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Perkin MR, Strachan DP. The hygiene hypothesis for allergy - conception and evolution. FRONTIERS IN ALLERGY 2022; 3:1051368. [PMID: 36506644 PMCID: PMC9731379 DOI: 10.3389/falgy.2022.1051368] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/20/2022] [Indexed: 11/25/2022] Open
Abstract
In 1989, a short paper entitled "Hay fever, hygiene and household size" observed that British children from larger families were less likely to develop hay fever and suggested that this could be because early exposure to infection prevents allergy. This sibship size association for hay fever, since replicated many times in Britain and other affluent countries and confirmed by objective measures of atopy, prompted what has come to be known as the "hygiene hypothesis for allergy", although that term was not specifically used in the 1989 paper. The present paper reviews the historical roots of the "hygiene hypothesis" and charts its development over more than 30 years. Initial scepticism among immunologists turned to enthusiasm in the mid-1990s as the Th1/Th2 paradigm for allergic sensitisation emerged from animal experiments and the concept of "immunological old friends" became popular from the early 2000s. From the late 1990s, observations of reduced allergy risk among children of anthroposophic families and those brought up on farms suggested that the sibship size effects formed part of a broader range of "hygiene-related" determinants of allergy. Children from large families with farming exposure have approximately sixfold reduction in prevalence of hay fever, indicating the potential strength and epidemiological importance of these environmental determinants. During the 21st century, a wide range of specific microbial, environmental and lifestyle factors have been investigated as possible underlying mechanisms, but sadly none have emerged as robust explanations for the family size and farming effects. Thus, while the "hygiene hypothesis" led to a fundamental reappraisal of our relationship with our microbial environment and to the concept that early exposure, rather than avoidance, is beneficial for developing a healthy immune system, the underlying mechanism for variations in allergy prevalence with family size remains, in Churchillian terms, "a riddle wrapped in a mystery inside an enigma".
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Gallegos-Alcalá P, Jiménez M, Cervantes-García D, Salinas E. The Keratinocyte as a Crucial Cell in the Predisposition, Onset, Progression, Therapy and Study of the Atopic Dermatitis. Int J Mol Sci 2021; 22:ijms221910661. [PMID: 34639001 PMCID: PMC8509070 DOI: 10.3390/ijms221910661] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 12/24/2022] Open
Abstract
The keratinocyte (KC) is the main functional and structural component of the epidermis, the most external layer of the skin that is highly specialized in defense against external agents, prevention of leakage of body fluids and retention of internal water within the cells. Altered epidermal barrier and aberrant KC differentiation are involved in the pathophysiology of several skin diseases, such as atopic dermatitis (AD). AD is a chronic inflammatory disease characterized by cutaneous and systemic immune dysregulation and skin microbiota dysbiosis. Nevertheless, the pathological mechanisms of this complex disease remain largely unknown. In this review, we summarize current knowledge about the participation of the KC in different aspects of the AD. We provide an overview of the genetic predisposing and environmental factors, inflammatory molecules and signaling pathways of the KC that participate in the physiopathology of the AD. We also analyze the link among the KC, the microbiota and the inflammatory response underlying acute and chronic skin AD lesions.
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Affiliation(s)
- Pamela Gallegos-Alcalá
- Department of Microbiology, Center of Basic Science, Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico; (P.G.-A.); (M.J.); (D.C.-G.)
| | - Mariela Jiménez
- Department of Microbiology, Center of Basic Science, Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico; (P.G.-A.); (M.J.); (D.C.-G.)
| | - Daniel Cervantes-García
- Department of Microbiology, Center of Basic Science, Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico; (P.G.-A.); (M.J.); (D.C.-G.)
- National Council of Science and Technology, Ciudad de México 03940, Mexico
| | - Eva Salinas
- Department of Microbiology, Center of Basic Science, Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico; (P.G.-A.); (M.J.); (D.C.-G.)
- Correspondence: ; Tel.: +52-449-9108424
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Immunomodulatory effect of different extracts from Angiostrongylus cantonensis on airway inflammation in an allergic asthma model. Parasitol Res 2020; 119:3719-3728. [PMID: 32955617 DOI: 10.1007/s00436-020-06884-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/13/2020] [Indexed: 10/23/2022]
Abstract
This study aimed to evaluate the effects of early-life exposure to different extracts of Angiostrongylus cantonensis (A. cantonensis) on airway inflammation in an allergic asthma model. The total soluble extract (TE) and the soluble extracts of the digestive (AcD), reproductive (AcR), and cuticle (AcC) systems of A. cantonensis were used for immunisation before ovalbumin (OVA)-sensitisation/challenge in an OVA-induced allergic asthma model. The initial hypothesis of the study was that some soluble extract of the systems (AcD, AcR, or AcC) could be more potent to the modulation of inflammation than the TE. Our data, however, shows that immunisation with the TE is more promising because it decreased the high influx of inflammatory cells on airways and promoted an increase of interferon-γ (IFN-ɣ) and interleukin-10 (IL-10) levels. Besides this, the immunisation with the TE also led to a reduction of goblet cells and mucus overproduction in the lung tissue of asthmatic mice. We believe that the extracts have a distinct capacity to modulate the immune system, due to the TE possessing a greater variability of molecules, which together leads to control of airway inflammation. In conclusion, this is the first study to reveal that the TE of A. cantonensis adult worms has a greater potential for developing a novel therapeutic for allergic asthma.
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Akiner U, Yener HM, Gozen ED, Kuzu SB, Canakcioglu S. Helicobacter pylori in allergic and non-allergic rhinitis does play a protective or causative role? Eur Arch Otorhinolaryngol 2019; 277:141-145. [DOI: 10.1007/s00405-019-05659-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/14/2019] [Indexed: 02/07/2023]
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Alper Z, Sapan N, Ercan İ, Canıtez Y, Bilgel N. Risk Factors for Wheezing in Primary School Children in Bursa, Turkey. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/194589240602000111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Wheezing is the most common symptom of childhood respiratory tract illnesses. It is important not only for its associated acute morbidity, but also for the fact that early childhood wheezing confers a high risk for asthma. Epidemiological studies from various countries show that 10–15% of children <1 year of age and 25% of children <5 years of age have wheezing-associated respiratory tract illness, and one-third of these children develop asthma later in life. Methods In this retrospective study, we evaluated the association between a history of wheezing and prenatal, postnatal, familial, and environmental risk factors in 858 7-year-old children, randomly selected from seven primary schools in Bursa, Turkey, by means of an easy-to-understand questionnaire form. Among these children, 12.4% had a history of early transient wheezing, 7.1% had persistent wheezing, and 7.7% had late onset wheezing; 72.8% had no wheezing symptoms and 33.3% of children who experienced wheezing during the first 3 years of life had physician-diagnosed asthma. Results Notable risk factors associated with wheezing were as follows: male gender, lower socioeconomic status, premature birth, maternal smoking during pregnancy, bottle-feeding before 2 months of age, dampness and mold at home, hospitalization due to any respiratory illness in infancy, history of croup between 6 months and 5 years of age, frequent upper respiratory infections during the first 3 years of life, allergic eczema in the child, and any allergic disease in the mother or siblings. Conclusion This study shows that the high rates of reported wheezing in the 858 primary school children in Bursa are clearly attributable to important risk factors that have long been recognized and discussed by researchers worldwide, and this suggests that all efforts at primary prevention may be insufficient.
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Affiliation(s)
- Züleyha Alper
- Department of Family Medicine, School of Medicine, University of Uludag, Bursa, Turkey
| | - Nihat Sapan
- Department of Pediatric Allergy, School of Medicine, University of Uludag, Bursa, Turkey
| | - İlker Ercan
- Department of Biostatistics, School of Medicine, University of Uludag, Bursa, Turkey
| | - Yakup Canıtez
- Department of Pediatric Allergy, School of Medicine, University of Uludag, Bursa, Turkey
| | - Nazan Bilgel
- Department of Family Medicine, School of Medicine, University of Uludag, Bursa, Turkey
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Perret JL, Matheson MC, Gurrin LC, Johns DP, Burgess JA, Thompson BR, Lowe AJ, Markos J, Morrison SS, McDonald CF, Wood-Baker R, Svanes C, Thomas PS, Hopper JL, Giles GG, Abramson MJ, Walters EH, Dharmage SC. Childhood measles contributes to post-bronchodilator airflow obstruction in middle-aged adults: A cohort study. Respirology 2018; 23:780-787. [PMID: 29560611 DOI: 10.1111/resp.13297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/09/2018] [Accepted: 02/20/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Chronic obstructive pulmonary disease (COPD) has potential origins in childhood but an association between childhood measles and post-bronchodilator (BD) airflow obstruction (AO) has not yet been shown. We investigated whether childhood measles contributed to post-BD AO through interactions with asthma and/or smoking in a non-immunized middle-aged population. METHODS The population-based Tasmanian Longitudinal Health Study (TAHS) cohort born in 1961 (n = 8583) underwent spirometry in 1968 before immunization was introduced. A history of childhood measles infection was obtained from school medical records. During the fifth decade follow-up (n = 5729 responses), a subgroup underwent further lung function measurements (n = 1389). Relevant main associations and interactions by asthma and/or smoking on post-BD forced expiratory volume in 1 s/forced vital capacity (FEV1 /FVC; continuous variable) and AO (FEV1 /FVC < lower limit of normal) were estimated by multiple regression. RESULTS Sixty-nine percent (n = 950) had a history of childhood measles. Childhood measles augmented the combined adverse effect of current clinical asthma and smoking at least 10 pack-years on post-BD FEV1 /FVC ratio in middle age (z-score: -0.70 (95% CI: -1.1 to -0.3) vs -1.36 (-1.6 to -1.1), three-way interaction: P = 0.009), especially for those with childhood-onset asthma. For never- and ever-smokers of <10 pack-years who had current asthma symptoms, compared with those without childhood measles, paradoxically, the odds for post-BD AO was not significant in the presence of childhood measles (OR: 12.0 (95% CI: 3.4-42) vs 2.17 (0.9-5.3)). CONCLUSION Childhood measles infection appears to compound the associations between smoking, current asthma and post-BD AO. Differences between asthma subgroups provide further insight into the complex aetiology of obstructive lung diseases for middle-aged adults.
