1
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Robinson A, Huff RD, Ryu MH, Carlsten C. Variants in transient receptor potential channels and toll-like receptors modify airway responses to allergen and air pollution: a randomized controlled response human exposure study. Respir Res 2023; 24:218. [PMID: 37679687 PMCID: PMC10485933 DOI: 10.1186/s12931-023-02518-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Environmental co-exposure to allergen and traffic-related air pollution is common globally and contributes to the exacerbation of respiratory diseases. Individual responses to environmental insults remain variable due to gene-environment interactions. OBJECTIVE This study examined whether single nucleotide polymorphisms (SNPs) in lung cell surface receptor genes modifies lung function change and immune cell recruitment in allergen-sensitized individuals exposed to diesel exhaust (DE) and allergen. METHODS In this randomized, double-blinded, four-arm, crossover study, 13 allergen-sensitized participants underwent allergen inhalation challenge following a 2-hour exposure to DE, particle-depleted diesel exhaust (PDDE) or filtered air (FA). Lung function tests and bronchoscopic sample collection were performed up to 48 h after exposures. Transient receptor potential channel (TRPA1 and TRPV1) and toll-like receptor (TLR2 and TLR4) risk alleles were used to construct an unweighted genetic risk score (GRS). Exposure-by-GRS interactions were tested using mixed-effects models. RESULTS In participants with high GRS, allergen exposure was associated with an increase in airway hyperresponsiveness (AHR) when co-exposed to PDDE (p = 0.03) but not FA or DE. FA and PDDE also were associated with a relative increase in macrophages and decrease in lymphocytes in bronchoalveolar lavage. CONCLUSIONS TRPs and TLRs variants are associated with increased AHR and altered immune cellularity in allergen-exposed individuals. This effect is blunted by DE exposure, suggesting greater influence of unmeasured gene variants as primary meditators of a particulate-rich co-exposure. TRIAL REGISTRATION The study was registered with ClinicalTrials.gov on December 20, 2013 (NCT02017431).
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Affiliation(s)
- Andrew Robinson
- Air Pollution Exposure Laboratory, Division of Respiratory Medicine, Department Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Ryan D Huff
- Air Pollution Exposure Laboratory, Division of Respiratory Medicine, Department Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Min Hyung Ryu
- Air Pollution Exposure Laboratory, Division of Respiratory Medicine, Department Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, BC, Canada
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Chris Carlsten
- Air Pollution Exposure Laboratory, Division of Respiratory Medicine, Department Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, BC, Canada.
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2
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Hovhannisyan L, Czechowska E, Gutowska-Owsiak D. The Role of Non-Immune Cell-Derived Extracellular Vesicles in Allergy. Front Immunol 2021; 12:702381. [PMID: 34489951 PMCID: PMC8417238 DOI: 10.3389/fimmu.2021.702381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/31/2021] [Indexed: 12/14/2022] Open
Abstract
Extracellular vesicles (EVs), and especially exosomes, have been shown to mediate information exchange between distant cells; this process directly affects the biological characteristics and functionality of the recipient cell. As such, EVs significantly contribute to the shaping of immune responses in both physiology and disease states. While vesicles secreted by immune cells are often implicated in the allergic process, growing evidence indicates that EVs from non-immune cells, produced in the stroma or epithelia of the organs directly affected by inflammation may also play a significant role. In this review, we provide an overview of the mechanisms of allergy to which those EVs contribute, with a particular focus on small EVs (sEVs). Finally, we also give a clinical perspective regarding the utilization of the EV-mediated communication route for the benefit of allergic patients.
