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Tang R, Lyu X, Hou Y, Yang Y, Fu G, Zhu L, Xue L, Li H, Wang R. Comparison of the therapeutic effects of medication therapy, specific immunotherapy and anti-IgE (Omalizumab) in patients with hay fever. Front Immunol 2024; 15:1363034. [PMID: 38482006 PMCID: PMC10933023 DOI: 10.3389/fimmu.2024.1363034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/12/2024] [Indexed: 04/17/2024] Open
Abstract
Background Hay fever, characterized by seasonal allergic reactions, poses a significant health challenge. Existing therapies encompass standard drug regimens, biological agents, and specific immunotherapy. This study aims to assess and compare the effectiveness of anti-IgE (omalizumab), medication therapy, and subcutaneous immunotherapy (SCIT) for hay fever. Methods Conducted as a retrospective cohort study, this research involved 98 outpatient hay fever patients who underwent routine medication, omalizumab treatment, or SCIT before the onset of the spring pollen season. A follow-up was performed one month after the start of the pollen season. The comprehensive symptoms and drug scores were used to evaluate patients with different intervention methods, facilitating a comparative analysis of therapeutic outcomes. Results Compared with before treatment, the symptoms of patients treated with the three methods were all significantly relieved, and the medication score were significantly reduced. Patients treated with omalizumab demonstrated higher symptoms and medication scores than SCIT group before treatment, but similar scores after treatment, which were both lower than medicine treatment group. After treatment with omalizumab or SCIT, patients in both groups had significantly lower medication scores than the medication group and were close to no longer using medication for symptom relief. The mountain juniper-sIgE was significantly higher after treatment than before treatment in both medicine treatment group and omalizumab treatment group. Conclusion Omalizumab and SCIT offer superior effects than medication therapy in hay fever patients.
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Affiliation(s)
- Rui Tang
- Department of Allergy, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xiaohong Lyu
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yibo Hou
- Department of Allergy, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yongshi Yang
- Department of Allergy, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Guodong Fu
- Department of Allergy, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Liping Zhu
- Department of Allergy, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Lu Xue
- Department of Allergy, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Hong Li
- Department of Allergy, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ruiqi Wang
- Department of Allergy, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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2
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Rook GAW. The old friends hypothesis: evolution, immunoregulation and essential microbial inputs. FRONTIERS IN ALLERGY 2023; 4:1220481. [PMID: 37772259 PMCID: PMC10524266 DOI: 10.3389/falgy.2023.1220481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/18/2023] [Indexed: 09/30/2023] Open
Abstract
In wealthy urbanised societies there have been striking increases in chronic inflammatory disorders such as allergies, autoimmunity and inflammatory bowel diseases. There has also been an increase in the prevalence of individuals with systemically raised levels of inflammatory biomarkers correlating with increased risk of metabolic, cardiovascular and psychiatric problems. These changing disease patterns indicate a broad failure of the mechanisms that should stop the immune system from attacking harmless allergens, components of self or gut contents, and that should terminate inappropriate inflammation. The Old Friends Hypothesis postulates that this broad failure of immunoregulation is due to inadequate exposures to the microorganisms that drive development of the immune system, and drive the expansion of components such as regulatory T cells (Treg) that mediate immunoregulatory mechanisms. An evolutionary approach helps us to identify the organisms on which we are in a state of evolved dependence for this function (Old Friends). The bottom line is that most of the organisms that drive the regulatory arm of the immune system come from our mothers and family and from the natural environment (including animals) and many of these organisms are symbiotic components of a healthy microbiota. Lifestyle changes that are interrupting our exposure to these organisms can now be identified, and many are closely associated with low socioeconomic status (SES) in wealthy countries. These insights will facilitate the development of education, diets and urban planning that can correct the immunoregulatory deficit, while simultaneously reducing other contributory factors such as epithelial damage.
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Affiliation(s)
- Graham A. W. Rook
- Centre for Clinical Microbiology, Department of Infection, UCL (University College London), London, United Kingdom
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3
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Du M, Xu S, Qiu B, Hu S, Tjakkes GHE, Li A, Ge S. Serum antibodies to periodontal pathogens are related to allergic symptoms. J Periodontol 2023; 94:204-216. [PMID: 35960608 DOI: 10.1002/jper.22-0346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The association between periodontitis and allergic symptoms has been investigated. However, the difference in immune signatures between them remains poorly understood. This cross-sectional study assessed the relationship between serum immunoglobulin G (IgG) antibodies to periodontal pathogens and allergic symptoms in a nationwide population cohort. METHODS Two phases of the Third National Health and Nutrition Examination Survey (NHANES III) were used as discovery dataset (n = 3700) and validation dataset (n = 4453), respectively. Based on the antibodies against 19 periodontal pathogens, we performed an unsupervised hierarchical clustering to categorize the population into three clusters. In the discovery dataset, cluster 1 (n = 2847) had the highest level of IgG antibodies, followed by clusters 2 (n = 588) and 3 (n = 265). Data on allergic symptoms (asthma, hay fever, and wheezing) were obtained using a self-reported questionnaire. Survey-weighted multivariable logistic regression evaluated the association between these clusters and allergic symptoms. RESULTS In the discovery dataset, the participants with lower levels of antibodies to periodontal pathogens exhibited a higher risk of asthma (odds ratio [OR]cluster 3 vs. cluster 1 = 1.820, 95% confidence interval [CI]: 1.153-2.873) and wheezing (ORcluster 3 vs. cluster 1 = 1.550, 95% CI: 1.095-2.194) compared to those with higher periodontal antibodies, but the non-significant association with hay fever. Consistent results were found in the validation dataset. CONCLUSIONS Serum IgG titers to periodontal pathogens were inversely associated with the risk of asthma and wheezing, suggesting the potentially protective role against allergic conditions.
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Affiliation(s)
- Mi Du
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration, Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Bingjiang Qiu
- Department of Radiology & Guangdong Cardiovascular Institute & Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Data Science Center in Health (DASH) & 3D Lab, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
| | - Shixian Hu
- Institute of Precision Medicine, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Gastroenterology and Hepatology, UMCG, University of Groningen, Groningen, The Netherlands
| | - Geerten-Has E Tjakkes
- Department of Periodontology, Center for Dentistry and Oral Hygiene, UMCG, University of Groningen, Groningen, The Netherlands
| | - An Li
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China.,Department of Periodontology, Center for Dentistry and Oral Hygiene, UMCG, University of Groningen, Groningen, The Netherlands
| | - Shaohua Ge
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration, Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
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4
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Ponsonby AL, Collier F, O'Hely M, Tang MLK, Ranganathan S, Gray L, Morwitch E, Saffery R, Burgner D, Dwyer T, Sly PD, Harrison LC, Vuillermin P. Household size, T regulatory cell development, and early allergic disease: a birth cohort study. Pediatr Allergy Immunol 2022; 33:e13810. [PMID: 35754137 PMCID: PMC9545943 DOI: 10.1111/pai.13810] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children born to larger households have less allergic disease. T regulatory cell (Treg) development may be a relevant mechanism, but this has not been studied longitudinally. OBJECTIVE We aim to (i) describe how prenatal and postnatal environmental factors are associated with Treg development and (ii) investigate whether serial Treg measures predict allergic outcomes at 1 year of age. METHODS A birth cohort (n = 1074) with information on prenatal and postnatal early life factors. Both naïve Treg (nTreg) and activated Treg (aTreg) cell populations (as a proportion of CD4+ T cells) were available in 463 infants at birth (cord blood), 600 at 6 months, and 675 at 12 months. 191 infants had serial measures. Measures of allergic status at 12 months were polysensitization (sensitization to 2 or more allergens), clinically proven food allergy, atopic eczema, and atopic wheeze. RESULTS Infants born to larger households (3 or more residents) had higher longitudinal nTreg proportions over the first postnatal year with a mean difference (MD) of 0.67 (95% CI 0.30-1.04)%. Higher nTreg proportions at birth were associated with a reduced risk of infant allergic outcomes. Childcare attendance and breastfeeding were associated with higher longitudinal nTreg proportions (MD 0.48 (95% CI 0.08-0.80)%. CONCLUSION Multiple prenatal and postnatal microbial factors are associated with nTreg and aTreg development. Larger household size was associated with higher nTreg at birth which in turn was associated with reduced allergic sensitization and disease at 12 months of age.
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Affiliation(s)
- Anne-Louise Ponsonby
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Fiona Collier
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Martin O'Hely
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Lawrence Gray
- School of Medicine, Deakin University, Geelong, Victoria, Australia.,Barwon Health, Geelong, Victoria, Australia
| | - Ellen Morwitch
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.,National Centre of Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Terence Dwyer
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,The George Institute for Global Health, Oxford University, Oxford, UK
| | - Peter D Sly
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,University of Queensland, South Brisbane, Queensland, Australia
| | | | - Peter Vuillermin
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,School of Medicine, Deakin University, Geelong, Victoria, Australia.,Barwon Health, Geelong, Victoria, Australia
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Meier HCS, Sandler DP, Wilkerson J, Miller FW, Dinse GE, Parks CG. Hygiene Hypothesis Indicators and Prevalence of Antinuclear Antibodies in US Adolescents. Front Immunol 2022; 13:789379. [PMID: 35154106 PMCID: PMC8832391 DOI: 10.3389/fimmu.2022.789379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
Autoimmunity prevalence, as measured by antinuclear antibodies (ANA), is increasing in U.S. adolescents. Improved hygiene and cleaner environments in childhood may reduce exposure to infections and other immune challenges, resulting in improper immune responses to later-life exposures. We examined associations of hygiene hypothesis indicators, including asthma, allergies, and antibodies to infectious agents, with ANA prevalence, measured by HEp-2 immunofluorescence, in adolescents (aged 12-19 years) over a 25-year time span in the National Health and Nutrition Examination Survey (NHANES) (N=2,709), adjusting for age, sex, race/ethnicity, body mass index, education and survey cycle, overall and within individual time periods, using logistic regression. Prevalence of ANA in adolescents increased from 5.0% in 1988-1991 to 12.8% in 2011-2012. ANA were positively associated with diagnosis of asthma in early childhood (OR: 2.07, CI: 1.09-3.99) and the effect estimate for current hay fever was elevated but not statistically significant (OR: 1.55, CI: 0.85-2.84). Fewer than 2% of those with ANA in 1988-1991 had been diagnosed with asthma, compared with 18% in 1999-2000, and 27% in 2003-2004 and 2011-2012. ANA trended negatively with Helicobacter pylori antibodies (OR: 0.49, CI: 0.24-0.99). ANA may be useful as an additional indicator of inadequate immune education in adolescence, a critical period of growth and development.
