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Schaub B. Asthma bronchiale. Monatsschr Kinderheilkd 2010. [DOI: 10.1007/s00112-009-2083-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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52
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Hol J, de Jongste JC, Nieuwenhuis EE. Quoting a landmark paper on the beneficial effects of probiotics. J Allergy Clin Immunol 2010; 124:1354-6.e9. [PMID: 19818483 DOI: 10.1016/j.jaci.2009.07.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 07/21/2009] [Accepted: 07/23/2009] [Indexed: 02/06/2023]
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53
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Flicker S, Marth K, Kofler H, Valenta R. Placental transfer of allergen-specific IgG but not IgE from a specific immunotherapy–treated mother. J Allergy Clin Immunol 2009; 124:1358-60.e1. [DOI: 10.1016/j.jaci.2009.09.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Revised: 09/02/2009] [Accepted: 09/09/2009] [Indexed: 10/20/2022]
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54
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Matson AP, Thrall RS, Rafti E, Puddington L. Breastmilk from allergic mothers can protect offspring from allergic airway inflammation. Breastfeed Med 2009; 4:167-74. [PMID: 19301986 PMCID: PMC2757118 DOI: 10.1089/bfm.2008.0130] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Breastfeeding is associated with a reduced risk of developing asthma in children. Using a murine model we previously demonstrated that mothers with Th1-type immunity to ovalbumin (OVA) transfer antigen-specific protection from OVA-induced allergic airway disease (AAD) to their offspring. The aim of this study was to evaluate the contribution of breastmilk and maternal B cell immunity from allergic mothers in the vertical transmission of protection from AAD. METHODS This was investigated using an adoptive nursing strategy. Naive offspring were nursed by allergic wild-type or B cell-deficient foster mothers with histories of Th2-type immunity to OVA. Following weaning, offspring were immunized with OVA-Al(OH)(3) and challenged with aerosolized OVA to induce AAD. RESULTS Offspring nursed by wild-type OVA-immune foster mothers demonstrated lower levels of OVA-specific immunoglobulin E, interleukin-5, and airway eosinophilia than progeny nursed by naive control mothers. In contrast, offspring nursed by B cell-deficient OVA-immune foster mothers had similar parameters of OVA-induced AAD as progeny nursed by naive control mothers. CONCLUSIONS These data demonstrate the ability of breastmilk from allergic mothers to protect offspring from AAD was dependent on intact maternal B cell immunity. Nursing alone, when done by wild-type mothers with AAD, was sufficient for offspring to acquire the antigen-specific protective factor(s) from breastmilk.
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Affiliation(s)
- Adam P Matson
- Department of Immunology, University of Connecticut Health Center, Farmington, Connecticut 06030-1319, USA
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55
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Fedulov AV, Kobzik L. Immunotoxicologic analysis of maternal transmission of asthma risk. J Immunotoxicol 2009; 5:445-52. [PMID: 19404877 DOI: 10.1080/15476910802481765] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Asthma has origins in early life. Epidemiological studies show that maternal, more than paternal, asthma significantly increases a child's risk of developing the disease. Experimental animal models exist which reproduce the increased susceptibility to asthma seen in human studies, and allow analysis of immunotoxic mechanisms that may contribute to neonatal allergy. In addition to maternal asthma, chemically-induced skin contact hypersensitivity or exposure during pregnancy of non-allergic females to certain environmental agents, e.g., air pollution particles, can also result in increased susceptibility to asthma in their offspring. We review here experimental models of maternal transmission of asthma risk, the progress to date in identifying mechanisms, and potential directions for future research.
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Affiliation(s)
- Alexey V Fedulov
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA
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56
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Abstract
Asthma and allergic disorders can affect the course and outcome of pregnancy. Pregnancy itself may also affect the course of asthma and related diseases. Optimal management of these disorders during pregnancy is vital to ensure the welfare of the mother and the baby.Specific pharmacological agents for treatment of asthma or allergic diseases must be cautiously selected and are discussed here with respect to safety considerations in pregnancy. Although most drugs do not harm the fetus, this knowledge is incomplete. Any drug may carry a small risk that must be balanced against the benefits of keeping the mother and baby healthy. The goals and principles of management for acute and chronic asthma, rhinitis, and dermatologic disorders are the same during pregnancy as those for asthma in the general population.Diagnosis of allergy during pregnancy should mainly consist of the patient's history and in vitro testing.The assured and well-evaluated risk factors revealed for sensitization in mother and child are very limited, to date, and include alcohol consumption, exposure to tobacco smoke, maternal diet and diet of the newborn, drug usage, and insufficient exposure to environmental bacteria. Consequently, the recommendations for primary and secondary preventive measures are also very limited in number and verification.