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Affiliation(s)
- Lilit Hovhannisyan
- University of Gdansk, Intercollegiate Faculty of Biotechnology of University of Gdansk and Medical University of Gdansk, Gdansk, Poland
- Department of in vitro Studies, Institute of Biotechnology and Molecular Medicine, Gdansk, Poland
| | - Ewa Czechowska
- University of Gdansk, Intercollegiate Faculty of Biotechnology of University of Gdansk and Medical University of Gdansk, Gdansk, Poland
| | - Danuta Gutowska-Owsiak
- University of Gdansk, Intercollegiate Faculty of Biotechnology of University of Gdansk and Medical University of Gdansk, Gdansk, Poland
- Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
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3
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Pointner L, Kraiem A, Thaler M, Richter F, Wenger M, Bethanis A, Klotz M, Traidl-Hoffmann C, Gilles S, Aglas L. Birch Pollen Induces Toll-Like Receptor 4-Dependent Dendritic Cell Activation Favoring T Cell Responses. FRONTIERS IN ALLERGY 2021; 2:680937. [PMID: 35386993 PMCID: PMC8974861 DOI: 10.3389/falgy.2021.680937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/15/2021] [Indexed: 12/12/2022] Open
Abstract
Seasonal exposure to birch pollen (BP) is a major cause of pollinosis. The specific role of Toll-like receptor 4 (TLR4) in BP-induced allergic inflammation and the identification of key factors in birch pollen extracts (BPE) initiating this process remain to be explored. This study aimed to examine (i) the importance of TLR4 for dendritic cell (DC) activation by BPE, (ii) the extent of the contribution of BPE-derived lipopolysaccharide (LPS) and other potential TLR4 adjuvant(s) in BPE, and (iii) the relevance of the TLR4-dependent activation of BPE-stimulated DCs in the initiation of an adaptive immune response. In vitro, activation of murine bone marrow-derived DCs (BMDCs) and human monocyte-derived DCs by BPE or the equivalent LPS (nLPS) was analyzed by flow cytometry. Polymyxin B (PMB), a TLR4 antagonist and TLR4-deficient BMDCs were used to investigate the TLR4 signaling in DC activation. The immunostimulatory activity of BPE was compared to protein-/lipid-depleted BPE-fractions. In co-cultures of BPE-pulsed BMDCs and Bet v 1-specific hybridoma T cells, the influence of the TLR4-dependent DC activation on T cell activation was analyzed. In vivo immunization of IL-4 reporter mice was conducted to study BPE-induced Th2 polarization upon PMB pre-treatment. Murine and human DC activation induced by either BPE or nLPS was inhibited by the TLR4 antagonist or by PMB, and abrogated in TLR4-deficient BMDCs compared to wild-type BMDCs. The lipid-free but not the protein-free fraction showed a reduced capacity to activate the TLR4 signaling and murine DCs. In human DCs, nLPS only partially reproduced the BPE-induced activation intensity. BPE-primed BMDCs efficiently stimulated T cell activation, which was repressed by the TLR4 antagonist or PMB, and the addition of nLPS to Bet v 1 did not reproduce the effect of BPE. In vivo, immunization with BPE induced a significant Th2 polarization, whereas administration of BPE pre-incubated with PMB showed a decreased tendency. These findings suggest that TLR4 is a major pathway by which BPE triggers DC activation that is involved in the initiation of adaptive immune responses. Further characterization of these BP-derived TLR4 adjuvants could provide new candidates for therapeutic strategies targeting specific mechanisms in BP-induced allergic inflammation.
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Affiliation(s)
- Lisa Pointner
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Amin Kraiem
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Michael Thaler
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Fabian Richter
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Mario Wenger
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | | | - Markus Klotz
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Claudia Traidl-Hoffmann
- Chair of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute of Environmental Medicine, Helmholtz Zentrum München, Neuherberg, Germany
- Christine Kühne 96 Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Stefanie Gilles
- Chair of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute of Environmental Medicine, Helmholtz Zentrum München, Neuherberg, Germany
| | - Lorenz Aglas
- Department of Biosciences, University of Salzburg, Salzburg, Austria
- *Correspondence: Lorenz Aglas
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4
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Pivniouk V, Gimenes Junior JA, Honeker LK, Vercelli D. The role of innate immunity in asthma development and protection: Lessons from the environment. Clin Exp Allergy 2021; 50:282-290. [PMID: 31581343 DOI: 10.1111/cea.13508] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/27/2019] [Accepted: 09/21/2019] [Indexed: 12/24/2022]
Abstract
Asthma, a complex, chronic disease characterized by airway inflammation, hyperresponsiveness and remodelling, affects over 300 million people worldwide. While the disease is typically associated with exaggerated allergen-induced type 2 immune responses, these responses are strongly influenced by environmental exposures that stimulate innate immune pathways capable of promoting or protecting from asthma. The dual role played by innate immunity in asthma pathogenesis offers multiple opportunities for both research and clinical interventions and is the subject of this review.