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Affiliation(s)
- Helen C S Meier
- Population, Neurodevelopment and Genetics Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), Durham, NC, United States
| | - Jesse Wilkerson
- Public Health & Scientific Research, Social and Scientific Systems, Durham, NC, United States
| | - Frederick W Miller
- Environmental Autoimmunity Group, National Institute of Environmental Health Sciences (NIEHS), Durham, NC, United States
| | - Gregg E Dinse
- Public Health & Scientific Research, Social and Scientific Systems, Durham, NC, United States
| | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), Durham, NC, United States
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6
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Alvarez CS, Avilés-Santa ML, Freedman ND, Perreira KM, Garcia-Bedoya O, Kaplan RC, Daviglus ML, Graubard BI, Talavera GA, Thyagarajan B, Camargo MC. Associations of Helicobacter pylori and hepatitis A seropositivity with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL): addressing the hygiene hypothesis. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2021; 17:120. [PMID: 34819160 PMCID: PMC8611872 DOI: 10.1186/s13223-021-00625-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The hygiene hypothesis posits that microbial exposure reduces risk of asthma and other respiratory-related diseases. Helicobacter pylori and hepatitis A virus (HAV) are common fecal-oral infections. Our study aimed to examine associations of seropositivity to these agents with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). METHODS A total of 12,471 HCHS/SOL participants with baseline data on self-reported physician-diagnosed asthma, and antibodies anti-H. pylori and anti-HAV were included in this cross-sectional analysis. Multivariable logistic regression models were used to estimate the odds ratios and 95% confidence intervals for the overall associations of seropositivity to each agent with asthma. Analyses were also stratified by Hispanic/Latino background. Effect modification by smoking status and nativity were tested. An analysis restricted to individuals with spirometry-defined chronic obstructive pulmonary disease (COPD) was also considered. RESULTS The weighted overall prevalence of asthma was 16.6%. The weighted seroprevalence of H. pylori was 56.6% and of HAV was 76.6%, and they significantly differed by Hispanic/Latino background. After accounting for age, sex, education and other key confounders, we found no associations between H. pylori or HAV seropositivity with asthma (with and without COPD), either for all individuals combined or for any of the six specific backgrounds. There were no significant interactions by smoking and nativity. CONCLUSION Our findings did not provide support for the role of H. pylori or HAV, as evidence of the hygiene hypothesis in asthma among the large and diverse Hispanic/Latino populations of the HCHS/SOL. Trial registration NCT02060344.
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Affiliation(s)
- Christian S Alvarez
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
| | - M Larissa Avilés-Santa
- Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities, Rockville, MD, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Krista M Perreira
- Department of Social Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - Olga Garcia-Bedoya
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
- Academic Internal Medicine and Geriatrics, Department of Medicine , University of Illinois at Chicago, Chicago, IL, USA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Barry I Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Gregory A Talavera
- South Bay Latino Research Center, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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7
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Fiuza BSD, Fonseca HF, Meirelles PM, Marques CR, da Silva TM, Figueiredo CA. Understanding Asthma and Allergies by the Lens of Biodiversity and Epigenetic Changes. Front Immunol 2021; 12:623737. [PMID: 33732246 PMCID: PMC7957070 DOI: 10.3389/fimmu.2021.623737] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Exposure to different organisms (bacteria, mold, virus, protozoan, helminths, among others) can induce epigenetic changes affecting the modulation of immune responses and consequently increasing the susceptibility to inflammatory diseases. Epigenomic regulatory features are highly affected during embryonic development and are responsible for the expression or repression of different genes associated with cell development and targeting/conducting immune responses. The well-known, "window of opportunity" that includes maternal and post-natal environmental exposures, which include maternal infections, microbiota, diet, drugs, and pollutant exposures are of fundamental importance to immune modulation and these events are almost always accompanied by epigenetic changes. Recently, it has been shown that these alterations could be involved in both risk and protection of allergic diseases through mechanisms, such as DNA methylation and histone modifications, which can enhance Th2 responses and maintain memory Th2 cells or decrease Treg cells differentiation. In addition, epigenetic changes may differ according to the microbial agent involved and may even influence different asthma or allergy phenotypes. In this review, we discuss how exposure to different organisms, including bacteria, viruses, and helminths can lead to epigenetic modulations and how this correlates with allergic diseases considering different genetic backgrounds of several ancestral populations.
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Affiliation(s)
| | | | - Pedro Milet Meirelles
- Instituto de Biologia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Nacional de Ciência e Tecnologia em Estudos Interdisciplinares e Transdisciplinares em Ecologia e Evolução (IN-TREE), Salvador, Brazil
| | - Cintia Rodrigues Marques
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brazil
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8
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Bach JF. Revisiting the Hygiene Hypothesis in the Context of Autoimmunity. Front Immunol 2021; 11:615192. [PMID: 33584703 PMCID: PMC7876226 DOI: 10.3389/fimmu.2020.615192] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022] Open
Abstract
Initially described for allergic diseases, the hygiene hypothesis was extended to autoimmune diseases in the early 2000s. A historical overview allows appreciation of the development of this concept over the last two decades and its discussion in the context of evolution. While the epidemiological data are convergent, with a few exceptions, the underlying mechanisms are multiple and complex. A major question is to determine what is the respective role of pathogens, bacteria, viruses, and parasites, versus commensals. The role of the intestinal microbiota has elicited much interest, but is it a cause or a consequence of autoimmune-mediated inflammation? Our hypothesis is that both pathogens and commensals intervene. Another question is to dissect what are the underlying cellular and molecular mechanisms. The role of immunoregulatory cytokines, in particular interleukin-10 and TGF beta is probably essential. An important place should also be given to ligands of innate immunity receptors present in bacteria, viruses or parasites acting independently of their immunogenicity. The role of Toll-Like Receptor (TLR) ligands is well documented including via TLR ligand desensitization.
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Affiliation(s)
- Jean-François Bach
- Université de Paris, Paris, France.,INSERM U1151, Institut Necker-Enfants Malades, Paris, France.,Academie des Sciences, Paris, France
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9
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Suther C, Moore MD, Beigelman A, Zhou Y. The Gut Microbiome and the Big Eight. Nutrients 2020; 12:nu12123728. [PMID: 33287179 PMCID: PMC7761723 DOI: 10.3390/nu12123728] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/28/2020] [Accepted: 12/01/2020] [Indexed: 12/11/2022] Open
Abstract
Food allergies are increasing at an alarming rate, with 6.5% of the general population affected. It has been hypothesized that the increase in allergies stems from the “hygiene hypothesis”. The gut microbiome, a collection of microbiota and their genetic contents from the gastrointestinal tract, has been shown to play a part in the development of food allergies. The Food and Drug Administration requires all regulated food companies to clearly state an inclusion of the major, or “big eight” food allergens on packaging. This review is to provide information on the significant advancements related to the gut microbiome and each of the eight major food allergies individually. Establishment of causal connection between the microbiome and food allergies has uncovered novel mechanisms. New strategies are discussed to prevent future sensitization and reaction through novel treatments involving functional additives and dietary changes that target the microbiome.
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Affiliation(s)
- Cassandra Suther
- Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA; (C.S.); (M.D.M.)
- Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Matthew D. Moore
- Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA; (C.S.); (M.D.M.)
| | - Avraham Beigelman
- Kipper Institute of Allergy and Immunology, Schneider Children’s Medical Center, Tel Aviv University, Tel Aviv 5891000, Israel;
| | - Yanjiao Zhou
- Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA
- Correspondence: ; Tel.: +1-860-679-6379
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10
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Kalra P, John A, Jaleel R, Simon EG, Babji S, Joseph AJ. Prevalence of past hepatitis A infection among Crohn's patients and controls - An examination of the 'hygiene hypothesis', and the need for hepatitis A vaccination. Trop Doct 2020; 51:193-197. [PMID: 33050841 DOI: 10.1177/0049475520961949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Our study aimed to determine the prevalence of prior exposure to hepatitis A virus in Crohn's disease patients, whose IgG antibody levels against hepatitis A virus were compared with age and sex-matched controls. All of the 41 cases with Crohn's disease and 43 controls included in the study tested positive for IgG anti-hepatitis A virus antibody, with titres (38.8 IU/ml, 22-63.9; median, IQR) similar to those in controls (40.7 IU/ml, 17.3-66.7; p = 0.75). Environmental sanitation remains poor in India, despite reasonable economic gains as reflected by universal exposure to hepatitis A virus infection. Vaccination against hepatitis A may not be important in patients attending inflammatory bowel disease clinic, owing to natural immunity provided by prior infection. The observed rise in inflammatory bowel disease incidence seems to be increasing despite persistently poor environmental hygiene.
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Affiliation(s)
- Parika Kalra
- Senior Registrar, Department of Gastroenterology, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Anoop John
- Assistant Professor, Department of Gastroenterology, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Rajeeb Jaleel
- Assistant Professor, Department of Gastroenterology, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Ebby G Simon
- Professor, Department of Gastroenterology, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Sudhir Babji
- Associate Professor, Department of GI Sciences, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - A J Joseph
- Professor, Department of Gastroenterology, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
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11
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Elias N, Nasrallah E, Khoury C, Mansour B, Abu Zuher L, Asato V, Muhsen K. Associations of Helicobacter pylori seropositivity and gastric inflammation with pediatric asthma. Pediatr Pulmonol 2020; 55:2236-2245. [PMID: 32543787 DOI: 10.1002/ppul.24905] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 06/13/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Controversy exists regarding an association between Helicobacter pylori infection and asthma in children. We examined the hypotheses of inverse associations of H. pylori seroprevalence and pepsinogen (PG) levels, as markers of gastric inflammation, with asthma in children. METHODS A hospital-based case-control study was conducted among children aged 4.8 to 17.3 years in Israel. Confirmed asthma cases (n = 75) were recruited through a pulmonary clinic, and controls (n = 160) without asthma were enrolled. Using enzyme-linked immunosorbent assays we measured the presence of H. pylori immunoglobulin G (IgG) antibodies, IgG antibodies to cytotoxin-associated gene A antigen (CagA) (virulent factor), serum PG levels and exposure to other enteric pathogens (Shigella flexneri). Multivariable logistic regression models were applied. RESULTS H. pylori IgG seropositivity was 25% and 40% among cases and controls, respectively (P = .03). H. pylori CagA IgG seropositivity was associated with reduced risk of asthma (adjusted odds ratio [OR], 0.33 [95% CI, 0.11-0.95] but not for the CagA negative serology (adjusted OR, 0.70 [95% CI, 0.32-1.54]). Children who were H. pylori seropositive with a PGI:PGII of ≤6.78 (severe gastric inflammation) had a lower likelihood of asthma (adjusted OR, 0.31 [95% CI, 0.10-0.89]) than did seronegative children. Exposure to Shigella flexneri did not differ between cases and controls, nor according to H. pylori seropositivity. Among the asthmatic children, pulmonary function did not differ according to H. pylori seropositivity. CONCLUSIONS H. pylori infection and its related gastric inflammation may have a protective role in the risk of pediatric asthma and further research into a potential causal pathway is required.