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Affiliation(s)
- Jennifer L Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia.,Department of Respiratory and Sleep Medicine, Austin Hospital, Melbourne, VIC, Australia.,Institute for Breathing and Sleep (IBAS), Melbourne, VIC, Australia
| | - Melanie C Matheson
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
| | - Lyle C Gurrin
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
| | - David P Johns
- "Breathe Well" Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - John A Burgess
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
| | - Bruce R Thompson
- Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, VIC, Australia.,Department of Medicine, Monash University, Melbourne, VIC, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
| | - James Markos
- Launceston General Hospital, Hobart, TAS, Australia
| | - Stephen S Morrison
- Department of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Christine F McDonald
- Department of Respiratory and Sleep Medicine, Austin Hospital, Melbourne, VIC, Australia.,Institute for Breathing and Sleep (IBAS), Melbourne, VIC, Australia
| | - Richard Wood-Baker
- "Breathe Well" Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukelaud University Hospital, Bergen, Norway
| | - Paul S Thomas
- Prince of Wales' Hospital Clinical School and School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - John L Hopper
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia.,Department of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Graham G Giles
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - E Haydn Walters
- "Breathe Well" Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
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Kim HY, Kim CW, Choi JY, Yu DS, Kim JW, Han KD, Park YG, Lee YB. Atopic dermatitis is inversely associated with hepatitis B antigen positivity: a population-based cohort study. J Eur Acad Dermatol Venereol 2017. [PMID: 28646620 DOI: 10.1111/jdv.14428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND No clear association between hepatitis B virus (HBV) infection and atopic dermatitis (AD) has been established. Some studies have reported that subjects with HBV had an increased risk of atopy; other studies reported an inverse association between HBV seropositivity and allergic diseases. OBJECTIVE We evaluated the association between AD and hepatitis B antigen (HBsAg) positivity using Korean National Health and Nutrition Examination Survey data. METHODS In total, 14 776 participants aged >19 years were included in the analysis. Multiple logistic regression analyses were used to evaluate the odds ratio of HBsAg positivity in association with AD and asthma. RESULTS The prevalence of HBsAg positivity was lower in individuals with AD than in those without AD (mean [SE], 0.7% [0.4] vs. 3.7% [0.2]; P < 0.001). However, HBsAg positivity was not significantly associated with asthma (3.7% [0.2] vs. 2.8% [0.8]; P < 0.001). HBsAg positivity decreased the risk of AD significantly (OR = 0.223; 95% CI = 0.069-0.72). CONCLUSIONS This study demonstrates an inverse association between AD and HBsAg positivity using a nationwide, population-based, cross-sectional health examination and survey.
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Affiliation(s)
- H Y Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C W Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J Y Choi
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - D S Yu
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J W Kim
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - K D Han
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Y G Park
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Y B Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Gourru-Lesimple G, Mathieu C, Thevenet T, Guillaume-Vasselin V, Jégou JF, Boer CG, Tomczak K, Bloyet LM, Giraud C, Grande S, Goujon C, Cornu C, Horvat B. Measles virus infection of human keratinocytes: Possible link between measles and atopic dermatitis. J Dermatol Sci 2017; 86:97-105. [PMID: 28233587 DOI: 10.1016/j.jdermsci.2017.01.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/21/2016] [Accepted: 01/10/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Measles virus (MV) infection is marked with a skin rash in the acute phase of the disease, which pathogenesis remains poorly understood. Moreover, the association between measles and progression of skin diseases, such as atopic dermatitis (AD), is still elusive. OBJECTIVE We have thus analysed the susceptibility of human keratinocytes to MV infection and explore the potential relationship between MV vaccination and the pathogenesis the AD. METHODS We performed immunovirological characterisation of MV infection in human keratinocytes and then tested the effect of live attenuated measles vaccine on the progression of AD in adult patients, in a prospective, double-blind study. RESULTS We showed that both human primary keratinocytes and the keratinocyte cell line HaCaT express MV receptors and could be infected by MV. The infection significantly modulated the expression of several keratinocyte-produced cytokines, known to be implicated in the pathogenesis of inflammatory allergic diseases, including AD. We then analysed the relationship between exposure to MV by vaccination and the progression of AD in 20 adults during six weeks. We found a significant decrease in CCL26 and thymic stromal lymphopoietin (TSLP) mRNA in biopsies from acute lesions of vaccinated patients, suggesting MV-induced modulation of skin cytokine expression. Clinical analysis revealed a transient improvement of SCORAD index in vaccinated compared to placebo-treated patients, two weeks after vaccination. CONCLUSIONS Altogether, these results clearly demonstrate that keratinocytes are susceptible to MV infection, which could consequently modulate their cytokine production, resulting with a beneficial effect in the progression of AD. This study provides thus a proof of concept for the vaccination therapy in AD and may open new avenues for the development of novel strategies in the treatment of this allergic disease.
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Affiliation(s)
- Geraldine Gourru-Lesimple
- CIRI, International Centre for Infectiology Research (Immunobiology of Viral Infections team), Inserm, U1111, University Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, France
| | - Cyrille Mathieu
- CIRI, International Centre for Infectiology Research (Immunobiology of Viral Infections team), Inserm, U1111, University Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, France
| | - Thomas Thevenet
- CIRI, International Centre for Infectiology Research (Immunobiology of Viral Infections team), Inserm, U1111, University Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, France
| | - Vanessa Guillaume-Vasselin
- CIRI, International Centre for Infectiology Research (Immunobiology of Viral Infections team), Inserm, U1111, University Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, France
| | - Jean-François Jégou
- Laboratoire Inflammation Tissus Epithéliaux et Cytokines, Equipe Accueil 4331, Université de Poitiers, Poitiers, France
| | - Cindy G Boer
- CIRI, International Centre for Infectiology Research (Immunobiology of Viral Infections team), Inserm, U1111, University Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, France
| | - Katarzyna Tomczak
- CIRI, International Centre for Infectiology Research (Immunobiology of Viral Infections team), Inserm, U1111, University Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, France
| | - Louis-Marie Bloyet
- CIRI, International Centre for Infectiology Research (Immunobiology of Viral Infections team), Inserm, U1111, University Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, France
| | - Celine Giraud
- CHU de Lyon, Service de Pharmacologie Clinique, Service de Pharmacologie Clinique, INSERM CIC1407, Lyon, France
| | - Sophie Grande
- Departement of Clinical Immunology and Allergy, Centre Hospitalier Lyon-Sud, Lyon, France
| | - Catherine Goujon
- CHU de Lyon, Service de Pharmacologie Clinique, Service de Pharmacologie Clinique, INSERM CIC1407, Lyon, France; Departement of Clinical Immunology and Allergy, Centre Hospitalier Lyon-Sud, Lyon, France
| | - Catherine Cornu
- CHU de Lyon, Service de Pharmacologie Clinique, Service de Pharmacologie Clinique, INSERM CIC1407, Lyon, France
| | - Branka Horvat
- CIRI, International Centre for Infectiology Research (Immunobiology of Viral Infections team), Inserm, U1111, University Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, France.
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9
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Ventura MT, Musi M, Giuliano G, Arsieni A, Di Leo E, Buquicchio R, Accettura G, Spanevello A, Foschino-Barbaro MP, Resta O. Latex Allergy and Sensitization in Cities: A Survey in a Population at Risk. Int J Immunopathol Pharmacol 2016; 19:821-30. [PMID: 17166403 DOI: 10.1177/039463200601900411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The constant increase in allergic diseases in western countries is correlated with changes in lifestyle and with the deterioration of the air inhaled by the inhabitants because of the growing concentrations of pollutant substances present. Within a population at risk, i.e., the inhabitants of cities, a group of subjects at even higher risk was selected, whose job exposes them to automobile exhaust fumes for many hours a day. All the study subjects underwent allergological screening and spirometry. The results obtained show an overall increase of respiratory allergic diseases but no increased sensitisation to latex. It therefore seems plausible that, besides social and lifestyle changes, the deterioration of the quality of the air could be considered responsible, at least in part, for the growing numbers of allergic subjects. This study offers an opportunity to reconsider the validity of the “hygiene hypothesis” as an explanation for the increase of allergic disease in western countries, although recent reports have indicated that a sedentary lifestyle may also contribute, together with environmental degradation, to the notably increased prevalence of allergic diseases in large cities in industrialized nations.
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Affiliation(s)
- M T Ventura
- Department of Internal Medicine, Immunology and Infectious Diseases (MIDIM), University of Bari Medical School, Policlinico, Bari, Italy.
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Timmermann CAG, Osuna CE, Steuerwald U, Weihe P, Poulsen LK, Grandjean P. Asthma and allergy in children with and without prior measles, mumps, and rubella vaccination. Pediatr Allergy Immunol 2015; 26:742-9. [PMID: 25845848 PMCID: PMC6190691 DOI: 10.1111/pai.12391] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND The existing literature on the association between measles vaccination and subsequent risk of allergic disease is inconclusive. The aim of this study was, therefore, to determine whether measles, mumps, and rubella (MMR) vaccination administered in early childhood was associated with asthma and allergic diseases at ages 5, 7 and 13 yrs in a birth cohort. METHODS In the Faroe Islands, 640 children were followed from birth. Follow-up examinations at ages 5, 7 and 13 yrs included a physical examination and a maternal questionnaire about the child's health. At age 7, total and grass-specific IgE was quantified in the child's serum, and at age 13, the children underwent skin prick tests (SPT). The child's vaccination card was reviewed at examinations. RESULTS At age 5, 533 of 555 children had been vaccinated for MMR. After confounder adjustment, we found early life MMR vaccination to be associated with a two-third reduction in the odds of asthma (OR: 0.33, 95% CI: 0.12; 0.90) and hypersensitivity/allergy (OR: 0.32, 95% CI: 0.11; 0.88) at age 5, and the substantially decreased odds of asthma were replicated at age 13 (OR: 0.22, 95% CI: 0.08; 0.56). At age 7, serum total IgE was reduced by 62.8% (CI 95%: -84.3%; -11.9%) in the vaccinated children. MMR vaccination was not significantly associated with allergic rhinoconjuctivitis symptoms, eczema, or SPT reactions at age 13. CONCLUSIONS MMR vaccination early in life may have a protective effect against allergy at least up to age 7 and against asthma through age 13 yrs.
