip M, Lönnrot M, Hyöty H. Rhinoviruses in infancy and risk of immunoglobulin E sensitization. J Med Virol 2019; 91:1470-1478. [PMID: 30866076 DOI: 10.1002/jmv.25455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/20/2019] [Accepted: 03/09/2019] [Indexed: 12/20/2022]
Abstract
Previous data about the role of viruses in the development of allergic immunoglobulin E (IgE) sensitization are contradictory. The aim of this study was to determine the possible associations between exposure to different viruses (rhinovirus, enterovirus, norovirus, and parechovirus) during the first year of life and IgE sensitization. Viruses were analyzed from stool samples collected monthly from infants participating in a prospective birth cohort study. From that study, 244 IgE sensitized case children and 244 nonsensitized control children were identified based on their allergen-specific IgE antibody levels at the age of 6, 18, and 36 months. Stool samples (n = 4576) from the case and control children were screened for the presence of rhinovirus, enterovirus, norovirus, and parechovirus RNA by reverse transcription quantitative polymerase chain reaction. The study showed that rhinovirus was the most prevalent virus detected, present in 921 (20%) samples. None of the viruses were associated with IgE sensitization in the full cohort but after stratifying by sex, the number of rhinovirus positive samples was inversely associated with IgE sensitization in boys (odds ratio [OR]: 0.81; 95% confidence interval [CI]: 0.69-0.94; P = 0.006). There was also a temporal relation between rhinoviruses and IgE sensitization, as rhinovirus exposure during the first 6 months of life was associated with a reduced risk of subsequent IgE sensitization in boys (OR: 0.76; 95% CI: 0.6-0.94; P = 0.016). In conclusion, early exposure to rhinoviruses was inversely associated with IgE sensitization but this protective association was restricted to boys.
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Affiliation(s)
- Laura Korhonen
- Department of Virology, Faculty of Medical Sciences and Biotechnology, Tampere University, Tampere, Finland.,Department of Dermatology, Tampere University Hospital, Tampere, Finland.,Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - Sami Oikarinen
- Department of Virology, Faculty of Medical Sciences and Biotechnology, Tampere University, Tampere, Finland.,Department of Clinical Microbiology, Fimlab Laboratories Ltd, Tampere, Finland
| | - Jussi Lehtonen
- Department of Virology, Faculty of Medical Sciences and Biotechnology, Tampere University, Tampere, Finland
| | - Neea Mustonen
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Iiris Tyni
- Department of Virology, Faculty of Medical Sciences and Biotechnology, Tampere University, Tampere, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Seinäjoki, Finland
| | - Hanna Honkanen
- Department of Virology, Faculty of Medical Sciences and Biotechnology, Tampere University, Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - Anu-Maaria Hämäläinen
- Department of Pediatrics, Jorvi Hospital, Helsinki University Hospital, Espoo, Finland
| | - Aleksandr Peet
- Department of Pediatrics, University of Tartu, Tartu, Estonia.,Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - Vallo Tillmann
- Department of Pediatrics, University of Tartu, Tartu, Estonia.,Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - Heli Siljander
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Mikael Knip
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Maria Lönnrot
- Department of Virology, Faculty of Medical Sciences and Biotechnology, Tampere University, Tampere, Finland.,Department of Dermatology, Tampere University Hospital, Tampere, Finland.,Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - Heikki Hyöty
- Department of Virology, Faculty of Medical Sciences and Biotechnology, Tampere University, Tampere, Finland.,Department of Clinical Microbiology, Fimlab Laboratories Ltd, Tampere, Finland
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Leynaert B, Le Moual N, Neukirch C, Siroux V, Varraso R. [Environmental risk factors for asthma developement]. Presse Med 2019; 48:262-273. [PMID: 30910274 DOI: 10.1016/j.lpm.2019.02.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 12/20/2022] Open
Abstract
The prevalence of asthma has increased rapidly since the early 1970s, and only changes in exposure to environmental factors; which go together with changes in lifestyle, are likely to explain such a rapid increase. Exposure to allergens is a risk factor for allergic sensitization, and allergic sensitization is a risk factor for allergic asthma. However, apart from indoor mold exposure as a risk factor for childhood asthma, there is insufficient evidence to conclude that the associations between allergen exposure and asthma development are causal. A new challenge for research is to analyze the huge amount of data derived from the metagenomic characterization of the environmental and human microbiome, to understand the role of interactions between viruses, bacteria and allergens in the development of asthma. It is recognized that prenatal and postnatal exposure to air pollution and maternal smoking increase the risk of developing asthma in children. In adults, the data are scarce and the results remain controversial as regards these exposures and asthma incidence. Further research is needed to appraise the effect of exposure to phenols, phthalates and perfluorinated compounds, which are widespread in the environment and may be associated with asthma, especially in children. Frequent use of chemicals for home cleaning especially in the form of sprays - which is a common practice at the population level - is a risk factor for the development of adult asthma. The domestic use of cleaning products might also be a risk factor for asthma in children exposed at home. The chemicals involved in these relationships are still to be identified. Occupational asthma is a major phenotype of adult asthma. A significant part of these asthma cases might relate to occupational exposure to cleaning products. While there is evidence of associations between diet during pregnancy or during childhood and the risk of developing asthma in children, the data in adults are insufficient. Beyond genetic factors, body composition is influenced by dietary choices and physical activity. Further research is needed to clarify the complex interplay between these nutritional factors and asthma development. The new challenge for research is to decipher the role of all the environmental factors to which the individual is exposed since conception ("exposome") in the development of asthma, using a holistic approach.
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Affiliation(s)
- Bénédicte Leynaert
- UMR 1152 physiopathologie et épidémiologie des maladies respiratoires, équipe épidémiologie, Inserm, Paris, France; UMR 1152, université Paris Diderot, Paris, France.
| | - Nicole Le Moual
- Inserm U1168, VIMA (aging and chronic diseases, epidemiological and public health approaches), Villejuif, France; UVSQ, UMR-S 1168, université Versailles, Saint-Quentin-en-Yvelines, France
| | - Catherine Neukirch
- UMR 1152 physiopathologie et épidémiologie des maladies respiratoires, équipe épidémiologie, Inserm, Paris, France; UMR 1152, université Paris Diderot, Paris, France; Service de pneumologie A, hôpital Bichat, Assistance publique-Hôpitaux de Paris, Paris, France; DHU FIRE, Paris, France
| | - Valérie Siroux
- Équipe épidémiologie environnement appliquée à la reproduction et la santé respiratoire, Inserm, CNRS, centre de recherche Inserm U1209, institute for advanced biosciences (IAB), université Grenoble-Alpes, Grenoble, France
| | - Raphaëlle Varraso
- Inserm U1168, VIMA (aging and chronic diseases, epidemiological and public health approaches), Villejuif, France; UVSQ, UMR-S 1168, université Versailles, Saint-Quentin-en-Yvelines, France
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Effect of Residential Greenness and Nearby Parks on Respiratory and Allergic Diseases among Middle School Adolescents in a Chinese City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060991. [PMID: 30893887 PMCID: PMC6466062 DOI: 10.3390/ijerph16060991] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 03/06/2019] [Accepted: 03/11/2019] [Indexed: 01/12/2023]
Abstract
Research on the health impacts of green environments has mainly been conducted in developed countries. Differences in the urban forms between China and Western countries make it essential to understand the role of greenspace in Chinese settings. From 2014 to 2015, middle school students (n = 5643) in Suzhou, China were enrolled in a study on the health effect of residential greenness. The normalized difference vegetation index (NDVI) and distance to the nearest park were calculated for each home address. Logistic regression was performed to test associations between exposure and self-reported doctor diagnoses of asthma, pneumonia, rhinitis, and eczema, adjusting for important confounders. No statistically significant associations were observed for any seasonal NDVI-based measures. However, the proximity of the participants’ residences to the closest park showed an inverse relationship to reported symptoms. The odds ratios for the furthest quartile compared to the closest quartile based on the distance to the nearest park were 0.58 (95% CI: 0.35, 0.99), 0.70 (95% CI: 0.50, 0.96), 0.92 (95% CI: 0.74, 1.15), 0.97 (95% CI: 0.76, 1.24), 0.86 (95% CI: 0.68, 1.10) for current asthma, ever asthma, ever pneumonia, ever rhinitis, and ever eczema, respectively. These findings focused on a single Chinese city and suggest that exposure to natural vegetation in urban areas may affect health through various pathways.