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Affiliation(s)
- Nael Elias
- Department of Pediatrics, Saint Vincent de Paul-French Hospital, Nazareth, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Tel Aviv, Israel
| | - Elias Nasrallah
- Department of Pediatrics, Saint Vincent de Paul-French Hospital, Nazareth, Israel
| | - Camelia Khoury
- Department of Pediatrics, Saint Vincent de Paul-French Hospital, Nazareth, Israel
| | - Bshara Mansour
- Department of Pediatrics, Saint Vincent de Paul-French Hospital, Nazareth, Israel
| | - Layaly Abu Zuher
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Tel Aviv, Israel
| | - Valeria Asato
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Tel Aviv, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Tel Aviv, Israel
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12
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Andrade MMC, Carneiro VL, Galvão AA, Fonseca TR, Vitor RWA, Alcantara-Neves NM, Cruz ÁA, Figueiredo CA. Toxoplasma gondii protects from IgE sensitization and induces Th1/Th2 immune profile. Parasite Immunol 2020; 42:e12694. [PMID: 31884701 DOI: 10.1111/pim.12694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 12/13/2022]
Abstract
Toxoplasma gondii (T gondii) infection has been associated with protection against allergy and autoimmune diseases. We investigated the effects of T gondii infection on cytokine and antibody responses in atopic and nonatopic Brazilian subjects. We have measured in whole-blood cultures, Th1 (IFN-γ and IL-12), Th2 (IL-5) and regulatory cytokine IL-10 in blood cells unstimulated and stimulated with pokeweed mitogen or T gondii soluble tachyzoites antigen (STAg) or Dermatophagoides pteronyssinus antigen. A significant negative association was found between high levels of anti-dust mite IgE and T gondii seropositivity (OR = 0.46; 95%CI = 0.25-0.85). STAg stimulation induced a mixed profile of Th1 and Th2 cytokines (IFN-γ, IL-12 and IL-5) in Tg-positive atopic individuals compared with Tg-negative atopic individuals (P < .0001, P = .033 and P = .003, respectively). In contrast, IL-10 production was not different between these groups. No association was found between T gondii infection and asthma. We hypothesized that the protective effect on atopy might be related to the strong Th1 immune response to T gondii found on the seropositive subjects. From our knowledge, this is the first study to investigate the association between atopy and T gondii infection in Brazilian subjects, analysing the cellular immune responses.
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Affiliation(s)
- Milena M C Andrade
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | | | - Alana A Galvão
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Thales R Fonseca
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Ricardo W A Vitor
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Álvaro A Cruz
- ProAR - Universidade Federal da Bahia, Salvador, Brazil
| | - Camila A Figueiredo
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
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13
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Perrone Sibilia MD, Aldirico MDLÄ, Soto AS, Picchio MS, Sánchez VR, Arcón N, Moretta R, Martín V, Vanzulli S, Fenoy IM, Goldman A. Chronic infection with the protozoan Toxoplasma gondii prevents the development of experimental atopic dermatitis in mice. J Dermatol Sci 2019; 96:143-150. [PMID: 31735466 DOI: 10.1016/j.jdermsci.2019.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/04/2019] [Accepted: 10/27/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Supporting the hypothesis thatT. gondii infection protects against allergy in humans we previously demonstrated that this infection can modulate not only the susceptibility to develop respiratory allergies in mice but also suppresses allergic responses at systemic level. This latter finding suggests that T. gondii infection could prevent the onset of other allergic diseases, such as atopic dermatitis. At present, few studies have investigated the modulation of atopic dermatitis by parasite infections. OBJECTIVE Here, we sought to investigate whether chronic infection with T. gondii is capable of modulating the development of atopic dermatitis. METHODS Chronically infected mice were sensitized by repeated epicutaneous ovalbumin administration. Skin histopathology, humoral response, cytokine production and innate type-II lymphoid cells (ILC2) were assessed. RESULTS A marked reduction in epidermal thickness and dermal inflammatory infiltrate along with a reduction in mast cell count was observed in infected mice compared to non-infected mice. These results correlated with a diminished TH2 and TH1 allergen specific response. Reduced type-II IL-4 and IL-5 cytokines were already detected during the first 24 h of allergen sensitization in splenocytes and draining lymph nodes from infected mice. Moreover, this reduced type-II profile in chronically infected animals correlated with diminished ILC2 number in draining lymph nodes. CONCLUSION Chronic infection withT. gondii prevents the development of atopic dermatitis. The diminished susceptibility seems to result from changes in type-II innate immune response that may lead to the induction of a deficient TH2 response and consequently to a lower susceptibility to develop atopic dermatitis.
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Affiliation(s)
- Matías Damián Perrone Sibilia
- Universidad Nacional de San Martín, CONICET, Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, ECyT, San Martín, Argentina
| | - María de Los Ängeles Aldirico
- Universidad Nacional de San Martín, CONICET, Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, ECyT, San Martín, Argentina
| | - Ariadna Soledad Soto
- Universidad Nacional de San Martín, CONICET, Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, ECyT, San Martín, Argentina
| | - Mariano Sergio Picchio
- Universidad Nacional de San Martín, CONICET, Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, ECyT, San Martín, Argentina
| | - Vanesa Roxana Sánchez
- Universidad Nacional de San Martín, CONICET, Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, ECyT, San Martín, Argentina
| | - Nadia Arcón
- Universidad Nacional de San Martín, CONICET, Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, ECyT, San Martín, Argentina
| | - Rosalía Moretta
- Universidad Nacional de San Martín, CONICET, Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, ECyT, San Martín, Argentina
| | - Valentina Martín
- Universidad Nacional de San Martín, CONICET, Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, ECyT, San Martín, Argentina
| | - Silvia Vanzulli
- Laboratorio de Anatomía Patológica, Instituto de Investigaciones Hematológicas, Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Ignacio Martín Fenoy
- Universidad Nacional de San Martín, CONICET, Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, ECyT, San Martín, Argentina
| | - Alejandra Goldman
- Universidad Nacional de San Martín, CONICET, Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, ECyT, San Martín, Argentina.
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14
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Kujansuu E, Kujansuu L, Paassilta M, Mustonen J, Vaarala O. Exposure to sewage water and the development of allergic manifestations in Finnish children. Pediatr Allergy Immunol 2019; 30:598-603. [PMID: 31169932 PMCID: PMC6852287 DOI: 10.1111/pai.13090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/26/2019] [Accepted: 05/27/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND The hygiene hypothesis suggests that a decreased microbial load contributes to an increased risk of allergies. In the Finnish municipality of Nokia, sewage water was accidentally mixed with drinking water for 2 days. We studied the association between exposure and the emergence of allergies in children. METHODS Children aged 2-5 years living in the accident area and an age-matched cohort from the control municipality were recruited. Based on the questionnaires, we identified 139 children exposed to the contaminated water and selected age- and sex-matched controls for them (mean age 16.59 months at the time of the accident). Allergic symptoms and diseases were recorded by ISAAC questionnaires and skin prick tests (SPTs) performed 2 and 5 years after the accident. RESULTS SPT positivity at 5 years of follow-up was decreased in the children exposed to the sewage water below 1 year of age (OR 0.311, 95% CI 0.118-0.820; P = 0.019), particularly in children who did not develop gastroenteritis at exposure. In contrast, the children over 1 year of age at the exposure tended more likely to be SPT-positive at 5 years of follow-up (OR 1.997, 95% CI 0.963-4.143; P = 0.070). CONCLUSIONS Sewage water exposure during the first year of life, but not later, decreased the risk of IgE sensitization emphasizing the importance of age as a modulator. The modulation of IgE sensitization by the presence of clinical gastroenteritis at the exposure suggests that the nature of microbial load may have importance or alternatively shared host defense mechanisms protect from infection and atopic sensitization.
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Affiliation(s)
- Eila Kujansuu
- Faculty of Medicine and Life Sciences, Tampere University, Tampere, Finland
| | - Leena Kujansuu
- Faculty of Medicine and Life Sciences, Tampere University, Tampere, Finland
| | | | - Jukka Mustonen
- Faculty of Medicine and Life Sciences, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Outi Vaarala
- Clinicum, University of Helsinki, Helsinki, Finland
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15
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Scadding GK, Kariyawasam HH, Scadding G, Mirakian R, Buckley RJ, Dixon T, Durham SR, Farooque S, Jones N, Leech S, Nasser SM, Powell R, Roberts G, Rotiroti G, Simpson A, Smith H, Clark AT. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clin Exp Allergy 2019; 47:856-889. [PMID: 30239057 DOI: 10.1111/cea.12953] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/01/2017] [Accepted: 05/04/2017] [Indexed: 12/12/2022]
Abstract
This is an updated guideline for the diagnosis and management of allergic and non-allergic rhinitis, first published in 2007. It was produced by the Standards of Care Committee of the British Society of Allergy and Clinical Immunology, using accredited methods. Allergic rhinitis is common and affects 10-15% of children and 26% of adults in the UK, it affects quality of life, school and work attendance, and is a risk factor for development of asthma. Allergic rhinitis is diagnosed by history and examination, supported by specific allergy tests. Topical nasal corticosteroids are the treatment of choice for moderate to severe disease. Combination therapy with intranasal corticosteroid plus intranasal antihistamine is more effective than either alone and provides second line treatment for those with rhinitis poorly controlled on monotherapy. Immunotherapy is highly effective when the specific allergen is the responsible driver for the symptoms. Treatment of rhinitis is associated with benefits for asthma. Non-allergic rhinitis also is a risk factor for the development of asthma and may be eosinophilic and steroid-responsive or neurogenic and non- inflammatory. Non-allergic rhinitis may be a presenting complaint for systemic disorders such as granulomatous or eosinophilic polyangiitis, and sarcoidoisis. Infective rhinitis can be caused by viruses, and less commonly by bacteria, fungi and protozoa.