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Affiliation(s)
- Clara Amalie Gade Timmermann
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Christa Elyse Osuna
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Ulrike Steuerwald
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands, Denmark
| | - Pál Weihe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands, Denmark
| | - Lars K Poulsen
- Allergy Clinic, Copenhagen University Hospital at Gentofte, Gentofte, Denmark
| | - Philippe Grandjean
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
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11
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Shim JU, Lee SE, Hwang W, Lee C, Park JW, Sohn JH, Nam JH, Kim Y, Rhee JH, Im SH, Koh YI. Flagellin suppresses experimental asthma by generating regulatory dendritic cells and T cells. J Allergy Clin Immunol 2015; 137:426-35. [PMID: 26303344 DOI: 10.1016/j.jaci.2015.07.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 07/03/2015] [Accepted: 07/15/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although the hygiene hypothesis suggests that microbial infections could subvert asthma and thus a microbial product might serve as a therapeutic adjuvant for asthma, the relationship between bacterial components and asthma is complex. Recently, low levels of flagellin, the Toll-like receptor (TLR) 5 ligand, have been reported to promote asthma. OBJECTIVE We show that a therapeutic dose of flagellin suppresses asthma and that the effect occurs through generating regulatory dendritic cells (rDCs) and regulatory T (Treg) cells. METHODS Ovalbumin (OVA)-induced wild-type and TLR5 knockout asthmatic mice were treated intranasally with a mixture of OVA and 10 μg of a flagellin B (FlaB; of Vibrio vulnificus). OVA/FlaB-treated rDCs were adoptively transferred to mice with OVA-induced asthma. Anti-CD25 mAb was used to deplete Treg cells. A mixture of house dust mite (HDM) and FlaB was used to treat mice with HDM-induced asthma. Blood CD14(+) monocyte-derived dendritic cells from HDM-sensitive asthmatic patients were treated with FlaB and incubated with autologous CD4(+) T cells. RESULTS An OVA/FlaB mixture ameliorated OVA-induced asthma by inhibiting TH1/TH2/TH17 responses in a TLR5-dependent manner through generating rDCs and Treg cells. The adoptive transfer of OVA/FlaB-treated dendritic cells inhibited OVA-induced asthma, whereas the depletion of CD25(+) cells eliminated the inhibitory effect. A similar effect of FlaB was observed in mice with HDM-induced asthma. In patients with HDM-sensitive asthma, FlaB-treated rDCs inhibited HDM-stimulated TH1/TH2 responses while enhancing Treg cells in an IL-10-dependent manner. CONCLUSION These findings collectively suggest that flagellin could be used as a tolerogenic adjuvant to treat allergic asthma.
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Affiliation(s)
- Jae-Uoong Shim
- Division of Allergy, Asthma and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Shee Eun Lee
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Won Hwang
- School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju, Korea; Academy of Immunology and Microbiology (AIM), Institute for Basic Science (IBS), Pohang, Korea
| | - Changhon Lee
- Academy of Immunology and Microbiology (AIM), Institute for Basic Science (IBS), Pohang, Korea; Division of Integrative Biosciences and Biotechnology (IBB), Pohang University of Science and Technology, Pohang, Korea
| | - Jung-Won Park
- Division of Allergy and Immunology, Department of Internal Medicine and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Jung-Ho Sohn
- Division of Allergy and Immunology, Department of Internal Medicine and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hee Nam
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Kim
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Joon Haeng Rhee
- Clinical Vaccine R&D Center, National Research Laboratory of Molecular Microbial Pathogenesis, Research Institute for Vibrio Infections, Department of Microbiology, Chonnam National University Medical School, Gwangju, Korea.
| | - Sin-Hyeog Im
- Academy of Immunology and Microbiology (AIM), Institute for Basic Science (IBS), Pohang, Korea; Division of Integrative Biosciences and Biotechnology (IBB), Pohang University of Science and Technology, Pohang, Korea.
| | - Young-Il Koh
- Division of Allergy, Asthma and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
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Dixon DL. The Role of Human Milk Immunomodulators in Protecting Against Viral Bronchiolitis and Development of Chronic Wheezing Illness. CHILDREN (BASEL, SWITZERLAND) 2015; 2:289-304. [PMID: 27417364 PMCID: PMC4928768 DOI: 10.3390/children2030289] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/21/2015] [Accepted: 06/29/2015] [Indexed: 12/26/2022]
Abstract
Infants who are breastfed are at an immunological advantage when compared with formula fed infants, evidenced by decreased incidence of infections and diminished propensity for long term conditions, including chronic wheeze and/or asthma. Exclusive breastfeeding reduces the duration of hospital admission, risk of respiratory failure and requirement for supplemental oxygen in infants hospitalised with bronchiolitis suggesting a potentially protective mechanism. This review examines the evidence and potential pathways for protection by immunomodulatory factors in human milk against the most common viral cause of bronchiolitis, respiratory syncytial virus (RSV), and subsequent recurrent wheeze in infants. Further investigations into the interplay between respiratory virus infections such as RSV and how they affect, and are affected by, human milk immunomodulators is necessary if we are to gain a true understanding of how breastfeeding protects many infants but not all against infections, and how this relates to long-term protection against conditions such as chronic wheezing illness or asthma.
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Affiliation(s)
- Dani-Louise Dixon
- Intensive and Critical Care Unit, Flinders Medical Centre, Adelaide 5042, Australia.
- Department of Critical Care Medicine, Flinders University, Adelaide 5001, Australia .
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13
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Mina MJ, Metcalf CJE, de Swart RL, Osterhaus ADME, Grenfell BT. Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality. Science 2015; 348:694-9. [PMID: 25954009 DOI: 10.1126/science.aaa3662] [Citation(s) in RCA: 237] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 04/01/2015] [Indexed: 12/14/2022]
Abstract
Immunosuppression after measles is known to predispose people to opportunistic infections for a period of several weeks to months. Using population-level data, we show that measles has a more prolonged effect on host resistance, extending over 2 to 3 years. We find that nonmeasles infectious disease mortality in high-income countries is tightly coupled to measles incidence at this lag, in both the pre- and post-vaccine eras. We conclude that long-term immunologic sequelae of measles drive interannual fluctuations in nonmeasles deaths. This is consistent with recent experimental work that attributes the immunosuppressive effects of measles to depletion of B and T lymphocytes. Our data provide an explanation for the long-term benefits of measles vaccination in preventing all-cause infectious disease. By preventing measles-associated immune memory loss, vaccination protects polymicrobial herd immunity.
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Affiliation(s)
- Michael J Mina
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA. Medical Scientist Training Program, School of Medicine, Emory University, Atlanta, GA, USA.
| | - C Jessica E Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA. Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Rik L de Swart
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - A D M E Osterhaus
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA. Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
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14
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Han DH, Ahn JC, Mun SJ, Park SK, Oh SY, Rhee CS. Novel Risk Factors for Allergic Rhinitis in Korean Elementary School Children: ARCO-kids Phase II in a Community. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2015; 7:234-40. [PMID: 25749770 PMCID: PMC4397363 DOI: 10.4168/aair.2015.7.3.234] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 08/17/2014] [Accepted: 10/01/2014] [Indexed: 02/04/2023]
Abstract
Purpose Allergic rhinitis (AR) is a multifactorial disease whose genetic and environmental risk factors have been studied for decades. Many pediatric studies have pointed out the familial history of allergy, hygiene hypothesis, breast-feeding, pet ownership, and diets as risk factors of AR. However, most of factors are still up for debate. This preliminary report aimed to confirm the known risk factors and find the novel risk factors for AR in the Korean pediatric population. Methods A bi-seasonal, winter and summer, study in 2 elementary schools included all students whose parents completed the questionnaire of medical and social histories, quality of life, infant and early-childhood history, and the living styles. Skin prick tests and endoscopic examinations were conducted on all participants. Results Among total 1,020 children, 338 participants had AR. The multivariate logistic regression analysis highlighted 6 factors: male gender (OR, 2.10; 95% CI, 1.32-3.33), older age (1.65; 1.03-2.65), previous history of allergic conjunctivitis (14.25; 4.99-40.74), asthma (2.73; 0.96-7.76) and pneumonia (0.39; 0.19-0.82), and an hour increase in daily playing time (0.90; 0.80-1.00). Conclusions Lack of pneumonia in early childhood and short playing time are newly found risk factors for Korean pediatric AR in this study confirming male gender, older age and previous history of allergic conjunctivitis and asthma as the risk factors.
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Affiliation(s)
- Doo Hee Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Cheul Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sue Jean Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.; Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.; Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Se Young Oh
- Department of Food and Nutrition, Kyung Hee University College of Human Ecology, Seoul, Korea
| | - Chae Seo Rhee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.; Graduate School of Immunology, Seoul National University College of Medicine, Seoul, Korea.; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Korea.; Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
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15
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Bisgaard H, Bønnelykke K, Stokholm J. Immune-mediated diseases and microbial exposure in early life. Clin Exp Allergy 2014; 44:475-81. [PMID: 24533884 DOI: 10.1111/cea.12291] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The non-communicable disease pandemic includes immune-mediated diseases such as asthma and allergy, which are likely originating in early life where the immature immune system is prone to alterations caused by the exposome. The timing of exposure seems critical for the developing immune system, and certain exposures may have detrimental effects in the earliest life, but no or even beneficial effects later. The human microbiome and infections are candidates as intermediary in the interaction between the host and the environment. The evidence seems inconsistent as infections as well as particular colonization patterns in neonates drive both short-term and long-term asthma symptoms, while, on the other hand, the composition of the microbiome in early life may protect against asthma and allergy in later life. This apparent contradiction may be explained by a deeper disease heterogeneity than we are currently able to discriminate, and in particular, the indiscriminate lumping together of different diseases into one atopic disease category. Also, the microbiome needs a differentiated understanding, considering balance between microbial groups, diversity and microbial genetic capability. Furthermore, the effects of the microbial exposure may only affect individuals with certain susceptibility genes. Few of the observations have been replicated, and publication bias is likely. Therefore, we are still far from understanding, or having proved, causal effects of the human microbiome. Still, the microbiome-gene interaction is a fascinating paradigm that fosters exiting research and promises a breakthrough in the understanding of the mechanisms driving asthma, allergy and eczema, and potentially also other immune-mediated non-communicable diseases.
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Affiliation(s)
- H Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Gentofte, Copenhagen, Denmark; The Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark
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16
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Abstract
This thesis explores the contribution of twin studies, particularly those studies originating from the Danish Twin Registry, to the understanding of the aetiology of asthma. First, it is explored how twin studies have established the contribution of genetic and environmental factors to the variation in the susceptibility to asthma, and to the variation in several aspects of the clinical expression of the disease such as its age at onset, its symptomatology, its intermediate phenotypes, and its relationship with other atopic diseases. Next, it is explored how twin studies have corroborated theories explaining asthma's recent increase in prevalence, and last, how these fit with the explanations of the epidemiological trends in other common chronic diseases of modernity.
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17
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Miller DS, Brown MP, Howley PM, Hayball JD. Current and emerging immunotherapeutic approaches to treat and prevent peanut allergy. Expert Rev Vaccines 2014; 11:1471-81. [DOI: 10.1586/erv.12.119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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18
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Abstract
Asthma has puzzled and confused physicians from the time of Hippocrates to the present day. The word “asthma” comes from a Greek word meaning “panting” (Keeney 1964), but reference to asthma can also be found in ancient Egyptian, Hebrew, and Indian medical writings (Ellul-Micallef 1976; Unger and Harris 1974). There were clear observations of patients experiencing attacks of asthma in the second century and evidence of disordered anatomy in the lung as far back as the seventeenth century (Dring et al. 1689).