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57
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Pali-Schöll I, Renz H, Jensen-Jarolim E. Update on allergies in pregnancy, lactation, and early childhood. J Allergy Clin Immunol 2009; 123:1012-21. [PMID: 19249083 DOI: 10.1016/j.jaci.2009.01.045] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2008] [Revised: 01/06/2009] [Accepted: 01/14/2009] [Indexed: 11/24/2022]
Abstract
The factors responsible for the induction of allergic disease at an early age have not been completely identified. Therefore a major research focus is their identification to elaborate recommendations for prevention of sensitization in high-risk or atopic children. This review analyzes known or suspected reasons for sensitization in pregnant women and infants from both clinical and experimental animal studies. Recent studies and meta-analyses could not confirm the protective effect of an allergen-poor diet on the part of the mother during pregnancy and lactation. Likewise, the type of bottle feeding or the introduction of solid food into the child's diet might not significantly influence the development of atopy, allergy, or asthma in the child's life. Disappointingly, the few preventive measures remaining to reduce the risk of allergic sensitization and atopic diseases in mother and child are the avoidance of smoking and alcohol consumption during pregnancy and lactation and the avoidance of the impairment of gastric function. Further studies are urgently needed to address the influence of certain foods and nutrients, as well as environmental factors, for prevention of allergic diseases in the low- or high-risk infant.
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58
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Fusaro AE, de Brito CA, Taniguchi EF, Muniz BP, Victor JR, Orii NM, Duarte AJDS, Sato MN. Balance between early life tolerance and sensitization in allergy: dependence on the timing and intensity of prenatal and postnatal allergen exposure of the mother. Immunology 2008; 128:e541-50. [PMID: 19740315 DOI: 10.1111/j.1365-2567.2008.03028.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Allergens can be maternally transferred to the fetus or neonate, though it is uncertain how this initial allergen exposure may impact the development of allergy responses. To evaluate the roles of timing and level of maternal allergen exposure in the early life sensitization of progeny, female BALB/c mice were given ovalbumin (OVA) orally during pregnancy, lactation or weekly at each stage to investigate the immunoglobulin E (IgE) antibody production and cellular responsiveness of their offspring. Exposure to OVA during pregnancy was also evaluated in OVA-specific T-cell receptor (TCR) transgenic (DO11.10) mice. The effect of prenatal antigen exposure on offspring sensitization was dependent on antigen intake, with low-dose OVA inducing tolerance followed by neonatal immunization that was sustained even when pups were immunized when 3 weeks old. These offspring received high levels of transforming growth factor-beta via breastfeeding. High-dose exposure during the first week of pregnancy or perinatal period induced transient inhibition of IgE production following neonatal immunization; although for later immunization IgE production was enhanced in these offspring. Postnatal maternal antigen exposure provided OVA transference via breastfeeding, which consequently induced increased offspring susceptibility to IgE antibody production according to week post-birth. The effect of low-dose maternal exposure during pregnancy was further evaluated using OVA transgenic TCR dams as a model. These progeny presented pronounced entry of CD4(+) T cells into the S phase of the cell cycle with a skewed T helper type 2 response early in life, revealing the occurrence of allergen priming in utero. The balance between tolerance and sensitization depended on the amount and timing of maternal allergen intake during pregnancy.
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Affiliation(s)
- Ana Elisa Fusaro
- Laboratory of Dermatology and Immunodeficiencies, School of Medicine, University of São Paulo, São Paulo, Brazil
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59
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Abstract
Maternal asthma significantly increases the risk of asthma in offspring, but the mechanisms remain poorly defined. We review animal models used to study the maternal effect, focusing on a murine model developed in our laboratory. Mother mice rendered allergic to ovalbumin produce offspring that are more susceptible to allergic sensitization, seen as airway hyperresponsiveness and allergic airway inflammation after a sensitization protocol, which has minimal effects on newborns from normal mothers. Mechanistic analyses identify a role for interleukin-4 (based on pre-mating injection of neutralizing antibodies), dendritic cells and allergen-specific T cells (based on adoptive transfer experiments). Other maternal exposures (e.g. pollutant exposure and non-pulmonary allergy) can increase asthma susceptibility in offspring. This observation implies that the maternal transmission of asthma represents a final common pathway to various types of inflammatory stimuli. Identification of the shared molecular mechanisms in these models may allow better prevention and therapy. Current knowledge, gaps in knowledge and future directions are discussed.
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Affiliation(s)
- Robert H Lim
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA.
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60
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Mishra NC, Rir-Sima-Ah J, Langley RJ, Singh SP, Peña-Philippides JC, Koga T, Razani-Boroujerdi S, Hutt J, Campen M, Kim KC, Tesfaigzi Y, Sopori ML. Nicotine primarily suppresses lung Th2 but not goblet cell and muscle cell responses to allergens. THE JOURNAL OF IMMUNOLOGY 2008; 180:7655-63. [PMID: 18490768 DOI: 10.4049/jimmunol.180.11.7655] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Allergic asthma, an inflammatory disease characterized by the infiltration and activation of various leukocytes, the production of Th2 cytokines and leukotrienes, and atopy, also affects the function of other cell types, causing goblet cell hyperplasia/hypertrophy, increased mucus production/secretion, and airway hyperreactivity. Eosinophilic inflammation is a characteristic feature of human asthma, and recent evidence suggests that eosinophils also play a critical role in T cell trafficking in animal models of asthma. Nicotine is an anti-inflammatory, but the association between smoking and asthma is highly contentious and some report that smoking cessation increases the risk of asthma in ex-smokers. To ascertain the effects of nicotine on allergy/asthma, Brown Norway rats were treated with nicotine and sensitized and challenged with allergens. The results unequivocally show that, even after multiple allergen sensitizations, nicotine dramatically suppresses inflammatory/allergic parameters in the lung including the following: eosinophilic/lymphocytic emigration; mRNA and/or protein expression of the Th2 cytokines/chemokines IL-4, IL-5, IL-13, IL-25, and eotaxin; leukotriene C(4); and total as well as allergen-specific IgE. Although nicotine did not significantly affect hexosaminidase release, IgG, or methacholine-induced airway resistance, it significantly decreased mucus content in bronchoalveolar lavage; interestingly, however, despite the strong suppression of IL-4/IL-13, nicotine significantly increased the intraepithelial-stored mucosubstances and Muc5ac mRNA expression. These results suggest that nicotine modulates allergy/asthma primarily by suppressing eosinophil trafficking and suppressing Th2 cytokine/chemokine responses without reducing goblet cell metaplasia or mucous production and may explain the lower risk of allergic diseases in smokers. To our knowledge this is the first direct evidence that nicotine modulates allergic responses.