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Affiliation(s)
- G K Scadding
- The Royal National Throat Nose and Ear Hospital, London, UK
| | - H H Kariyawasam
- The Royal National Throat Nose and Ear Hospital, London, UK.,UCLH NHS Foundation Trust, London, UK
| | - G Scadding
- Department of Upper Respiratory Medicine, Imperial College NHLI, London, UK
| | - R Mirakian
- The Royal National Throat Nose and Ear Hospital, London, UK
| | - R J Buckley
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | - T Dixon
- Royal Liverpool and Broad green University Hospital NHS Trust, Liverpool, UK
| | - S R Durham
- Department of Upper Respiratory Medicine, Imperial College NHLI, London, UK
| | - S Farooque
- Chest and Allergy Department, St Mary's Hospital, Imperial College NHS Trust, London, UK
| | - N Jones
- The Park Hospital, Nottingham, UK
| | - S Leech
- Department of Child Health, King's College Hospital, London, UK
| | - S M Nasser
- Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - R Powell
- Department of Clinical Immunology and Allergy, Nottingham University, Nottingham UK
| | - G Roberts
- Department of Child Health, University of Southampton Hospital, Southampton, UK
| | - G Rotiroti
- The Royal National Throat Nose and Ear Hospital, London, UK
| | - A Simpson
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, UK
| | - H Smith
- Division of Primary Care and Public Health, University of Sussex, Brighton, UK
| | - A T Clark
- Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
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16
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Nowrouzian FL, Ljung A, Nilsson S, Hesselmar B, Adlerberth I, Wold AE. Neonatal gut colonization by Staphylococcus aureus strains with certain adhesins and superantigens is negatively associated with subsequent development of atopic eczema. Br J Dermatol 2019; 180:1481-1488. [PMID: 30474111 DOI: 10.1111/bjd.17451] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Insufficient early immune stimulation may predispose to atopic disease. Staphylococcus aureus, a skin and gut colonizer, produces the B-cell mitogen protein A and T-cell-activating superantigens. Early gut colonization by S. aureus strains that possess the superantigens encoded by the enterotoxin gene (egc) cluster and elastin-binding protein is negatively associated with development of atopic eczema. OBJECTIVES To investigate (i) whether these findings could be replicated in a second birth cohort, FARMFLORA, and (ii) whether nasal colonization by S. aureus also relates to subsequent atopic eczema development. METHODS Faecal samples and nasal swabs from infants in the FARMFLORA birth cohort (n = 65) were cultured for S. aureus. Individual strains were distinguished by random amplified polymorphic DNA and assessed for adhesin and superantigen gene carriage by polymerase chain reaction. Atopic eczema at 18 months of age was related to nasal and gut S. aureus colonization patterns during the first 2 months of life (well before onset of eczema). RESULTS Staphylococcus aureus colonization per se was unrelated to subsequent eczema development. However, gut S. aureus strains from the infants who subsequently developed atopic eczema less frequently carried the ebp gene, encoding elastin-binding protein, and superantigen genes encoded by egc, compared with strains from children who remained healthy. Nasal colonization by S. aureus was less clearly related to subsequent eczema development. CONCLUSIONS The results precisely replicate our previous observations and may suggest that mucosal colonization by certain S. aureus strains provides immune stimulation that strengthens the epithelial barrier and counteracts the development of atopic eczema.
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Affiliation(s)
- F L Nowrouzian
- Institution for Biomedicine, Department of Infectious Disease, University of Gothenburg, Gothenburg, Sweden
| | - A Ljung
- Institution for Biomedicine, Department of Infectious Disease, University of Gothenburg, Gothenburg, Sweden
| | - S Nilsson
- Institution for Biomedicine, Department of Infectious Disease, University of Gothenburg, Gothenburg, Sweden
| | - B Hesselmar
- Institution for Biomedicine, Department of Infectious Disease, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics, Institution of Clinical Science, University of Gothenburg, Gothenburg, Sweden
| | - I Adlerberth
- Institution for Biomedicine, Department of Infectious Disease, University of Gothenburg, Gothenburg, Sweden
| | - A E Wold
- Institution for Biomedicine, Department of Infectious Disease, University of Gothenburg, Gothenburg, Sweden
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17
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Shin EC, Jeong SH. Natural History, Clinical Manifestations, and Pathogenesis of Hepatitis A. Cold Spring Harb Perspect Med 2018; 8:cshperspect.a031708. [PMID: 29440324 DOI: 10.1101/cshperspect.a031708] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Hepatitis A virus (HAV) is transmitted by the fecal-oral route and is a major cause of acute viral hepatitis. The clinical manifestations of HAV infection range from asymptomatic infection to acute liver failure (ALF), but do not include progression to chronic hepatitis. Risk factors for severe acute hepatitis A are older age (>40 years) and preexisting liver disease. Some patients may show atypical clinical features such as relapsing hepatitis, prolonged cholestasis, or extrahepatic manifestations. Almost all hepatitis A patients spontaneously recover with supportive care. However, in the case of ALF (<1%), intensive care and urgent decision on liver transplantation are required. Liver injury during hepatitis A is not directly caused by HAV but is known to be caused by immune-mediated mechanisms. In this review, the natural history and clinical manifestations of hepatitis A are described. In addition, mechanisms of immunopathogenesis in hepatitis A are discussed.
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Affiliation(s)
- Eui-Cheol Shin
- Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, KAIST, Daejeon 34141, Republic of Korea
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seongnam, Gyeonggido 13620, Republic of Korea
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18
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HAVCR1 (CD365) and Its Mouse Ortholog Are Functional Hepatitis A Virus (HAV) Cellular Receptors That Mediate HAV Infection. J Virol 2018; 92:JVI.02065-17. [PMID: 29437974 DOI: 10.1128/jvi.02065-17] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/31/2018] [Indexed: 12/12/2022] Open
Abstract
The hepatitis A virus (HAV) cellular receptor 1 (HAVCR1), classified as CD365, was initially discovered as an HAV cellular receptor using an expression cloning strategy. Due to the lack of HAV receptor-negative replication-competent cells, it was not possible to fully prove that HAVCR1 was a functional HAV receptor. However, biochemistry, classical virology, and epidemiology studies further supported the functional role of HAVCR1 as an HAV receptor. Here, we show that an anti-HAVCR1 monoclonal antibody that protected African green monkey kidney (AGMK) cells against HAV infection only partially protected monkey Vero E6 cells and human hepatoma Huh7 cells, indicating that these two cell lines express alternative yet unidentified HAV receptors. Therefore, we focused our work on AGMK cells to further characterize the function of HAVCR1 as an HAV receptor. Advances in clustered regularly interspaced short palindromic repeat/Cas9 technology allowed us to knock out the monkey ortholog of HAVCR1 in AGMK cells. The resulting AGMK HAVCR1 knockout (KO) cells lost susceptibility to HAV infection, including HAV-free viral particles (vpHAV) and exosomes purified from HAV-infected cells (exo-HAV). Transfection of HAVCR1 cDNA into AGMK HAVCR1 KO cells restored susceptibility to vpHAV and exo-HAV infection. Furthermore, transfection of the mouse ortholog of HAVCR1, mHavcr1, also restored the susceptibility of AGMK HAVCR1 KO cells to HAV infection. Taken together, our data clearly show that HAVCR1 and mHavcr1 are functional HAV receptors that mediate HAV infection. This work paves the way for the identification of alternative HAV receptors to gain a complete understanding of their interplay with HAVCR1 in the cell entry and pathogenic processes of HAV.IMPORTANCE HAVCR1, an HAV receptor, is expressed in different cell types, including regulatory immune cells and antigen-presenting cells. How HAV evades the immune response during a long incubation period of up to 4 weeks and the mechanism by which the subsequent necroinflammatory process clears the infection remain a puzzle that most likely involves the HAV-HAVCR1 interaction. Based on negative data, a recent paper from the S. M. Lemon and W. Maury laboratories (A. Das, A. Hirai-Yuki, O. Gonzalez-Lopez, B. Rhein, S. Moller-Tank, R. Brouillette, L. Hensley, I. Misumi, W. Lovell, J. M. Cullen, J. K. Whitmire, W. Maury, and S. M. Lemon, mBio 8:e00969-17, 2017, https://doi.org/10.1128/mBio.00969-17) suggested that HAVCR1 is not a functional HAV receptor, nor it is it required for HAV infection. However, our data, based on regain of the HAV receptor function in HAVCR1 knockout cells transfected with HAVCR1 cDNA, disagree with their findings. Our positive data show conclusively that HAVCR1 is indeed a functional HAV receptor and lays the ground for the identification of alternative HAV receptors and how they interact with HAVCR1 in cell entry and the pathogenesis of HAV.
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19
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Skevaki C, Hudemann C, Matrosovich M, Möbs C, Paul S, Wachtendorf A, Alashkar Alhamwe B, Potaczek DP, Hagner S, Gemsa D, Garn H, Sette A, Renz H. Influenza-derived peptides cross-react with allergens and provide asthma protection. J Allergy Clin Immunol 2017; 142:804-814. [PMID: 29132960 DOI: 10.1016/j.jaci.2017.07.056] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 07/04/2017] [Accepted: 07/19/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND The hygiene hypothesis is the leading concept to explain the current asthma epidemic, which is built on the observation that a lack of bacterial contact early in life induces allergic TH2 immune responses. OBJECTIVE Because little is known about the contribution of respiratory tract viruses in this context, we evaluated the effect of prior influenza infection on the development of allergic asthma. METHODS Mice were infected with influenza and, once recovered, subjected to an ovalbumin- or house dust mite-induced experimental asthma protocol. Influenza-polarized effector memory T (Tem) cells were transferred adoptively to allergen-sensitized animals before allergen challenge. A comprehensive in silico analysis assessed homologies between virus- and allergen-derived proteins. Influenza-polarized Tem cells were stimulated ex vivo with candidate peptides. Mice were immunized with a pool of virus-derived T-cell epitopes. RESULTS In 2 murine models we found a long-lasting preventive effect against experimental asthma features. Protection could be attributed about equally to CD4+ and CD8+ Tem cells from influenza-infected mice. An in silico bioinformatic analysis identified 4 influenza- and 3 allergen-derived MHC class I and MHC class II candidate T-cell epitopes with potential antigen-specific cross-reactivity between influenza and allergens. Lymphocytes from influenza-infected mice produced IFN-γ and IL-2 but not IL-5 on stimulation with the aforementioned peptides. Immunization with a mixture of the influenza peptides conferred asthma protection, and peptide-immunized mice transferred protection through CD4+ and CD8+ Tem cells. CONCLUSION For the first time, our results illustrate heterologous immunity of virus-infected animals toward allergens. This finding extends the original hygiene hypothesis.
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Affiliation(s)
- Chrysanthi Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry, Member of the German Center for Lung Research (DZL), Philipps University Marburg, Marburg, Germany
| | - Christoph Hudemann
- Institute of Laboratory Medicine and Pathobiochemistry, Member of the German Center for Lung Research (DZL), Philipps University Marburg, Marburg, Germany
| | | | - Christian Möbs
- Department of Dermatology and Allergology, Philipps University Marburg, Marburg, Germany
| | - Sinu Paul
- La Jolla Institute for Allergy and Immunology, La Jolla, Calif
| | - Andreas Wachtendorf
- Institute of Laboratory Medicine and Pathobiochemistry, Member of the German Center for Lung Research (DZL), Philipps University Marburg, Marburg, Germany
| | - Bilal Alashkar Alhamwe
- Institute of Laboratory Medicine and Pathobiochemistry, Member of the German Center for Lung Research (DZL), Philipps University Marburg, Marburg, Germany
| | - Daniel P Potaczek
- Institute of Laboratory Medicine and Pathobiochemistry, Member of the German Center for Lung Research (DZL), Philipps University Marburg, Marburg, Germany; John Paul II Hospital, Krakow, Poland
| | - Stefanie Hagner
- Institute of Laboratory Medicine and Pathobiochemistry, Member of the German Center for Lung Research (DZL), Philipps University Marburg, Marburg, Germany
| | - Diethard Gemsa
- Institute of Laboratory Medicine and Pathobiochemistry, Member of the German Center for Lung Research (DZL), Philipps University Marburg, Marburg, Germany
| | - Holger Garn
- Institute of Laboratory Medicine and Pathobiochemistry, Member of the German Center for Lung Research (DZL), Philipps University Marburg, Marburg, Germany
| | | | - Harald Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Member of the German Center for Lung Research (DZL), Philipps University Marburg, Marburg, Germany.