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19
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Singh M, Das RR, Kumar L, Kumar R. Bacille Calmette-Guérin vaccination is associated with lower prevalence of allergic diseases in Indian children. Am J Rhinol Allergy 2013; 27:e107-12. [PMID: 23883802 DOI: 10.2500/ajra.2013.27.3940] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Immunization with bacille Calmette-Guérin (BCG) has been shown to augment T helper (Th) 1 biased response and hence gives protection against developing allergies. However, results across the studies have been inconclusive and there is no Indian study verifying this association. We explored the link between BCG vaccination and prevalence of allergic diseases among school children of Chandigarh, North India. METHODS In a large cross-sectional study, children aged 7-14 years, with and without documentation and/or scar consistent with BCG vaccination, were examined over a period of 2 years and 5 months with the help of a questionnaire-based survey followed by skin-prick test (SPT). RESULTS A total of 10,028 children were included. The mean age was 11.04 ± 2.8 years and M/F ratio was 1.1:1. Among them, 77.7% had documentation of BCG vaccination, 17% had a BCG-like scar but no documentation and 5.3% had no scar/documentation. SPT was performed on 1614 (16%) children. In the BCG group (vaccination and/or scar) 16.7% were atopic (positive SPT) compared with 21.3% in no BCG (no vaccination/scar). The prevalence of allergic diseases among BCG(+) subjects was 10.1%. Among these, asthma was the commonest one (6.1%), followed by rhinitis (3.5%) and eczema (0.5%). There was significant negative correlation between BCG positivity, atopy (p = 0.037), and allergic diseases as a whole (p = 0.028), but on independent analysis the negative correlation was strongest with allergic rhinitis (p = 0.011). CONCLUSION BCG vaccination is associated with lower prevalence of allergic disorders in Indian children.
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Affiliation(s)
- Meenu Singh
- Department of Pediatrics, Post-Graduate Institute of Medical Education and Research, Chandigarh, India.
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20
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Kiraly N, Benn CS, Biering-Sørensen S, Rodrigues A, Jensen KJ, Ravn H, Allen KJ, Aaby P. Vitamin A supplementation and BCG vaccination at birth may affect atopy in childhood: long-term follow-up of a randomized controlled trial. Allergy 2013; 68:1168-76. [PMID: 23991838 DOI: 10.1111/all.12216] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND Recent evidence suggests that immunogenic interventions such as vaccines and micronutrients may affect atopic sensitization and atopic disease. We aimed to determine whether neonatal BCG vaccination, vitamin A supplementation and other vaccinations affect atopy in childhood. METHODS In Guinea-Bissau, low-birthweight infants were randomized to early (intervention) or delayed (usual policy) BCG. A subgroup was also randomly assigned vitamin A supplementation or placebo in a two-by-two factorial design. Participants were followed up at age 3-9 years. The main outcome was atopy defined as skin prick test reaction ≥3 mm. Secondary outcomes were symptoms of eczema, asthma and food allergy. RESULTS Two hundred eighty-one children had valid skin prick tests performed, and 14% (39/281) were atopic. There was no significant difference in atopy between the early and delayed BCG groups (OR, 0.71; 95% CI, 0.34-1.47). Atopy was significantly reduced in children who had responded to BCG with a scar (OR, 0.42; 0.19-0.94). Vitamin A supplementation was associated with increased atopy (OR, 2.88; 1.26-6.58), especially in those who received simultaneous BCG (5.99; 1.99-18.1, P = 0.09 for interaction between vitamin A supplementation and BCG). Early vs delayed BCG was not associated with symptoms of atopic disease, but vitamin A supplementation increased odds of wheeze within the past 12 months (OR, 2.45; 1.20-4.96). CONCLUSIONS There were no statistically significant effects of early vs delayed BCG on atopy or symptoms of atopic disease. Having a BCG scar was associated with reduced atopy, whereas neonatal vitamin A supplementation was associated with increased atopy. STUDY REGISTRATION Clinicaltrials.gov NCT 01420705.
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Affiliation(s)
| | | | | | - A. Rodrigues
- Bandim Health Project; Indepth Network; Bissau; Guinea-Bissau; Australia
| | - K. J. Jensen
- Bandim Health Project; Indepth Network; Bissau; Guinea-Bissau; Australia
| | - H. Ravn
- Research Center for Vitamins and Vaccines (CVIVA); Bandim Health Project; Statens Serum Institute; Copenhagen; Denmark
| | - K. J. Allen
- Murdoch Childrens Research Institute; Parkville; VIC; Australia
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Marrs T, Bruce KD, Logan K, Rivett DW, Perkin MR, Lack G, Flohr C. Is there an association between microbial exposure and food allergy? A systematic review. Pediatr Allergy Immunol 2013; 24:311-320.e8. [PMID: 23578298 DOI: 10.1111/pai.12064] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2013] [Indexed: 10/27/2022]
Abstract
The environmental factors driving the recent increase in the prevalence of food allergy (FA) are unclear. Since associations have been demonstrated between microbial exposure and the likelihood of eczema and respiratory allergies, we reviewed the evidence for FA. Medline was systematically searched from inception to the end of July 2012 for studies investigating links between FA and environmental exposures, likely to influence microbial exposure, such as Caesarean delivery, family size, day-care attendance, childhood infections, immunizations and antibiotic use. We selected studies reporting food challenge data, reported doctor-diagnosed (RDD) FA and food sensitization. Methodological differences and study heterogeneity precluded meta-analysis. A total of 46 studies were identified, of which 28 (60.9%) were prospective and 13 (28.3%) used food challenges to diagnose FA. Caesarean delivery was investigated in 13 studies, of which three infant cohorts demonstrated an increase in challenge-proven FA (one cohort) and food sensitization (two cohorts), and one cross-sectional study reported increased RDDFA. Four studies investigated the effect of having siblings, with one infant cohort demonstrating less challenge-proven FA and a cross-sectional study showing a decrease in RDDFA. Attending childcare before 6 months was associated with less challenge-proven FA in one cohort. A cross-sectional survey identified an inverse relationship between hepatitis A serology and peanut sensitization. One of eleven trials investigating probiotics demonstrated a quicker acquisition of milk tolerance amongst allergic infants. Factors influencing microbial exposure may be partly responsible for rising FA burden, but further prospective studies using double-blind placebo controlled food challenges as an outcome are required.
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Affiliation(s)
- Tom Marrs
- Department of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, UK.
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22
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Al-Daghri NM, Alokail MS, Abd-Alrahman SH, Draz HM, Yakout SM, Clerici M. Polycyclic aromatic hydrocarbon exposure and pediatric asthma in children: a case-control study. Environ Health 2013; 12:1. [PMID: 23286340 PMCID: PMC3621697 DOI: 10.1186/1476-069x-12-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 12/11/2012] [Indexed: 05/18/2023]
Abstract
BACKGROUND Bronchial asthma is one of the most prevalent diseases in Arab children. Environmental pollution has been suggested to be considered causative of asthma, nasal symptoms and bronchitis in both children and adult. The objectives of this study were to evaluate the association between serum polycyclic aromatic hydrocarbons (PAHs) levels, asthma and allergic outcomes among Saudi children aged up to 15 yrs. We hypothesized that increased serum PAHs are associated with allergy, asthma, or respiratory symptoms. METHODS A total of 195 Saudi children (98 asthma pediatric patients and 97 healthy controls) were randomly selected from the Riyadh Cohort Study for inclusion. The diagnosis of Asthma was based on established pediatric diagnosis and medications taken. RESULTS Asthma related markers showed highly significant differences between children with and without asthma. Thus IgE, resistin and IL-4 were significantly increased (p 0.004, 0.001 and 0.003, respectively) in children with asthma compared with non-asthma control subjects. GMCSF, IFN-γ, IL-5, IL-8 and IL-10, on the other hand, were significantly decreased in children with asthma (p 0.003, 0.03, 0.001, 0.004 and 0.03, respectively). Strong associations between serum PAHs levels and biomarkers of childhood asthma were detected in Arabic children. Data confirmed the role of naphthalene, 4H-cyclobenta[def]phenanthrene, 1,2-benzanthracene, chrysene and benzo(e)acephenanthrylene in childhood asthma; levels of these PAHs were correlated with asthma related biomarkers including IgE, resistin, GMCSF and IFN-γ as well as IL-4, IL-5, IL-8 and IL-10 cytokines. CONCLUSIONS This data highlight the pivotal role of specific PAHs in childhood asthma.
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Affiliation(s)
- Nasser M Al-Daghri
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Majed S Alokail
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Sherif H Abd-Alrahman
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
- Pesticides Residues and Environmental Pollution Dept., Central Agricultural Pesticide Laboratory, Agricultural Research Center, Giza 12618, Egypt
| | - Hossam M Draz
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
- Biochemistry Department, National Research Centre, Dokki, Cairo 12311, Egypt
| | - Sobhy M Yakout
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mario Clerici
- Department of Biomedical Sciences and Technology, Milano University Medical School, Segrate-Milano 20090, Italy and Fondazioe Don C Gnocchi, Milan, Italy
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Burgess JA, Abramson MJ, Gurrin LC, Byrnes GB, Matheson MC, May CL, Giles GG, Johns DP, Hopper JL, Walters EH, Dharmage SC. Childhood infections and the risk of asthma: a longitudinal study over 37 years. Chest 2013; 142:647-654. [PMID: 22459783 DOI: 10.1378/chest.11-1432] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Few studies have examined common childhood infections and adult asthma. We examined associations between childhood infectious diseases, childhood pneumonia, and current, persisting, and incident asthma to middle age. METHODS We analyzed data from the Tasmanian Longitudinal Health Study (TAHS). A history of pneumonia was ascertained from their parents when the TAHS participants were 7 years old. Measles, rubella, mumps, chickenpox, diphtheria, and pertussis were identified from school medical records. Associations with current, persisting, or incident asthma were examined using regression techniques. RESULTS Greater infectious diseases load was negatively associated with persisting asthma at all ages. Individually, pertussis (adjusted OR [aOR], 0.53; 95% CI, 0.28-1.00) was negatively associated with asthma persisting to age 13 years, chickenpox (aOR, 0.58; 95% CI, 0.38-0.88) was negatively associated with asthma persisting to age 32 years, and rubella was negatively associated with asthma persisting to ages 32 (aOR, 0.61; 95% CI, 0.31-0.96) and 44 years (aOR 0.53; 95% CI, 0.35-0.82). Pertussis was associated with preadolescent incident asthma (adjusted hazard ratio [aHR], 1.80; 95% CI, 1.10-2.96), whereas measles was associated with adolescent incident asthma (aHR, 1.66; 1.06-2.56). Childhood pneumonia was associated with current asthma at ages 7 (aOR, 3.12; 95% CI, 2.61-3.75) and 13 years (aOR, 1.32; 95% CI, 1.00-1.75), an association stronger in those without than those with eczema (aOR, 3.46; 95% CI, 2.83-4.24 vs aOR, 2.08; 95% CI, 1.38-3.12). CONCLUSIONS Overall, childhood infectious diseases protected against asthma persisting in later life, but pertussis and measles were associated with new-onset asthma after childhood. Measles and pertussis immunization might lead to a reduction in incident asthma in later life.
