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Paciência I, Sharma N, Hugg TT, Rantala AK, Heibati B, Al-Delaimy WK, Jaakkola MS, Jaakkola JJ. The Role of Biodiversity in the Development of Asthma and Allergic Sensitization: A State-of-the-Science Review. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:66001. [PMID: 38935403 PMCID: PMC11218706 DOI: 10.1289/ehp13948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 05/06/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Changes in land use and climate change have been reported to reduce biodiversity of both the environment and human microbiota. These reductions in biodiversity may lead to inadequate and unbalanced stimulation of immunoregulatory circuits and, ultimately, to clinical diseases, such as asthma and allergies. OBJECTIVE We summarized available empirical evidence on the role of inner (gut, skin, and airways) and outer (air, soil, natural waters, plants, and animals) layers of biodiversity in the development of asthma, wheezing, and allergic sensitization. METHODS We conducted a systematic search in SciVerse Scopus, PubMed MEDLINE, and Web of Science up to 5 March 2024 to identify relevant human studies assessing the relationships between inner and outer layers of biodiversity and the risk of asthma, wheezing, or allergic sensitization. The protocol was registered in PROSPERO (CRD42022381725). RESULTS A total of 2,419 studies were screened and, after exclusions and a full-text review of 447 studies, 82 studies were included in the comprehensive, final review. Twenty-nine studies reported a protective effect of outer layer biodiversity in the development of asthma, wheezing, or allergic sensitization. There were also 16 studies suggesting an effect of outer layer biodiversity on increasing asthma, wheezing, or allergic sensitization. However, there was no clear evidence on the role of inner layer biodiversity in the development of asthma, wheezing, and allergic sensitization (13 studies reported a protective effect and 15 reported evidence of an increased risk). CONCLUSIONS Based on the reviewed literature, a future systematic review could focus more specifically on outer layer biodiversity and asthma. It is unlikely that association with inner layer biodiversity would have enough evidence for systematic review. Based on this comprehensive review, there is a need for population-based longitudinal studies to identify critical periods of exposure in the life course into adulthood and to better understand mechanisms linking environmental exposures and changes in microbiome composition, diversity, and/or function to development of asthma and allergic sensitization. https://doi.org/10.1289/EHP13948.
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Affiliation(s)
- Inês Paciência
- Center for Environmental and Respiratory Health Research, Population Health, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Needhi Sharma
- University of California, San Diego, San Diego, California, USA
| | - Timo T. Hugg
- Center for Environmental and Respiratory Health Research, Population Health, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Aino K. Rantala
- Center for Environmental and Respiratory Health Research, Population Health, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Behzad Heibati
- Center for Environmental and Respiratory Health Research, Population Health, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | | | - Maritta S. Jaakkola
- Center for Environmental and Respiratory Health Research, Population Health, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Jouni J.K. Jaakkola
- Center for Environmental and Respiratory Health Research, Population Health, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Finnish Meteorological Institute, Helsinki, Finland
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Chudzik A, Jalkanen K, Täubel M, Szponar B, Paściak M. Identification of environmental Actinobacteria in buildings by means of chemotaxonomy, 16S rRNA sequencing, and MALDI-TOF MS. Microbiol Spectr 2024; 12:e0359623. [PMID: 38299830 PMCID: PMC10913483 DOI: 10.1128/spectrum.03596-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
Actinobacteria are abundant in soil and other environmental ecosystems and are also an important part of the human microbiota. Hence, they can also be detected in indoor environments and on building materials, where actinobacterial proliferation on damp materials can indicate moisture damage. The aim of this study was to evaluate the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for the identification of 28 environmental strains of Actinobacteria isolated from building materials and indoor and outdoor air samples, mainly collected in the context of moisture damage investigations in buildings in Finland. The 16S rRNA gene sequencing and chemotaxonomic analyses were performed, and results were compared with the MALDI-TOF MS Biotyper identification. Using 16S rRNA gene sequencing, all isolates were identified on the species or genus level and were representatives of Streptomyces, Nocardia, and Pseudonocardia genera. Based on MALDI-TOF MS analysis, initially, 11 isolates were identified as Streptomyces spp. and 1 as Nocardia carnea with a high identification score. After an upgrade in the MALDI-TOF MS in-house database and re-evaluation of mass spectra, 13 additional isolates were identified as Nocardia, Pseudonocardia, and Streptomyces. MALDI-TOF MS has the potential in environmental strain identification; however, the standard database needs to be considerably enriched by environmental Actinobacteria representatives. IMPORTANCE The manuscript addresses the challenges in identifying environmental bacteria using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) Biotyper-based protein profiling. The matter of the studies-actinobacterial strains-has been isolated mostly from building materials that originated from a confirmed moisture-damaged situation. Polyphasic taxonomy, 16S RNA gene sequencing, and MALDI-TOF mass spectrometry were applied for identification purposes. In this experimental paper, a few important facts are highlighted. First, Actinobacteria are abundant in the natural as well as built environment, and their identification on the species and genus levels is difficult and time-consuming. Second, MALDI-TOF MS is an effective tool for identifying bacterial environmental strains, and in parallel, continuous enrichment of the proteomics mass spectral databases is necessary for proper identification. Third, the chemical approach aids in the taxonomical inquiry of Actinobacteria environmental strains.
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Affiliation(s)
- Anna Chudzik
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Kaisa Jalkanen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Martin Täubel
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Bogumiła Szponar
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Mariola Paściak
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Zhang Q, Zhang C, Zhang Y, Liu Y, Wang J, Gao Z, Sun J, Li Q, Sun J, Cui X, Wang Y, Fu L. Early-life risk factors for food allergy: Dietary and environmental factors revisited. Compr Rev Food Sci Food Saf 2023; 22:4355-4377. [PMID: 37679957 DOI: 10.1111/1541-4337.13226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 09/09/2023]
Abstract
There appears a steep increase in the prevalence of food allergy worldwide in the past few decades. It is believed that, rather than genetic factors, the recently altered dietary and environmental factors are the driving forces behind the rapid increase of this disease. Accumulating evidence has implied that external exposures that occurred in prenatal and postnatal periods could affect the development of oral tolerance in later life. Understanding the potential risk factors for food allergy would greatly benefit the progress of intervention and therapy. In this review, we present updated knowledge on the dietary and environmental risk factors in early life that have been shown to impact the development of food allergy. These predominantly include dietary habits, microbial exposures, allergen exposure routes, environmental pollutants, and so on. The key evidence, conflicts, and potential research topics of each theory are discussed, and associated interventional strategies to prevent the disease development and ameliorate treatment burden are included. Accumulating evidence has supported the causative role of certain dietary and environmental factors in the establishment of oral tolerance in early life, especially the time of introducing allergenic foods, skin barrier function, and microbial exposures. In addition to certain immunomodulatory factors, increasing interest is raised toward modern dietary patterns, where adequately powered studies are required to identify contributions of those modifiable risk factors. This review broadens our understanding of the connections between diet, environment, and early-life immunity, thus benefiting the progress of intervention and therapy of food allergy.