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Schwarzer M, Hermanova P, Srutkova D, Golias J, Hudcovic T, Zwicker C, Sinkora M, Akgün J, Wiedermann U, Tuckova L, Kozakova H, Schabussova I. Germ-Free Mice Exhibit Mast Cells With Impaired Functionality and Gut Homing and Do Not Develop Food Allergy. Front Immunol 2019; 10:205. [PMID: 30809227 PMCID: PMC6379318 DOI: 10.3389/fimmu.2019.00205] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 01/23/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Mucosal mast cells (MC) are key players in IgE-mediated food allergy (FA). The evidence on the interaction between gut microbiota, MC and susceptibility to FA is contradictory. Objective: We tested the hypothesis that commensal bacteria are essential for MC migration to the gut and their maturation impacting the susceptibility to FA. Methods: The development and severity of FA symptoms was studied in sensitized germ-free (GF), conventional (CV), and mice mono-colonized with L. plantarum WCFS1 or co-housed with CV mice. MC were phenotypically and functionally characterized. Results: Systemic sensitization and oral challenge of GF mice with ovalbumin led to increased levels of specific IgE in serum compared to CV mice. Remarkably, despite the high levels of sensitization, GF mice did not develop diarrhea or anaphylactic hypothermia, common symptoms of FA. In the gut, GF mice expressed low levels of the MC tissue-homing markers CXCL1 and CXCL2, and harbored fewer MC which exhibited lower levels of MC protease-1 after challenge. Additionally, MC in GF mice were less mature as confirmed by flow-cytometry and their functionality was impaired as shown by reduced edema formation after injection of degranulation-provoking compound 48/80. Co-housing of GF mice with CV mice fully restored their susceptibility to develop FA. However, this did not occur when mice were mono-colonized with L. plantarum. Conclusion: Our results demonstrate that microbiota-induced maturation and gut-homing of MC is a critical step for the development of symptoms of experimental FA. This new mechanistic insight into microbiota-MC-FA axis can be exploited in the prevention and treatment of FA in humans.
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Affiliation(s)
- Martin Schwarzer
- Laboratory of Gnotobiology, Institute of Microbiology of the Czech Academy of Sciences, Novy Hradek, Czechia
| | - Petra Hermanova
- Laboratory of Gnotobiology, Institute of Microbiology of the Czech Academy of Sciences, Novy Hradek, Czechia
| | - Dagmar Srutkova
- Laboratory of Gnotobiology, Institute of Microbiology of the Czech Academy of Sciences, Novy Hradek, Czechia
| | - Jaroslav Golias
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czechia
| | - Tomas Hudcovic
- Laboratory of Gnotobiology, Institute of Microbiology of the Czech Academy of Sciences, Novy Hradek, Czechia
| | - Christian Zwicker
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Marek Sinkora
- Laboratory of Gnotobiology, Institute of Microbiology of the Czech Academy of Sciences, Novy Hradek, Czechia
| | - Johnnie Akgün
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Ursula Wiedermann
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Ludmila Tuckova
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czechia
| | - Hana Kozakova
- Laboratory of Gnotobiology, Institute of Microbiology of the Czech Academy of Sciences, Novy Hradek, Czechia
| | - Irma Schabussova
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria
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Murrison LB, Brandt EB, Myers JB, Hershey GKK. Environmental exposures and mechanisms in allergy and asthma development. J Clin Invest 2019; 129:1504-1515. [PMID: 30741719 DOI: 10.1172/jci124612] [Citation(s) in RCA: 174] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Environmental exposures interplay with human host factors to promote the development and progression of allergic diseases. The worldwide prevalence of allergic disease is rising as a result of complex gene-environment interactions that shape the immune system and host response. Research shows an association between the rise of allergic diseases and increasingly modern Westernized lifestyles, which are characterized by increased urbanization, time spent indoors, and antibiotic usage. These environmental changes result in increased exposure to air and traffic pollution, fungi, infectious agents, tobacco smoke, and other early-life and lifelong risk factors for the development and exacerbation of asthma and allergic diseases. It is increasingly recognized that the timing, load, and route of allergen exposure affect allergic disease phenotypes and development. Still, our ability to prevent allergic diseases is hindered by gaps in understanding of the underlying mechanisms and interaction of environmental, viral, and allergen exposures with immune pathways that impact disease development. This Review highlights epidemiologic and mechanistic evidence linking environmental exposures to the development and exacerbation of allergic airway responses.
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Affiliation(s)
- Liza Bronner Murrison
- Division of Asthma Research, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Eric B Brandt
- Division of Asthma Research, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA
| | - Jocelyn Biagini Myers
- Division of Asthma Research, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Gurjit K Khurana Hershey
- Division of Asthma Research, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Jheeta S, Smith D. Seeing the wood for the trees: A new way to view the human intestinal microbiome and its connection with non-communicable disease. Med Hypotheses 2019; 125:70-74. [PMID: 30902154 DOI: 10.1016/j.mehy.2019.02.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/23/2019] [Accepted: 02/02/2019] [Indexed: 12/19/2022]
Abstract
Our paper briefly reviews the connection of the intestinal microbiome to the rise in non-communicable conditions related to atopic disease, obesity and mental health. We consider that the microbiome is best treated as if it were a single entity and have borrowed the terms semiochemical, allomone and kairomone (5) to describe interspecies relationship between the microbiome and ourselves (Fig. 1). We use the term dysbiosis to describe the breakdown of these relationships leading to disease (Fig. 2). As a result of this analysis we tentatively suggest that components of the microbiome assess microbial antigens in our food and pass this information back to our immune system via as yet undescribed chemical messengers: kairomones. We call these hypothetical microbial agents Sentinel Cells. Our suggestion is that atopic disease arises partly as a result of consuming processed food that has insufficient antigens to activate this kairomone feedback mechanism, which atrophies as a result. We note that this is potentially similar to the Old Friends concept of Rook and his co-workers (16). We suggest that obesity is a consequence of dysbiosis-induced waning of the output of allomone-like psychotropic compounds (including the known microbial metabolites dopamine and serotonin) leading to the weakening of the gut-brain axis and a negative effect on mental health. Although dysbiosis can occur in other ways, including antibiotic use and sterile caesarian section, we believe that all these problems can be overcome to provide a future free of these non-communicable diseases.
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Solana E, Cruz MJ, Romero-Mesones C, Muñoz X. Concomitant hypersensitivity pneumonitis and occupational asthma caused by 2 different etiologic agents. Ann Allergy Asthma Immunol 2019; 122:424-425.e1. [PMID: 30641195 DOI: 10.1016/j.anai.2019.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/18/2018] [Accepted: 01/07/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Elena Solana
- Servicio de Neumología, Hospital General Universitario Morales Messeguer, Murcia, Spain
| | - Maria-Jesus Cruz
- Servicio de Neumología Hospital Universitario Vall d'Hebron, Barcelona, Spain; Centro de Investigación en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
| | | | - Xavier Muñoz
- Servicio de Neumología Hospital Universitario Vall d'Hebron, Barcelona, Spain; Centro de Investigación en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Department of Cell Biology, Physiology, and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain
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Abstract
Background: Cleaning and disinfecting agents are widely used in modern life, in homes, schools, public places, and workplaces as well as in recreational facilities such as swimming pools. Use has been for sanitizing purposes and to assist in reduction of infection as well as for deodorizing purposes. However, adverse respiratory effects have been associated with use of cleaning products ranging from effects in infancy and early childhood up to adults at home and work. Methods: This review summarizes recent published literature on the effects of cleaning agents used pre-natally, in childhood and adult life, at home, work, and in swimming pools. Results: Several studies have indicated that there is an increased risk of developing asthma among adults with frequent exposure to cleaning products at work and in the home. Potential mechanisms include sensitization and respiratory irritant effects. Exposure to irritant chlorine by-products from swimming pools have also been associated with respiratory effects and increased risk of asthma. Potential effects from maternal exposures to cleaning products on infants, and effects on early childhood atopy are less clear. Conclusions: Exposure to cleaning agents increases relative risks of asthma among workers, and adults using these agents in the home. Risks are also increased with exposure to chlorinated by-products from swimming pools, both in adults and children. Further studies are needed to understand the mechanisms of these associations.
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69
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Katsoulis K, Ismailos G, Kipourou M, Kostikas K. Microbiota and asthma: Clinical implications. Respir Med 2018; 146:28-35. [PMID: 30665515 DOI: 10.1016/j.rmed.2018.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/01/2018] [Accepted: 11/20/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Konstantinos Katsoulis
- Pulmonary Department, 424 Army General Hospital, Periferiaki Odos, 56429, Efkarpia, Thessaloniki, Greece
| | - Georgios Ismailos
- Experimental-Research Center ELPEN, ELPEN Pharmaceuticals, Leoforos Marathonos 95, 19009, Pikermi, Attika, Greece
| | - Maria Kipourou
- Pulmonary Department, 424 Army General Hospital, Periferiaki Odos, 56429, Efkarpia, Thessaloniki, Greece.
| | - Konstantinos Kostikas
- 2nd Respiratory Medicine Department, University of Athens Medical School, Attikon Hospital, Athens, Greece
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Boehmer D, Schuster B, Krause J, Darsow U, Biedermann T, Zink A. Prevalence and treatment of allergies in rural areas of Bavaria, Germany: a cross-sectional study. World Allergy Organ J 2018; 11:36. [PMID: 30473740 PMCID: PMC6241034 DOI: 10.1186/s40413-018-0218-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/12/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND There is a high prevalence of allergies in Germany, with approximately 20% of the population having at least one allergy and only about 10% of these being treated adequately. We conducted a cross-sectional study in a rural area of Bavaria (Southern Germany) to evaluate the prevalence of allergies and their treatment, because research regarding this topic is currently limited. METHODS Data were collected in 10 offices of non-dermatological doctors using a self-filled questionnaire to ask participants about allergies and treatment. RESULTS A total of 641 questionnaires were appropriate for analysis. The prevalence of allergies in the Bavarian countryside was higher than that reported for Germany (37.3% vs. 20.0%). Furthermore, almost a third (30.4%) of allergies were not treated at all. The most frequently consulted therapist was found to be a general practitioner. CONCLUSIONS Based on the study results, there is a need for prevention programs and establishment of treatments for certain allergies to minimize long-term health effects. Moreover, more studies are needed to analyze the prevalence of allergies in farmers who had a higher prevalence of allergies compared to previously reported prevalence in literature reviews. TRIAL REGISTRATIONS The study was approved by the ethical review committee of the Technical University Munich (EC number 548/16S).