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20
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Toxoplasma gondii tachyzoite-extract acts as a potent immunomodulator against allergic sensitization and airway inflammation. Sci Rep 2017; 7:15211. [PMID: 29123241 PMCID: PMC5680314 DOI: 10.1038/s41598-017-15663-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/26/2017] [Indexed: 01/08/2023] Open
Abstract
Epidemiological and experimental studies have shown an inverse relationship between infections with certain parasites and a reduced incidence of allergic diseases. We and others have shown that infection with Toxoplasma gondii prevents the development of allergy in mice. To establish whether this beneficial effect could be recapitulated by soluble products of this parasite, we tested an extract derived from T. gondii tachyzoites. Immunization of BALB/c mice with tachyzoites lysate antigen (TLA) elicited mixed Th1/Th2 responses. When TLA was applied together with the sensitizing ovalbumin (OVA), the development of allergic airway inflammation was reduced, with decreased airway hyperresponsiveness associated with reduced peribronchial and perivascular cellular infiltration, reduced production of OVA-specific Th2 cytokines in lungs and spleens and reduced levels of serum OVA-specific IgG1 as well as IgE-dependent basophil degranulation. Of note, TLA retained its immunomodulatory properties, inducing high levels of IL-6, TNFα, IL-10 and IL-12p70 in bone marrow-derived dendritic cells after heat-inactivation or proteinase K-treatment for disruption of proteins, but not after sodium metaperiodate-treatment that degrades carbohydrate structures, suggesting that carbohydrates may play a role in immunomodulatory properties of TLA. Here we show that extracts derived from parasites may replicate the benefits of parasitic infection, offering new therapies for immune-mediated disorders.
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The immunology of the allergy epidemic and the hygiene hypothesis. Nat Immunol 2017; 18:1076-1083. [PMID: 28926539 DOI: 10.1038/ni.3829] [Citation(s) in RCA: 227] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/04/2017] [Indexed: 12/18/2022]
Abstract
The immunology of the hygiene hypothesis of allergy is complex and involves the loss of cellular and humoral immunoregulatory pathways as a result of the adoption of a Western lifestyle and the disappearance of chronic infectious diseases. The influence of diet and reduced microbiome diversity now forms the foundation of scientific thinking on how the allergy epidemic occurred, although clear mechanistic insights into the process in humans are still lacking. Here we propose that barrier epithelial cells are heavily influenced by environmental factors and by microbiome-derived danger signals and metabolites, and thus act as important rheostats for immunoregulation, particularly during early postnatal development. Preventive strategies based on this new knowledge could exploit the diversity of the microbial world and the way humans react to it, and possibly restore old symbiotic relationships that have been lost in recent times, without causing disease or requiring a return to an unhygienic life style.
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Helicobacter pylori inversely related to clinical and functional severity of adult asthma. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2017. [DOI: 10.1016/j.ejcdt.2017.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Truong W, Shapiro AMJ. The TIM Family of Cosignaling Receptors: Emerging Targets for the Regulation of Autoimmune Disease and Transplantation Tolerance. Cell Transplant 2017; 16:977-986. [DOI: 10.3727/000000007783472390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Currently, lifelong immune suppression regimens are required for solid organ and cellular transplantation and carry significant increased risk of infection, malignancy, and toxicity. For non-life-saving procedures such as islet transplantation, the risk/benefit ratio of lifelong immunosuppression versus benefit from transplantation requires even more careful balance. The search for specific agents to modulate the immune system without chronic immunosuppression is important for the broad application of islet transplantation. The T-cell immunoglobulin mucin (TIM) family is a distinct group of coreceptors that are differentially expressed on TH1 and TH2 cells, and have the potential to regulate both cytotoxic and humoral immune responses. Completed murine studies demonstrate Tim pathways may be important in the regulation of tolerance to self (auto), harmless (allergic), and transplant (allo) antigen; however, the potential impact of targeting Tim coreceptors has yet to be fully explored in transplantation tolerance induction or autoimmune disease. The current review examines the impact of Tim coreceptor targeting as an emerging therapeutic option for regulating autoimmune diseases and prevention of allograft rejection.
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Affiliation(s)
- Wayne Truong
- The Surgical Medical Research Institute, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - A. M. James Shapiro
- The Surgical Medical Research Institute, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
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Wander K, Shell-Duncan B, Brindle E, O'Connor K. Hay fever, asthma, and eczema and early infectious diseases among children in Kilimanjaro, Tanzania. Am J Hum Biol 2017; 29. [PMID: 28083975 DOI: 10.1002/ajhb.22957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 08/24/2016] [Accepted: 12/13/2016] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To investigate the hygiene (or "old friends") hypothesis in a high-infectious disease (ID) environment, rural Kilimanjaro, Tanzania. METHODS Among a cross-sectional sample of 2- to 7-year-old children, we collected physician-diagnosed hay fever, asthma, and eczema, history of hospitalization, family size, and household environment information via questionnaire; performed active and passive surveillance for ID; and, evaluated total immunoglobulin E (IgE) and biomarkers of inflammation in dried blood spot specimens. We used regression models to describe patterns in allergic diseases. RESULTS Complete information was available for 280 children: 12.5% had been diagnosed with hay fever; 18.9% with eczema; 2.1% with asthma. There was a positive association between hay fever and eczema diagnoses (π2 : 4.07; P = 0.044); total IgE was positively associated with eczema (β: 0.24; P = 0.100) and allergic diseases together (β: 0.26; P = 0.042). ID were common: the incidence of any ID diagnosis was 28 per 100 children per month. Hay fever was inversely associated with household animals (OR: 0.27; P = 0.006), and positively associated with earth housing materials (OR: 1.93; P = 0.079) and hospitalization in infancy with an ID (3.16; P = 0.066); patterns were similar when allergic disease outcomes were considered together. Few associations between these predictors and eczema or asthma alone were apparent. CONCLUSIONS Allergic diseases were common among children in Kilimanjaro. The inverse association between household animals and allergy is consistent with the hygiene/old friends hypothesis; however, positive associations between allergic diseases and earth housing materials and early hospitalization with ID bear further explanation.
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Affiliation(s)
- Katherine Wander
- Department of Anthropology, Binghamton University (SUNY), Binghamton, New York, 13902.,Department of Anthropology, University of Washington, Seattle, Washington, 98195.,Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, 98195
| | - Bettina Shell-Duncan
- Department of Anthropology, University of Washington, Seattle, Washington, 98195.,Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, 98195
| | - Eleanor Brindle
- Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, 98195
| | - Kathleen O'Connor
- Department of Anthropology, University of Washington, Seattle, Washington, 98195.,Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, 98195
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Wold A. Why is there still confusion about the impact of breast-feeding on the risk of allergy development? SCANDINAVIAN JOURNAL OF FOOD & NUTRITION 2016. [DOI: 10.1080/11026480600617774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Agnes Wold
- Department of Clinical Bacteriology, Go¨ teborg University, Sweden
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26
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Wagner A, Schabussova I, Drinic M, Akgün J, Loupal G, Kundi M, Joachim A, Wiedermann U. Oocyst-Derived Extract of Toxoplasma Gondii Serves as Potent Immunomodulator in a Mouse Model of Birch Pollen Allergy. PLoS One 2016; 11:e0155081. [PMID: 27149118 PMCID: PMC4857930 DOI: 10.1371/journal.pone.0155081] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/24/2016] [Indexed: 12/22/2022] Open
Abstract
Introduction Previously, we have shown that oral infection with Toxoplasma gondii oocysts prevented type I allergy in mice. Here we investigated whether the application of a T. gondii oocyst lysate antigen (OLA) could also reduce allergy development. BALB/c mice were immunised twice with OLA followed by sensitisation with the major birch pollen (BP) allergen Bet v 1 and an aerosol challenge with BP extract. Methods First, we tested OLA in vitro. Stimulation of splenocytes and bone marrow-derived dendritic cells (BMDC) with OLA led to the production of pro-inflammatory and regulatory cytokines such as IL-6, IFN-γ and IL-10. Moreover, BMDC exposed to OLA upregulated the maturation markers CD40, CD80, CD86, and MHCII. Furthermore, OLA was recognised by TLR2-transfected human embryonic kidney cells. Results Immunisation of mice with OLA induced high levels of Toxoplasma-specific IgG antibodies in sera along with increased production of IFN-γ and IL-10 in Toxoplasma-antigen restimulated splenocytes. OLA reduced allergic airway inflammation as manifested by significant reduction of eosinophils in bronchoalveolar fluids, decreased cellular infiltrates and mucus production in the lungs. Accordingly, Bet v 1-specific IgE was decreased in OLA-pretreated mice. The reduced allergic immune responses were accompanied by increased numbers of CD4+CD25highFoxp3+ regulatory T cells in spleens as well as by increased numbers of granulocytic myeloid-derived suppressor cells in lungs when compared to sensitised controls suggesting that these two cell populations might be involved in the suppression of the allergic immune responses. Conclusion Our data demonstrate that pretreatment with the oocyst extract can exert anti-allergic effects comparable to T. gondii infection. Thus, the immunomodulatory properties of the parasite extract indicate that this extract and in the future defined molecules thereof might serve as immunomodulatory adjuvants in allergy treatment and prophylaxis.