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Affiliation(s)
- Neerad C Mishra
- Immunology Program, Lovelace Respiratory Research Institute, Albuquerque, NM 87108, USA
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61
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Matson AP, Zhu L, Lingenheld EG, Schramm CM, Clark RB, Selander DM, Thrall RS, Breen E, Puddington L. Maternal transmission of resistance to development of allergic airway disease. THE JOURNAL OF IMMUNOLOGY 2007; 179:1282-91. [PMID: 17617621 PMCID: PMC3155847 DOI: 10.4049/jimmunol.179.2.1282] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Parental phenotype is known to influence the inheritance of atopic diseases, such as allergic asthma, with a maternal history being a more significant risk factor for progeny than paternal history. We hypothesized that recall Th1- or Th2-type immune responses during pregnancy would result in transfer of maternal factors that would differentially impact development of immune responsiveness in offspring. Following weaning, susceptibility and severity of allergic airway disease (a murine model of human asthma) was evaluated in progeny, disease being elicited by immunization with OVA-Al(OH)(3) and challenge with aerosolized OVA. We found that progeny of mothers with Th1-biased immunity to OVA subjected to recall aerosol challenge during pregnancy had reduced levels of Ag-specific IgE and airway eosinophilia compared with progeny of mothers with Th2-biased immunity to OVA or naive mothers. Interestingly, progeny of mothers with Th1-type immunity to a heterologous albumin, BSA, were not protected from developing OVA-induced allergic airway disease. These findings demonstrated that maternal transfer of protection from development of allergic airway disease to offspring in this model of maternal Th1-type immunity was Ag specific.
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Affiliation(s)
- Adam P. Matson
- Department of Immunology, University of Connecticut Health Center, Farmington, CT 06030
- Division of Neonatology, Connecticut Children’s Medical Center, Hartford, CT 06106
| | - Li Zhu
- Department of Immunology, University of Connecticut Health Center, Farmington, CT 06030
| | | | - Craig M. Schramm
- Division of Pulmonary Medicine, Department of Pediatrics, Connecticut Children’s Medical Center, Hartford, CT 06106
| | - Robert B. Clark
- Department of Immunology, University of Connecticut Health Center, Farmington, CT 06030
| | - Dawn M. Selander
- Department of Immunology, University of Connecticut Health Center, Farmington, CT 06030
| | - Roger S. Thrall
- Department of Immunology, University of Connecticut Health Center, Farmington, CT 06030
| | - Elena Breen
- Department of Immunology, University of Connecticut Health Center, Farmington, CT 06030
| | - Lynn Puddington
- Department of Immunology, University of Connecticut Health Center, Farmington, CT 06030
- Address correspondence and reprint requests to Dr. Lynn Puddington, Department of Immunology, Center for Integrative Immunology and Vaccine Research, MC-1319, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-1319.
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62
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Lim RH, Arredouani MS, Fedulov A, Kobzik L, Hubeau C. Maternal allergic contact dermatitis causes increased asthma risk in offspring. Respir Res 2007; 8:56. [PMID: 17662138 PMCID: PMC1959186 DOI: 10.1186/1465-9921-8-56] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Accepted: 07/27/2007] [Indexed: 12/04/2022] Open
Abstract
Background Offspring of asthmatic mothers have increased risk of developing asthma, based on human epidemiologic data and experimental animal models. The objective of this study was to determine whether maternal allergy at non-pulmonary sites can increase asthma risk in offspring. Methods BALB/c female mice received 2 topical applications of vehicle, dinitrochlorobenzene, or toluene diisocyanate before mating with untreated males. Dinitrochlorobenzene is a skin-sensitizer only and known to induce a Th1 response, while toluene diisocyanate is both a skin and respiratory sensitizer that causes a Th2 response. Both cause allergic contact dermatitis. Offspring underwent an intentionally suboptimal protocol of allergen sensitization and aerosol challenge, followed by evaluation of airway hyperresponsiveness, allergic airway inflammation, and cytokine production. Mothers were tested for allergic airway disease, evidence of dermatitis, cellularity of the draining lymph nodes, and systemic cytokine levels. The role of interleukin-4 was also explored using interleukin-4 deficient mice. Results Offspring of toluene diisocyanate but not dinitrochlorobenzene-treated mothers developed an asthmatic phenotype following allergen sensitization and challenge, seen as increased Penh values, airway inflammation, bronchoalveolar lavage total cell counts and eosinophilia, and Th2 cytokine imbalance in the lung. Toluene diisocyanate treated interleukin-4 deficient mothers were able to transfer asthma risk to offspring. Mothers in both experimental groups developed allergic contact dermatitis, but not allergic airway disease. Conclusion Maternal non-respiratory allergy (Th2-skewed dermatitis caused by toluene diisocyanate) can result in the maternal transmission of asthma risk in mice.