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Affiliation(s)
- Vadim Pivniouk
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA.,Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ, USA
| | | | - Linnea K Honeker
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Donata Vercelli
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA.,Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ, USA
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5
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Alberca-Custodio RW, Faustino LD, Gomes E, Nunes FPB, de Siqueira MK, Labrada A, Almeida RR, Câmara NOS, da Fonseca DM, Russo M. Allergen-Specific Immunotherapy With Liposome Containing CpG-ODN in Murine Model of Asthma Relies on MyD88 Signaling in Dendritic Cells. Front Immunol 2020; 11:692. [PMID: 32391011 PMCID: PMC7191058 DOI: 10.3389/fimmu.2020.00692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/26/2020] [Indexed: 01/05/2023] Open
Abstract
Changing the immune responses to allergens is the cornerstone of allergen immunotherapy. Allergen-specific immunotherapy that consists of repeated administration of increasing doses of allergen extract is potentially curative. The major inconveniences of allergen-specific immunotherapy include failure to modify immune responses, long-term treatment leading to non-compliance and the potential for developing life-threating anaphylaxis. Here we investigated the effect of a novel liposomal formulation carrying low dose of allergen combined with CpG-ODN, a synthetic TLR9 agonist, on established allergic lung inflammation. We found that challenge with allergen (OVA) encapsulated in cationic liposome induced significantly less severe cutaneous anaphylactic reaction. Notably, short-term treatment (three doses) with a liposomal formulation containing co-encapsulated allergen plus CpG-ODN, but not allergen or CpG-ODN alone, reversed an established allergic lung inflammation and provided long-term protection. This liposomal formulation was also effective against allergens derived from Blomia tropicalis mite extract. The attenuation of allergic inflammation was not associated with increased numbers of Foxp3-positive or IL-10-producing regulatory T cells or with increased levels of IFN-gamma in the lungs. Instead, the anti-allergic effect of the liposomal formulation was dependent of the innate immune signal transduction generated in CD11c-positive putative dendritic cells expressing MyD88 molecule. Therefore, we highlight the pivotal role of dendritic cells in mediating the attenuation of established allergic lung inflammation following immunotherapy with a liposomal formulation containing allergen plus CpG-ODN.
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Affiliation(s)
| | - Lucas D. Faustino
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Eliane Gomes
- Institute of Biomedical Sciences, Department of Immunology, University of São Paulo, São Paulo, Brazil
| | | | | | - Alexis Labrada
- Department of Allergens, National Center of Bioproducts (BIOCEN), Havana, Cuba
| | - Rafael Ribeiro Almeida
- Institute of Biomedical Sciences, Department of Immunology, University of São Paulo, São Paulo, Brazil
| | | | - Denise Morais da Fonseca
- Institute of Biomedical Sciences, Department of Immunology, University of São Paulo, São Paulo, Brazil
| | - Momtchilo Russo
- Institute of Biomedical Sciences, Department of Immunology, University of São Paulo, São Paulo, Brazil
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6
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Sangaphunchai P, Todd I, Fairclough LC. Extracellular vesicles and asthma: A review of the literature. Clin Exp Allergy 2020; 50:291-307. [PMID: 31925972 DOI: 10.1111/cea.13562] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 12/22/2019] [Accepted: 12/28/2019] [Indexed: 12/12/2022]
Abstract
Asthma is a chronic, recurrent and incurable allergy-related respiratory disease characterized by inflammation, bronchial hyperresponsiveness and narrowing of the airways. Extracellular vesicles (EVs) are a universal feature of cellular function and can be detected in different bodily fluids. Recent evidence has shown the possibility of using EVs in understanding the pathogenesis of asthma, including their potential as diagnostic and therapeutic tools. Studies have reported that EVs released from key cells involved in asthma can induce priming and activation of other asthma-associated cells. A literature review was conducted on all current research regarding the role and function of EVs in the pathogenesis of asthma via the PRISMA statement method. An electronic search was performed using EMBASE and PubMed through to November 2018. The EMBASE search returned 76 papers, while the PubMed search returned 211 papers. Following duplicate