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Affiliation(s)
- Qiaozhi Zhang
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Chi Zhang
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Yong Zhang
- Nutrition Department of the First Medical Centre of PLA General Hospital, Beijing, China
| | - Yinghua Liu
- Nutrition Department of the First Medical Centre of PLA General Hospital, Beijing, China
| | - Jin Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
- Department of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - Zhongshan Gao
- Allergy Research Center, Zhejiang University, Hangzhou, China
| | - Jinlyu Sun
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qianqian Li
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Jiachen Sun
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Xin Cui
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Yanbo Wang
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Linglin Fu
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
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Täubel M, Jalanka J, Kirjavainen PV, Tuoresmäki P, Hyvärinen A, Skevaki C, Piippo-Savolainen E, Pekkanen J, Karvonen AM. Fungi in Early-Life House Dust Samples and the Development of Asthma: A Birth Cohort Study. Ann Am Thorac Soc 2023; 20:1456-1464. [PMID: 37535826 PMCID: PMC10559140 DOI: 10.1513/annalsats.202303-187oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/03/2023] [Indexed: 08/05/2023] Open
Abstract
Rationale: Fungal exposure has been associated with predisposing and protective effects on the development of childhood asthma. Objectives: To study whether early-life house dust mycobiota composition is associated with the development of asthma. Methods: Mycobiota were determined by amplicon sequencing from 382 dust samples collected from living room floors 2 months after birth in homes of the LUKAS cohort. Asthma status by 10.5 years of age was defined from questionnaires and assigned as ever asthma (n = 68) or current asthma (n = 27). Inhalant atopy was clinically determined at the same age. β-composition was analyzed using PERMANOVA-S, and asthma and atopy analyses were performed using discrete time hazard models and logistic regression, respectively. Results: The house dust mycobiota composition based on Bray-Curtis distance was different in the homes of children who later did or did not develop asthma. The first and the fourth axes scores of principal coordinates analysis based on Bray-Curtis were associated with ever asthma. Of the genera with the strongest correlation with these axes, the relative abundance of Boeremia, Cladosporium, Microdochium, Mycosphaerella, and Pyrenochaetopsis showed protective associations with asthma. None of these associations remained significant after mutual adjustment among the five genera or when mutually adjusted for other microbial cell wall markers and previously identified asthma-protective bacterial indices. Neither fungal α-diversity nor load was associated with asthma in the whole population, but higher fungal richness was a risk factor among children on farms. Higher fungal loads (measured via quantitative polymerase chain reaction) in house dust were associated with the risk of inhalant atopy. Conclusions: The results of our analyses from this well-characterized birth cohort suggest that the early-life house dust mycobiota in Finnish homes, characterized via DNA amplicon sequencing, do not have strong predisposing or protective effects on asthma development.
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Affiliation(s)
- Martin Täubel
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Jonna Jalanka
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Pirkka V. Kirjavainen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Pauli Tuoresmäki
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Anne Hyvärinen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Chrysanthi Skevaki
- Institute of Laboratory Medicine, Philipps University Marburg, Marburg, Germany
- Universities of Giessen and Marburg Lung Center, German Center for Lung Research, Marburg, Germany
| | | | - Juha Pekkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anne M. Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
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Wang J, Zhou Y, Zhang H, Hu L, Liu J, Wang L, Wang T, Zhang H, Cong L, Wang Q. Pathogenesis of allergic diseases and implications for therapeutic interventions. Signal Transduct Target Ther 2023; 8:138. [PMID: 36964157 PMCID: PMC10039055 DOI: 10.1038/s41392-023-01344-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/20/2023] [Accepted: 02/03/2023] [Indexed: 03/26/2023] Open
Abstract
Allergic diseases such as allergic rhinitis (AR), allergic asthma (AAS), atopic dermatitis (AD), food allergy (FA), and eczema are systemic diseases caused by an impaired immune system. Accompanied by high recurrence rates, the steadily rising incidence rates of these diseases are attracting increasing attention. The pathogenesis of allergic diseases is complex and involves many factors, including maternal-fetal environment, living environment, genetics, epigenetics, and the body's immune status. The pathogenesis of allergic diseases exhibits a marked heterogeneity, with phenotype and endotype defining visible features and associated molecular mechanisms, respectively. With the rapid development of immunology, molecular biology, and biotechnology, many new biological drugs have been designed for the treatment of allergic diseases, including anti-immunoglobulin E (IgE), anti-interleukin (IL)-5, and anti-thymic stromal lymphopoietin (TSLP)/IL-4, to control symptoms. For doctors and scientists, it is becoming more and more important to understand the influencing factors, pathogenesis, and treatment progress of allergic diseases. This review aimed to assess the epidemiology, pathogenesis, and therapeutic interventions of allergic diseases, including AR, AAS, AD, and FA. We hope to help doctors and scientists understand allergic diseases systematically.
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Affiliation(s)
- Ji Wang
- National Institute of TCM constitution and Preventive Medicine, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, P.R. China
| | - Yumei Zhou
- National Institute of TCM constitution and Preventive Medicine, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, P.R. China
| | - Honglei Zhang
- National Institute of TCM constitution and Preventive Medicine, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, P.R. China
| | - Linhan Hu
- National Institute of TCM constitution and Preventive Medicine, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, P.R. China
| | - Juntong Liu
- National Institute of TCM constitution and Preventive Medicine, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, P.R. China
| | - Lei Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 1000210, China
| | - Tianyi Wang
- National Institute of TCM constitution and Preventive Medicine, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, P.R. China
| | - Haiyun Zhang
- National Institute of TCM constitution and Preventive Medicine, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, P.R. China
| | - Linpeng Cong
- National Institute of TCM constitution and Preventive Medicine, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, P.R. China
| | - Qi Wang
- National Institute of TCM constitution and Preventive Medicine, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, P.R. China.
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Karenzmaßnahmen bei Milbenallergie - ein Update. ALLERGO JOURNAL 2023. [DOI: 10.1007/s15007-022-5667-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Early exposure to farm dust in an allergic airway inflammation rabbit model: Does it affect bronchial and cough hyperresponsiveness? PLoS One 2023; 18:e0279498. [PMID: 36706084 PMCID: PMC9882901 DOI: 10.1371/journal.pone.0279498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/08/2022] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Over the past 50 years, the prevalence of allergic respiratory diseases has been increasing. The Hygiene hypothesis explains this progression by the decrease in the bio-diversity of early microbial exposure. This study aims to evaluate the effect of early-life farm exposure on airway hyperresponsiveness and cough hypersensitivity in an allergic airway inflammation rabbit model. METHOD A specific environment was applied to pregnant rabbits and their offspring until six weeks after birth. Rabbits were housed in a pathogen-free zone for the control group and a calf barn for the farm group. At the end of the specific environmental exposure, both groups were then housed in a conventional zone and then sensitized to ovalbumin. Ten days after sensitization, the rabbit pups received ovalbumin aerosols to provoke airway inflammation. Sensitization to ovalbumin was assessed by specific IgE assay. Cough sensitivity was assessed by mechanical stimulation of the trachea, and bronchial reactivity was assessed by methacholine challenge. The farm environment was characterized by endotoxin measurement. RESULTS A total of 38 rabbit pups were included (18 in the farm group). Endotoxin levels in the farm environment varied from 30 to 1854 EU.m-3. There was no significant difference in specific IgE values to ovalbumin (p = 0.826) between the two groups. The mechanical threshold to elicit a cough did not differ between the two groups (p = 0.492). There was no difference in the number of cough (p = 0.270) or the intensity of ventilatory responses (p = 0.735). After adjusting for age and weight, there was no difference in respiratory resistance before and after methacholine challenge. CONCLUSION Early exposure to the calf barn did not affect cough sensitivity or bronchial reactivity in ovalbumin-sensitized rabbits. These results suggest that not all farm environments protect against asthma and atopy. Continuous exposure to several sources of microbial diversity is probably needed.