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Affiliation(s)
- Robert H Lim
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Mohamed S Arredouani
- Department of Surgery, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Alexey Fedulov
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Lester Kobzik
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
- Department of Pathology, Brigham & Women's Hospital, Boston, MA, USA
| | - Cedric Hubeau
- Department of Biology, Momenta Pharmaceuticals, Inc., Cambridge, MA, USA
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63
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Abstract
Asthma is one of the most common chronic diseases in children, with increasing morbidity and mortality. A genetic predisposition and exposure to allergens have been implicated as major risk factors for the development of asthma. However, increasing evidence indicates that the mother plays a crucial role in mediating the development of fetal-infant immune responses to inhaled allergens. The exact nature and mechanism of this maternal influence and how it might be associated with the development of allergic sensitization and asthma are not clear. Under normal conditions, the maternal environment during pregnancy promotes an initial Th2 skewed immune response in the offspring which transitions to a nonallergic Th1 type response after birth. However, the allergic mother's influence may delay the normal transition to a nonallergic immune response to inhaled allergens in her children, thus increasing the risk for the development of allergic sensitization and/or asthma. Understanding the underlying mechanisms by which the maternal immune environment can influence the development of the fetal-infant immune response to inhaled allergens may lead to identifying new targets for the prevention of allergic sensitization and asthma.
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64
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Fusaro AE, Brito CA, Victor JR, Rigato PO, Goldoni AL, Duarte AJS, Sato MN. Maternal-fetal interaction: preconception immunization in mice prevents neonatal sensitization induced by allergen exposure during pregnancy and breastfeeding. Immunology 2007; 122:107-15. [PMID: 17608811 PMCID: PMC2265981 DOI: 10.1111/j.1365-2567.2007.02618.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Allergen exclusion measures during pregnancy and lactation have been given consideration in studies of primary allergy prevention but complete avoidance of mother/neonatal allergen exposure has proven to be a difficult procedure. To evaluate a strategy to prevent allergen sensitization in early life in mice, we first established a neonatal model with ovalbumin sensitization through maternal allergen exposure during pregnancy or breastfeeding. The modulatory potential of preconception immunization was investigated on the neonatal development of subsequent allergic responses to maternal allergen exposure. Herein, we demonstrate that immunized mothers exposed to antigen during pregnancy or breastfeeding underwent intense vertical transmission of antibodies, including immunoglobulin G (IgG) in complex with ovalbumin and IgG1 antibody with anaphylactic function. It was further shown that maternal immunization efficiently decreased the passage of free antigens through breastfeeding and inhibited the enhanced IgE antibody response after postnatal antigen exposure. In addition, antenatal immunization decreased the antigen-specific proliferative response of immunized neonates, in parallel with profound downmodulatory effects on both the activation and differentiation of T and B cells after a non-specific stimulus and cytokine production. These findings showed that early life sensitization, subsequent to maternal allergen exposure during both the prenatal and postnatal periods, could be avoided by preventive vaccination of the mother.
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Affiliation(s)
- Ana E Fusaro
- Laboratory of Dermatology and Immunodeficiencies, School of Medicine, University of São Paulo, Brazil
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65
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Liang YC, Yeh JY, Ou BR. Effect of maternal myostatin antibody on offspring growth performance and body composition in mice. ACTA ACUST UNITED AC 2007; 210:477-83. [PMID: 17234617 DOI: 10.1242/jeb.02665] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Myostatin (GDF8) is a member of the transforming growth factor beta (TGF-beta) superfamily. The finding that animals with a knockout or mutation of the myostatin-encoding gene show increased muscle mass suggests that myostatin negatively regulates muscle growth. The study reported here was designed to investigate the effect of induction of maternal myostatin antibody on the growth performance and body composition of the mouse. Female mice were induced to produce myostatin antibody by immunization with synthetic myostatin peptide prior to mating with male mice. The body masses of offspring were measured weekly and the body compositions of offspring were determined at 8 weeks of age. The results showed that myostatin antibody was detected in both immunized female mice and their 8-week-old offspring. The growth performance of offspring from the myostatin antibody-induced (mstn Ab-induced) group was higher than that from the control group at 8 weeks of age. The body composition of both male and female offspring from the mstn Ab-induced group contained higher crude protein and lower crude fat than those from the control group (P<0.05). The litter number from the maternal mstn Ab-induced group was less than that from control mice, while embryo development was normal in both groups. However, the amount of developing follicle in ovaries of the mstn Ab-induced group was lower than that in the control group. It is concluded that induction of maternal mstn Ab enhances the growth performance of offspring and influences the offspring body composition by increasing the crude protein and reducing crude fat.