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Affiliation(s)
- Danielle Boehmer
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Barbara Schuster
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Julia Krause
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Ulf Darsow
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
- Clinical Unit Allergology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Neuherberg, Germany
| | - Alexander Zink
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
- Clinical Unit Allergology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Neuherberg, Germany
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Boutin RCT, Dwyer Z, Farmer K, Rudyk C, Forbes MR, Hayley S. Perinatal antibiotic exposure alters composition of murine gut microbiota and may influence later responses to peanut antigen. Allergy Asthma Clin Immunol 2018; 14:42. [PMID: 30410548 PMCID: PMC6211427 DOI: 10.1186/s13223-018-0263-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 04/30/2018] [Indexed: 01/06/2023] Open
Abstract
Background Accumulating evidence suggests that the gut microbiota shapes developmental processes within the immune system. Early life antibiotic use is one factor which may contribute to immune dysfunction and the recent surge in allergies by virtue of its effects on gut microbiota. Objective and methods As a first step towards determining whether a relationship exists between perinatal antibiotic induced changes in the gut microbiota and the later development of a peanut allergy, we exposed newborn mice to either the broad-spectrum antibiotic vancomycin or to a vehicle for 6 weeks and then used a novel murine model of peanut allergy. Results Early-life treatment with vancomycin resulted in a significant shift in the gut microbiota community characterized by a reduction in the abundance of firmicutes and preponderance of inflammatory proteobacteria. Mice with an antibiotic-altered microbiota, showed a localized allergic-like response characterized by ear swelling and scratching following intra-dermal peanut antigen challenge. Likewise, circulating IgE levels were increased in antibiotic-treated mice, but no evidence of a systemic allergic or anaphylactic-like response was observed. Importantly, we utilized the naturally occurring pro-inflammatory cytokine, tumor necrosis factor-α (TNF-α), rather than the more commonly used cholera toxin, as an adjuvant together with the peanut antigen. Conclusion Our data suggest that early antibiotic exposure promotes a shift in the gut microbiota community that may in turn, influence how mice later respond to a TNF-α + antigen challenge. However, further studies verifying the capacity of microbiota restoration to protect against allergic responses will be needed to confirm a causal role of antibiotic-induced microbiota variations in promoting allergic disease phenotypes.
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Affiliation(s)
- Rozlyn C T Boutin
- 1Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada.,2Department of Biology, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada
| | - Zach Dwyer
- 1Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada.,2Department of Biology, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada
| | - Kyle Farmer
- 1Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada.,2Department of Biology, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada
| | - Chris Rudyk
- 1Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada.,2Department of Biology, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada
| | - Mark R Forbes
- 1Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada.,2Department of Biology, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada
| | - Shawn Hayley
- 1Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada.,2Department of Biology, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6 ON Canada
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Ayuk AC, Ramjith J, Zar HJ. Environmental risk factors for asthma in 13-14 year old African children. Pediatr Pulmonol 2018; 53:1475-1484. [PMID: 30238644 DOI: 10.1002/ppul.24162] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 08/22/2018] [Indexed: 12/19/2022]
Abstract
Background Asthma prevalence in African children is high. Factors driving the prevalence or disease severity are poorly understood. This study aims to investigate environmental factors associated with asthma and severity in African children. Methods Population based cross-sectional study of children aged 13-14 years from 10 African centers who participated in ISAAC III. Self-reported environmental exposures included engaging in physical exercise, television watching, various biomass and ETS exposure, consumption of paracetamol, large family sizes and having pets in the home. Univariable and multivariable analyses were done adjusting for center variations. Prevalences, odds ratio and 95% confidence intervals (CI) were calculated. Results There were 258 267 children recruited among the 13-14-year-old participants. Of these, 28,391 respondents from 232 schools completed both the written questionnaire (WQ) and environmental questionnaire (EQ). The prevalence of asthma and severe asthma were 12.8% (CI 12.4-13.2), and 8.7% (CI 8.4-8.0) respectively. Factors strongly associated with asthma were maternal smoking (OR = 1.41; 95%CI: 1.23-1.64), open fire heating (OR = 1.28; 95%CI: 1.08-1.51) electric heating (OR = 1.13; 95%CI: 1.01-1.28), physical exercise (OR = 1.29; 95%CI: 1.11-1.50), monthly paracetamol use (OR 1.23; 95%CI 1.13-1.33), having an elder sibling (OR = 0.87; 95%CI 0.77-0.98). Factors associated with severe asthma were maternal smoking (OR = 1.61; 95%CI: 1.38-1.89), cat pet (OR = 1.14; 95%CI: 1.04-1.25), frequent physical exercise (OR = 1.42; 95%CI: 1.23-1.64) and monthly paracetamol use (OR = 1.20; 95%CI 1.07, 1.34). Conclusion Several environmental exposures were associated with asthma and severe disease.
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Affiliation(s)
- Adaeze C Ayuk
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital University of Cape Town, Cape Town, South Africa.,Department of Paediatrics, College of Medicine, University of Nigeria Nsukka Enugu campus and University of Nigeria Teaching Hospital Enugu, Enugu, Nigeria
| | - Jordache Ramjith
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital University of Cape Town, Cape Town, South Africa.,SA MRC Unit of Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
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Remes S, Kulmala P. The interplay between risk and preventive factors explains why some children develop allergies to certain foods and others show tolerance. Acta Paediatr 2018; 107:1677-1683. [PMID: 29751365 DOI: 10.1111/apa.14391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/26/2018] [Accepted: 05/03/2018] [Indexed: 01/02/2023]
Abstract
AIM A number of studies have clarified the tolerance mechanisms and risk factors for food allergies. Our aim was to explore food allergy symptoms by target organs, together with the risk factors and how to prevent food allergies and induce tolerance. METHODS We carried out a thorough review of studies on paediatric food allergies published in the last decade. RESULTS Food allergy symptoms may affect the skin, nasal and oral mucosa, conjunctivae, gastrointestinal tract or, in severe cases, the respiratory tract and cardiovascular organs. Immunoglobulin E (IgE)-mediated symptoms appear rapidly after exposure to the offending allergen, whereas non-IgE-mediated symptoms are typically delayed. The immunological processes involved in non-IgE-mediated allergic reactions are poorly understood, but T-cell activation is probably involved. There are several factors that influence the food sensitisation process: genetic predisposition, disruption of oral tolerance development, impaired skin barriers in atopic eczema and the influence of microbiomes. CONCLUSION The symptoms and intensity of reactions vary considerably with regard to food allergies, and these depend on the individual's concomitant immunological and regulatory mechanisms. There is strong evidence that dietary diversity is important for children, even when they come from families with high allergy risks.
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Affiliation(s)
- Sami Remes
- Department of Paediatrics; Kuopio University Hospital; Kuopio Finland
| | - Petri Kulmala
- PEDEGO Research Unit and Medical Research Center (MRC) Oulu; University of Oulu; Oulu University Hospital; Oulu Finland
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74
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Abstract
PURPOSE OF REVIEW The review provides insight into recent findings on bedroom allergen exposures, primarily focusing on pet, pest, and fungal exposures. RECENT FINDINGS Large-scale studies and improved exposure assessment technologies, including measurement of airborne allergens and of multiple allergens simultaneously, have extended our understanding of indoor allergen exposures and their impact on allergic disease. Practical, streamlined methods for exposure reduction have shown promise in some settings, and potential protective effects of early-life exposures have been further elucidated through the investigation of specific bacterial taxa. Advances in molecular allergology have yielded novel data on sensitization profiles and cross-reactivity. The role of indoor allergen exposures in allergic disease is complex and remains incompletely understood. Advancing our knowledge of various co-exposures, including the environmental and host microbiome, that interact with allergens in early life will be crucial for the development of efficacious interventions to reduce the substantial economic and social burden of allergic diseases including asthma.
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75
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Yu JE, Mallapaty A, Miller RL. It's not just the food you eat: Environmental factors in the development of food allergies. ENVIRONMENTAL RESEARCH 2018; 165:118-124. [PMID: 29689456 DOI: 10.1016/j.envres.2018.03.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 06/08/2023]
Abstract
The dramatic rise in the prevalence of food allergy and food allergy-associated anaphylaxis in the past few decades has fueled investigative interest into understanding this puzzling trend. Here, we review the question as to whether important external environmental determinants beyond dietary habits and exposure to food allergens are involved. This review will summarize our current understanding of these environment determinants, derived from the latest experimental and epidemiological research. Specifically, we will review the role of exposures that affect skin barrier function, development of a diverse microbiome, and food processing. Additional exposures of concern are insufficient sunlight, endocrine disrupting chemicals and pesticides, and use of specific pharmaceutical agents that may drive or modify the risk for food allergy. Despite limitations in the quantity and quality of research to date, many new epidemiological associations and experimental data in support of this paradigm have emerged.