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Fakunle AG, Jafta N, Smit LAM, Naidoo RN. Indoor bacterial and fungal aerosols as predictors of lower respiratory tract infections among under-five children in Ibadan, Nigeria. BMC Pulm Med 2022; 22:471. [PMID: 36494686 PMCID: PMC9733100 DOI: 10.1186/s12890-022-02271-w] [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: 08/26/2021] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to investigate the association between exposure to diverse indoor microbial aerosols and lower respiratory tract infections (LRTI) among children aged 1 to 59 months in Ibadan, Nigeria. METHODS One hundred and seventy-eight (178) hospital-based LRTI cases among under-five children were matched for age (± 3 months), sex and geographical location with 180 community-based controls (under-five children without LRTI). Following consent from caregivers of eligible participants, a child's health questionnaire, clinical proforma and standardized home-walkthrough checklist were used to collect data. Participant homes were visited and sampled for indoor microbial exposures using active sampling approach by Anderson sampler. Indoor microbial count (IMC), total bacterial count (TBC), and total fungal count (TFC) were estimated and dichotomized into high (> median) and low (≤ median) exposures. Alpha diversity measures including richness (R), Shannon (H) and Simpson (D) indices were also estimated. Conditional logistic regression models were used to test association between exposure to indoor microbial aerosols and LRTI risk among under-five children. RESULTS Significantly higher bacterial and fungal diversities were found in homes of cases (R = 3.00; H = 1.04; D = 2.67 and R = 2.56; H = 0.82; D = 2.33) than homes of controls (R = 2.00; H = 0.64; D = 1.80 and R = 1.89; H = 0.55; D = 1.88) p < 0.001, respectively. In the multivariate models, higher categories of exposure to IMC (aOR = 2.67, 95% CI 1.44-4.97), TBC (aOR = 2.51, 95% CI 1.36-4.65), TFC (aOR = 2.75, 95% CI 1.54-4.89), bacterial diversity (aOR = 1.87, 95% CI 1.08-3.24) and fungal diversity (aOR = 3.00, 95% CI 1.55-5.79) were independently associated with LRTI risk among under-five children. CONCLUSIONS This study suggests an increased risk of LRTI when children under the age of five years are exposed to high levels of indoor microbial aerosols.
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Affiliation(s)
- Adekunle Gregory Fakunle
- grid.16463.360000 0001 0723 4123Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, 321 George Campbell Building Howard College Campus, Durban, 4041 South Africa ,grid.412422.30000 0001 2045 3216Department of Public Health, College of Health Sciences, Osun State University, Osogbo, Osun State Nigeria
| | - Nkosana Jafta
- grid.16463.360000 0001 0723 4123Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, 321 George Campbell Building Howard College Campus, Durban, 4041 South Africa
| | - Lidwien A. M. Smit
- grid.5477.10000000120346234Institute for Risk Assessment (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Rajen N. Naidoo
- grid.16463.360000 0001 0723 4123Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, 321 George Campbell Building Howard College Campus, Durban, 4041 South Africa
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Yazar B, Meydanlioglu A. The prevalence and associated factors of asthma, allergic rhinitis, and eczema in Turkish children and adolescents. Pediatr Pulmonol 2022; 57:2491-2501. [PMID: 35809022 DOI: 10.1002/ppul.26065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/14/2022] [Accepted: 06/25/2022] [Indexed: 11/11/2022]
Abstract
AIM We aim to determine the prevalence and related risk factors of asthma and allergic diseases in school children and adolescent in Konya, Turkey, and to compare this prevalence with that of 11 years ago. METHODS This descriptive correlational study also includes the third phase of the International Study of Asthma and Allergies in Childhood protocol. A total of 2220 students aged between 6 and 18 took part in this study. RESULTS In our study, prevalence of wheezing of 21.8%, eczema of 4.3%, and allergic rhinitis of 43.2% were found in students until this age. In the study, student smoking, school location, history of asthma in the family, mold or moisture at home, and mother's smoking now were related factors for wheezing, while eating habits, breastfeeding, and student's gender were determined as related factors for allergic rhinitis symptoms in the past 12 months. In addition, having a pet, eating habits, and school level were determined as related factors for eczema symptoms in the past 12 months (p < 0.05). As a result of comparison of the findings of this study with the results of the study conducted by Güner et al., it was determined that the rates of wheezing and allergic rhinitis had increased, whereas the rate of eczema had decreased (p < 0.05). CONCLUSION It was determined that under the effect of urbanization in Konya, the prevalence of asthma and allergic rhinitis in students had increased, while the prevalence of eczema had decreased.
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Affiliation(s)
- Birgul Yazar
- Ali Kemal Belviranlı Obstetrics and Pediatrics Hospital, Konya, Turkey
| | - Ayse Meydanlioglu
- Department of Community Health Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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Fu X, Ou Z, Sun Y. Indoor microbiome and allergic diseases: From theoretical advances to prevention strategies. ECO-ENVIRONMENT & HEALTH (ONLINE) 2022; 1:133-146. [PMID: 38075599 PMCID: PMC10702906 DOI: 10.1016/j.eehl.2022.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 12/20/2023]
Abstract
The prevalence of allergic diseases, such as asthma, rhinitis, eczema, and sick building syndrome (SBS), has increased drastically in the past few decades. Current medications can only relieve the symptoms but not cure these diseases whose development is suggested to be greatly impacted by the indoor microbiome. However, no study comprehensively summarizes the progress and general rules in the field, impeding subsequent translational application. To close knowledge gaps between theoretical research and practical application, we conducted a comprehensive literature review to summarize the epidemiological, environmental, and molecular evidence of indoor microbiome studies. Epidemiological evidence shows that the potential protective indoor microorganisms for asthma are mainly from the phyla Actinobacteria and Proteobacteria, and the risk microorganisms are mainly from Bacilli, Clostridia, and Bacteroidia. Due to extremely high microbial diversity and geographic variation, different health-associated species/genera are detected in different regions. Compared with indoor microbial composition, indoor metabolites show more consistent associations with health, including microbial volatile organic compounds (MVOCs), lipopolysaccharides (LPS), indole derivatives, and flavonoids. Therefore, indoor metabolites could be a better indicator than indoor microbial taxa for environmental assessments and health outcome prediction. The interaction between the indoor microbiome and environmental characteristics (surrounding greenness, relative humidity, building confinement, and CO2 concentration) and immunology effects of indoor microorganisms (inflammatory cytokines and pattern recognition receptors) are briefly reviewed to provide new insights for disease prevention and treatment. Widely used tools in indoor microbiome studies are introduced to facilitate standard practice and the precise identification of health-related targets.