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Affiliation(s)
- Yu-Chuan Liang
- Department of Animal Science and Biotechnology, Tunghai University, Taichung 407, Taiwan, Republic of China
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66
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Schöll I, Ackermann U, Özdemir C, Blümer N, Dicke T, Sel S, Sel S, Wegmann M, Szalai K, Knittelfelder R, Untersmayr E, Scheiner O, Garn H, Jensen-Jarolim E, Renz H. Anti-ulcer treatment during pregnancy induces food allergy in mouse mothers and a Th2-bias in their offspring. FASEB J 2007; 21:1264-70. [PMID: 17227952 PMCID: PMC2999745 DOI: 10.1096/fj.06-7223com] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The treatment of dyspeptic disorders with anti-acids leads to an increased risk of sensitization against food allergens. As these drugs are taken by 30-50% of pregnant women due to reflux and heartburn, we aimed here to investigate the impact of maternal therapy with anti-acids on the immune response in the offspring in a murine model. Codfish extract as model allergen was fed with or without sucralfate, an anti-acid drug, to pregnant BALB/c mice during pregnancy and lactation. These mothers developed a codfish-specific allergic response shown as high IgG1 and IgE antibody levels and positive skin tests. In the next step we analyzed whether this maternal sensitization impacts a subsequent sensitization in the offspring. Indeed, in stimulated splenocytes of these offspring we found a relative Th2-dominance, because the Th1- and T-regulatory cytokines were significantly suppressed. Our data provide evidence that the anti-acid drug sucralfate supports sensitization against food in pregnant mice and favors a Th2-milieu in their offspring. From these results we propose that anti-acid treatment during pregnancy could be responsible for the increasing number of sensitizations against food allergens in young infants.
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Affiliation(s)
- Isabella Schöll
- Department of Pathophysiology, Medical University of Vienna, Vienna, Austria
| | - Ute Ackermann
- Department of Clinical Chemistry and Molecular Diagnostics, Hospital of the Philipps-University of Marburg, Marburg, Germany
| | - Cevdet Özdemir
- Pediatric Allergy and Immunology Division, Marmara University, School of Medicine, Istanbul, Turkey
| | - Nicole Blümer
- Department of Clinical Chemistry and Molecular Diagnostics, Hospital of the Philipps-University of Marburg, Marburg, Germany
| | - Tanja Dicke
- Department of Clinical Chemistry and Molecular Diagnostics, Hospital of the Philipps-University of Marburg, Marburg, Germany
| | - Serdar Sel
- Department of Clinical Chemistry and Molecular Diagnostics, Hospital of the Philipps-University of Marburg, Marburg, Germany
| | - Sarper Sel
- Department of Clinical Chemistry and Molecular Diagnostics, Hospital of the Philipps-University of Marburg, Marburg, Germany
| | - Michael Wegmann
- Department of Clinical Chemistry and Molecular Diagnostics, Hospital of the Philipps-University of Marburg, Marburg, Germany
| | - Krisztina Szalai
- Department of Pathophysiology, Medical University of Vienna, Vienna, Austria
| | | | - Eva Untersmayr
- Department of Pathophysiology, Medical University of Vienna, Vienna, Austria
| | - Otto Scheiner
- Department of Pathophysiology, Medical University of Vienna, Vienna, Austria
| | - Holger Garn
- Department of Clinical Chemistry and Molecular Diagnostics, Hospital of the Philipps-University of Marburg, Marburg, Germany
| | - Erika Jensen-Jarolim
- Department of Pathophysiology, Medical University of Vienna, Vienna, Austria
- Correspondence: Department of Pathophysiology, Medical University of Vienna, Währinger Gürtel1090 Vienna, Austria.
| | - Harald Renz
- Department of Clinical Chemistry and Molecular Diagnostics, Hospital of the Philipps-University of Marburg, Marburg, Germany
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67
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Abstract
Allergic diseases continue to increase in prevalence, and now affect over a third of the population in many countries. There is evidence that the increase in such diseases has its origins in early life exposures. Pregnancy or early childhood may therefore be critical periods for preventing the onset of allergic disease, and prenatal interventions are an attractive possibility for a population-based preventive approach. Here we review the data suggesting that prenatal exposures are important in the development of allergic disease, and that interventions during this time might be effective in prevention. We find evidence from both animal and human studies that prenatal interventions can influence the future development of allergic disease. There are a number of mechanisms through which such interventions may act to prevent allergic sensitization. We conclude that prenatal interventions have the potential to reduce the burden of allergic disease, and merit continued investigation. Further research in this area may lead to significant public health initiatives.