removal, titles and abstracts were screened for eligibility with a total of 34 studies included in the final qualitative analysis. The review found evidence of association between the presence of EVs and physiological changes characteristic of asthma, suggesting that EVs are involved in the pathogenesis, with the weight of evidence presently favouring deleterious effects of EVs in asthma. Numerous studies highlighted differences in exosomal contents between EVs of healthy and asthmatic individuals, which could be employed as potential diagnostic markers. In some circumstances, EVs were also found to be suppressive to disease, but more often promote inflammation and airway remodelling. In conclusion, EVs hold immense potential in understanding the pathophysiology of asthma, and as diagnostic and therapeutic markers. While more research is needed for definitive conclusions and their application in medical practice, the literature presented in this review should encourage further research and discovery within the field of EVs and asthma.
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Affiliation(s)
| | - Ian Todd
- School of Life Sciences, The University of Nottingham, Nottingham, UK
| | - Lucy C Fairclough
- School of Life Sciences, The University of Nottingham, Nottingham, UK
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7
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Poole A, Song Y, Brown H, Hart PH, Zhang G(B. Cellular and molecular mechanisms of vitamin D in food allergy. J Cell Mol Med 2018; 22:3270-3277. [PMID: 29577619 PMCID: PMC6010899 DOI: 10.1111/jcmm.13607] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 02/18/2018] [Indexed: 12/19/2022] Open
Abstract
Food allergies are becoming increasingly prevalent, especially in young children. Epidemiological evidence from the past decade suggests a role of vitamin D in food allergy pathogenesis. Links have been made between variations in sunlight exposure, latitude, birth season and vitamin D status with food allergy risk. Despite the heightened interest in vitamin D in food allergies, it remains unclear by which exact mechanism(s) it acts. An understanding of the roles vitamin D plays within the immune system at the cellular and genetic levels, as well as the interplay between the microbiome and vitamin D, will provide insight into the importance of the vitamin in food allergies. Here, we discuss the effect of vitamin D on immune cell maturation, differentiation and function; microbiome; genetic and epigenetic regulation (eg DNA methylation); and how these processes are implicated in food allergies.
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Affiliation(s)
- Ashlyn Poole
- School of Public HealthCurtin UniversityBentleyWAAustralia
| | - Yong Song
- School of Public HealthCurtin UniversityBentleyWAAustralia
- Centre for Genetic Origins of Health and DiseaseThe University of Western Australia and Curtin UniversityCrawleyWAAustralia
| | - Helen Brown
- School of Public HealthCurtin UniversityBentleyWAAustralia
| | - Prue H. Hart
- Telethon Kids InstituteThe University of Western AustraliaCrawleyWAAustralia
| | - Guicheng (Brad) Zhang
- School of Public HealthCurtin UniversityBentleyWAAustralia
- Centre for Genetic Origins of Health and DiseaseThe University of Western Australia and Curtin UniversityCrawleyWAAustralia
- Telethon Kids InstituteThe University of Western AustraliaCrawleyWAAustralia
- Curtin Health Innovation Research InstituteCurtin UniversityBentleyWAAustralia
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8
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Farrokhi S, Abbasirad N, Movahed A, Khazaei HA, Pishjoo M, Rezaei N. TLR9-based immunotherapy for the treatment of allergic diseases. Immunotherapy 2017; 9:339-346. [PMID: 28303762 DOI: 10.2217/imt-2016-0104] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Toll-like receptors (TLRs), a family of pattern recognition receptors expressed on many cell types of innate immunity, recognize the pathogen-associated molecular patterns of microbes. The hygiene hypothesis suggests that a reduced microbial exposure in early childhood increases the susceptibility to allergic diseases due to deviation in development of the immune system. TLRs are key roles in the right and healthy direction of adaptive immunity with the induction of T-helper 2 toward Th1 immune responses and regulatory T cells. TLR ligand CpG-ODN-based immunomodulation is independent of allergen and it mainly affects innate immune system. While, CpG-oligodeoxynucleotide-based vaccination is allergen specific and induces adaptive immune system. The use of agonists of TLR9 in two distinct strategies of immunotherapy, immunomodulation and vaccination, could be presented as the curative method for the treatment of allergic diseases.