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Affiliation(s)
- Xi Fu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510006, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Zheyuan Ou
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou 510642, China
- Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou 510642, China
| | - Yu Sun
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou 510642, China
- Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou 510642, China
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Kopp MV, Muche-Borowski C, Abou-Dakn M, Ahrens B, Beyer K, Blümchen K, Bubel P, Chaker A, Cremer M, Ensenauer R, Gerstlauer M, Gieler U, Hübner IM, Horak F, Klimek L, Koletzko BV, Koletzko S, Lau S, Lob-Corzilius T, Nemat K, Peters EM, Pizzulli A, Reese I, Rolinck-Werninghaus C, Rouw E, Schaub B, Schmidt S, Steiß JO, Striegel AK, Szépfalusi Z, Schlembach D, Spindler T, Taube C, Trendelenburg V, Treudler R, Umpfenbach U, Vogelberg C, Wagenmann M, Weißenborn A, Werfel T, Worm M, Sitter H, Hamelmann E. S3 guideline Allergy Prevention. Allergol Select 2022; 6:61-97. [PMID: 35274076 PMCID: PMC8905073 DOI: 10.5414/alx02303e] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The persistently high prevalence of allergic diseases in Western industrial nations and the limited possibilities of causal therapy make evidence-based recommendations for primary prevention necessary. METHODS The recommendations of the S3 guideline Allergy Prevention, published in its last version in 2014, were revised and consulted on the basis of a current systematic literature search. The evidence search was conducted for the period 06/2013 - 11/2020 in the electronic databases Cochrane and MEDLINE, as well as in the reference lists of current reviews and through references from experts. The literature found was screened in two filtering processes, first by title and abstract, and the remaining papers were screened in the full text for relevance. The studies included after this were sorted by level of evidence, and the study quality was indicated in terms of potential bias (low/high). The revised recommendations were formally agreed and consented upon with the participation of representatives of the relevant professional societies and (self-help) organizations (nominal group process). Of 5,681 hits, 286 studies were included and assessed. RESULTS Recommendations on maternal nutrition during pregnancy and breastfeeding as well as on infant nutrition in the first months of life again play an important role in the updated guideline: Many of the previous recommendations were confirmed by the current data. It was specified that breastfeeding should be exclusive for the first 4 - 6 months after birth, if possible, and that breastfeeding should continue with the introduction of complementary foods. A new recommendation is that supplementary feeding of cow's milk-based formula should be avoided in the first days of life if the mother wishes to breastfeed. Furthermore, it was determined that the evidence for a clear recommendation for hydrolyzed infant formula in non-breastfed infants at risk is currently no longer sufficient. It is therefore currently recommended to check whether an infant formula with proven efficacy in allergy prevention studies is available until the introduction of complementary feeding. Finally, based on the EAACI guideline, recommendations were made for the prevention of chicken egg allergy by introducing and regularly giving thoroughly heated (e.g., baked or hard-boiled) but not "raw" chicken egg (also no scrambled egg) with the complementary food. The recommendation to introduce peanut in complementary feeding was formulated cautiously for the German-speaking countries: In families who usually consume peanut, the regular administration of peanut-containing foods in age-appropriate form (e.g., peanut butter) with the complementary diet can be considered for the primary prevention of peanut allergy in infants with atopic dermatitis (AD). Before introduction, a clinically relevant peanut allergy must be ruled out, especially in infants with moderate to severe AD. There is still insufficient evidence for an allergy-preventive efficacy of prebiotics or probiotics, vitamin D, or other vitamins in the form of supplements so that recommendations against their supplementation were adopted for the first time in the current guideline. Biodiversity plays an important role in the development of immunological tolerance to environmental and food allergens: there is clear evidence that growing up on a farm is associated with a lower risk of developing asthma and allergic diseases. This is associated with early non-specific immune stimulation due to, among other things, the greater microbial biodiversity of house dust in this habitat. This aspect is also reflected in the recommendations on animal husbandry, on which a differentiated statement was made: In families without a recognizable increased allergy risk, pet keeping with cats or dogs should not generally be restricted. Families with an increased allergy risk or with children with already existing AD should not acquire a new cat - in contrast, however, dog ownership should not be discouraged. Interventions to reduce exposure to dust mite allergens in the home, such as the use of mite allergen-proof mattress covers ("encasings"), should be restricted to patients with already proven specific sensitization against house dust mite allergen. Children born by caesarean section have a slightly increased risk of asthma - this should be taken into account when advising on mode of delivery outside of emergency situations. Recent work also supports the recommendations on air pollutants: Active and passive exposure to tobacco smoke increase the risk of allergies, especially asthma, and should therefore be avoided. Exposure to nitrogen oxides, ozone, and small particles (PM 2.5) is associated with an increased risk, especially for asthma. Therefore, exposure to emissions of nitrogen oxides, ozone, and small particles (PM 2.5) should be kept low. The authors of this guideline are unanimously in favor of enacting appropriate regulations to minimize these air pollutants. There is no evidence that vaccinations increase the risk of allergies, but conversely there is evidence that vaccinations can reduce the risk of allergies. All children, including children at risk, should be vaccinated according to the current recommendations of the national public health institutes, also for reasons of allergy prevention. CONCLUSION The consensus of recommendations in this guideline is based on an extensive evidence base. The update of the guideline enables evidence-based and up-to-date recommendations for the prevention of allergic diseases including asthma and atopic dermatitis.
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Affiliation(s)
- Matthias V. Kopp
- Airway Research Center North, University of Lübeck, Member of Deutsches Zentrum für Lungenforschung, Universitätsklinik für Kinderheilkunde, Inselspital, Bern, Switzerland
| | - Cathleen Muche-Borowski
- Institut für Allgemeinmedizin, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Abou-Dakn
- Clinic for Gynecology and Obstetrics, St. Joseph-Krankenhaus Berlin-Tempelhof, Germany
| | - Birgit Ahrens
- Children’s Hospital, University Hospital Frankfurt, Germany
| | - Kirsten Beyer
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Germany
| | | | | | - Adam Chaker
- HNO-Klinik, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Monika Cremer
- Ökotrophologin, Journalistin, Idstein/Taunus, Germany
| | - Regina Ensenauer
- Institut für Kinderernährung, Max Rubner-Institut, Karlsruhe, Germany
| | | | - Uwe Gieler
- Klinik für Psychosomatik und Psychotherapie des UKGM, Universitätsklinik, Giessen, Germany
| | - Inga-Marie Hübner
- Arbeitsgemeinschaft Dermatologiche Prävention e.V., Hamburg, Germany
| | | | - Ludger Klimek
- Zentrum für Rhinologie und Allergologie, Wiesbaden, Germany
| | - Berthold V. Koletzko
- Integriertes Sozialpädiatrisches Zentrum, Dr. von Haunerschen Kinderspital, LMU Klinikum der Universität München, Munich, Germany
| | - Sybille Koletzko
- Abteilung für Stoffwechsel und Ernährung, Dr. von Haunersches Kinderspital, LMU Klinikum der Universität München, Munich, Germany
| | - Susanne Lau
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Germany
| | | | - Katja Nemat
- Kinderzentrum Dresden-Friedrichstadt, Dresden, Germany
| | - Eva M.J. Peters
- Klinik für Psychosomatik und Psychotherapie des UKGM, Universitätsklinik, Giessen, Germany
| | - Antonio Pizzulli
- Schwerpunktpraxis für Allergologie und Lungenheilkunde im Kinder- und Jugendalter, Berlin, Germany
| | - Imke Reese
- Ernährungsberatung und -therapie mit Schwerpunkt Allergologie, Munich, Germany
| | | | | | - Bianca Schaub
- Asthma- und Allergieambulanz, Dr. von Haunersches Kinderspital, LMU Klinikum der Universität, Munich, Germany
| | - Sebastian Schmidt
- Allgemeine Pädiatrie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | | | | | - Zsolt Szépfalusi
- Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Vienna, Austria
| | | | | | - Christian Taube
- Klinik für Pneumologie, Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum, Essen, Germany
| | - Valérie Trendelenburg
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Germany