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Affiliation(s)
- R J Boyle
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC., Australia
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68
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Yamashita T, Freigang S, Eberle C, Pattison J, Gupta S, Napoli C, Palinski W. Maternal Immunization Programs Postnatal Immune Responses and Reduces Atherosclerosis in Offspring. Circ Res 2006; 99:e51-64. [PMID: 16946133 DOI: 10.1161/01.res.0000244003.08127.cc] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Maternal hypercholesterolemia during pregnancy increases offspring susceptibility to atherosclerosis by an oxidation-dependent mechanism. The present studies investigated whether maternal immunization with oxidized LDL (OxLDL) before pregnancy protects the fetus from atherogenic in utero programming by maternal hypercholesterolemia. Maternal immunization of NZW rabbits and LDL receptor-deficient mice indeed reduced atherosclerosis in adult offspring by up to 56%, but the protective effect could not be attributed to a reduction of fetal exposure to hypercholesterolemia alone, and even nonspecific immune stimulation with adjuvant only provided some protection. Unexpectedly, offspring of immunized mothers developed increased IgM antibodies to selective OxLDL epitopes and increased IgM-LDL immune complexes, compared with offspring of nonimmunized controls. Even naïve offspring of OxLDL-immunized mothers never exposed to postnatal hypercholesterolemia responded to a one-time OxLDL and KLH challenge with greater OxLDL-specific IgM responses, increased OxLDL-specific IgM-secreting B cells, and more IgM-LDL immune complexes. In contrast, maternal immunization with KLH, a T cell-dependent nonmammalian antigen, did not influence postnatal immune responses. Effects of maternal OxLDL-immunization on offspring B cells and selective antibodies were independent of transplacental passage of maternal immunoglobulins. Results show that maternal immunization with antigens prevalent in atherosclerotic lesions reduces atherogenesis in their offspring by mechanisms that include, but are not limited to, reduced fetal exposure to maternal hypercholesterolemia and lipid peroxidation. More importantly, they demonstrate in principle that maternal adaptive immunity to selective antigens influences postnatal B cell and antibody responses in offspring, and that modulation of in utero immune programming may influence immune-modulated diseases later in life.
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Affiliation(s)
- Tomoya Yamashita
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0682, USA
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Szépfalusi Z, Loibichler C, Hänel-Dekan S, Dehlink E, Gerstmayr M, Pichler J, Eiwegger T, Horvat R, Urbanek R. Most of diaplacentally transferred allergen is retained in the placenta. Clin Exp Allergy 2006; 36:1130-7. [PMID: 16961712 DOI: 10.1111/j.1365-2222.2006.02559.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Transplacental transfer of nutritive and inhalant allergens has been described being potentially responsible for a series of events leading to antigen-specific immune responses in the fetus. As such, cord blood T cell responses appear ubiquitously. However, studies failed to reveal a consistent dose-response relationship between antenatal allergen exposure and allergen-specific cellular reactivity in cord blood. OBJECTIVE To examine the transfer process of allergens (ovalbumin (OVA), beta-lactoglobulin (BLG), birch pollen allergen Bet v1) in placental tissue (BeWo cell line, ex vivo placenta model). METHODS The choriocarcinoma cell line BeWo was used to study the allergen uptake and transfer experiments in vitro. In the ex vivo placenta model the contribution of different placental compartments was evaluated. For this, immuno-histochemistry, immuno-electronmicroscopy and ELISA techniques were applied using monoclonal antibodies to Bet v1, OVA and -BLG. RESULTS In vitro transfer studies on a BeWo cell-layer revealed an intracellular allergen uptake and a trans-trophoblastic allergen transfer, which was temperature- and concentration dependent, pH sensitive and asymmetric. Allergen-specific staining of placental tissue after allergen perfusion (BLG) demonstrated bulk of the allergen in the syncytio-trophoblastic cell layer and minor staining in the villous stroma and in the endothelium of fetal vessels. Immunogold staining revealed an accumulation of the perfused allergen in the trophoblastic basement membrane. CONCLUSION In vitro/ex vivo trans-trophoblastic and trans-placental allergen transfer is shown with an accumulation of most of the allergen in placental tissues, potentially explaining the missing direct dose-response relationship between prenatal (maternal) allergen exposure and allergen-specific cellular reactivity in cord blood.
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Affiliation(s)
- Z Szépfalusi
- Department of Pediatrics and Juvenile Medicine, Medical University of Vienna, Vienna, Austria.
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70
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Hubeau C, Apostolou I, Kobzik L. Adoptively transferred allergen-specific T cells cause maternal transmission of asthma risk. THE AMERICAN JOURNAL OF PATHOLOGY 2006; 168:1931-9. [PMID: 16723708 PMCID: PMC1606611 DOI: 10.2353/ajpath.2006.051231] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In addition to genetics and environment, maternal asthma is an identified risk factor for developing the disease during childhood. The mechanisms of this maternal effect remain poorly understood. We tested the role of allergen-specific T cells in the maternal transmission of asthma risk by modifying a model where offspring of asthmatic mothers are more prone to develop asthma after an intentionally suboptimal asthma induction. Normal BALB/c females were injected with allergen-specific T cells from ovalbumin-specific T cell receptor (TCR) transgenic DO11.10 donors before mating. Using the protocol of suboptimal asthma induction, offspring of normal and recipient mothers were tested for their susceptibility to develop asthma. Only pups of recipient mothers showed increased airway responsiveness (Penh), allergic airway inflammation with eosinophilia, and local Th2-skewed cytokine production. Although recipient mothers did not develop asthma, serum levels of interferon-gamma, interleukin (IL)-4, IL-10, and IL-13 were significantly increased during pregnancy. Consistent with this finding, a subset of DO11.10 T cells persisted in the spleen and placenta of expectant recipient mothers. We conclude that allergen-specific T cells are sufficient to orchestrate the maternal transmission of asthma risk. Because overt maternal asthma was not required, our results suggest that similar maternal-fetal interactions may occur in other allergic disorders.