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Affiliation(s)
- John A Burgess
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Carlton, VIC, Australia.
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, Monash University, The Alfred, Melbourne, VIC, Australia
| | - Lyle C Gurrin
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Carlton, VIC, Australia
| | - Graham B Byrnes
- Biostatistics Group, International Agency for Research on Cancer, Lyon, France
| | - Melanie C Matheson
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Carlton, VIC, Australia
| | - Cathryn L May
- Victorian Cervical Cytology Registry, East Melbourne, VIC, Australia
| | - Graham G Giles
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Carlton, VIC, Australia; Cancer Epidemiology Centre, The Cancer Council Victoria, Carlton, VIC, Australia
| | - David P Johns
- Respiratory Research Group, Menzies Research Institute, The University of Tasmania, Hobart, TAS, Australia
| | - John L Hopper
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Carlton, VIC, Australia
| | - E Haydn Walters
- Respiratory Research Group, Menzies Research Institute, The University of Tasmania, Hobart, TAS, Australia
| | - Shyamali C Dharmage
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Carlton, VIC, Australia
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Herrant M, Loucoubar C, Bassène H, Gonçalves B, Boufkhed S, Diene Sarr F, Fontanet A, Tall A, Baril L, Mercereau-Puijalon O, Mécheri S, Sakuntabhai A, Paul R. Asthma and atopic dermatitis are associated with increased risk of clinical Plasmodium falciparum malaria. BMJ Open 2013; 3:bmjopen-2013-002835. [PMID: 23883878 PMCID: PMC3731724 DOI: 10.1136/bmjopen-2013-002835] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To assess the impact of atopy and allergy on the risk of clinical malaria. DESIGN A clinical and immunological allergy cross-sectional survey in a birth cohort of 175 children from 1 month to 14 years of age followed for up to 15 years in a longitudinal open cohort study of malaria in Senegal. Malaria incidence data were available for 143 of these children (aged 4 months to 14 years of age) for up to 15 years. Mixed-model regression analysis was used to determine the impact of allergy status on malaria incidence, adjusting for age, gender, sickle-cell trait and force of infection. MAIN OUTCOME MEASURES Asthma, allergic rhinoconjunctivitis and atopic dermatitis status, the number of clinical Plasmodium falciparum malaria episodes since birth and associated parasite density. RESULTS 12% of the children were classified as asthmatic and 10% as having atopic dermatitis. These groups had respectively a twofold (OR 2.12 95%; CI 1.46 to 3.08; p=8×10(-5)) and threefold (OR 3.15; 1.56 to 6.33; p=1.3×10(-3)) increase in the risk of clinical P falciparum malaria once older than the age of peak incidence of clinical malaria (3-4 years of age). They also presented with higher P falciparum parasite densities (asthma: mean 105.3 parasites/μL±SE 41.0 vs 51.3±9.7; p=6.2×10(-3). Atopic dermatitis: 135.4±70.7 vs 52.3±11.0; p=0.014). There was no effect of allergy on the number of non-malaria clinical presentations. Individuals with allergic rhinoconjunctivitis did not have an increased risk of clinical malaria nor any difference in parasite densities. CONCLUSIONS These results demonstrate that asthma and atopic dermatitis delay the development of clinical immunity to P falciparum. Despite the encouraging decrease in malaria incidence rates in Africa, a significant concern is the extent to which the increase in allergy will exacerbate the burden of malaria. Given the demonstrated antiparasitic effect of antihistamines, administration to atopic children will likely reduce the burden of clinical malaria in these children, increase the efficacy of first-line treatment antimalarials and alleviate the non-infectious consequences of atopy.
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Affiliation(s)
- Magali Herrant
- Institut Pasteur, Unité de la Génétique Fonctionnelle des Maladies Infectieuses, CNRS URA3012, Paris, France
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | - Cheikh Loucoubar
- Institut Pasteur, Unité de la Génétique Fonctionnelle des Maladies Infectieuses, CNRS URA3012, Paris, France
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
- INSERM, U946, Genetic Variation and Human Diseases Unit,Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Paris, France
| | - Hubert Bassène
- Institut de Recherche pour le Développement (IRD), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS-IRD 198 UMR 6236, Dakar, Sénégal
| | - Bronner Gonçalves
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | - Sabah Boufkhed
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | - Fatoumata Diene Sarr
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | - Arnaud Fontanet
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France
- Conservatoire National des Arts et Métiers, Paris, France
| | - Adama Tall
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | - Laurence Baril
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | | | - Salaheddine Mécheri
- Institut Pasteur, Unité de Biologie des Interactions Hôte Parasite, Paris, France
- Centre National de la Recherche Scientifique, Unité de Recherche Associée 2581, Paris, France
| | - Anavaj Sakuntabhai
- Institut Pasteur, Unité de la Génétique Fonctionnelle des Maladies Infectieuses, CNRS URA3012, Paris, France
- Complex Systems Group, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Richard Paul
- Institut Pasteur, Unité de la Génétique Fonctionnelle des Maladies Infectieuses, CNRS URA3012, Paris, France
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Nagel G, Weinmayr G, Flohr C, Kleiner A, Strachan DP. Association of pertussis and measles infections and immunizations with asthma and allergic sensitization in ISAAC Phase Two. Pediatr Allergy Immunol 2012; 23:737-46. [PMID: 23005697 DOI: 10.1111/pai.12007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/21/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pertussis and measles infection as well as vaccination have been suspected as possible mediating factors of allergic disease in childhood. METHODS Between 1995 and 2005 cross-sectional studies were performed in 29 centers in 21 countries. Parental questionnaires were used to collect information on allergic diseases and exposures. We analyzed data from 54,943 randomly selected schoolchildren aged 8-12 yr. A subgroup of 31,759 children was also skin prick tested (SPT) to common environmental allergens. Combined odds ratios were calculated by random effect models for meta-analysis. RESULTS Pertussis and measles vaccination were not significantly associated with any of the allergy outcomes or SPT positivity. However, pertussis infection was associated with wheeze (OR(ad) 1.68; 95% CI 1.44-1.97) and rhinoconjunctivitis (OR(ad) 1.63; 95% 1.33-2.00). Pertussis infection was also significantly associated with a higher prevalence of reported eczema during the past year in non-affluent countries. Measles infection was associated with a higher prevalence of wheeze (OR(ad) 1.26; 95% 1.10-1.43) and reported eczema (OR(ad) 1.22; 95% 1.08-1.39). No association with SPT positivity was found, suggesting that these associations are unlikely to be mediated by an allergic component. CONCLUSIONS Associations of pertussis and measles infection with symptoms of asthma, rhinoconjunctivitis and eczema were found in both affluent and non-affluent countries and are unlikely to be mediated by IgE.
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Affiliation(s)
- Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
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Kondrashova A, Seiskari T, Ilonen J, Knip M, Hyöty H. The 'Hygiene hypothesis' and the sharp gradient in the incidence of autoimmune and allergic diseases between Russian Karelia and Finland. APMIS 2012; 121:478-93. [PMID: 23127244 DOI: 10.1111/apm.12023] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 10/04/2012] [Indexed: 12/13/2022]
Abstract
Autoimmune and allergic diseases have become a major health problem in the Western world during past decades. The hygiene hypothesis suggests that decreased microbial exposure in childhood leads to increasing prevalence of these diseases. This review summarizes epidemiological evidence and current immunological knowledge concerning the hygiene hypothesis. Recent results from Russian Karelia and Finland imply that environmental factors have greatly contributed to the increasing prevalence of immune-mediated disorders. Infections, or lack of them, may indeed be strongly involved in the development of both autoimmune and allergic diseases.
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Rujeni N, Taylor DW, Mutapi F. Human schistosome infection and allergic sensitisation. J Parasitol Res 2012; 2012:154743. [PMID: 22970345 PMCID: PMC3434398 DOI: 10.1155/2012/154743] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 06/28/2012] [Indexed: 12/24/2022] Open
Abstract
Several field studies have reported an inverse relationship between the prevalence of helminth infections and that of allergic sensitisation/atopy. Recent studies show that immune responses induced by helminth parasites are, to an extent, comparable to allergic sensitisation. However, helminth products induce regulatory responses capable of inhibiting not only antiparasite immune responses, but also allergic sensitisation. The relative effects of this immunomodulation on the development of protective schistosome-specific responses in humans has yet to be demonstrated at population level, and the clinical significance of immunomodulation of allergic disease is still controversial. Nonetheless, similarities in immune responses against helminths and allergens pose interesting mechanistic and evolutionary questions. This paper examines the epidemiology, biology and immunology of allergic sensitisation/atopy, and schistosome infection in human populations.
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Affiliation(s)
- Nadine Rujeni
- Institute of Immunology and Infection Research, Centre for Immunity, Infection, and Evolution, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, King's Buildings, West Mains Rd, Edinburgh EH9 3JT, UK
| | - David W. Taylor
- Institute of Immunology and Infection Research, Centre for Immunity, Infection, and Evolution, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, King's Buildings, West Mains Rd, Edinburgh EH9 3JT, UK
| | - Francisca Mutapi
- Institute of Immunology and Infection Research, Centre for Immunity, Infection, and Evolution, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, King's Buildings, West Mains Rd, Edinburgh EH9 3JT, UK
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Wilsher M, Hopkins R, Zeng I, Cornere M, Douglas R. Prevalence of asthma and atopy in sarcoidosis. Respirology 2012; 17:285-90. [PMID: 21942997 DOI: 10.1111/j.1440-1843.2011.02066.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE We hypothesized that the prevalence of allergic disorders, characterized by the release of type 2 cytokines (IL-4, IL-5, IL-10), would be lower in sarcoidosis in which there is a dominant type 1 immune response (IL-2, interferon-gamma). The objective was to measure the prevalence of atopy and self-reported asthma in patients with sarcoidosis. METHODS Sarcoidosis patients (n = 136, 72 M, age range 22-75), recruited in the outpatient setting, completed a modified European Community Respiratory Health Survey. 123 of these patients provided blood for allergy testing. RESULTS For the cohort as a whole the self-reported prevalence of asthma ever (21.5%) and asthma attack in the last 12 months (7.5%), was high as was wheezing (42.1%), breathlessness with wheeze (22.3%) and use of an asthma medication (13.1%). The prevalence of atopy was 34%. These data are not different from the previously reported prevalence of asthma and atopy in New Zealand. CONCLUSIONS The same prevalence of asthma symptoms and atopy as in the normal population suggests that the immune system is not skewed away from mounting T helper type 2 immune responses in sarcoidosis.