| | - Regina Treudler
- Klinik für Dermatologie, Venerologie und Allergologie, Leipziger Allergie-Centrum LICA – CAC, Universitätsmedizin, Leipzig, Germany
| | | | - Christian Vogelberg
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus an der Technischen Universität, Dresden, Germany
| | - Martin Wagenmann
- HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Anke Weißenborn
- German Federal Institute for Risk Assessment, Berlin, Germany
| | - Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Margitta Worm
- Klinik für Dermatologie, Allergologie und Venerologie, Campus Charité Mitte, Universitätsmedizin Berlin, Berlin, Germany
| | - Helmut Sitter
- Institut für Chirurgische Forschung, Philipps-Universität, Marburg, Germany, and
| | - Eckard Hamelmann
- Kinder-Zentrum Bethel, Evangelisches Klinikum Bethel, Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum OWL, Universität Bielefeld, Bielefeld, Germany
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12
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Deckers J, Marsland BJ, von Mutius E. Protection against allergies: Microbes, immunity, and the farming effect. Eur J Immunol 2021; 51:2387-2398. [PMID: 34415577 DOI: 10.1002/eji.202048938] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/08/2021] [Accepted: 08/17/2021] [Indexed: 12/19/2022]
Abstract
The prevalence of asthma and other allergic diseases has rapidly increased in "Westernized" countries over recent decades. This rapid increase suggests the involvement of environmental factors, behavioral changes or lifestyle, rather than genetic drift. It has become increasingly clear that the microbiome plays a key role in educating the host immune system and, thus, regulation of disease susceptibility. This review will focus on recent advances uncovering immunological and microbial mechanisms that protect against allergies, in particular, within the context of a farming environment. A whole body of epidemiological data disclosed the nature of the protective exposures in a farm. Current evidence points toward an important role of the host microbiome in setting an immunological equilibrium that determines progression toward, or protection against allergic diseases. Conclusive mechanistic insights on how microbial exposures prevent from developing allergic diseases in humans are still lacking but findings from experimental models reveal plausible immunological mechanisms. Gathering further knowledge on these mechanisms and confirming their relevance in humans is of great importance to develop preventive strategies for children at risk of developing allergies.
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Affiliation(s)
- Julie Deckers
- Laboratory of Immunoregulation and Mucosal Immunology, VIB Center for Inflammation Research, Ghent (Zwijnaarde), Belgium.,Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Benjamin J Marsland
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Erika von Mutius
- Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Lung Research, München, Germany.,Dr. von Hauner Children's Hospital, Ludwig Maximilian University of Munich, Munich, Germany
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13
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Hyytiäinen H, Kirjavainen PV, Täubel M, Tuoresmäki P, Casas L, Heinrich J, Herberth G, Standl M, Renz H, Piippo-Savolainen E, Hyvärinen A, Pekkanen J, Karvonen AM. Microbial diversity in homes and the risk of allergic rhinitis and inhalant atopy in two European birth cohorts. ENVIRONMENTAL RESEARCH 2021; 196:110835. [PMID: 33582132 DOI: 10.1016/j.envres.2021.110835] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Microbial exposures in early childhood direct the development of the immune system and their diversity may influence the risk of allergy development. We aimed to determine whether the indoor microbial diversity at early-life is associated with the development of allergic rhinitis and inhalant atopy. METHODS The study population included children within two birth cohorts: Finnish rural-suburban LUKAS (N = 312), and German urban LISA from Munich and Leipzig study centers (N = 248). The indoor microbiota diversity (Chao1 richness and Shannon entropy) was characterized from floor dust samples collected at the child age of 2-3 months by Illumina MiSeq sequencing of bacterial and fungal DNA amplicons. Allergic rhinitis and inhalant atopy were determined at the age of 10 years and analyzed using logistic regression models. RESULTS High bacterial richness (aOR 0.19, 95%CI 0.09-0.42 for middle and aOR 0.12, 95%CI 0.05-0.29 for highest vs. lowest tertile) and Shannon entropy were associated with lower risk of allergic rhinitis in LISA, and similar trend was seen in LUKAS. We observed some significant associations between bacterial and fungal diversity measured and the risk of inhalant atopy, but the associations were inconsistent between the two cohorts. High bacterial diversity tended to be associated with increased risk of inhalant atopy in rural areas, but lower risk in more urban areas. Fungal diversity tended to be associated with increased risk of inhalant atopy only in LISA. CONCLUSIONS Our study suggests that a higher bacterial diversity may reduce the risk of allergic rhinitis later in childhood. The environment-dependent heterogeneity in the associations with inhalant atopy - visible here as inconsistent results between two differing cohorts - suggests that specific constituents of the diversity may be relevant.
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Affiliation(s)
- Heidi Hyytiäinen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Pirkka V Kirjavainen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland; Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Martin Täubel
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Pauli Tuoresmäki
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Lidia Casas
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Social Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Joachim Heinrich
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximillians University Munich, Member of German Center for Lung Research (DZL), Munich, Germany
| | - Gunda Herberth
- Department of Environmental Immunology/Core Facility Studies, Helmholtz Centre for Environmental Research- UFZ, Leipzig, Germany
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Harald Renz
- Department of Clinical Chemistry and Molecular Diagnostics, Philipps University of Marburg, Marburg, Germany; Member of the German Center for Lung Research, Germany
| | - Eija Piippo-Savolainen
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland; Department of Pediatrics, University of Eastern Finland, Kuopio; Finland
| | - Anne Hyvärinen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Juha Pekkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anne M Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.
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14
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Atopy risk among school-aged children in relation to early exposures to a farm environment: A systematic review. Respir Med 2021; 186:106378. [PMID: 34252858 DOI: 10.1016/j.rmed.2021.106378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Childhood atopy is a complex condition with both a genetic and an environmental component. This systematic review will explore the current understanding of the importance of early life exposures to a farm in the development of atopy measured by objective markers of skin prick testing, and specific IgE measurements in school age children. METHODS A systematic review was performed. RESULTS Among 7285 references identified, 14 studies met the inclusion criteria (13 cross-sectional studies and 1 case-control study). The results were fairly consistent in that early farm-related exposures can protect children from becoming atopic at school age. In general, there was heterogeneity in the assessment of outcomes and exposures. CONCLUSIONS Early-life farm exposures are associated with a protective effect on childhood atopy as assessed by objective markers. Future work should focus on understanding specific farm exposures that may important in these associations between atopy and farm exposures in children.
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15
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Indoor Microbial Exposures and Chronic Lung Disease: From Microbial Toxins to the Microbiome. Clin Chest Med 2021; 41:777-796. [PMID: 33153695 DOI: 10.1016/j.ccm.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Effects of environmental microbial exposures on human health have long been of interest. Microbes were historically assumed to be harmful, but data have suggested that microbial exposures can modulate the immune system. We focus on the effects of indoor environmental microbial exposure on chronic lung diseases. We found contradictory data in bacterial studies using endotoxin as a surrogate for bacterial exposure. Contradictory data also exist in studies of fungal exposure. Many factors may modulate the effect of environmental microbial exposures on lung health, including coexposures. Future studies need to clarify which method of assessing environmental microbial exposures is most relevant.