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Affiliation(s)
- Angelika Wagner
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology & Immunology, Medical University of Vienna, Vienna, Austria
| | - Irma Schabussova
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology & Immunology, Medical University of Vienna, Vienna, Austria
| | - Mirjana Drinic
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology & Immunology, Medical University of Vienna, Vienna, Austria
| | - Johnnie Akgün
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology & Immunology, Medical University of Vienna, Vienna, Austria
| | - Gerhard Loupal
- Institute of Pathology and Forensic Veterinary Medicine, Department of Pathobiology, University of Veterinary Medicine, Vienna, Austria
| | - Michael Kundi
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Anja Joachim
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine, Vienna, Austria
| | - Ursula Wiedermann
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology & Immunology, Medical University of Vienna, Vienna, Austria
- * E-mail:
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Lim JH, Kim N, Lim SH, Kwon JW, Shin CM, Chang YS, Kim JS, Jung HC, Cho SH. Inverse Relationship Between Helicobacter Pylori Infection and Asthma Among Adults Younger than 40 Years: A Cross-Sectional Study. Medicine (Baltimore) 2016; 95:e2609. [PMID: 26937899 PMCID: PMC4778996 DOI: 10.1097/md.0000000000002609] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Recent studies have suggested that Helicobacter pylori could prevent allergic disease, particularly in children. However, whether this is true in adults is controversial. The aim of this study was to investigate whether there is negative association between H. pylori infection and asthma among adults in an area with a high prevalence of H. pylori.This was a cross-sectional study using 2011 health surveillance data. Blood samples were taken from all participants to measure serum H. pylori IgG status. Information on demographics, socioeconomic status, and medical history, including asthma and other allergic conditions were collected by a questionnaire.Of the 15,032 patients, 9492 (63.1%) had a history of H. pylori infection, 359 (2.4%) had asthma, and 3277 (21.8%) had other allergic conditions. H. pylori infection was positively correlated with age (OR, 1.050; 95% CI, 1.047-1.053, P < 0.001). Asthma history was positively correlated with age (OR, 1.022; 95% CI, 1.013-1.032, P < 0.001). H. pylori and age were shown to have interaction on asthma in the total participants (OR, 1.041; 95% CI, 1.021-1.062, P < 0.001). In subgroup analysis, H. pylori infection among those < 40 years old was inversely correlated with asthma (OR, 0.503; 95% CI, 0.280-0.904, P = 0.021). Other allergic conditions were not related with H. pylori infection among the total and those <40 years old.The inverse association between H. pylori infection and asthma among young adults suggests that the underlying immune mechanism induced by H. pylori infection may affect allergic reactions associated with asthma in young adults.
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Affiliation(s)
- Joo Hyun Lim
- From the Seoul National University Hospital, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul (JHL, SHL, JSK, S-HC); Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do (NK, CMS, Y-SC); College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu (J-WK); and Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea (LJH, NK, JSK, HCJ)
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Campbell BE, Lodge CJ, Lowe AJ, Burgess JA, Matheson MC, Dharmage SC. Exposure to 'farming' and objective markers of atopy: a systematic review and meta-analysis. Clin Exp Allergy 2015; 45:744-57. [PMID: 25270644 DOI: 10.1111/cea.12429] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
There is growing interest in the 'farm effect' on the spectrum of allergy. Evidence concerning the farm effect on asthma, eczema, and allergic rhinitis has been systematically synthesized, but without a specific focus on objective markers of sensitization. This focus is important, as farm exposures may be related to allergy but not to non-allergic phenotypes of disease. We aimed to systematically review and meta-analyse literature that has investigated associations between farm exposure at any age and objective measures of atopy, that is serum IgE or skin prick tests results. Using predefined inclusion and exclusion criteria, we identified 29 articles for review. IgE levels were measured in either childhood or adulthood by eighteen studies, while skin prick testing was performed in sixteen studies. Newcastle-Ottawa Scale quality assessments indicated that the majority of these studies demonstrated a representative sample of selected participants. Due to significant heterogeneity in study measures and methodology between studies, only few were meta-analysed. This meta-analysis showed a significant protective effect of farm exposure before 1 year of life on allergic sensitization (OR = 0.60 [0.52-0.70]). Farm exposure during childhood was also associated with a reduced risk of sensitization to cat or timothy (OR = 0.60 [0.51-0.70]; OR=0.46 [0.41-0.51]). Studies investigating the effect of farm exposure in adult life could not be meta-analysed, and their results were inconsistent. Insufficient studies investigated food sensitization as an outcome to allow synthesis. The majority of studies included in this review investigated childhood farm exposure, finding evidence to support a protective childhood 'farm effect' against subsequent atopy. There is inconsistent evidence on the association between farm exposure in adulthood and allergic sensitization. Further studies are needed to tease out the exact exposures and timing associated with farming environments that protect against allergic disease.
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Affiliation(s)
- B E Campbell
- Allergy and Lung Health Unit, Centre for Epidemiology & Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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29
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Haahtela T, Laatikainen T, Alenius H, Auvinen P, Fyhrquist N, Hanski I, von Hertzen L, Jousilahti P, Kosunen TU, Markelova O, Mäkelä MJ, Pantelejev V, Uhanov M, Zilber E, Vartiainen E. Hunt for the origin of allergy - comparing the Finnish and Russian Karelia. Clin Exp Allergy 2015; 45:891-901. [DOI: 10.1111/cea.12527] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 01/13/2015] [Accepted: 01/16/2015] [Indexed: 12/12/2022]
Affiliation(s)
- T. Haahtela
- Skin and Allergy Hospital; Helsinki University Central Hospital; Helsinki Finland
| | - T. Laatikainen
- National Institute for Health and Welfare; Helsinki Finland
- Institute of Public Health and Clinical Nutrition; University of Eastern Finland; Helsinki Finland
| | - H. Alenius
- Institute of Occupational Health; Helsinki Finland
| | - P. Auvinen
- Institute of Biotechnology; University of Helsinki; Helsinki Finland
| | - N. Fyhrquist
- Institute of Occupational Health; Helsinki Finland
| | - I. Hanski
- Department of Biosciences; University of Helsinki; Helsinki Finland
| | - L. von Hertzen
- Skin and Allergy Hospital; Helsinki University Central Hospital; Helsinki Finland
| | - P. Jousilahti
- National Institute for Health and Welfare; Helsinki Finland
| | - T. U. Kosunen
- Department of Bacteriology and Immunology; Haartman Institute; University of Helsinki; Helsinki Finland
| | - O. Markelova
- Petrozavodsk State University; Petrozavodsk Russia
| | - M. J. Mäkelä
- Skin and Allergy Hospital; Helsinki University Central Hospital; Helsinki Finland
| | | | - M. Uhanov
- Parliament of the Republic of Karelia; Petrozavodsk Russia
| | - E. Zilber
- Scientific Research Institute of Phthisiopulmonology; St. Petersburg Russia
| | - E. Vartiainen
- National Institute for Health and Welfare; Helsinki Finland
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Chang TW. Changing patterns of antigen exposure and their impact on the prevalence of allergy. Pediatr Allergy Immunol 2014; 25:733-9. [PMID: 25378142 DOI: 10.1111/pai.12297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2014] [Indexed: 11/27/2022]
Abstract
Industrial development has advanced at a varying pace in different parts of the world over the past 200 years. Inhabitants of the most industrially advanced regions have experienced major changes in patterns of antigen exposure to infectious agents and to environmental biologic substances. This article analyzes the major factors that affect the amounts and variety of antigens to which the immune system of a young child is exposed. Depending on individual living environments and lifestyles, the types of antigen exposure of young children are graded into five patterns: 'primitive', 'pre-modern', 'early modern', 'modern', and 'ultramodern'. These patterns represent increasing deviation from the pattern of human immune system exposure to antigens prior to the industrial revolution. This article further discusses how such changes in antigen exposure have affected the immunologic system, especially with regard to the development of total IgE and allergic response-relevant antigen-specific IgE, and how the patterns of antigen exposure are related to the propensity to develop allergy.
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Affiliation(s)
- Tse Wen Chang
- Genomics Research Center, Academia Sinica, Taipei, 11529, Taiwan
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31
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Regulation of T cell trafficking by the T cell immunoglobulin and mucin domain 1 glycoprotein. Trends Mol Med 2014; 20:675-84. [DOI: 10.1016/j.molmed.2014.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 09/30/2014] [Accepted: 10/13/2014] [Indexed: 12/30/2022]
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Athari SS, Omidi R. Report of a patient with complex composites of hepatitis B virus, allergic asthma and diabetes. Asian Pac J Trop Biomed 2014; 4:S59-61. [PMID: 25183147 DOI: 10.12980/apjtb.4.2014c683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 02/27/2014] [Indexed: 01/01/2023] Open
Abstract
HBV is a non-cytopathic virus and cell mediated immune response against this. Humoral mediated immune response are responsible for allergic diseases. Balance between these two subsets of Th CD4+ cells are result of the immune system response. A 56 year old woman presented with chronic HBV infection, allergic asthma, type 2 diabetes mellitus and high blood pressure and high blood lipid. Patients should be followed for the allergic and autoimmune diseases along with their viral reactivation.
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Affiliation(s)
- Seyyed Shamsadin Athari
- Department of Immunology, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Razie Omidi
- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Abstract
Hepatitis A virus (HAV) is a faeco-orally transmitted picornavirus and is one of the main causes of acute hepatitis worldwide. An overview of the molecular biology of HAV is presented with an emphasis on recent findings. Immune evasion strategies and a possible correlation between HAV and atopy are discussed as well. Despite the availability of efficient vaccines, antiviral drugs targeting HAV are required to treat severe cases of fulminant hepatitis, contain outbreaks, and halt the potential spread of vaccine-escape variants. Additionally, such drugs could be used to shorten the period of illness and decrease associated economical costs. Several known inhibitors of HAV with various mechanisms of action will be discussed. Since none of these molecules is readily useable in the clinic and since the availability of an anti-HAV drug would be of clinical importance, increased efforts should be targeted toward discovery and development of such antivirals.
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Affiliation(s)
- Yannick Debing
- Rega Institute for Medical ResearchUniversity of LeuvenLeuvenBelgium
| | - Johan Neyts
- Rega Institute for Medical ResearchUniversity of LeuvenLeuvenBelgium
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Obieglo K, van Wijck Y, de Kleijn S, Smits HH, Taube C. Microorganism-induced suppression of allergic airway disease: novel therapies on the horizon? Expert Rev Respir Med 2014; 8:717-30. [PMID: 25138640 DOI: 10.1586/17476348.2014.949244] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Allergic airway disease is a major global health burden, and novel treatment options are urgently needed. Numerous epidemiological and experimental studies suggest that certain helminths and bacteria protect against respiratory allergies. These microorganisms are strong regulators of the immune system, and various potential regulatory mechanisms by which they protect against allergic airway inflammation have been proposed. Whereas early studies addressed the beneficial effect of natural infections, the focus now shifts toward identifying the dominant protective molecules and exploring their efficacy in models of allergic airway disease. In this article, we will review the evidence for microbe-mediated protection from allergic airway disease, the potential modes of action involved and discuss advances as well as limitations in the translation of this knowledge into novel treatment strategies against allergic airway disease.