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Affiliation(s)
- Joyce E Yu
- Division of Allergy, Immunology, Rheumatology, Department of Pediatrics, PH8E-101, Columbia University Medical Center, 630 W. 168th St., New York, NY 10032, USA
| | - Anu Mallapaty
- Division of Allergy, Immunology, Rheumatology, Department of Pediatrics, PH8E-101, Columbia University Medical Center, 630 W. 168th St., New York, NY 10032, USA
| | - Rachel L Miller
- Division of Allergy, Immunology, Rheumatology, Department of Pediatrics, PH8E-101, Columbia University Medical Center, 630 W. 168th St., New York, NY 10032, USA; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, PH8E-101, Columbia University Medical Center, 630 W. 168th St., New York, NY 10032, USA; Department of Environmental Health Sciences, Mailman School of Public Health, 722 W. 168th St., New York, NY 10032, USA.
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76
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Abstract
Sublingual immunotherapy (SLIT) is effective for the treatment of allergic rhinitis and allergic asthma in adults and children. In a limited number of studies, SLIT efficacy has been demonstrated for the treatment of food allergy. SLIT has a higher safety profile versus subcutaneous immunotherapy, although some systemic reactions have been reported. Appropriate patient selection, meticulous patient education, and routine follow-up are key for the safe and effective administration of SLIT. With organization and attention to detail, adding SLIT to one's practice can provide a highly valued patient service.
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77
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The Rise and Rise of Eosinophilic Gut Diseases Including Eosinophilic Esophagitis Is Probably Not Explained by the Disappearance of Helicobacter pylori, so Who or What's to Blame? Am J Gastroenterol 2018; 113:941-944. [PMID: 29910462 DOI: 10.1038/s41395-018-0125-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 04/30/2018] [Indexed: 02/06/2023]
Abstract
A dramatic increase in eosinophilic esophagitis (EoE) and atopic disease and a dramatic decline in Helicobacter pylori infection has been observed in the last few decades. Previously, it was speculated that the immune response to H. pylori may protect against allergic diseases including EoE, but this study by Molina-Infante et al. shows no clear relationship, and suggests that any correlation is not causal. In truth it is likely that a combination of many factors, including a changing microbiome with increasing hygiene and alterations in early life such as antibiotic exposure, changing diet and other lifestyle factors drive increasing atopic diseases including food allergies and EoE.
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78
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Jensen ET, Dellon ES. Environmental factors and eosinophilic esophagitis. J Allergy Clin Immunol 2018; 142:32-40. [PMID: 29729305 PMCID: PMC6035771 DOI: 10.1016/j.jaci.2018.04.015] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/30/2018] [Accepted: 04/24/2018] [Indexed: 12/17/2022]
Abstract
The incidence and prevalence of eosinophilic esophagitis (EoE) have markedly increased over the past 2 decades, outpacing increased detection of the disease. Although genetic susceptibility markers for EoE have begun to be elucidated, the rate at which EoE has increased in incidence suggests environmental factors predominate. Despite many advances in understanding of the pathogenesis of EoE, the cause of EoE is unknown. This article reviews the emerging data related to environmental risk factors for EoE. Many of these environmental factors are rooted in the theoretical framework of the hygiene hypothesis, specifically mediation of disease development through dysbiosis. Other hypotheses are based on associations that have been observed in studies of non-EoE allergic disease. We describe the evidence that early-life exposures, including antibiotic use, acid suppression, and cesarean delivery, can increase the risk of disease. We also describe the evidence that infectious agents, such as Helicobacter pylori, are inversely associated with disease. Current evidence on geographic risk factors, such as population density, climate zone, and seasonality, is reviewed. We also describe behavioral factors that have been evaluated. Limitations of the existing research are discussed, and recommendations for future areas of research, including assessment of gene-environment interaction, are presented.
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Affiliation(s)
- Elizabeth T Jensen
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Wake Forest Baptist Medical Center, Winston-Salem, NC; Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Evan S Dellon
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC.
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79
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Borde A, Åstrand A. Alopecia areata and the gut-the link opens up for novel therapeutic interventions. Expert Opin Ther Targets 2018; 22:503-511. [PMID: 29808708 DOI: 10.1080/14728222.2018.1481504] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION This review aims to raise the potential of the modern society's impact on gut integrity often leading to increased intestinal permeability, as a cause or driver of Alopecia Areata (AA) in genetically susceptible people. With the increasing rate of T cell-driven autoimmunity, we hypothesize that there is a common root cause of these diseases that originates from chronic inflammation, and that the gut is the most commonly exposed area with our modern lifestyle. Areas covered: We will discuss the complexity in the induction of AA and its potential link to increased intestinal permeability. Our main focus will be on the gut microbiome and mechanisms involved in the interplay with the immune system that may lead to local and/or peripheral inflammation and finally, tissue destruction. Expert opinion: We have seen a link between AA and a dysfunctional gastrointestinal system which raised the hypothesis that an underlying intestinal inflammation drives the priming and dysregulation of immune cells that lead to hair follicle destruction. While it is still important to resolve local inflammation and restore the IP around the hair follicles, we believe that the root cause needs to be eradicated by long-term interventions to extinguish the fire driving the disease.
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Affiliation(s)
- Annika Borde
- a Respiratory, Inflammation and Autoimmunity IMED Biotech Unit , AstraZeneca , Gothenburg , Sweden
| | - Annika Åstrand
- a Respiratory, Inflammation and Autoimmunity IMED Biotech Unit , AstraZeneca , Gothenburg , Sweden
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80
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Freer G, Maggi F, Pifferi M, Di Cicco ME, Peroni DG, Pistello M. The Virome and Its Major Component, Anellovirus, a Convoluted System Molding Human Immune Defenses and Possibly Affecting the Development of Asthma and Respiratory Diseases in Childhood. Front Microbiol 2018; 9:686. [PMID: 29692764 PMCID: PMC5902699 DOI: 10.3389/fmicb.2018.00686] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 03/23/2018] [Indexed: 12/13/2022] Open
Abstract
The microbiome, a thriving and complex microbial community colonizing the human body, has a broad impact on human health. Colonization is a continuous process that starts very early in life and occurs thanks to shrewd strategies microbes have evolved to tackle a convoluted array of anatomical, physiological, and functional barriers of the human body. Cumulative evidence shows that viruses are part of the microbiome. This part, called virome, has a dynamic composition that reflects what we eat, how and where we live, what we do, our genetic background, and other unpredictable variables. Thus, the virome plays a chief role in shaping innate and adaptive host immune defenses. Imbalance of normal microbial flora is thought to trigger or exacerbate many acute and chronic disorders. A compelling example can be found in the respiratory apparatus, where early-life viral infections are major determinants for the development of allergic diseases, like asthma, and other non-transmissible diseases. In this review, we focus on the virome and, particularly, on Anelloviridae, a recently discovered virus family. Anelloviruses are major components of the virome, present in most, if not all, human beings, where they are acquired early in life and replicate persistently without causing apparent disease. We will discuss how modulation of innate and adaptive immune systems by Anelloviruses can influence the development of respiratory diseases in childhood and provide evidence for the use of Anelloviruses as useful and practical molecular markers to monitor inflammatory processes and immune system competence.
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Affiliation(s)
- Giulia Freer
- Retrovirus Center, Department of Translational Research, University of Pisa, Pisa, Italy
| | | | - Massimo Pifferi
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Maria E Di Cicco
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Diego G Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Mauro Pistello
- Retrovirus Center, Department of Translational Research, University of Pisa, Pisa, Italy.,Virology Unit, University Hospital of Pisa, Pisa, Italy
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81
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Erturk-Hasdemir D, Kasper DL. Finding a needle in a haystack: Bacteroides fragilis polysaccharide A as the archetypical symbiosis factor. Ann N Y Acad Sci 2018. [PMID: 29528123 DOI: 10.1111/nyas.13660] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Starting from birth, all animals develop a symbiotic relationship with their resident microorganisms that benefits both the microbe and the host. Recent advances in technology have substantially improved our ability to direct research toward the identification of important microbial species that affect host physiology. The identification of specific commensal molecules from these microbes and their mechanisms of action is still in its early stages. Polysaccharide A (PSA) of Bacteroides fragilis is the archetypical example of a commensal molecule that can modulate the host immune system in health and disease. This zwitterionic polysaccharide has a critical impact on the development of the mammalian immune system and also on the stimulation of interleukin 10-producing CD4+ T cells; consequently, PSA confers benefits to the host with regard to experimental autoimmune, inflammatory, and infectious diseases. In this review, we summarize the current understanding of the immunomodulatory effects of B. fragilis PSA and discuss these effects as a novel immunological paradigm. In particular, we discuss recent advances in our understanding of the unique functional mechanisms of this molecule and its therapeutic potential, and we review the recent literature in the field of microbiome research aimed at discovering new commensal products and their immunomodulatory potential.