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16
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Vesper S, Wymer L, Cox D, Dewalt G, Pinzer E, Friedman W, Ashley PJ. The Environmental Relative Moldiness Index reveals changes in mold contamination in United States homes over time. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:35-41. [PMID: 33314963 PMCID: PMC7853420 DOI: 10.1080/15459624.2020.1844892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The Environmental Relative Moldiness Index (ERMI) is a scale created to compare mold contamination levels in U.S. homes. The ERMI was developed as a result of the Department of Housing and Urban Development's (HUD) first American Healthy Homes Survey (AHHS I), which sampled 1,096 homes selected to be representative of the U.S. housing stock. In AHHS I, a dust sample from each home was analyzed using quantitative PCR assays (qPCR) for 36 common indoor molds: 26 Group 1 molds, which were associated with water damage in homes and 10 Group 2 molds, which primarily enter the home from the outside environment. In 2019, HUD completed AHHS II by sampling 695 homes. Because lead was banned from paint in 1978, a larger proportion of homes selected for AHHS II had been built before 1978 compared to AHHS I. The 36 ERMI molds were analyzed in AHHS II exactly as in AHHS I. For the 36-ERMI molds, the rates of detection, average concentrations, and geometric means were in significant concordance (p < 0.001) between AHHS I and II, indicating that the ERMI methodology was stable over time. However, the average ERMI value in AHHS II homes was greater than in AHHS I. The reason for the difference was investigated by examining the Group 1 and 2 mold populations. The average summed logs of Group 1 molds were significantly greater in homes built before 1978 than the average for homes built later. Conversely, the average summed logs of Group 2 mold populations were the same in homes built before 1978 and homes built later. Since the summed logs of Group 2 mold is subtracted from the summed logs of Group 1 molds in the ERMI calculation, the average ERMI value was higher in AHHS II homes than AHHS I. In conclusion, by using the ERMI metric, we were able to demonstrate that water damage and mold growth were more likely to occur as homes get older.
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Affiliation(s)
- Stephen Vesper
- Center for Environmental Measurement and Modeling, United States Environmental Protection Agency , Cincinnati , Ohio
| | - Larry Wymer
- Center for Environmental Measurement and Modeling, United States Environmental Protection Agency , Cincinnati , Ohio
| | | | | | - Eugene Pinzer
- Department of Housing and Urban Development , Washington, DC
| | - Warren Friedman
- Department of Housing and Urban Development , Washington, DC
| | - Peter J Ashley
- Department of Housing and Urban Development , Washington, DC
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17
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Juel Holst G, Pørneki A, Lindgreen J, Thuesen B, Bønløkke J, Hyvärinen A, Elholm G, Østergaard K, Loft S, Brooks C, Douwes J, Linneberg A, Sigsgaard T. Household dampness and microbial exposure related to allergy and respiratory health in Danish adults. Eur Clin Respir J 2020; 7:1706235. [PMID: 32128077 PMCID: PMC7034447 DOI: 10.1080/20018525.2019.1706235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 12/11/2019] [Indexed: 11/03/2022] Open
Abstract
Background: Indoor dampness has consistently been associated with respiratory symptoms and exacerbations. The causal mechanisms may involve increased microbial exposures. However, the evidence regarding the influence of indoor microbial exposures under damp- and non-damp conditions on the risk of asthma and allergy has been inconclusive. Objective: The aim of this study was to investigate the association between dampness and microbial exposure with allergy and respiratory health in Danish adults using a cross-sectional design. Methods: From 1,866 participants of the Health2006 cohort, we selected three non-overlapping groups: 196 at random, 107 with confirmed atopy, and 99 without atopy. Bedroom dust was sampled using electrostatic dust fall collectors and analysed for endotoxin, β-(1,3)-D-glucan, 19 microbial species or groups, and total fungal load. Household moisture-related problems and asthma were self-reported by questionnaire. Atopy was determined by skin-prick-testing and lung function was measured by spirometry. Results: Household moisture damage was positively associated with asthma outcomes, although this was statistically significant only in atopics for self-reported asthma (odds ratio (OR) 3.52; 95%CI 1.01-12.7). Mould odor was positively associated with wheezing (OR 6.05; 95%CI 1.19-30.7) in atopics. Inconsistent associations were found for individual microbial exposures and health outcomes. Inverse associations were observed between microbial diversity and rhinitis in the random sample and both doctor-diagnosed and self-reported asthma in non-atopics. Conclusions: In conclusion, our findings suggest that household moisture damage may increase the risk of asthma and wheeze with mould odor in atopics. In addition, asthma and allergy may be affected by the indoor microbial composition in urban domestic environments. Further studies are needed to identify and understand the causal agents and underlying mechanisms behind the potential effects of environmental microbial exposure on human health.
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Affiliation(s)
- G Juel Holst
- Section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
| | | | | | - B Thuesen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Denmark
| | - J Bønløkke
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - A Hyvärinen
- Environment and Health Unit, National Institute for Health and Welfare - THL, Kuopio, Finland
| | - G Elholm
- Section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
| | - K Østergaard
- Section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
| | - S Loft
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - C Brooks
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - J Douwes
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - A Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Sigsgaard
- Section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
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18
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Microbial Agents in the Indoor Environment: Associations with Health. CURRENT TOPICS IN ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE 2020. [PMCID: PMC7122805 DOI: 10.1007/978-981-32-9182-9_9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There is international consensus that damp buildings and indoor mould can increase the risk of asthma, rhinitis, bronchitis and respiratory tract infections but we do not know which types of microbial agents that are causing the observed adverse health effects. Microbial indoor exposure is a broader concept than microbial growth in buildings. Other sources of indoor microbial exposure include the outdoor environment, humans (crowdedness) and furry pet keeping. Microbial exposure can have different health effects depending on the dose, different exposure route, genetic disposition and the timing of exposure. Microbial stimulation linked to large microbial diversity in early life can protect against disease development, especially for allergic asthma and atopy. Protective effects are more often reported for bacterial exposure and adverse health effects are more often linked to mould exposure. There are many studies on health associations for indoor exposure to endotoxin, mainly from homes. The risk of getting atopic asthma may be less if you are exposed to endotoxin in childhood but the risk of non-atopic asthma may increase if exposed to endotoxin especially in adulthood. Moreover, genetic disposition modifies health effects of endotoxin. Epidemiological studies on muramic acid (from gram-positive bacteria) or ergosterol (from mould) are few. Studies on health effects of indoor exposure to beta-1-3-glucan (from mould) have conflicting results (positive as well as negative associations). Epidemiological studies on health effects of indoor exposure to mycotoxins are very few. Some studies have reported health associations for MVOC, but it is unclear to what extent MVOC has microbial sources in indoor environments. Many studies have reported health associations for fungal DNA, especially as a risk factor for childhood asthma at home. Since most studies on health effects of indoor exposure to mould, bacteria and microbial agents are cross-sectional, it is difficult to draw conclusions on causality. More prospective studies on indoor microbial exposure are needed and studies should include other indoor environments than homes, such as day care centers, schools, hospitals and offices.