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Affiliation(s)
- Katja Obieglo
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
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35
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Janse JJ, Wong GWK, Potts J, Ogorodova LM, Fedorova OS, Mahesh PA, Sakellariou A, Papadopoulos NG, Knulst AC, Versteeg SA, Kroes ACM, Vossen ACTM, Campos Ponce M, Kummeling I, Burney P, van Ree R, Yazdanbakhsh M. The association between foodborne and orofecal pathogens and allergic sensitisation -- EuroPrevall study. Pediatr Allergy Immunol 2014; 25:250-6. [PMID: 24325443 DOI: 10.1111/pai.12175] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND An inverse association between markers of exposure to foodborne and orofecal pathogens and allergic sensitization has been reported. However, the findings of epidemiological studies have not been consistent. This study investigated the relationship between antibodies to hepatitis A, Toxoplasma gondii and salmonella and allergic sensitization to food and aeroallergens in children from different geographical areas. METHODS Specific IgE and/or skin prick testing against food and aeroallergens were measured in children from 6 to 12 years of age residing in Greece, the Netherlands, China, India and Russia. Seropositivity to the three pathogens was measured, and data on potential confounders were collected using questionnaire. RESULTS Data from 800 children (126 from Athens; 248 from Utrecht; 110 from Hong Kong; 119 from urban Tomsk; and 197 from rural Tomsk) could be analysed. The highest percentage of positive serology to salmonella was found in Hong Kong (46.4%), to T. gondii in urban Tomsk (13.4%) and to hepatitis A in Athens (71.2%). Although not significant, T. gondii seropositivity tends to be negatively associated, and hepatitis A seropositivity tends to be positively associated with allergic sensitization. CONCLUSION Inconsistent associations were observed between allergic sensitization to food and aeroallergens and markers of exposure to two common foodborne pathogens. The association with T. gondii tends to be negative, consistent with the 'hygiene hypothesis', but the association with hepatitis A tends to be positive. Taken together, there is no clear evidence that past exposure to foodborne and orofecal pathogens protects against allergic sensitization to food or aeroallergens.
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Affiliation(s)
- Jacqueline J Janse
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
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Simultaneous Production of Biosurfactants and Bacteriocins by Probiotic Lactobacillus casei MRTL3. Int J Microbiol 2014; 2014:698713. [PMID: 24669225 PMCID: PMC3941777 DOI: 10.1155/2014/698713] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 11/13/2013] [Indexed: 12/18/2022] Open
Abstract
Lactic acid bacteria (LAB) are ubiquitous and well-known commensal bacteria in the human and animal microflora. LAB are extensively studied and used in a variety of industrial and food fermentations. They are widely used for humans and animals as adjuvants, probiotic formulation, and dietary supplements and in other food fermentation applications. In the present investigation, LAB were isolated from raw milk samples collected from local dairy farms of Haryana, India. Further, the isolates were screened for simultaneous production of biosurfactants and bacteriocins. Biosurfactant produced was found to be a mixture of lipid and sugar similar to glycolipids. The bacteriocin obtained was found to be heat stable (5 min at 100°C). Further, DNA of the strain was extracted and amplified by the 16S rRNA sequencing using universal primers. The isolate Lactobacillus casei MRTL3 was found to be a potent biosurfactant and bacteriocin producer. It seems to have huge potential for food industry as a biopreservative and/or food ingredient.
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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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Kim HY, Chang YJ, Chuang YT, Lee HH, Kasahara DI, Martin T, Hsu JT, Savage PB, Shore SA, Freeman GJ, Dekruyff RH, Umetsu DT. T-cell immunoglobulin and mucin domain 1 deficiency eliminates airway hyperreactivity triggered by the recognition of airway cell death. J Allergy Clin Immunol 2013; 132:414-25.e6. [PMID: 23672783 DOI: 10.1016/j.jaci.2013.03.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 03/21/2013] [Accepted: 03/25/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Studies of asthma have been limited by a poor understanding of how nonallergic environmental exposures, such as air pollution and infection, are translated in the lung into inflammation and wheezing. OBJECTIVE Our goal was to understand the mechanism of nonallergic asthma that leads to airway hyperreactivity (AHR), a cardinal feature of asthma independent of adaptive immunity. METHOD We examined mouse models of experimental asthma in which AHR was induced by respiratory syncytial virus infection or ozone exposure using mice deficient in T-cell immunoglobulin and mucin domain 1 (TIM1/HAVCR1), an important asthma susceptibility gene. RESULTS TIM1(-/-) mice did not have airways disease when infected with RSV or when repeatedly exposed to ozone, a major component of air pollution. On the other hand, the TIM1(-/-) mice had allergen-induced experimental asthma, as previously shown. The RSV- and ozone-induced pathways were blocked by treatment with caspase inhibitors, indicating an absolute requirement for programmed cell death and apoptosis. TIM-1-expressing, but not TIM-1-deficient, natural killer T cells responded to apoptotic airway epithelial cells by secreting cytokines, which mediated the development of AHR. CONCLUSION We defined a novel pathway in which TIM-1, a receptor for phosphatidylserine expressed by apoptotic cells, drives the development of asthma by sensing and responding to injured and apoptotic airway epithelial cells.
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Affiliation(s)
- Hye Young Kim
- Division of Immunology and Allergy, Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Taube C, Müller A. The role of Helicobacter pylori infection in the development of allergic asthma. Expert Rev Respir Med 2013; 6:441-9. [PMID: 22971068 DOI: 10.1586/ers.12.40] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Asthma is one of the most prevalent chronic diseases in developed countries, with steady increases in asthma prevalence evident, particularly in the last few decades. As genetic factors are unlikely to contribute to the rise in asthma prevalence, changes in lifestyle and exposure to environmental stimuli have been proposed to account for this trend. The 'disappearing microbiota' hypothesis postulates that major shifts in the human microbiome, resulting from dramatic lifestyle changes, account for the increase in asthma prevalence. In this context, persistent gastric colonization with the human-specific pathogen Helicobacter pylori has been negatively associated with the occurrence of asthma in epidemiological studies. In addition, experimental models of allergic airway disease revealed a direct link between infection with H. pylori and suppression of allergic airway disease through the induction of regulatory T cells. These and other new insights hold the promise of opening up new avenues toward the development of innovative, new strategies directed at asthma treatment and prevention.
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Affiliation(s)
- Christian Taube
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
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Chen JP, Zhao WL, He NH, Gui Q, Xiong JP, Zhou HM, Wang Y, Chen S, Zhou P. Association of Hepatitis A exposure and TIM-1 with childhood allergic asthma. J Asthma 2012; 49:697-702. [PMID: 22857392 DOI: 10.3109/02770903.2012.694539] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Hepatitis A virus (HAV) receptor (TIM-1) polymorphism plays an important role in asthma and autoimmune diseases. Objective. To analyze the association of TIM-1 polymorphism and HAV infection with childhood allergic asthma in Southwest China. METHODS TIM-1 exon 4 (157insMTTTVP) and two polymorphism loci, -416G>C and -1454G>A, in the HAV receptor promoter region were studied. Polymerase chain reaction (PCR) was used to test the genotypes of three polymorphism loci among 579 cases of asthma and 524 controls. The HAV infection status was determined in a case-control study with stratified analysis. RESULTS HAV exposure associated with childhood allergic asthma in the study population was compared with controls (odds ratio (OR) = 0.181, 95% confidence interval (CI) 0.126-0.260, p < .001). The -416G>C polymorphism was associated with asthma (OR = 1.384, 95% CI 1.148-1.669, p < .001), but the insertion variant 157delMTTTVP of exon 4 and the -1454G>A polymorphism were not. CONCLUSION Our results indicated that the -416G>C polymorphism of the TIM-1 gene is associated with childhood allergic asthma, providing a better understanding of the pathogenesis of the allergic asthma among children aged below 15 years in Southwest China.
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Affiliation(s)
- Jian-Ping Chen
- Department of Pediatrics, Southwest Hospital, The Third Military Medical University, Chongqing 400038, China
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Santiago HDC, Bennuru S, Ribeiro JMC, Nutman TB. Structural differences between human proteins and aero- and microbial allergens define allergenicity. PLoS One 2012; 7:e40552. [PMID: 22815762 PMCID: PMC3399830 DOI: 10.1371/journal.pone.0040552] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 06/08/2012] [Indexed: 01/28/2023] Open
Abstract
The current paradigm suggests that structural homology of allergenic proteins to microbial (particularly helminths) or human proteins underlie their allergenic nature. To examine systematically the structural relationships among allergens and proteins of pathogens (helminths, protozoans, fungi and bacteria) as they relate to allergenicity, we compared the amino acid sequence of 499 molecularly-defined allergens with the predicted proteomes of fifteen known pathogens, including Th2 inducing helminths and Th1-inducing protozoans, and humans using a variety of bioinformatic tools. Allergenicity was assessed based on IgE prevalences using publicly accessible databases and the literature. We found multiple homologues of common allergens among proteins of helminths, protozoans, fungi and humans, but not of bacteria. In contrast, 187 allergens showed no homology with any of the microbial genera studied. Interestingly, allergens without homologues or those with limited levels of sequence conservation were the most allergenic displaying high IgE prevalences in the allergic population. There was an inverse relationship between allergenicity and amino acid conservation levels with either parasite, including helminth, or human proteins. Our results suggest that allergenicity may be associated with the relative "uniqueness" of an antigen, i.e. immunogenicity, while similarity would lead to immunological tolerance.
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Affiliation(s)
- Helton da Costa Santiago
- The Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sasisekhar Bennuru
- The Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - José M. C. Ribeiro
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, United States of America
| | - Thomas B. Nutman
- The Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
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Abstract
Throughout the twentieth century, there were striking increases in the incidences of many chronic inflammatory disorders in the rich developed countries. These included autoimmune disorders such as Type 1 diabetes and multiple sclerosis. Although genetics and specific triggering mechanisms such as molecular mimicry and viruses are likely to be involved, the increases have been so rapid that any explanation that omits environmental change is incomplete. This chapter suggests that a series of environmental factors, most of them microbial, have led to a decrease in the efficiency of our immunoregulatory mechanisms because we are in a state of evolved dependence on organisms with which we co-evolved (and that had to be tolerated) as inducers of immunoregulatory circuits. These organisms ("Old Friends") are depleted from the modern urban environment. Rather than considering fetal programming by maternal microbial exposures, neonatal programming, the hygiene hypothesis, gut microbiota, and diet as separate and competing hypotheses, I attempt here to integrate these ideas under a single umbrella concept that can provide the missing immunoregulatory environmental factor that is needed to explain the recent increases in autoimmune disease.
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Affiliation(s)
- Graham A W Rook
- Department of Infection, Centre for Clinical Microbiology, University College London (UCL), London, UK.
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Arram EO, Shahin DA, Sherif MM. Asthma is inversely associated with Helicobacter pylori status. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2012. [DOI: 10.1016/j.ejcdt.2012.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hygiene hypothesis: why south/north geographical differences in prevalence of asthma and sarcoidosis? Med Hypotheses 2012; 79:363-4. [PMID: 22704943 DOI: 10.1016/j.mehy.2012.05.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 05/22/2012] [Accepted: 05/23/2012] [Indexed: 11/20/2022]
Abstract
Although asthma is multi-factorial and generally worsens during winter, prevalence of asthma tends to be higher in warm regions. By contrast, sarcoidosis, which like asthma results from immunological abnormalities that disturb the lower respiratory tracts and unlike asthma is characterized by T helper (Th) 1 response, occurs predominantly in colder regions. The hygiene hypothesis proposes that infection by intracellular pathogens such as early childhood viruses promotes Th1 immune phenotype and decreases susceptibility to later occurrence of Th2-associated asthma, since Th1 and Th2 cells are mutually inhibitory. As respiratory viral infections are generally more common under colder conditions, it is hypothesized that more respiratory viral infections in colder climates than one's natural environment during early childhood may promote subsequent occurrence of sarcoidosis, while less infections in warmer environments may promote subsequent occurrence of asthma.