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Affiliation(s)
- Shokrollah Farrokhi
- Department of Immunology, Asthma & Allergy, The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Narjes Abbasirad
- Department of Immunology, Asthma & Allergy, The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Ali Movahed
- Department of Biochemistry, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hossein Ali Khazaei
- Clinical Immunology Research Center, Department of Immunology & Hematology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Masoud Pishjoo
- Clinical Immunology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
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9
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Gray LEK, O'Hely M, Ranganathan S, Sly PD, Vuillermin P. The Maternal Diet, Gut Bacteria, and Bacterial Metabolites during Pregnancy Influence Offspring Asthma. Front Immunol 2017; 8:365. [PMID: 28408909 PMCID: PMC5374203 DOI: 10.3389/fimmu.2017.00365] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 03/14/2017] [Indexed: 01/04/2023] Open
Abstract
This review focuses on the current evidence that maternal dietary and gut bacterial exposures during pregnancy influence the developing fetal immune system and subsequent offspring asthma. Part 1 addresses exposure to a farm environment, antibiotics, and prebiotic and probiotic supplementation that together indicate the importance of bacterial experience in immune programming and offspring asthma. Part 2 outlines proposed mechanisms to explain these associations including bacterial exposure of the fetoplacental unit; immunoglobulin-related transplacental transport of gut bacterial components; cytokine signaling producing fetomaternal immune alignment; and immune programming via metabolites produced by gut bacteria. Part 3 focuses on the interplay between diet, gut bacteria, and bacterial metabolites. Maternal diet influences fecal bacterial composition, with dietary microbiota-accessible carbohydrates (MACs) selecting short-chain fatty acid (SCFA)-producing bacteria. Current evidence from mouse models indicates an association between increased maternal dietary MACs, SCFA exposure during pregnancy, and reduced offspring asthma that is, at least in part, mediated by the induction of regulatory T lymphocytes in the fetal lung. Part 4 discusses considerations for future studies investigating maternal diet-by-microbiome determinants of offspring asthma including the challenge of measuring dietary MAC intake; limitations of the existing measures of the gut microbiome composition and metabolic activity; measures of SCFA exposure; and the complexities of childhood respiratory health assessment.