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Affiliation(s)
- Deniz Erturk-Hasdemir
- Division of Immunology, Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts
| | - Dennis L Kasper
- Division of Immunology, Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts
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82
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Bloomfield SF, Rook GA, Scott EA, Shanahan F, Stanwell-Smith R, Turner P. Time to abandon the hygiene hypothesis: new perspectives on allergic disease, the human microbiome, infectious disease prevention and the role of targeted hygiene. Perspect Public Health 2018; 136:213-24. [PMID: 27354505 PMCID: PMC4966430 DOI: 10.1177/1757913916650225] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Aims: To review the burden of allergic and infectious diseases and the evidence for
a link to microbial exposure, the human microbiome and immune system, and to
assess whether we could develop lifestyles which reconnect us with exposures
which could reduce the risk of allergic disease while also protecting
against infectious disease. Methods: Using methodology based on the Delphi technique, six experts in infectious
and allergic disease were surveyed to allow for elicitation of group
judgement and consensus view on issues pertinent to the aim. Results: Key themes emerged where evidence shows that interaction with microbes that
inhabit the natural environment and human microbiome plays an essential role
in immune regulation. Changes in lifestyle and environmental exposure, rapid
urbanisation, altered diet and antibiotic use have had profound effects on
the human microbiome, leading to failure of immunotolerance and increased
risk of allergic disease. Although evidence supports the concept of immune
regulation driven by microbe–host interactions, the term ‘hygiene
hypothesis’ is a misleading misnomer. There is no good evidence that
hygiene, as the public understands, is responsible for the clinically
relevant changes to microbial exposures. Conclusion: Evidence suggests a combination of strategies, including natural childbirth,
breast feeding, increased social exposure through sport, other outdoor
activities, less time spent indoors, diet and appropriate antibiotic use,
may help restore the microbiome and perhaps reduce risks of allergic
disease. Preventive efforts must focus on early life. The term ‘hygiene
hypothesis’ must be abandoned. Promotion of a risk assessment approach
(targeted hygiene) provides a framework for maximising protection against
pathogen exposure while allowing spread of essential microbes between family
members. To build on these findings, we must change public, public health
and professional perceptions about the microbiome and about hygiene. We need
to restore public understanding of hygiene as a means to prevent infectious
disease.
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Affiliation(s)
- Sally F Bloomfield
- London School of Hygiene & Tropical Medicine and International Scientific Forum on Home Hygiene, The Old Dairy Cottage, Montacute, Somerset TA15 6XL, UK
| | - Graham Aw Rook
- Centre for Clinical Microbiology, Department of Infection, University College London (UCL), London, UK
| | - Elizabeth A Scott
- Center for Hygiene and Health, Department of Biology, Simmons College, Boston, MA, USA
| | - Fergus Shanahan
- APC Microbiome Institute, University College Cork - National University of Ireland, Cork, Ireland
| | | | - Paul Turner
- Section of Paediatrics (Allergy & Infectious Diseases) and MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, UK; Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, NSW, Australia
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83
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Kim BS, Lee E, Lee MJ, Kang MJ, Yoon J, Cho HJ, Park J, Won S, Lee SY, Hong SJ. Different functional genes of upper airway microbiome associated with natural course of childhood asthma. Allergy 2018; 73:644-652. [PMID: 29052232 DOI: 10.1111/all.13331] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Microbial colonization of the airway plays a role in the pathogenesis of asthma; however, the effect of the upper airway microbiome on childhood asthma is not fully understood. We analyzed the metagenome of airway microbiome to understand the associated role of upper airway microbiome with the natural course of childhood asthma. METHODS Nasopharyngeal swabs were collected from children with asthma, those in asthma remission, and control groups. High-throughput sequencing was used to examine the structure and functional dynamics of the airway microbiome with respect to asthma phenotypes. RESULTS The composition of microbiota differed among healthy control, asthma, and remission groups. The relative abundance of Streptococcus was negatively associated with FEV1% predicted (P = .023) and that of Staphylococcus was negatively associated with methacholine PC20 (P = .013). Genes related to arachidonic acid metabolites, lysine residues, and glycosaminoglycans in the microbiome could be associated with airway inflammation. In particular, genes related to synthesis of anti-inflammatory prostaglandin E2 (PGE2 ) were not detected from the airway microbiome in the asthma group. CONCLUSIONS These data suggest that alterations in the composition and function of the upper airway microbiome could be related with the natural course of asthma in children.
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Affiliation(s)
- B.-S. Kim
- Department of Life Science; Multidisciplinary Genome Institute; Hallym University; Chuncheon Korea
| | - E. Lee
- Department of Pediatrics; Chonnam National University Hospital; Gwangju Korea
| | - M.-J. Lee
- Department of Life Science; Multidisciplinary Genome Institute; Hallym University; Chuncheon Korea
| | - M.-J. Kang
- Asan Institute for Life Science; University of Ulsan College of Medicine; Seoul Korea
| | - J. Yoon
- Department of Pediatrics; Childhood Asthma Atopy Center; Environmental Health Center; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - H.-J. Cho
- Department of Pediatrics; Childhood Asthma Atopy Center; Environmental Health Center; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - J. Park
- Interdisciplinary Program of Bioinformatics; Seoul National University; Seoul Korea
| | - S. Won
- Interdisciplinary Program of Bioinformatics; Seoul National University; Seoul Korea
- Department of Public Health Science; Seoul National University; Seoul Korea
- Institute of Health and Environment; Seoul National University; Seoul Korea
| | - S. Y. Lee
- Department of Pediatrics; Childhood Asthma Atopy Center; Environmental Health Center; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - S. J. Hong
- Department of Pediatrics; Childhood Asthma Atopy Center; Environmental Health Center; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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84
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Wark PAB, Ramsahai JM, Pathinayake P, Malik B, Bartlett NW. Respiratory Viruses and Asthma. Semin Respir Crit Care Med 2018; 39:45-55. [PMID: 29427985 PMCID: PMC7117086 DOI: 10.1055/s-0037-1617412] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Asthma remains the most prevalent chronic respiratory disorder, affecting people of all ages. The relationship between respiratory virus infection and asthma has long been recognized, though remains incompletely understood. In this article, we will address key issues around this relationship. These will include the crucial role virus infection plays in early life, as a potential risk factor for the development of asthma and lung disease. We will assess the impact that virus infection has on those with established asthma as a trigger for acute disease and how this may influence asthma throughout life. Finally, we will explore the complex interaction that occurs between the airway and the immune responses that make those with asthma so susceptible to the effects of virus infection.
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Affiliation(s)
- Peter A B Wark
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New South Wales, Australia
| | - James Michael Ramsahai
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New South Wales, Australia
| | - Prabuddha Pathinayake
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New South Wales, Australia
| | - Bilal Malik
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia
| | - Nathan W Bartlett
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia.,School of Biomedical Sciences, The University of Newcastle, New South Wales, Australia
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85
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Kenny LC, Kell DB. Immunological Tolerance, Pregnancy, and Preeclampsia: The Roles of Semen Microbes and the Father. Front Med (Lausanne) 2018; 4:239. [PMID: 29354635 PMCID: PMC5758600 DOI: 10.3389/fmed.2017.00239] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/12/2017] [Indexed: 12/18/2022] Open
Abstract
Although it is widely considered, in many cases, to involve two separable stages (poor placentation followed by oxidative stress/inflammation), the precise originating causes of preeclampsia (PE) remain elusive. We have previously brought together some of the considerable evidence that a (dormant) microbial component is commonly a significant part of its etiology. However, apart from recognizing, consistent with this view, that the many inflammatory markers of PE are also increased in infection, we had little to say about immunity, whether innate or adaptive. In addition, we focused on the gut, oral and female urinary tract microbiomes as the main sources of the infection. We here marshall further evidence for an infectious component in PE, focusing on the immunological tolerance characteristic of pregnancy, and the well-established fact that increased exposure to the father's semen assists this immunological tolerance. As well as these benefits, however, semen is not sterile, microbial tolerance mechanisms may exist, and we also review the evidence that semen may be responsible for inoculating the developing conceptus (and maybe the placenta) with microbes, not all of which are benign. It is suggested that when they are not, this may be a significant cause of PE. A variety of epidemiological and other evidence is entirely consistent with this, not least correlations between semen infection, infertility and PE. Our view also leads to a series of other, testable predictions. Overall, we argue for a significant paternal role in the development of PE through microbial infection of the mother via insemination.