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Affiliation(s)
- Margaret Wilsher
- Respiratory Services, Auckland District Health Board, Auckland, New Zealand.
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Amarasekera M, Gunawardena NK, de Silva NR, Douglass JA, O'Hehir RE, Weerasinghe A. Impact of helminth infection on childhood allergic diseases in an area in transition from high to low infection burden. Asia Pac Allergy 2012; 2:122-8. [PMID: 22701862 PMCID: PMC3345325 DOI: 10.5415/apallergy.2012.2.2.122] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 04/10/2012] [Indexed: 12/28/2022] Open
Abstract
Background The effect of helminth infections on allergic diseases is still inconclusive. Furthermore, the effect of helminth infections on childhood allergic diseases in a tropical area where prevalence of helminth infections has undergone dramatic changes is not well documented. Objective To investigate the relationship between allergic diseases and helminth infection in a cohort of schoolchildren in an area that has undergone dramatic changes in intensity of helminth infections. Methods Children attending grade 5 were recruited from 17 schools in Western Province of Sri Lanka. They were assessed for allergic diseases using the International Study of Asthma and Allergies in Childhood questionnaire. Their serum total IgE (tIgE) and allergen-specific IgE (sIgE) for five common aeroallergens were measured by ImmunoCAP® method and stools were examined for the presence of helminth infections. Results A total of 640 children (mean age 10 years) were recruited to the study. Of them, 33.7% had evidence of allergic disease and 15.5% had helminth infections. Majority of infections (68.9%) were of low intensity. A significant relationship between allergic disease and helminth infections was not observed, however, a trend toward protective role of helminth infections against allergic diseases was noted. Multivariate analysis showed helminth infections to be an independent predictor of high tIgE levels whereas allergic disease was not. Allergic sensitization (atopy) was a significant risk factor for allergic disease only among non-infected children (odds ratio 3.025, p = 0.022) but not in infected children. The ratio of sIgE to tIgE was higher in non-infected children. Conclusion Though not significant, a reduced risk of allergy in helminth-infected children was observed in this population. A Decrease in intensity of helminth infections may have contributed to the reduced capacity of immune-modulation by helminths in this paediatric population.
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Affiliation(s)
- Manori Amarasekera
- Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama 11010, Sri Lanka
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Ige OM, Falade AG, Arinola OG. Atopy is a risk factor for adult asthma in urban community of Southwestern Nigeria. Lung India 2012; 29:114-9. [PMID: 22628923 PMCID: PMC3354482 DOI: 10.4103/0970-2113.95301] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
RATIONALE Factors affecting asthma course are not clearly elucidated in urban communities in developing countries. Furthermore, the interaction between factors such as atopy, environmental exposure, urbanization, and helminthic infections in modulating asthma have not been well investigated. OBJECTIVES To determine factors, which affect asthma in adults being evaluated at urban tertiary health center of Southwestern part of Nigeria. MATERIALS AND METHODS A random sample of 24 (12 males, 12 females) consecutive asthmatics seen in the Outpatient Pulmonary Clinic of University College Hospital of Ibadan and 27 (13 males, 14 females) age and gender-matched controls underwent evaluation, which included blood tests for eosinophils, serum IgE, allergy skin tests to eight common environmental allergens, and spirometry. The modified version of the questionnaire of the International study of Asthma and Allergies in Children (ISAAC) Phase III used by the same study group of researchers in Nigeria was used to assess the asthma symptoms. Wilcoxon sign-rank tests were used to compare eosinophil counts, percentage eosinophils, and allergic skin test between the two groups, while paired t test was used to compare spirometry variables. RESULTS Asthmatics had significantly more positive skin reaction to house dust mite and mould than controls (P<0.05). Total serum IgE was also significantly higher in asthmatics than in controls (mean 210 vs 60 IU/mL; P=0.003). However, no significant differences were observed in total eosinophil counts. No significant difference in the degree of intestinal helminthes infection in the two groups, which means stool parasitism was similar. FEV(1) % was significantly lower in asthmatics (P=0.02) but FEV(1) was similar between the two groups (P=0.02). CONCLUSION The elevated levels of IgE and positive skin reactions to some of the common environmental allergens suggests an important role of atopy in the expression of asthma in this developing country's urban setting. Intestinal parasites were seen in both, control and asthma subjects, but appear not to play any role in the course of asthma, so also is the blood group, genotype and G6PD status.
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Affiliation(s)
- O. M. Ige
- Department of Medicine, Pulmonary Unit (Adult), College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - A. G. Falade
- Department of Paediatrics, Pulmonary Unit, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - O. G. Arinola
- Department of Chemical Pathology, Immunology Unit, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Tallman PS, Kuzawa C, Adair L, Borja JB, McDade TW. Microbial exposures in infancy predict levels of the immunoregulatory cytokine interleukin-4 in Filipino young adults. Am J Hum Biol 2012; 24:446-53. [PMID: 22307655 DOI: 10.1002/ajhb.22244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 12/12/2011] [Accepted: 12/27/2011] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Infancy represents a window of development during which long-term immunological functioning can be influenced. In this study, we evaluate proxies of microbial exposures in infancy as predictors of interleukin-4 (IL-4) in young adulthood. IL-4 is an immunoregulatory cytokine that plays a role in the pathogenesis of atopic and allergic diseases. METHODS Data were obtained from 1,403 participants in the Cebu Longitudinal Health and Nutrition Survey, an ongoing population-based study in the Philippines. Relationships between microbial and nutritional environments in infancy and plasma IL-4 concentrations in adulthood were evaluated using tobit regression models. RESULTS Having older siblings and more episodes of respiratory illness in infancy significantly predicted lower concentrations of plasma IL-4 in adulthood. Unexpectedly, more episodes of diarrheal illness in infancy were associated with higher IL-4 in adulthood. Interactions between a composite household pathogen exposure score and the duration of exclusive breastfeeding approached significance. This interaction showed that the negative association between household pathogen exposure in infancy and adult IL-4 was only significant for individuals who had been exclusively breastfed for a short duration of time. Finally, currently living in an urban household was unexpectedly, negatively associated with adult IL-4. Associations were independent of early nutrition, socioeconomic status (SES), and urbanicity, as well as current measures of infection, body fat, SES, and smoking. CONCLUSIONS This study builds on a growing body of literature demonstrating that early ecological conditions have long-term effects on human biology by providing evidence that multiple proxies of microbial exposures in infancy are associated with adult IL-4.
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Affiliation(s)
- Paula Skye Tallman
- Department of Anthropology, Northwestern University, Chicago, Illinois 60201, USA.
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Abstract
There has been a global epidemic of asthma during the past half-century. More recently, the prevalence has leveled off or declined in many Western countries, whereas the prevalence in less affluent nations is still increasing. The reasons for this and the different geographical patterns of asthma prevalence remain unclear. This paper provides an epidemiologic perspective on whether allergen exposure and allergies can explain these trends. In particular, the paper discusses 1) geographical and temporal trends in asthma and the role of allergens and allergy, 2) the importance of nonallergic mechanisms, 3) nonallergenic exposures that may modify the risk of allergies and asthma, and 4) new and emerging risk and protective factors. Although allergy and asthma are closely related, allergen exposure and allergy alone cannot explain current time trends and geographical patterns of asthma. Population-based studies focusing on recently identified risk and protective factors may provide further insight.
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Miranda-Hernandez S, Gerlach N, Fletcher JM, Biros E, Mack M, Körner H, Baxter AG. Role for MyD88, TLR2 and TLR9 but not TLR1, TLR4 or TLR6 in experimental autoimmune encephalomyelitis. THE JOURNAL OF IMMUNOLOGY 2011; 187:791-804. [PMID: 21685327 DOI: 10.4049/jimmunol.1001992] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The potential roles of TLRs in the cause and pathogenesis of autoimmune CNS inflammation remain contentious. In this study, we examined the effects of targeted deletions of TLR1, TLR2, TLR4, TLR6, TLR9, and MyD88 on the induction of myelin oligodendrocyte glycoprotein 35-55 (MOG(35-55)) peptide/CFA/pertussis toxin-induced autoimmune encephalomyelitis. Although C57BL/6.Tlr1(-/-), C57BL/6.Tlr4(-/-) and C57BL/6.Tlr6(-/-) mice showed normal susceptibility to disease, signs were alleviated in female C57BL/6.Tlr2(-/-) and C57BL/6.Tlr9(-/-) mice and C57BL/6.Tlr2/9(-/-) mice of both sexes. C57BL/6.Myd88(-/-) mice were completely protected. Lower clinical scores were associated with reduced leukocyte infiltrates. These results were confirmed by passive adoptive transfer of disease into female C57BL/6.Tlr2(-/-) and C57BL/6.Tlr9(-/-) mice, where protection in the absence of TLR2 was associated with fewer infiltrating CD4(+) cells in the CNS, reduced prevalence of detectable circulating IL-6, and increased proportions of central (CD62L(+)) CD4(+)CD25(+)Foxp3(+) regulatory T cells. These results provide a potential molecular mechanism for the observed effects of TLR signaling on the severity of autoimmune CNS inflammation.
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Yang X, Gao X. Role of dendritic cells: a step forward for the hygiene hypothesis. Cell Mol Immunol 2011; 8:12-8. [PMID: 21200379 PMCID: PMC4002986 DOI: 10.1038/cmi.2010.51] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 08/20/2010] [Accepted: 09/02/2010] [Indexed: 12/20/2022] Open
Abstract
The hygiene hypothesis was proposed more than two decades ago, but its mechanism remains unclear. This review focuses on recent advances in the field, especially on the role played by dendritic cells (DCs) and their modulating effects on various infections and allergic diseases, including allergic asthma. DCs isolated from mice long after the resolution of an infection were reported to have a significant modulating effect on allergen-specific Th2 responses in both in vitro and in vivo systems. These DCs showed DC1-like and/or tolerogenic DC capacity, which allowed for the inhibition of allergic responses by immune deviation (enhancing Th1 response) and immune regulation (through regulatory T-cell and Th2 hyporesponsiveness) mechanisms. These findings represented a significant advance in the elucidation of the mechanisms underlying the hygiene hypothesis. Further investigation on the mechanisms by which DCs are 'educated' by infectious agents and the influence of the type, time, and extent of infections on this 'education' process will help us understand immune regulation in disease settings and in the rational design of preventive/therapeutic approaches to allergy/asthma and infections.