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Manangeeswaran M, Jacques J, Tami C, Konduru K, Amharref N, Perrella O, Casasnovas JM, Umetsu DT, Dekruyff RH, Freeman GJ, Perrella A, Kaplan GG. Binding of hepatitis A virus to its cellular receptor 1 inhibits T-regulatory cell functions in humans. Gastroenterology 2012; 142:1516-25.e3. [PMID: 22430395 PMCID: PMC3367104 DOI: 10.1053/j.gastro.2012.02.039] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Revised: 02/02/2012] [Accepted: 02/11/2012] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS CD4+ T-regulatory (Treg) cells suppress immune responses and control self-tolerance and immunity to pathogens, cancer, and alloantigens. Most pathogens activate Treg cells to minimize immune-mediated tissue damage and prevent clearance, which promotes chronic infections. However, hepatitis A virus (HAV) temporarily inhibits Treg-cell functions. We investigated whether the interaction of HAV with its cellular receptor 1 (HAVCR1), a T-cell co-stimulatory molecule, inhibits the function of Treg cells to control HAV infection. METHODS We studied the effects of HAV interaction with HAVCR1 on human T cells using binding, signal transduction, apoptosis, activation, suppression, cytokine production, and confocal microscopy analyses. Cytokines were analyzed in sera from 14 patients with HAV infection using bead arrays. RESULTS Human Treg cells constitutively express HAVCR1. Binding of HAV to HAVCR1 blocked phosphorylation of Akt, prevented activation of the T-cell receptor, and inhibited function of Treg cells. At the peak viremia, patients with acute HAV infection had no Treg-cell suppression function, produced low levels of transforming growth factor-β , which limited leukocyte recruitment and survival, and produced high levels of interleukin-22, which prevented liver damage. CONCLUSIONS Interaction between HAV and its receptor HAVCR1 inhibits Treg-cell function, resulting in an immune imbalance that allows viral expansion with limited hepatocellular damage during early stages of infection-a characteristic of HAV pathogenesis. The mechanism by which HAV is cleared in the absence of Treg-cell function could be used as a model to develop anticancer therapies, modulate autoimmune and allergic responses, and prevent transplant rejection.
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Affiliation(s)
- Mohanraj Manangeeswaran
- Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, USA
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Wander K, O'Connor K, Shell-Duncan B. Expanding the hygiene hypothesis: early exposure to infectious agents predicts delayed-type hypersensitivity to Candida among children in Kilimanjaro. PLoS One 2012; 7:e37406. [PMID: 22616000 PMCID: PMC3355133 DOI: 10.1371/journal.pone.0037406] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 04/19/2012] [Indexed: 12/12/2022] Open
Abstract
Background Multiple lines of evidence suggest that infections in early life prevent the development of pathological immune responses to allergens and autoantigens (the hygiene hypothesis). Early infections may also affect later immune responses to pathogen antigen. Methods To evaluate an association between early infections and immune responses to pathogen antigen, delayed-type hypersensitivity (DTH) to Candida albicans was evaluated among 283 2- to 7-year-old children in Kilimanjaro, Tanzania. A questionnaire and physical examination were used to characterize variables reflecting early exposure to infectious agents (family size, house construction materials, BCG vaccination, hospitalization history). Logistic regression was used to evaluate the association between early exposure to infectious agents and DTH to C. albicans. Results Triceps skinfold thickness (OR: 1.11; 95% CI: 1.01, 1.22) and age (OR: 1.27; 95% CI: 1.04, 1.55) were positively associated with DTH to C. albicans. Adjusted for age and sex, large family size (OR: 2.81; 95% CI: 1.04, 7.61), BCG vaccination scar (OR: 3.10; 95% CI: 1.10, 8.71), and hospitalization during infancy with an infectious disease (OR: 4.67; 95% CI: 1.00, 21.74) were positively associated with DTH to C. albicans. Conclusions Early life infections were positively associated with later DTH to C. albicans. This result supports an expansion of the hygiene hypothesis to explain not only pathological immune responses to allergens, but also appropriate immune responses to pathogens. Immune system development may be responsive to early infections as an adaptive means to tailor reactivity to the local infectious disease ecology.
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Affiliation(s)
- Katherine Wander
- Department of Anthropology, University of Washington, Seattle, Washington, United States of America.
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Svensson A, Nordström I, Rudin A, Bergström T, Eriksson K. Enveloped virus but not bacteria block IL-13 responses in human cord blood T cells in vitro. Scand J Immunol 2012; 75:409-18. [PMID: 22229804 PMCID: PMC7190188 DOI: 10.1111/j.1365-3083.2012.02676.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Infections that occur early in life may have a beneficial effect on the immune system and thereby reduce the risk of allergen sensitization and/or allergic disease. It is not yet clear to what extent specific virus and/or bacteria can mediate this effect. The purpose of this study was to assess the role of virus and bacteria in CD4+ T cell‐derived cytokine production in newborns. We compared the effects of five bacteria (Staphlococcus aureus, Escherichia coli, Clostridium difficile, Lactobacillus rhamnosus and Bifidobacterium bifidus) and seven virus (adenovirus, coronavirus, cytomegalovirus, herpes simplex virus, influenza virus, morbillivirus and poliovirus) on the Th1/Th2 cytokine production in mixed lymphocyte reactions using CD4+ T cells from cord blood cocultured with allogenic myeloid or plasmacytoid dendritic cells. When comparing the baseline cytokine production prior to microbial stimulation, we observed that cord plasmacytoid DC were stronger inducers of Th2 cytokines (IL‐5 and IL‐13) compared with cord myeloid DC and to adult DC. When adding microbes to these cultures, bacteria and virus differed in two major respects; Firstly, all enveloped viruses, but none of the bacteria, blocked Th2 (IL‐13) production by cord CD4+ cells. Secondly, all Gram‐positive bacteria, but none of the virus, induced IL‐12p40 responses, but the IL‐12p40 responses did not affect Th1 cytokine production (IFN‐γ). Instead, Th1 responses were correlated with the capacity to induce IFN‐α secretion, which in cord cells were induced by S. aureus and influenza virus alone. These data imply that enveloped virus can deviate Th2 responses in human cord T cells.
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Affiliation(s)
- A Svensson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Fujimoto Y, Pradipta AR, Inohara N, Fukase K. Peptidoglycan as Nod1 ligand; fragment structures in the environment, chemical synthesis, and their innate immunostimulation. Nat Prod Rep 2012; 29:568-79. [PMID: 22370813 DOI: 10.1039/c2np00091a] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Covering: up to 2011. This review focuses on the recent revealing of the immunostimulatory bacterial cell wall peptidoglycan (PGN) fragments as Nod1 ligands, especially a newly developed chemical synthesis of the partial structures, fragment structures in the environment and bacterial supernatant, and the immunostimulatory activities of the Nod1 ligands.
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Affiliation(s)
- Yukari Fujimoto
- Department of Chemistry, Graduate School of Science, Osaka University, Machikaneyama 1-1, Toyonaka, Osaka 560-0043, Japan.
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Yuan J, Tang ZL, Yang S, Cao JY, Li K. Molecular characteristics of the porcine TIMD4 gene and its association analysis. Biochem Genet 2012; 50:538-48. [PMID: 22354463 DOI: 10.1007/s10528-012-9498-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Accepted: 09/26/2011] [Indexed: 11/30/2022]
Abstract
As a member of the T cell immunoglobulin domain and mucin domain (TIM) gene family, TIMD4 plays an important role in the immune response. To understand its function more precisely, we isolated it and analyzed its subcellular localization, expression pattern, and associations. The porcine TIMD4 gene included nine exons and eight introns with an open reading frame of 1086 bp encoding 361 amino acids. It had relatively high levels in liver, lymph, and spleen. The fusion protein was localized mainly in the cytoplasm of pig kidney cells (PK15). The promoter region contained a TATA box and GATA3 consensus sites. A single nucleotide polymorphism was identified in intron 3 of the porcine TIMD4 gene, and analysis indicated that it had significant associations with the 17-day red blood cell count (p = 0.0106), hemoglobin (p = 0.0149), and hematocrit (p = 0.0063) and with 32-day hemoglobin (p = 0.0140).
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Affiliation(s)
- Jing Yuan
- State Key Laboratory for Animal Nutrition, Key Laboratory for Domestic Animal Genetic Resources and Breeding of Ministry of Agriculture of China, Institute of Animal Science, Chinese Academy of Agricultural Sciences, 2 Yuanmingyuan West Road, Haidian District, Beijing 100193, China
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Alcantara-Neves NM, Veiga RV, Dattoli VCC, Fiaccone RL, Esquivel R, Cruz ÁA, Cooper PJ, Rodrigues LC, Barreto ML. The effect of single and multiple infections on atopy and wheezing in children. J Allergy Clin Immunol 2011; 129:359-67, 367.e1-3. [PMID: 22035877 DOI: 10.1016/j.jaci.2011.09.015] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Revised: 08/28/2011] [Accepted: 09/13/2011] [Indexed: 12/26/2022]
Abstract
BACKGROUND The current epidemic of asthma and atopy has been explained by alterations in immune responses related to reduction in childhood infections. However, the findings of epidemiologic studies investigating the association between infection with atopy and asthma have been inconsistent. OBJECTIVE We sought to investigate the effect of single or multiple infections (pathogen burden) on atopy and wheeze in urban children from Latin America. METHODS Specific IgE against aeroallergens (sIgE) and skin prick test (SPT) reactivity for the most common local allergens were measured in 1128 children aged 4 to 11 years. Data on wheezing and potential confounders were collected by questionnaire. Infections by 8 pathogens were assessed by using serology and stool examination. Associations of wheeze and atopic outcomes with single and multiple infections were analyzed by means of logistic regression. RESULTS Negative results for Toxoplasma gondii were associated with a higher prevalence of sIgE (≥0.70 kU/L), whereas negative results for Ascaris lumbricoides, T gondii, herpes simplex virus, and EBV were associated with a higher prevalence of SPT reactivity. Children with 3 or fewer infection markers had a higher prevalence of sIgE and SPT reactivity compared with those with 4 or more infection markers. However, isolated infections or pathogen burden were not associated with the prevalence of atopic or nonatopic wheeze. CONCLUSION The findings provide support for the idea that the hygiene hypothesis is operating in an urban Latin American context, but its expression is thus far restricted to the atopic status of patients and not the perceived asthma symptoms.
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Affiliation(s)
- Neuza Maria Alcantara-Neves
- Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
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