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Affiliation(s)
- Cedric Hubeau
- Department of Environmental Health, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115, USA
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71
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Vance GHS, Lewis SA, Grimshaw KEC, Wood PJ, Briggs RA, Thornton CA, Warner JO. Exposure of the fetus and infant to hens' egg ovalbumin via the placenta and breast milk in relation to maternal intake of dietary egg. Clin Exp Allergy 2006; 35:1318-26. [PMID: 16238791 DOI: 10.1111/j.1365-2222.2005.02346.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Maternally derived allergens may be transferred to the developing infant during pregnancy and lactation. However, it is not known how manipulation of environmental allergen levels might impact on this early-life exposure. OBJECTIVE To measure dietary egg allergen (ovalbumin (OVA)) in gestation-associated environments, in relation to maternal dietary egg intake. METHOD OVA was measured by allergen-specific ELISA in maternal blood collected throughout pregnancy, infant blood at birth (umbilical cord) and in breast milk at 3 months post-partum. Samples derived from pregnant women undergoing diagnostic amniocentesis at 16-18 weeks gestation who were not subject to any dietary intervention, and from pregnant women, with personal or partner atopy, randomized to complete dietary egg exclusion or an unmodified healthy diet before 20 weeks gestation as a primary allergy prevention strategy. Maternal dietary egg intake was monitored closely throughout the study period by diary record and serial measurement of OVA-specific immunoglobulin G concentration. RESULTS Circulating OVA was detected throughout pregnancy in 20% of women and correlated with both presence (P<0.001) and concentration (r=0.754, P<0.001) of infant OVA at birth (umbilical cord). At 3 months post-partum OVA was detected in breast milk samples of 35% women, in higher concentrations than measured in blood. Blood and breast milk OVA were not related to maternal dietary intake or atopic pre-disposition. CONCLUSIONS Rigorous dietary egg exclusion does not eliminate trans-placental and breast milk egg allergen passage. This early-life exposure could modulate developing immune responses.
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Affiliation(s)
- G H S Vance
- Child Health, Infection, Inflammation & Repair Division, University of Southampton, Southampton, UK.
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72
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Lima C, Souza VMO, Faquim-Mauro EL, Hoshida MS, Bevilacqua E, Macedo MS, Tavares-de-Lima W, Vargaftig BB. Modulation of the induction of lung and airway allergy in the offspring of IFN-gamma-treated mother mice. THE JOURNAL OF IMMUNOLOGY 2005; 175:3554-9. [PMID: 16148098 DOI: 10.4049/jimmunol.175.6.3554] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Recent studies have highlighted the influence of fetal/maternal interactions on the development of asthma. Because IFN-gamma reduces Th2-mediated allergic responses, we assessed its capacity to modulate asthma in the offspring when injected into mothers during pregnancy. IFN-gamma was injected in CD1 female mice on day 6.5 of gestation. Immediately after birth, male newborns were housed in cages with interchanged mothers: the offspring from IFN-gamma-treated mothers were breastfed by normal mothers (IFN/nor), and those from normal mothers were breastfed by IFN-gamma-treated (Nor/IFN) or normal mothers (Nor/nor). Immediately after weaning, the spleen cells from IFN/nor and Nor/IFN mice produced less IL-4 and more IFN-gamma than Nor/nor mice when stimulated with Con A. At the age of 6-7 wk, mice were immunized with OVA on days 0 and 7. From day 14 to 16, they were exposed to aerosolized OVA. The bronchoalveolar lavage fluid from Nor/nor mice showed eosinophilia, a large number of these cells being present in perivascular and peribronchial regions of lung tissues. IFN/nor or Nor/IFN mice showed greatly reduced eosinophil numbers in bronchoalveolar lavage fluid. In addition, lung sections from IFN/nor, but not Nor/IFN mice showed almost normal histology. In OVA-sensitized IFN/nor and Nor/IFN mice, the production of IFN-gamma, IL-4, and IL-5 by spleen cells was significantly reduced as compared with cells from the OVA-sensitized Nor/nor group. IgE and anaphylactic IgG1 were also reduced in plasma of IFN/nor mice. In conclusion, the presence of IFN-gamma during pregnancy confers to the fetus a protection against allergenic provocations in the adult life.
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Affiliation(s)
- Carla Lima
- Department of Pharmacology, University of São Paulo, São Paulo, Brazil
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73
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Blümer N, Herz U, Wegmann M, Renz H. Prenatal lipopolysaccharide-exposure prevents allergic sensitization and airway inflammation, but not airway responsiveness in a murine model of experimental asthma. Clin Exp Allergy 2005; 35:397-402. [PMID: 15784121 DOI: 10.1111/j.1365-2222.2005.02184.x] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Epidemiological evidence underlines the impact of prenatal environmental factors on the development of postnatal allergies. In this regard an inverse correlation between lipopolysaccharide (LPS) exposure and development of childhood allergy has been found. OBJECTIVE To assess the impact of prenatal LPS exposure on the development of postnatal respiratory allergies in a mouse model of experimental asthma. METHODS Female BALB/c mice were exposed to LPS before conception and during pregnancy. Several weeks after birth offspring were sensitized to ovalbumin (OVA) followed by aerosol allergen challenges. RESULTS Prenatal, maternal LPS-exposure enhanced neonatal IFN-gamma, but not IL-4 and IL-2 production. OVA sensitization of prenatally LPS-exposed mice was accompanied by a marked suppression in anti-OVA IgG1 and IgE as well as unchanged IgG2a antibody responses, paralleled by a significant reduction in IL-5 and IL-13 levels following mitogenic stimulation of splenic leucocytes. Assessment of bronchoalveolar lavage fluids following allergen challenges revealed a marked reduction in eosinophils and macrophages in these mice. Surprisingly, development of airway hyper-responsiveness, a hallmark of bronchial asthma, was not affected. CONCLUSION This study provides first experimental evidence that LPS may already operate in prenatal life in order to modulate the development of allergies in the offspring.