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Affiliation(s)
- Xi Yang
- Laboratory for Infection and Immunity, Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada.
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Sarinho E, Kunz FC, Bellesi N, Maia PFCDMD, Rizzo JA, Silva AR. Can multiple doses of BCG vaccine protect against asthma? J Bras Pneumol 2010; 36:281-5. [PMID: 20625663 DOI: 10.1590/s1806-37132010000300003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Accepted: 12/18/2009] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To compare BCG vaccination involving a single intradermal dose and that involving multiple doses, one given with the multiple puncture technique, in terms of the protective effect against the subsequent onset of asthma. METHODS A retrospective cohort study involving 2,311 individuals having received the BCG vaccine. The patients were classified according to the number of doses of BCG vaccine administered (one; two; or three or more). The minimum follow-up period in order to determine whether there was any protective effect of BCG vaccination regarding the diagnosis of asthma was 10 years. RESULTS The sample included 1,317 individuals (56.99%) who had received only one BCG dose, 644 (27.87%) who had received two doses, and 350 (15.14%) who had received three or more doses. The number of patients diagnosed with asthma among those who had received one dose, two doses and three or more doses was, respectively, 216 (16.40%), 107 (16.61%) and 50 (14.28%). There were no significant differences among the groups. CONCLUSIONS In the study sample, the prevalence of asthma among individuals having received multiple doses of the BCG vaccine was no different than that observed among those having received a single dose.
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Affiliation(s)
- Emanuel Sarinho
- Federal University of Pernambuco School of Medicine, Recife, Brazil.
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36
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Abstract
A relationship between infections and allergic airway disease has long been recognized, and many reviews have been written on this topic. However, both clinical and basic science studies published in the last 3 years provide new insights into the relationship between infection and allergic conditions. In this review, we focus on these very recent studies, which address the role of infection in the development, maintenance, and exacerbation of asthma. Bacterial, viral, fungal, and parasitic infections have each been examined and provide a framework for these novel concepts.
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Affiliation(s)
- C M Sevin
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2650, USA
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Abstract
Viral respiratory tract infections are common and usually selflimited illnesses. For patients at risk of asthma, or with existing asthma, viral respiratory tract infections can have a profound effect on the expression of disease or loss of control. New evidence has shown that wheezing episodes early in life due to human rhinoviruses are a major risk factor for the later diagnosis of asthma at age 6 years. For those with existing asthma, exacerbations are a major cause of morbidity, can need acute care, and can, albeit rarely, result in death. Viral respiratory tract infections, predominantly those caused by human rhinoviruses, are associated with asthma exacerbations. There is also evidence that deficiencies in antiviral activity and the integrity of the airway epithelial barrier could make individuals with asthma more likely to have severe viral respiratory infections of the lower airway, and thus increase the risk of exacerbation. In view of the effect of respiratory viruses on many aspects of asthma, efforts to understand the mechanisms and risk factors by which these airway infections cause changes in airway pathophysiology are a first step towards improved treatment.
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Affiliation(s)
- William W Busse
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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Shim JY, Kim HB, Lee SY, Yu J, Kim WK, Kang D, Lee CG, Ha M, Kwon HJ, Hong YC, Park KS, Lee HR, Hong SJ. Effects of early measles on later rhinitis and bronchial hyperresponsiveness. Ann Allergy Asthma Immunol 2010; 105:43-9. [PMID: 20642203 DOI: 10.1016/j.anai.2010.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The hygiene hypothesis suggests that infectious diseases in early life reduce the risk of allergic diseases. OBJECTIVE To investigate the association between measles infection during early childhood and the prevalence of allergic diseases, lung function, bronchial hyperresponsiveness (BHR), and sensitization in later childhood. METHODS A survey was conducted 5 years after a nationwide measles outbreak in Korea. From September 1 through November 30, 2006, we obtained information on history of measles and allergic diseases but not of measles vaccination through a questionnaire completed by 1004 schoolchildren aged 6 to 7 years. Furthermore, we measured measles antibody titers and performed skin prick tests, pulmonary function tests, and methacholine challenge tests. Children were divided into groups based on their history of measles infection and antibody titers. RESULTS Prevalence of measles infection was 8.2%. Children with both a positive measles history and a positive antimeasles antibody had significantly higher antimeasles antibody levels than those without a measles history. The prevalence of current rhinitis (adjusted odds ratio [aOR], 1.86; 95% confidence interval [CI], 1.02-3.40), rhinitis ever (aOR, 2.17; 95% CI, 1.19-3.94), and current BHR (aOR, 1.98; 95% CI, 1.04-3.78) was significantly higher in the group with a positive measles history compared with the group with a negative measles antibody. No differences were found among groups in the prevalence of asthma, lung function, provocation concentration that caused a decrease in forced expiratory volume of 1 second of 20%, or sensitization. CONCLUSION Early measles infection was associated with increased prevalence of rhinitis and BHR at the age of 7 years but has no effect on the development of asthma and allergy at the age of 7 years. This study indicates that common childhood infections such as measles in early age do not protect against later development of allergic diseases.
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Affiliation(s)
- Jung Yeon Shim
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
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Imamura S, Sugimoto M, Kanemasa K, Sumida Y, Okanoue T, Yoshikawa T, Yamaoka Y. Inverse association between Helicobacter pylori infection and allergic rhinitis in young Japanese. J Gastroenterol Hepatol 2010; 25:1244-9. [PMID: 20594251 PMCID: PMC3732487 DOI: 10.1111/j.1440-1746.2010.06307.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM The prevalence of allergic disorders, including asthma, atopic dermatitis, and allergic rhinitis has been increasing, and the prevalence of Helicobacter pylori (H. pylori) infection has been decreasing. Chronic bacterial infection during childhood is reported to protect the development of allergic diseases. The aim of the present study was to identify whether H. pylori infection influences the prevalence of allergic rhinitis, which has become a serious social problem, especially in the developed countries. METHODS We initially investigated the association between the prevalence of H. pylori and pollinosis symptoms in 97 healthy volunteers. We had investigated the association between the serum H. pylori-immunoglobulin (Ig) G antibodies and specific IgE antibodies for pollen, mites, and house dust in 211 consecutive patients. RESULTS There were 52.2% (36/69) of H. pylori-negative volunteers with allergic symptoms, which was significantly higher than H. pylori-positive volunteers (14.3%, 4/28, P < 0.05). The risk of pollinosis symptoms by H. pylori infection was 0.148 (95% confidence interval): 0.046-0.475, P < 0.05). The prevalence of H. pylori infection increased according to age, whereas that of specific IgE-positive patients gradually decreased. Among the IgE-positive patients, the prevalence of H. pylori-negative patients was significantly higher than H. pylori-positive patients who were younger in age (P < 0.05). CONCLUSION H. pylori infection decreased the pollinosis effects, especially among the younger volunteers. However, the prevalence of pollinosis in patients who were 50 years or older were almost same between H. pylori-positive and H. pylori-negative patients; therefore, the recent increase of pollinosis might relate to not only H. pylori infection, but also change in social environment.
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Affiliation(s)
- Shigeyoshi Imamura
- Department of Internal Medicine, Aiseikai Yamashina Hospital, Kyoto Prefectural University of Medicine, Kyoto
| | - Mitsushige Sugimoto
- Department of Medicine–Gastroenterology, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA
| | | | - Yoshio Sumida
- Center for Digestive and Liver Diseases, Nara City Hospital, Nara
| | - Takeshi Okanoue
- Division of Gastroenterology, Saiseikai Suita Hospital, Suita
| | - Toshikazu Yoshikawa
- Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Oita University, Yufu, Japan,Department of Medicine–Gastroenterology, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA
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Abstract
Food allergy seems to represent a new spectrum of disease that has elicited significant community concern and extended waiting lists for allergists and gastroenterologists alike. The apparent rise in prevalence of IgE-mediated food allergy (and associated risk of anaphylaxis) has been postulated to result from effects of a "modern lifestyle" but as yet clear environmental risk factors have not yet emerged. Family history seems to contribute to risk suggesting that gene-environment interactions will be important for identifying a subpopulation with increased susceptibility to any identified lifestyle effects. Non-IgE-mediated food allergy (including food-induced enteropathies and colitides, eosinophilic esophagitis, and Crohn's disease) with potentially similar environmental triggers resulting in diverse immune dysregulatory mechanisms. The evidence underpinning the putative rise in food allergy is discussed and potential mechanisms of disease explored. Clinical aspects of various food allergic conditions including non-IgE-mediated food allergy are outlined.
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Administration of antibiotics during infancy promoted the development of atopic dermatitis-like skin lesions in NC/Nga mice. Biosci Biotechnol Biochem 2010; 74:358-63. [PMID: 20139606 DOI: 10.1271/bbb.90709] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study aimed to determine whether oral antibiotic administration during infancy is associated with the spontaneous development of atopic dermatitis-like skin lesions by modulating intestinal microbiota. Female NC/Nga mice at 3 weeks of age were orally administered kanamycin or polymyxin B. Clinical symptoms, scratching behavior, and serum antibody levels were evaluated. Changes in intestinal microbiota were determined by culture-independent analysis and cultural analysis. The kanamycin-treated mice showed higher clinical scores and scratching frequency than the control mice. IgE levels were significantly higher in the kanamycin-treated mice than in the control mice. Transient changes in intestinal microbiota were observed under kanamycin treatment. Polymyxin B treatment failed to affect scratching behavior. These results suggest that oral administration of kanamycin during infancy promoted the development of atopic dermatitis-like skin lesions in NC/Nga mice and was associated with a transient change in intestinal microbiota.