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19
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Casas L, Karvonen AM, Kirjavainen PV, Täubel M, Hyytiäinen H, Jayaprakash B, Lehmann I, Standl M, Pekkanen J, Heinrich J. Early life home microbiome and hyperactivity/inattention in school-age children. Sci Rep 2019; 9:17355. [PMID: 31758010 PMCID: PMC6874766 DOI: 10.1038/s41598-019-53527-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 10/30/2019] [Indexed: 12/18/2022] Open
Abstract
This study evaluates the association between indoor microbial diversity early in life and hyperactivity/inattention symptoms in children at ages 10 and 15 years.A random sample enriched with subjects with hyperactivity/inattention at age 15 years was selected from the German LISA birth cohort. Bedroom floor dust was collected at age 3 months and 4 bacterial and fungal diversity measures [number of observed operational taxonomic units (OTUs), Chao1, Shannon and Simpson indices] were calculated from Illumina MiSeq sequencing data. Hyperactivity/inattention was based on the Strengths and Difficulties Questionnaire at ages 10 and 15 (cut-off ≥7). Adjusted associations between 4 diversity measures in tertiles and hyperactivity/inattention were investigated with weighted and survey logistic regression models. We included 226 individuals with information on microbial diversity and hyperactivity/inattention. Early life bacterial diversity was inversely associated with hyperactivity/inattention at age 10 [bacterial OTUs (medium vs low: aOR = 0.4, 95%CI = (0.2–0.8)) and Chao1 (medium vs low: 0.3 (0.1–0.5); high vs low: 0.3 (0.2–0.6)], whereas fungal diversity was directly associated [Chao1 (high vs low: 2.1 (1.1–4.0)), Shannon (medium vs low: 2.8 (1.3–5.8)), and Simpson (medium vs low: 4.7 (2.4–9.3))]. At age 15, only Shannon index was significantly associated with hyperactivity/inattention [bacteria (medium vs low: 2.3 (1.2–4.2); fungi (high vs low: 0.5 (0.3–0.9))]. In conclusion, early life exposure to microbial diversity may play a role in the psychobehavioural development. We observe heterogeneity in the direction of the associations encouraging further longitudinal studies to deepen our understanding of the characteristics of the microbial community underlying the observed associations.
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Affiliation(s)
- Lidia Casas
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Anne M Karvonen
- Environmental Health Unit, Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Pirkka V Kirjavainen
- Environmental Health Unit, Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,Institue of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Martin Täubel
- Environmental Health Unit, Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Heidi Hyytiäinen
- Environmental Health Unit, Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | | | - Irina Lehmann
- Charitè - Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany.,Department of Environmental Immunology/Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Juha Pekkanen
- Environmental Health Unit, Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Joachim Heinrich
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximillians University Munich, Member of German Center for Lung Research (DZL), Munich, Germany
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20
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Vuitton D, Divaret-Chauveau A, Dalphin ML, Laplante JJ, von Mutius E, Dalphin JC. Protection contre l’allergie par l’environnement de la ferme : en 15 ans, qu’avons-nous appris de la cohorte européenne « PASTURE » ? BULLETIN DE L'ACADÉMIE NATIONALE DE MÉDECINE 2019. [DOI: 10.1016/j.banm.2019.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Karvonen AM, Kirjavainen PV, Täubel M, Jayaprakash B, Adams RI, Sordillo JE, Gold DR, Hyvärinen A, Remes S, von Mutius E, Pekkanen J. Indoor bacterial microbiota and development of asthma by 10.5 years of age. J Allergy Clin Immunol 2019; 144:1402-1410. [PMID: 31415782 DOI: 10.1016/j.jaci.2019.07.035] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 06/06/2019] [Accepted: 07/11/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Early-life indoor bacterial exposure is associated with the risk of asthma, but the roles of specific bacterial genera are poorly understood. OBJECTIVE We sought to determine whether individual bacterial genera in indoor microbiota predict the development of asthma. METHODS Dust samples from living rooms were collected at 2 months of age. The dust microbiota was characterized by using Illumina MiSeq sequencing amplicons of the bacterial 16S ribosomal RNA gene. Children (n = 373) were followed up for ever asthma until the age of 10.5 years. RESULTS Richness was inversely associated with asthma after adjustments (P = .03). The phylogenetic microbiota composition in asthmatics patients' homes was characteristically different from that in nonasthmatic subjects' homes (P = .02, weighted UniFrac, adjusted association, permutational multivariate analysis of variance, PERMANOVA-S). The first 2 axis scores of principal coordinate analysis of the weighted UniFrac distance matrix were inversely associated with asthma. Of 658 genera detected in the dust samples, the relative abundances of 41 genera correlated (r > |0.4|) with one of these axes. Lactococcus genus was a risk factor for asthma (adjusted odds ratio, 1.36 [95% CI, 1.13-1.63] per interquartile range change). The abundance of 12 bacterial genera (mostly from the Actinomycetales order) was associated with lower asthma risk (P < .10), although not independently of each other. The sum relative abundance of these 12 intercorrelated genera was significantly protective and explained the majority of the association of richness with less asthma. CONCLUSION Our data confirm that phylogenetic differences in the microbiota of infants' homes are associated with subsequent asthma risk and suggest that communities of selected bacteria are more strongly linked to asthma protection than individual bacterial taxa or mere richness.
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Affiliation(s)
- Anne M Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass.
| | - Pirkka V Kirjavainen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Martin Täubel
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | | | - Rachel I Adams
- Plant & Microbial Biology, University of California, Berkeley, Calif; California Department of Public Health, Environmental Health Laboratory Branch, Richmond, Calif
| | - Joanne E Sordillo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass
| | - Diane R Gold
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
| | - Anne Hyvärinen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Sami Remes
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Erika von Mutius
- Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität, Munich, Germany; Member of the German Center for Lung Research, Giessen, Germany; Institute for Asthma and Allergy Prevention (IAP), Helmholtz Zentrum München, Munich, Germany
| | - Juha Pekkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
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22
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Farm-like indoor microbiota in non-farm homes protects children from asthma development. Nat Med 2019; 25:1089-1095. [PMID: 31209334 DOI: 10.1038/s41591-019-0469-4] [Citation(s) in RCA: 178] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 04/25/2019] [Indexed: 01/04/2023]
Abstract
Asthma prevalence has increased in epidemic proportions with urbanization, but growing up on traditional farms offers protection even today1. The asthma-protective effect of farms appears to be associated with rich home dust microbiota2,3, which could be used to model a health-promoting indoor microbiome. Here we show by modeling differences in house dust microbiota composition between farm and non-farm homes of Finnish birth cohorts4 that in children who grow up in non-farm homes, asthma risk decreases as the similarity of their home bacterial microbiota composition to that of farm homes increases. The protective microbiota had a low abundance of Streptococcaceae relative to outdoor-associated bacterial taxa. The protective effect was independent of richness and total bacterial load and was associated with reduced proinflammatory cytokine responses against bacterial cell wall components ex vivo. We were able to reproduce these findings in a study among rural German children2 and showed that children living in German non-farm homes with an indoor microbiota more similar to Finnish farm homes have decreased asthma risk. The indoor dust microbiota composition appears to be a definable, reproducible predictor of asthma risk and a potential modifiable target for asthma prevention.
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23
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Erliana UD, Fly AD. The Function and Alteration of Immunological Properties in Human Milk of Obese Mothers. Nutrients 2019; 11:nu11061284. [PMID: 31174304 PMCID: PMC6627488 DOI: 10.3390/nu11061284] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/28/2019] [Accepted: 06/01/2019] [Indexed: 01/08/2023] Open
Abstract
Maternal obesity is associated with metabolic changes in mothers and higher risk of obesity in the offspring. Obesity in breastfeeding mothers appears to influence human milk production as well as the quality of human milk. Maternal obesity is associated with alteration of immunological factors concentrations in the human milk, such as C-reactive protein (CRP), leptin, IL-6, insulin, TNF-Alpha, ghrelin, adiponectin, and obestatin. Human milk is considered a first choice for infant nutrition due to the complete profile of macro nutrients, micro nutrients, and immunological properties. It is essential to understand how maternal obesity influences immunological properties of human milk because alterations could impact the nutrition status and health of the infant. This review summarizes the literature regarding the impact of maternal obesity on the concentration of particular immunological properties in the human milk.