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Affiliation(s)
- Louise C. Kenny
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Douglas B. Kell
- School of Chemistry, The University of Manchester, Manchester, United Kingdom
- The Manchester Institute of Biotechnology, The University of Manchester, Manchester, United Kingdom
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86
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Kim DH, Han K, Kim SW. Effects of Antibiotics on the Development of Asthma and Other Allergic Diseases in Children and Adolescents. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:457-465. [PMID: 30088366 PMCID: PMC6082825 DOI: 10.4168/aair.2018.10.5.457] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 04/17/2018] [Accepted: 05/03/2018] [Indexed: 01/15/2023]
Abstract
Purpose Our aim was to explore whether antibiotic exposure in children and adolescents is associated with the later development of allergic diseases, using nationwide population-based claims data. Methods We collected information from the National Health Insurance Service (2006–2015) database. A total of 5,626,328 children and adolescents were eligible for the study. We explored whether exposure to antibiotics over the prior 7 years affects the later development of allergic diseases. We ran 3 analytical models after adjusting for confounding factors including age, sex, the number of visits to healthcare providers, income, and the place of residence (urban/rural). Results Allergic diseases were most common in male children and those aged < 10 years (atopic dermatitis, asthma and allergic rhinitis; all P < 0.01). Also, urban residents with higher incomes were more likely to develop allergic diseases (all P < 0.01). The annual number of days on which antibiotics were prescribed differed significantly between subjects with each allergic disease studied and a comparison group (all P < 0.01). Multiple logistic regression showed that as the duration of antibiotic exposure increased, the incidences of atopic dermatitis, asthma, and allergic rhinitis trended upward, even after adjusting for confounding factors (P for trend < 0.01). Conclusions Antibiotic use early in life is associated with an increased risk of allergic disease, especially in young children; the risk increases as the duration of antibiotic therapy rises. Moreover, urban residence was more strongly associated with a longer duration of antibiotic use than was rural residence.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, The Catholic University of Korea, Seoul, Korea
| | - Soo Whan Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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87
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Johnston JD, Kruman BA, Nelson MC, Merrill RM, Graul RJ, Hoybjerg TG, Tuttle SC, Myers SJ, Cook RB, Weber KS. Differential effects of air conditioning type on residential endotoxin levels in a semi-arid climate. INDOOR AIR 2017; 27:946-954. [PMID: 28141892 DOI: 10.1111/ina.12369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/25/2017] [Indexed: 06/06/2023]
Abstract
Residential endotoxin exposure is associated with protective and pathogenic health outcomes. Evaporative coolers, an energy-efficient type of air conditioner used in dry climates, are a potential source of indoor endotoxins; however, this association is largely unstudied. We collected settled dust biannually from four locations in homes with evaporative coolers (n=18) and central air conditioners (n=22) in Utah County, Utah (USA), during winter (Jan-Apr) and summer (Aug-Sept), 2014. Dust samples (n=281) were analyzed by the Limulus amebocyte lysate test. Housing factors were measured by survey, and indoor temperature and relative humidity measures were collected during both seasons. Endotoxin concentrations (EU/mg) were significantly higher in homes with evaporative coolers from mattress and bedroom floor samples during both seasons. Endotoxin surface loads (EU/m2 ) were significantly higher in homes with evaporative coolers from mattress and bedroom floor samples during both seasons and in upholstered furniture during winter. For the nine significant season-by-location comparisons, EU/mg and EU/m2 were approximately three to six times greater in homes using evaporative coolers. A plausible explanation for these findings is that evaporative coolers serve as a reservoir and distribution system for Gram-negative bacteria or their cell wall components in homes.
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Affiliation(s)
- J D Johnston
- Department of Health Science, Brigham Young University, Provo, Utah, USA
| | - B A Kruman
- Department of Health Science, Brigham Young University, Provo, Utah, USA
| | - M C Nelson
- Microbiology & Molecular Biology, Brigham Young University, Provo, Utah, USA
| | - R M Merrill
- Department of Health Science, Brigham Young University, Provo, Utah, USA
| | - R J Graul
- Department of Health Science, Brigham Young University, Provo, Utah, USA
| | - T G Hoybjerg
- Microbiology & Molecular Biology, Brigham Young University, Provo, Utah, USA
| | - S C Tuttle
- Department of Health Science, Brigham Young University, Provo, Utah, USA
| | - S J Myers
- Microbiology & Molecular Biology, Brigham Young University, Provo, Utah, USA
| | - R B Cook
- Microbiology & Molecular Biology, Brigham Young University, Provo, Utah, USA
| | - K S Weber
- Microbiology & Molecular Biology, Brigham Young University, Provo, Utah, USA
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88
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Correlation between early-life regulation of the immune system by microbiota and allergy development. J Allergy Clin Immunol 2017; 139:1084-1091. [PMID: 28390575 DOI: 10.1016/j.jaci.2017.02.011] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/15/2017] [Accepted: 02/22/2017] [Indexed: 01/09/2023]
Abstract
Early postnatal life is a key time for development of the immune system and colonization of the host by microbiota. Recent studies have shown that specific limbs of the immune system can be regulated by microbiota in a time-restricted period during early life. Studies in mouse models have shown that perturbations of the microbiota during early life can cause immune effects that can persist into adulthood and create increased host susceptibility to certain diseases. Here we discuss the role of early-life regulation of the immune system by the microbiota and how it can be related to allergy development.
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89
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Hara A, Iwasa Y. When is allergen immunotherapy effective? J Theor Biol 2017; 425:23-42. [PMID: 28483565 DOI: 10.1016/j.jtbi.2017.04.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 02/07/2023]
Abstract
Allergen immunotherapy is used to treat allergic symptoms such as rhinitis and itchy eyes in Japanese patients with cedar pollen allergy (JCPA). Administration of small amounts of pollen over several years may suppress severe allergic symptoms when these patients are later exposed to large amounts of pollen in the environment. Herein, we developed a simple mathematical model to identify conditions in which allergen immunotherapy is effective. We considered the dynamics of type 2 T helper cells (Th2) and regulatory T cells (Treg), both of which differentiate from naive T cells. Therapy was considered successful under the following three conditions: (1) Without therapy patients develop allergic symptoms upon exposure to environmental pollen, (2) with therapy patients do not develop symptoms upon exposure, and (3) patients do not develop allergic symptoms to the therapy itself. We defined scores for therapeutic success and identified ranges of parameters in which allergen immunotherapy is likely to be successful. Treg cells have a longer lifespan than Th2 cells, allowing accumulation over many years. In accordance, therapy with linear dose increases (rather than constant doses) reduced the risk of allergies to the therapy itself, and led to stronger accumulation of resistance to pollen exposure.
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Affiliation(s)
- Akane Hara
- Department of Biology, Faculty of Science, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan .
| | - Yoh Iwasa
- Department of Biology, Faculty of Science, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
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90
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Liu AH, Anderson WC, Dutmer CM, Searing DA, Szefler SJ. Advances in asthma 2015: Across the lifespan. J Allergy Clin Immunol 2017; 138:397-404. [PMID: 27497278 DOI: 10.1016/j.jaci.2016.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/21/2016] [Accepted: 06/23/2016] [Indexed: 12/19/2022]
Abstract
In 2015, progress in understanding asthma ranged from insights to asthma inception, exacerbations, and severity to advancements that will improve disease management throughout the lifespan. 2015's insights to asthma inception included how the intestinal microbiome affects asthma expression with the identification of specific gastrointestinal bacterial taxa in early infancy associated with less asthma risk, possibly by promoting regulatory immune development at a critical early age. The relevance of epigenetic mechanisms in regulating asthma-related gene expression was strengthened. Predicting and preventing exacerbations throughout life might help to reduce progressive lung function decrease and disease severity in adulthood. Although allergy has long been linked to asthma exacerbations, a mechanism through which IgE impairs rhinovirus immunity and underlies asthma exacerbations was demonstrated and improved by anti-IgE therapy (omalizumab). Other key molecular pathways underlying asthma exacerbations, such as cadherin-related family member 3 (CDHR3) and orosomucoid like 3 (ORMDL3), were elucidated. New anti-IL-5 therapeutics, mepolizumab and reslizumab, were US Food and Drug Administration approved for the treatment of patients with severe eosinophilic asthma. In a clinical trial the novel therapeutic inhaled GATA3 mRNA-specific DNAzyme attenuated early- and late-phase allergic responses to inhaled allergen. These current findings are significant steps toward addressing unmet needs in asthma prevention, severity modification, disparities, and lifespan outcomes.
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Affiliation(s)
- Andrew H Liu
- Breathing Institute and Pulmonary Medicine Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo.
| | - William C Anderson
- Allergy & Immunology Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Cullen M Dutmer
- Allergy & Immunology Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Daniel A Searing
- Allergy & Immunology Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Stanley J Szefler
- Breathing Institute and Pulmonary Medicine Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
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91
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Shargorodsky J, Garcia-Esquinas E, Umanskiy R, Navas-Acien A, Lin SY. Household pet exposure, allergic sensitization, and rhinitis in the U.S. population. Int Forum Allergy Rhinol 2017; 7:645-651. [PMID: 28544629 DOI: 10.1002/alr.21929] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/18/2017] [Accepted: 01/31/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND The effect of animal dander exposure on allergic sensitization may be age-dependent. A comparison between the association of the levels of exposure to pet allergen with rhinitis symptoms and allergic sensitization in children and adults is yet to be performed in the U.S. POPULATION METHODS Cross-sectional study of 3034 adults (age, 20 to 85 years) and 2104 children (age, 6 to 19 years) in the National Health and Nutrition Examination Survey, 2005-2006. Samples of household dust were collected to measure the amounts of indoor allergens in the participants' homes. Self-reported rhinitis was based on symptoms during the past 12 months, and allergen sensitization was defined as a positive response to any of the 19 specific immunoglobulin E (IgE) antigens tested. RESULTS Higher levels of exposure to dog dander were associated with a higher prevalence of any allergic sensitization in adults (prevalence ratio [PR] 1.19; 95% confidence interval [CI], 1.01 to 1.39), but a lower prevalence in children (PR 0.84; 95% CI, 0.73 to 0.096), p-interaction by age group 0.02. Cat exposure was associated with an increased prevalence of rhinitis symptoms in adults (PR for the 3rd vs lowest tertile of cat dander concentrations: 1.14; 95% CI, 1.05 to 1.23) but not in children (PR for the 3rd vs lowest tertile of cat dander IgE concentrations: 0.86; 95% CI, 0.70 to 1.07), p-interaction 0.01. CONCLUSION Allergic sensitization and symptomatic response to pet dander exposure may vary based on age. Further studies are necessary to assess the mechanisms for these apparent differences.