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Affiliation(s)
- Lawrence E K Gray
- Barwon Infant Study, School of Medicine, Deakin University, Geelong, VIC, Australia.,Child Health Research Unit, Barwon Health, Geelong, VIC, Australia
| | - Martin O'Hely
- Barwon Infant Study, School of Medicine, Deakin University, Geelong, VIC, Australia.,Respiratory Diseases, Infection and Immunity Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Sarath Ranganathan
- Respiratory Diseases, Infection and Immunity Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Peter David Sly
- Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Peter Vuillermin
- Barwon Infant Study, School of Medicine, Deakin University, Geelong, VIC, Australia.,Child Health Research Unit, Barwon Health, Geelong, VIC, Australia
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10
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Lim FL, Hashim Z, Md Said S, Than LTL, Hashim JH, Norbäck D. Fractional exhaled nitric oxide (FeNO) among office workers in an academic institution, Malaysia--associations with asthma, allergies and office environment. J Asthma 2015; 53:170-8. [PMID: 26300213 DOI: 10.3109/02770903.2015.1077861] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE There are few studies on fractional exhaled nitric oxide (FeNO) and respiratory symptoms among adults in tropical areas. The aim was to study associations between FeNO and selected personal factors, respiratory symptoms, allergies, office characteristics and indoor office exposures among office workers (n = 460) from a university in Malaysia. METHODS Information on health was collected by a questionnaire, skin prick test and FeNO measurement. Temperature, relative air humidity, carbon monoxide and carbon dioxide were measured in the offices. Settled dust was vacuumed in the offices and analyzed for endotoxin, (1,3)-β-glucan and house dust mites allergens, namely Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1). Two-level linear mixed models and multiple logistic regression were used to analyze the associations. RESULTS One-fourth (25.9%) of the office workers had elevated FeNO level (≥ 25 ppb) and 61.5% had HDM, cat, seafood or pollen allergy. Male gender (p < 0.001), current smoking (p = 0.037), height (p < 0.001) and atopy (p < 0.001) were associated with FeNO. The amount of vacuumed dust was associated with FeNO among atopic subjects (p = 0.009). Asthma and rhinitis symptoms were associated with FeNO (p < 0.05), especially among atopic subjects. In particular, a combination of atopy and elevated FeNO were associated with doctor-diagnosed asthma (p < 0.001), rhinitis (p < 0.001) and airway symptoms last 12 months (p < 0.001). CONCLUSION Gender, smoking, height and atopy are important risk factors for elevated FeNO levels. A combination of allergy testing and FeNO measurement could be useful in respiratory illness epidemiology studies and patient investigations in tropical areas.
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Affiliation(s)
- Fang Lee Lim
- a Department of Environmental and Occupational Health
| | | | | | - Leslie Thian Lung Than
- c Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences , Universiti Putra Malaysia , UPM Serdang , Selangor , Malaysia
| | - Jamal Hisham Hashim
- d United Nations University-International Institute for Global Health (UNU-IIGH), UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Federal Territory of Kuala Lumpur , Malaysia .,e Department of Community Health, Faculty of Health Sciences , National University of Malaysia, Jalan Raja Muda Aziz , Kuala Lumpur , Malaysia , and
| | - Dan Norbäck
- f Department of Medical Sciences , Occupational and Environmental Medicine, Uppsala University and University Hospital , Uppsala , Sweden
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11
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Reynolds LA, Finlay BB. A case for antibiotic perturbation of the microbiota leading to allergy development. Expert Rev Clin Immunol 2014; 9:1019-30. [DOI: 10.1586/1744666x.2013.851603] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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12
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Lombardi C, Passalaqua G, Canonica GW. "United airways disease" and phenotypic peculiarities of respiratory allergy in immigrants. World Allergy Organ J 2013; 2:13-6. [PMID: 23282932 PMCID: PMC3652591 DOI: 10.1186/1939-4551-2-2-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Allergy is the result of a complex interaction between genetic background and environmental factors, including exposure to allergens and lifestyle. Migration is a process that involves many radical changes in the environment, including diet, pollutants, allergens, different housing conditions, and patterns of infections. Thus, studies in immigrants may provide important information about the role of environmental factors in the development of allergic respiratory diseases. Several studies addressed this aspect and consistently found that migrants develop allergies at different rates from the local population, and very often the symptoms appear with a delay of 3 to 5 years after migration. More recent data showed that the severity of allergic diseases is greater in migrants, and that usually the onset is with associated asthma and rhinitis. The immigration model strongly suggests that environmental factors overcome the genetic background, and that the clinical phenotype of respiratory allergy in migrants has some peculiarities.
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Affiliation(s)
- Carlo Lombardi
- From the Allergy and Respiratory Diseases, Department of Internal Medicine, University of Genoa, Genoa, Italy
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13
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Anolik R. Desloratadine and pseudoephedrine combination therapy as a comprehensive treatment for allergic rhinitis and nasal congestion. Expert Opin Drug Metab Toxicol 2009; 5:683-94. [DOI: 10.1517/17425250902980187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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