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Affiliation(s)
- N Blümer
- Department of Clinical Chemistry and Molecular Diagnostics, Hospital of the Philipps-University Marburg, 35033 Marburg, Germany
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74
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Prater MR, Zimmerman KL, Ward DL, Holladay SD. Reduced birth defects caused by maternal immune stimulation in methylnitrosourea-exposed mice: association with placental improvement. ACTA ACUST UNITED AC 2005; 70:862-9. [PMID: 15526292 DOI: 10.1002/bdra.20082] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Methylnitrosourea (MNU) is a potent carcinogen and teratogen that is associated with central nervous system, craniofacial, skeletal, ocular, and appendicular birth defects following transplacental exposure at critical time points during development, and preliminary studies have suggested that nonspecific maternal immunostimulation may offer protection against development of these birth defects. METHODS Our study examined morphologic alterations in fetal limb and digital development and placental integrity following maternal exposure to MNU on GD 9 in CD-1 mice, and characterized the improvement in placental integrity and abrogation of fetal defects following maternal immune stimulation with interferon-gamma (IFN-gamma) on GD 7. RESULTS Fetal limbs were significantly shortened (p < 0.0001) and incidence of limb and digital defects (syndactyly, polydactyly, oligodactyly, clubbing, and webbing) was dramatically increased following mid-gestational maternal MNU exposure. Maternal immune stimulation with IFN-gamma on GD 7 lessened incidence of fetal limb shortening and maldevelopment on GD 12 and 14. Further, disruption of placental spongiotrophoblast integrity, increased cell death in placental trophoblasts with increased intercellular spaces in the spongiotrophoblast layer and minimal inflammation, and increased loss of fetal labyrinthine endothelial cells from MNU-exposed dams suggested that MNU-induced placental breakdown may contribute to fetal limb and digital maldevelopment. MNU + IFN-gamma was associated with diminished cell death within all layers of the placenta, especially in the labyrinthine layer. CONCLUSIONS These data verify improved distal limb development in MNU-exposed mice as a result of maternal IFN-gamma administration, and suggest a link between placental integrity and proper fetal development.
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MESH Headings
- Abnormalities, Drug-Induced/embryology
- Abnormalities, Drug-Induced/etiology
- Abnormalities, Drug-Induced/immunology
- Abnormalities, Drug-Induced/prevention & control
- Alkylating Agents/toxicity
- Animals
- Drug Therapy, Combination
- Ear, Inner/drug effects
- Ear, Inner/immunology
- Ear, Inner/pathology
- Endothelial Cells/drug effects
- Endothelial Cells/immunology
- Endothelial Cells/pathology
- Female
- Immune System/drug effects
- Interferon-gamma/pharmacology
- Limb Deformities, Congenital/chemically induced
- Limb Deformities, Congenital/immunology
- Limb Deformities, Congenital/prevention & control
- Male
- Maternal-Fetal Exchange
- Methylnitrosourea/toxicity
- Mice
- Placenta/immunology
- Pregnancy
- Trophoblasts/drug effects
- Trophoblasts/immunology
- Trophoblasts/pathology
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Affiliation(s)
- Mary Renee Prater
- Edward Via Virginia College of Osteopathic Medicine, Blacksburg, Virginia 24061, USA.
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75
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Karmaus W, Arshad SH, Sadeghnejad A, Twiselton R. Does maternal immunoglobulin E decrease with increasing order of live offspring? Investigation into maternal immune tolerance. Clin Exp Allergy 2004; 34:853-9. [PMID: 15196270 DOI: 10.1111/j.1365-2222.2004.01959.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Identifying the protective effect of a higher number of siblings is a significant finding in understanding the aetiology of allergic sensitization, asthma, eczema, and hayfever. Knowledge about causes behind the sibling effect may allow us to prevent atopic manifestations. OBJECTIVE We tested the hypothesis that rising order of live offspring increases maternal immune tolerance (immune non-reactivity) against allergens. To this end, we investigated whether maternal IgE levels are associated with the number of live offspring. METHODS In a cohort of 1456 newborns recruited between January 1989 and February 1990 on the Isle of Wight, UK, we determined maternal and cord serum IgE, and the order of live offspring. The data were analysed by means of linear and path analysis. RESULTS Maternal and cord serum IgE were available in 820 mother-infant pairs with birth order information. We found that the number of live offspring significantly reduces maternal IgE. The decline was more prominent in mothers with atopy (n=268). The geometric means of IgE after the first, second, and third or higher delivery were 74.4, 66.6, and 43.0 kU/L, respectively. Findings of path analysis suggest a significant direct effect of birth order on maternal IgE, but no direct effect of birth order on cord serum IgE. CONCLUSION The findings support that maternal immune tolerance against allergens may increase with increasing order of live offspring and thus pass on a lower risk of developing atopy in children of higher birth order.
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Affiliation(s)
- W Karmaus
- Department of Epidemiology, Michigan State University, East Lansing, MI 48823, USA.
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