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Affiliation(s)
| | - Esther Garcia-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.,Instituto de Investigacíon Hospital Universitario La Paz (IdiPaz) and Centro de Investigacíon Biomédica en Red (CIBER) of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Sandra Y Lin
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
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92
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Hill LJ, Williams AC. Meat Intake and the Dose of Vitamin B 3 - Nicotinamide: Cause of the Causes of Disease Transitions, Health Divides, and Health Futures? Int J Tryptophan Res 2017; 10:1178646917704662. [PMID: 28579801 PMCID: PMC5419340 DOI: 10.1177/1178646917704662] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/15/2017] [Indexed: 12/26/2022] Open
Abstract
Meat and vitamin B3 - nicotinamide - intake was high during hunter-gatherer times. Intake then fell and variances increased during and after the Neolithic agricultural revolution. Health, height, and IQ deteriorated. Low dietary doses are buffered by 'welcoming' gut symbionts and tuberculosis that can supply nicotinamide, but this co-evolved homeostatic metagenomic strategy risks dysbioses and impaired resistance to pathogens. Vitamin B3 deficiency may now be common among the poor billions on a low-meat diet. Disease transitions to non-communicable inflammatory disorders (but longer lives) may be driven by positive 'meat transitions'. High doses of nicotinamide lead to reduced regulatory T cells and immune intolerance. Loss of no longer needed symbiotic 'old friends' compounds immunological over-reactivity to cause allergic and auto-immune diseases. Inhibition of nicotinamide adenine dinucleotide consumers and loss of methyl groups or production of toxins may cause cancers, metabolic toxicity, or neurodegeneration. An optimal dosage of vitamin B3 could lead to better health, but such a preventive approach needs more equitable meat distribution. Some people may require personalised doses depending on genetic make-up or, temporarily, when under stress.
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Affiliation(s)
- Lisa J Hill
- Neuroscience and Ophthalmology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Adrian C Williams
- Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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93
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Du Toit G, Foong RX, Lack G. The role of dietary interventions in the prevention of IgE-mediated food allergy in children. Pediatr Allergy Immunol 2017; 28:222-229. [PMID: 28258631 DOI: 10.1111/pai.12711] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 02/06/2023]
Abstract
Over the last 30 years, the prevalence of food allergy has been on the rise and remains a disease that can have a significant impact on the quality of life of children and their families. There are several hypotheses that have been suggested to account for the increasing prevalence, but this review will focus on the impact that dietary factors have on food allergy development. In the past food allergy, prevalence has largely focused on allergen avoidance; however, there is increasing evidence from interventional studies that have shown that early introduction to potential food allergens may have a beneficial role in allergy prevention. This review aims to look at the evidence in support of early introduction of allergens into infant diets to prevent against the development of food allergy.
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Affiliation(s)
- George Du Toit
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Ru-Xin Foong
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas' NHS Foundation Trust, London, UK.,Institute of Child Health, University College of London, London, UK
| | - Gideon Lack
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas' NHS Foundation Trust, London, UK
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94
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Chicoulaa B, Haas H, Viala J, Salvetat M, Olives JP. How French general practitioners manage and prevent recurrent respiratory tract infections in children: the SOURIRRE survey. Int J Gen Med 2017; 10:61-68. [PMID: 28293116 PMCID: PMC5345982 DOI: 10.2147/ijgm.s125806] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recurrent respiratory tract infections (RRTIs) are the most common reason for children's visits to primary care physicians in France; however, little is known about general practitioners' (GPs) opinions and expectations concerning the management and prevention of these common and recurrent pathologies. PURPOSE To describe French GPs' daily practice in the management of respiratory infections and the prevention of their recurrence in children. METHODS A sample group of French GPs answered a structured questionnaire on risk factors, RRTI management, antibiotic use and prevention measures. RESULTS A total of 358 GPs participated in the survey. Rhinopharyngitis, the most frequent respiratory infection, was considered to be recurrent if six or more episodes occurred in a year. Four risk factors were acknowledged as substantial: living in communities, passive smoking, pollution and allergies. Around 63% of GPs said that RRTIs are too often treated with antibiotics. More than 85% thought that prevention of RRTIs is possible. Smoking cessation, vaccination, allergen avoidance and hygiene were identified as the main preventive measures. A large majority of GPs (84%) prescribed products for prevention and ~90% would prescribe a product stimulating immunity if the efficacy and tolerability of these agents was proven and confirmed in their daily practice. CONCLUSIONS French GPs are well aware of the health and socioeconomic burdens resulting from RRTIs, as well as the risk of antibiotic overuse. They have a prevention-oriented approach, implement preventive measures when possible and prescribe products for prevention.
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Affiliation(s)
| | - Hervé Haas
- Paediatric Emergency and Infectious Disease Departments, Lenval University Hospital, Nice
| | - Jérôme Viala
- Gastroenterology Department, Robert-Debré Hospital, Paris
| | | | - Jean-Pierre Olives
- Gastroenterology and Nutrition Department, Children's Hospital, University Hospital, Toulouse, France
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95
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Mirza A, Mao-Draayer Y. The gut microbiome and microbial translocation in multiple sclerosis. Clin Immunol 2017; 183:213-224. [PMID: 28286112 DOI: 10.1016/j.clim.2017.03.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/03/2017] [Accepted: 03/07/2017] [Indexed: 02/07/2023]
Abstract
Individuals with multiple sclerosis (MS) have a distinct intestinal microbial community (microbiota) and increased low-grade translocation of bacteria from the intestines into the circulation. The observed change of intestinal bacteria in MS patients regulate immune functions involved in MS pathogenesis. These functions include: systemic and central nervous system (CNS) immunity (including peripheral regulatory T cell function), the blood-brain barrier (BBB) permeability and CNS-resident cell activity. This review discusses the MS intestinal microbiota implication on MS systemic- and CNS-immunopathology. We introduce the possible contributions of MS low-grade microbial translocation (LG-MT) to the development of MS, and end on a discussion on microbiota therapies for MS patients.
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Affiliation(s)
- Ali Mirza
- Department of Microbiology and Immunology, University of Michigan School of Medicine, 4258 Alfred Taubman Biomedical Sciences Research Bldg. 109 Zina Pitcher Place, Ann Arbor, MI 48109-2200, United States; Department of Neurology, University of Michigan School of Medicine, 4258 Alfred Taubman Biomedical Sciences Research Bldg. 109 Zina Pitcher Place, Ann Arbor, MI 48109-2200, United States
| | - Yang Mao-Draayer
- Department of Neurology, University of Michigan School of Medicine, 4015 Alfred Taubman Biomedical Sciences Research Bldg. 109 Zina Pitcher Place, Ann Arbor, MI 48109-2200, United States.
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96
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Miraglia Del Giudice M, Indolfi C, Capasso M, Maiello N, Decimo F, Ciprandi G. Bifidobacterium mixture (B longum BB536, B infantis M-63, B breve M-16V) treatment in children with seasonal allergic rhinitis and intermittent asthma. Ital J Pediatr 2017; 43:25. [PMID: 28270216 PMCID: PMC5341466 DOI: 10.1186/s13052-017-0340-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/24/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Allergic rhinitis (AR) and allergic asthma are caused by an IgE-mediated inflammatory reaction. Probiotics may exert anti-inflammatory and immune-modulatory activity. Thus, this study aimed at investigating whether a Bifidobacteria mixture could be able to relieve nasal symptoms, and affect quality of life (QoL) in children with AR and intermittent asthma due to Parietaria allergy. MATERIALS AND METHODS The present study was conducted as placebo-controlled, double-blinded, and randomized. Globally, 40 children (18 males; mean age 9 ± 2.2 years) were enrolled. They were treated with probiotics or placebo: 1 sachet/day for 4 weeks. AR symptoms, and QoL were assessed at baseline and after treatment. Use of rescue medications, such as cetirizine syrup and salbutamol spray, was also permitted and recorded. RESULTS Children treated with probiotic mixture achieved a significant improvement of symptoms (p < 0.005), and QoL ((p < 0.001). Placebo group had worsening of symptoms (p < 0.005) and QoL (p < 0.001). The use of rescue medications was overlapping in the two groups. The intergroup analysis showed that probiotic mixture was significantly superior than placebo for all parameters. CONCLUSIONS The current study demonstrated that a Bifidobacteria mixture was able of significantly improving AR symptoms and QoL in children with pollen-induced AR and intermittent asthma. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov ID NCT02807064 .