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Roesler E, Weiss R, Weinberger EE, Fruehwirth A, Stoecklinger A, Mostböck S, Ferreira F, Thalhamer J, Scheiblhofer S. Immunize and disappear—Safety-optimized mRNA vaccination with a panel of 29 allergens. J Allergy Clin Immunol 2009; 124:1070-7.e1-11. [DOI: 10.1016/j.jaci.2009.06.036] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 05/27/2009] [Accepted: 06/25/2009] [Indexed: 10/20/2022]
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Abstract
PURPOSE OF REVIEW To describe what is currently known about the role of virus vaccines in the pathogenesis of asthma and atopy and summarize their role in the prevention of morbidity due to childhood asthma. RECENT FINDINGS The development of virus vaccines and their incorporation into infant and childhood immunization programmes over the last few decades of the twentieth century have been accompanied by a striking concomitant rise in the incidence of asthma and atopy. However, a causal relationship is not supported by the majority of observational studies. The role of childhood immunization against respiratory viruses in the reduction of morbidity from asthma is another important public health issue. Recent findings suggest that influenza is not strongly associated with exacerbations of asthma in children, despite recommendations that this group should be immunized against it. SUMMARY Current evidence suggests that virus vaccination is well tolerated and does not lead to an increased incidence of asthma or atopy in children receiving vaccines. Debate continues regarding the place of respiratory virus vaccination in the therapeutic armamentarium for children with asthma. In the case of influenza, there appears to be an absence of harm, but benefit seems to be limited to younger children.
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Rosenlund H, Bergström A, Alm JS, Swartz J, Scheynius A, van Hage M, Johansen K, Brunekreef B, von Mutius E, Ege MJ, Riedler J, Braun-Fahrländer C, Waser M, Pershagen G. Allergic disease and atopic sensitization in children in relation to measles vaccination and measles infection. Pediatrics 2009; 123:771-8. [PMID: 19255001 DOI: 10.1542/peds.2008-0013] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Our aim was to investigate the role of measles vaccination and measles infection in the development of allergic disease and atopic sensitization. METHODS A total of 14 893 children were included from the cross-sectional, multicenter Prevention of Allergy-Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle study, conducted in 5 European countries (Austria, Germany, the Netherlands, Sweden, and Switzerland). The children were between 5 and 13 years of age and represented farm children, Steiner-school children, and 2 reference groups. Children attending Steiner schools often have an anthroposophic (holistic) lifestyle in which some immunizations are avoided or postponed. Parental questionnaires provided information on exposure and lifestyle factors as well as symptoms and diagnoses in the children. A sample of the children was invited for additional tests, and 4049 children provided a blood sample for immunoglobulin E analyses. Only children with complete information on measles vaccination and infection were included in the analyses (84%). RESULTS In the whole group of children, atopic sensitization was inversely associated with measles infection, and a similar tendency was seen for measles vaccination. To reduce risks of disease-related modification of exposure, children who reported symptoms of wheezing and/or eczema debuting during first year of life were excluded from some analyses. After this exclusion, inverse associations were observed between measles infection and "any allergic symptom" and "any diagnosis of allergy by a physician." However, no associations were found between measles vaccination and allergic disease. CONCLUSION Our data suggest that measles infection may protect against allergic disease in children.
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Affiliation(s)
- Helen Rosenlund
- Karolinska Institutet, Institute of Environmental Medicine, Department of Environmental Epidemiology, Box 210, SE-171 77 Stockholm, Sweden.
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Matheson MC, Walters EH, Simpson JA, Wharton CL, Ponsonby AL, Johns DP, Jenkins MA, Giles GG, Hopper JL, Abramson MJ, Dharmage SC. Relevance of the hygiene hypothesis to early vs. late onset allergic rhinitis. Clin Exp Allergy 2009; 39:370-8. [DOI: 10.1111/j.1365-2222.2008.03175.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Infection and regulation of the immune response. Immunol Lett 2009; 122:138-40. [DOI: 10.1016/j.imlet.2008.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Revised: 12/09/2008] [Accepted: 12/14/2008] [Indexed: 11/20/2022]
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Hviid A, Melbye M. Measles-mumps-rubella vaccination and asthma-like disease in early childhood. Am J Epidemiol 2008; 168:1277-83. [PMID: 18845551 DOI: 10.1093/aje/kwn253] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The authors evaluated the association between receipt of measles-mumps-rubella (MMR) vaccine and asthma-like disease in early childhood in a Danish nationwide cohort study (N = 871,234). Two outcomes were included: hospitalizations with asthma diagnoses and use of anti-asthma medications (for a subset of the cohort only). Poisson regression was used to estimate rate ratios according to vaccination status. MMR-vaccinated children were less often hospitalized with an asthma diagnosis (rate ratio (RR) = 0.75, 95% confidence interval (CI): 0.73, 0.78) and used fewer courses of anti-asthma medication (RR = 0.92, 95% CI: 0.91, 0.92) than unvaccinated children. This "protective" effect of MMR vaccine was more pronounced for hospitalizations with severe asthma diagnoses (status asthmaticus: RR = 0.63, 95% CI: 0.49, 0.82) and use of medication that was highly specific for asthma (long-acting beta2-agonist inhalant: RR = 0.68, 95% CI: 0.63, 0.73). MMR vaccine was not negatively associated with anti-asthma medications often used for wheezing illnesses in early childhood (systemic beta2-agonist: RR = 1.02, 95% CI: 1.01, 1.02). These results are compatible not with an increased risk of asthma following MMR vaccination but rather with the hypothesis that MMR vaccination is associated with a reduced risk of asthma-like disease in young children.
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Affiliation(s)
- Anders Hviid
- Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
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Ege MJ, Herzum I, Büchele G, Krauss-Etschmann S, Lauener RP, Bitter S, Roponen M, Remes S, Vuitton DA, Riedler J, Brunekreef B, Dalphin JC, Braun-Fahrländer C, Pekkanen J, Renz H, von Mutius E. Specific IgE to allergens in cord blood is associated with maternal immunity to Toxoplasma gondii and rubella virus. Allergy 2008; 63:1505-11. [PMID: 18925886 DOI: 10.1111/j.1398-9995.2008.01793.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Various studies have found reduced prevalences of atopic sensitization and atopic diseases in children previously exposed to infections or living conditions with a high microbial burden, such as the farming environment. OBJECTIVE We sought to determine the relationships of cord blood immunoglobulin E (IgE) with maternal health conditions before and during pregnancy. METHODS Pregnant women living in rural areas in five European countries were recruited in the third trimester of pregnancy. Information on maternal health during pregnancy was collected from maternity records and by questionnaires (n = 497). Specific IgE for inhalant and food allergens was assessed in cord blood and peripheral blood samples of the mothers. RESULTS Inverse associations of cord blood IgE to seasonal allergens with positive maternal records for Toxoplasma gondii (adjusted odds ratio = 0.37 [0.17-0.81]) and rubella virus (adjusted odds ratio = 0.35 [0.13-0.96]) were found. The previously described effect of prenatal farm exposure on IgE to seasonal allergens was partly confounded by a positive maternal record for T. gondii. The number of maternal siblings, maternal contact to cats during pregnancy or during her first year of life, predicted a positive maternal record for T. gondii. CONCLUSIONS Maternal immunity to T. gondii and rubella may impact on atopic sensitization in the fetus. A positive T. gondii record explained the previously identified effect of prenatal farm exposure on IgE to seasonal allergens only to a minor extent.
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Affiliation(s)
- M J Ege
- University Children's Hospital, Munich, Germany
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Schmidt G, Gadermaier G, Pertl H, Siegert M, Oksman-Caldentey KM, Ritala A, Himly M, Obermeyer G, Ferreira F. Production of recombinant allergens in plants. PHYTOCHEMISTRY REVIEWS : PROCEEDINGS OF THE PHYTOCHEMICAL SOCIETY OF EUROPE 2008; 7:539-552. [PMID: 21258627 PMCID: PMC3024541 DOI: 10.1007/s11101-008-9099-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
A large percentage of allergenic proteins are of plant origin. Hence, plant-based expression systems are considered ideal for the recombinant production of certain allergens. First attempts to establish production of plant-derived allergens in plants focused on transient expression in Nicotiana benthamiana infected with recombinant viral vectors. Accordingly, allergens from birch and mugwort pollen, as well as from apple have been expressed in plants. Production of house dust mite allergens has been achieved by Agrobacterium-mediated transformation of tobacco plants. Beside the use of plants as production systems, other approaches have focused on the development of edible vaccines expressing allergens or epitopes thereof, which bypasses the need of allergen purification. The potential of this approach has been convincingly demonstrated for transgenic rice seeds expressing seven dominant human T cell epitopes derived from Japanese cedar pollen allergens. Parallel to efforts in developing recombinant-based diagnostic and therapeutic reagents, different gene-silencing approaches have been used to decrease the expression of allergenic proteins in allergen sources. In this way hypoallergenic ryegrass, soybean, rice, apple, and tomato were developed.
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Affiliation(s)
- Georg Schmidt
- Christian Doppler Laboratory for Allergy Diagnosis and Therapy, Department of Molecular Biology, University of Salzburg, Hellbrunnerstr. 34, 5020 Salzburg, Austria
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Bernsen RMD, van der Wouden JC. Measles, mumps and rubella infections and atopic disorders in MMR-unvaccinated and MMR-vaccinated children. Pediatr Allergy Immunol 2008; 19:544-51. [PMID: 18266826 DOI: 10.1111/j.1399-3038.2007.00684.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Vaccinations have been incriminated in the increase of atopic disorders. Especially the measles-mumps-rubella (MMR) vaccination is often refused by people having a notion that these infectious diseases are beneficial for a healthy development of a child's immune system. This practice endangers herd immunity and is the cause of repeated outbreaks. As the clinical course of infections and also its possible impact on the development of atopy may be different in vaccinated and unvaccinated individuals, we explored in vaccinated and unvaccinated children associations of MMR infection with atopic disorders. Using data from a previously conducted study on the relationship between the diphtheria-tetanus-pertussis-(inactivated) poliomyelitis vaccination in the first year of life and atopic disorders, the study population of 1872 8-12-yr-old was divided as children MMR-unvaccinated and children MMR-vaccinated in the first year of life. Within each group the association between MMR infections and atopic disorders (both as reported by the parents) was assessed. We found a statistically significant positive association between measles infection and 'any atopic disorder' [adjusted odds ratio, OR (95% confidence interval, CI): 1.77 (1.20-2.61)] in the MMR-vaccinated group, mainly because of the relationship with eczema. For rubella there was a negative association with eczema and food allergy in the unvaccinated group: adjusted OR (95% CI): 0.57 (0.38-0.85) and 0.23 (0.07-0.76), respectively. All other associations were not statistically significant. We found a positive relationship between measles infection and any atopy in a group of MMR-vaccinated children and a negative association between rubella infection and eczema and food allergy in unvaccinated children. However, we cannot conclude that these relationships are causal. The negative association with rubella may be an artefact. This study shows no evidence for any protective effects from MMR diseases for the development of atopy and therefore supports conclusions found elsewhere that childhood vaccinations do not cause atopy.
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Affiliation(s)
- Roos M D Bernsen
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
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