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Affiliation(s)
| | - Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Michele Capasso
- Department of Paediatrics, Ospedale Civile 'Ave Gratia Plena', Piedimonte Matese, CE, Italy
| | - Nunzia Maiello
- Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Fabio Decimo
- Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Giorgio Ciprandi
- Department of Medicine, IRCCS-AOU San Martino-IST, Genoa, Italy.
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97
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Salazar F, Awuah D, Negm OH, Shakib F, Ghaemmaghami AM. The role of indoleamine 2,3-dioxygenase-aryl hydrocarbon receptor pathway in the TLR4-induced tolerogenic phenotype in human DCs. Sci Rep 2017; 7:43337. [PMID: 28256612 PMCID: PMC5335671 DOI: 10.1038/srep43337] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 01/25/2017] [Indexed: 12/27/2022] Open
Abstract
A controlled inflammatory response is required for protection against infection, but persistent inflammation causes tissue damage. Dendritic cells (DCs) have a unique capacity to promote both inflammatory and anti-inflammatory processes. One key mechanism involved in DC-mediated immunosuppression is the expression of tryptophan-metabolizing enzyme indoleamine 2,3-dioxygenase (IDO). IDO has been implicated in diverse processes in health and disease but its role in endotoxin tolerance in human DCs is still controversial. Here we investigated the role of IDO in shaping DCs phenotype and function under endotoxin tolerance conditions. Our data show that TLR4 ligation in LPS-primed DCs, induced higher levels of both IDO isoforms together with the transcription factor aryl-hydrocarbon receptor (AhR), compared to unprimed controls. Additionally, LPS conditioning induced an anti-inflammatory phenotype in DCs - with an increase in IL-10 and higher expression of programmed death ligand (PD-L)1 and PD-L2 - which were partially dependent on IDO. Furthermore, we demonstrated that the AhR-IDO pathway was responsible for the preferential activation of non-canonical NF-κB pathway in LPS-conditioned DCs. These data provide new insight into the mechanisms of the TLR4-induced tolerogenic phenotype in human DCs, which can help the better understanding of processes involved in induction and resolution of chronic inflammation and tolerance.
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MESH Headings
- B7-H1 Antigen/genetics
- B7-H1 Antigen/immunology
- Basic Helix-Loop-Helix Transcription Factors/genetics
- Basic Helix-Loop-Helix Transcription Factors/immunology
- Cell Adhesion Molecules/genetics
- Cell Adhesion Molecules/immunology
- Cell Differentiation/drug effects
- Dendritic Cells/cytology
- Dendritic Cells/drug effects
- Dendritic Cells/immunology
- Gene Expression Regulation
- Granulocyte-Macrophage Colony-Stimulating Factor/pharmacology
- Humans
- Immune Tolerance
- Indoleamine-Pyrrole 2,3,-Dioxygenase/genetics
- Indoleamine-Pyrrole 2,3,-Dioxygenase/immunology
- Interleukin-10/genetics
- Interleukin-10/immunology
- Interleukin-4/pharmacology
- Lectins, C-Type/genetics
- Lectins, C-Type/immunology
- Lipopolysaccharides/pharmacology
- Monocytes/cytology
- Monocytes/drug effects
- Monocytes/immunology
- NF-kappa B/genetics
- NF-kappa B/immunology
- Primary Cell Culture
- Programmed Cell Death 1 Ligand 2 Protein/genetics
- Programmed Cell Death 1 Ligand 2 Protein/immunology
- Protein Serine-Threonine Kinases/genetics
- Protein Serine-Threonine Kinases/immunology
- Receptors, Aryl Hydrocarbon/genetics
- Receptors, Aryl Hydrocarbon/immunology
- Receptors, Cell Surface/genetics
- Receptors, Cell Surface/immunology
- Signal Transduction
- TNF Receptor-Associated Factor 3/genetics
- TNF Receptor-Associated Factor 3/immunology
- Toll-Like Receptor 4/genetics
- Toll-Like Receptor 4/immunology
- Transcription Factor RelB/genetics
- Transcription Factor RelB/immunology
- NF-kappaB-Inducing Kinase
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Affiliation(s)
- Fabián Salazar
- Division of Immunology, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, United Kingdom
| | - Dennis Awuah
- Division of Immunology, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, United Kingdom
| | - Ola H. Negm
- Division of Immunology, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, United Kingdom
- Medical Microbiology and Immunology Department, Mansoura University, Egypt
| | - Farouk Shakib
- Division of Immunology, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, United Kingdom
| | - Amir M. Ghaemmaghami
- Division of Immunology, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, United Kingdom
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98
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Suh DI, Chang HY, Lee E, Yang SI, Hong SJ. Prenatal Maternal Distress and Allergic Diseases in Offspring: Review of Evidence and Possible Pathways. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2017; 9:200-211. [PMID: 28293926 PMCID: PMC5352571 DOI: 10.4168/aair.2017.9.3.200] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/29/2016] [Accepted: 01/04/2017] [Indexed: 12/14/2022]
Abstract
Recent studies have suggested a close association between prenatal maternal distress and allergic diseases in the offspring. We selected relevant birth-cohort or national registry studies using a keyword search of the PubMed database and summarized current evidence on the impact of prenatal maternal distress on the development of offspring's allergic diseases. Moreover, we postulated possible pathways linking prenatal distress and allergic diseases based on relevant human and animal studies. Both dysregulated hypothalamic-pituitary-adrenal axis and increased oxidative stress may cause structural (altered brain/lung development) and functional (skewed immune development) changes, which may predispose the fetus to developing allergic diseases during childhood. Although many facts are yet to be discovered, changes in the placental response and epigenetic modification are presumed to mediate the whole process from maternal distress to allergic diseases. Maternal prenatal distress can also interact with other physical or environmental factors, including familial or physical factors, indoor and outdoor pollutants, and early childhood psychological distress. The gut-microbiome-brain axis and the role of the microbiome as an immune modulator should be considered when investigating the stress-allergy relationship and exploring potential intervention modalities. Further research is needed, and particular attention should be given to defining the most vulnerable subjects and critical time periods. To this end, studies exploring relevant biomarkers are warranted, which can enable us to explore adequate intervention strategies.
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Affiliation(s)
- Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hyoung Yoon Chang
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea
| | - Song I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Soo Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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99
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Berni Canani R, Di Costanzo M, Bedogni G, Amoroso A, Cosenza L, Di Scala C, Granata V, Nocerino R. Extensively hydrolyzed casein formula containing Lactobacillus rhamnosus GG reduces the occurrence of other allergic manifestations in children with cow's milk allergy: 3-year randomized controlled trial. J Allergy Clin Immunol 2016; 139:1906-1913.e4. [PMID: 28043872 DOI: 10.1016/j.jaci.2016.10.050] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 09/13/2016] [Accepted: 10/17/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Children with cow's milk allergy (CMA) have an increased risk of other allergic manifestations (AMs). OBJECTIVE We performed a parallel-arm randomized controlled trial to test whether administration of an extensively hydrolyzed casein formula (EHCF) containing the probiotic Lactobacillus rhamnosus GG (LGG) can reduce the occurrence of other AMs in children with CMA. METHODS Children with IgE-mediated CMA were randomly allocated to the EHCF or EHCF+LGG groups and followed for 36 months. The main outcome was occurrence of at least 1 AM (eczema, urticaria, asthma, and rhinoconjunctivitis). The secondary outcome was tolerance acquisition, which was defined as the negativization of a double-blind food challenge results at 12, 24, and 36 months. AMs were diagnosed according to standardized criteria. Tolerance acquisition was evaluated every 12 months. RESULTS A total of 220 children (147 boys [67%]) with a median age of 5.0 months (interquartile range, 3.0-8.0 months) were randomized; 110 children were placed in the EHCF group, and 110 children were placed in the EHCF+LGG group. In the complete case analysis the absolute risk difference for the occurrence of at least 1 AM over 36 months was -0.23 (95% CI, -0.36 to -0.10; P < .001), and the absolute risk difference for the acquisition of cow's milk tolerance was 0.20 (95% CI, 0.05-0.35; P < .01) at 12 months, 0.24 (95% CI, 0.08-0.41; P < .01) at 24 months, and 0.27 (95% CI, 0.11-0.43; P < .001) at 36 months. In the sensitivity analysis the effect size of the main outcome was virtually unchanged when the occurrence of AMs was assigned to all 27 missing children. CONCLUSIONS EHCF+LGG reduces the incidence of other AMs and hastens the development of oral tolerance in children with IgE-mediated CMA.
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Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University of Naples "Federico II", Naples, Italy; CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy.
| | - Margherita Di Costanzo
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Giorgio Bedogni
- CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy; Clinical Epidemiology Unit, Liver Research Center Basovizza, Trieste, Italy
| | - Antonio Amoroso
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy; CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Linda Cosenza
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Carmen Di Scala
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Viviana Granata
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy; CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
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100
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Lactobacillus reuteri DSM 17938 plus vitamin D3 as ancillary treatment in allergic children with asthma. Ann Allergy Asthma Immunol 2016; 117:710-712. [PMID: 27720582 DOI: 10.1016/j.anai.2016.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 11/18/2022]
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