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Affiliation(s)
- Ummu D Erliana
- Indiana University Bloomington School of Public Health, Bloomington, IN 47405, USA.
| | - Alyce D Fly
- Indiana University Bloomington School of Public Health, Bloomington, IN 47405, USA.
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24
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Stephens B, Azimi P, Thoemmes MS, Heidarinejad M, Allen JG, Gilbert JA. Microbial Exchange via Fomites and Implications for Human Health. CURRENT POLLUTION REPORTS 2019; 5:198-213. [PMID: 34171005 PMCID: PMC7149182 DOI: 10.1007/s40726-019-00123-6] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
PURPOSE OF REVIEW Fomites are inanimate objects that become colonized with microbes and serve as potential intermediaries for transmission to/from humans. This review summarizes recent literature on fomite contamination and microbial survival in the built environment, transmission between fomites and humans, and implications for human health. RECENT FINDINGS Applications of molecular sequencing techniques to analyze microbial samples have increased our understanding of the microbial diversity that exists in the built environment. This growing body of research has established that microbial communities on surfaces include substantial diversity, with considerable dynamics. While many microbial taxa likely die or lay dormant, some organisms survive, including those that are potentially beneficial, benign, or pathogenic. Surface characteristics also influence microbial survival and rates of transfer to and from humans. Recent research has combined experimental data, mechanistic modeling, and epidemiological approaches to shed light on the likely contributors to microbial exchange between fomites and humans and their contributions to adverse (and even potentially beneficial) human health outcomes. SUMMARY In addition to concerns for fomite transmission of potential pathogens, new analytical tools have uncovered other microbial matters that can be transmitted indirectly via fomites, including entire microbial communities and antibiotic-resistant bacteria. Mathematical models and epidemiological approaches can provide insight on human health implications. However, both are subject to limitations associated with study design, and there is a need to better understand appropriate input model parameters. Fomites remain an important mechanism of transmission of many microbes, along with direct contact and short- and long-range aerosols.
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Affiliation(s)
- Brent Stephens
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Alumni Memorial Hall 228E, 3201 South Dearborn Street, Chicago, IL 60616 USA
| | - Parham Azimi
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Megan S. Thoemmes
- Department of Pediatrics, University of California San Diego School of Medicine, San Diego, CA USA
| | - Mohammad Heidarinejad
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Alumni Memorial Hall 228E, 3201 South Dearborn Street, Chicago, IL 60616 USA
| | - Joseph G. Allen
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Jack A. Gilbert
- Department of Pediatrics, University of California San Diego School of Medicine, San Diego, CA USA
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25
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Ruffner MA, Kennedy K, Cianferoni A. Pathophysiology of eosinophilic esophagitis: recent advances and their clinical implications. Expert Rev Clin Immunol 2019; 15:83-95. [PMID: 30394139 PMCID: PMC9044497 DOI: 10.1080/1744666x.2019.1544893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/02/2018] [Indexed: 02/06/2023]
Abstract
Introduction: Diagnostic and therapeutic strategies in eosinophilic esophagitis (EoE) are evolving. New knowledge regarding the pathophysiology of EoE has been the foundation for updated diagnostic recommendations and new therapeutic trials. Areas covered: We performed structured literature searches in Medline and PubMed, Cochrane meta-analyses, and abstracts of international congresses to review therapeutic approaches for EoE in July 2018. Additional articles were obtained by perusing the references of articles identified in the original PubMed search. Articles were excluded if they did not focus on the mechanism of disease, diagnosis, or treatment of humans with EoE. Expert commentary: Recent advances in the understanding of mechanisms underlying the pathology of EoE have resulted in significant change in the diagnostic algorithm for EoE, and are identifying promising potential targets for personalized medicine. There is a clinical need for improved targeted therapy for EoE, and better understanding the underlying pathophysiology of EoE will help to determine therapeutic targets. In this review, we highlight key mechanisms in the pathophysiology of EoE and how they are being utilized to change therapy in EoE.
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Affiliation(s)
- Melanie A Ruffner
- Division of Allergy & Immunology, Children’s Hospital of Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perlman School of Medicine, USA
| | - Katie Kennedy
- Division of Allergy & Immunology, Children’s Hospital of Philadelphia, PA, USA
| | - Antonella Cianferoni
- Division of Allergy & Immunology, Children’s Hospital of Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perlman School of Medicine, USA
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26
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Lunjani N, Satitsuksanoa P, Lukasik Z, Sokolowska M, Eiwegger T, O'Mahony L. Recent developments and highlights in mechanisms of allergic diseases: Microbiome. Allergy 2018; 73:2314-2327. [PMID: 30325537 DOI: 10.1111/all.13634] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/11/2018] [Accepted: 10/05/2018] [Indexed: 12/13/2022]
Abstract
All body surfaces are exposed to a wide variety of microbes, which significantly influence immune reactivity within the host. This review provides an update on some of the critical novel findings that have been published on the influence of the microbiome on atopic dermatitis, food allergy and asthma. Microbial dysbiosis has consistently been observed in the skin, gut and lungs of patients with atopic dermatitis, food allergy and asthma, respectively, and the role of specific microbes in allergic disorders is being intensively investigated. However, many of these discoveries have yet to be translated into routine clinical practice.
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Affiliation(s)
- Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- University of Cape Town; Cape Town South Africa
| | | | - Zuzanna Lukasik
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - Thomas Eiwegger
- Program in Translational Medicine; The Hospital for Sick Children; Toronto Ontario Canada
- Department of Immunology; The University of Toronto; Toronto Ontario Canada
- Division of Immunology and Allergy; Food allergy and Anaphylaxis Program; The Department of Paediatrics; The Hospital for Sick Children; Toronto Ontario Canada
| | - Liam O'Mahony
- Departments of Medicine and Microbiology; APC Microbiome Ireland; National University of Ireland; Cork Ireland
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27
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Cox J, Isiugo K, Ryan P, Grinshpun SA, Yermakov M, Desmond C, Jandarov R, Vesper S, Ross J, Chillrud S, Dannemiller K, Reponen T. Effectiveness of a portable air cleaner in removing aerosol particles in homes close to highways. INDOOR AIR 2018; 28:818-827. [PMID: 30133950 PMCID: PMC6188808 DOI: 10.1111/ina.12502] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 08/19/2018] [Indexed: 05/18/2023]
Abstract
Outdoor traffic-related airborne particles can infiltrate a building and adversely affect the indoor air quality. Limited information is available on the effectiveness of high efficiency particulate air (HEPA) filtration of traffic-related particles. Here, we investigated the effectiveness of portable HEPA air cleaners in reducing indoor concentrations of traffic-related and other aerosols, including black carbon (BC), PM2.5 , ultraviolet absorbing particulate matter (UVPM) (a marker of tobacco smoke), and fungal spores. This intervention study consisted of a placebo-controlled cross-over design, in which a HEPA cleaner and a placebo "dummy" were placed in homes for 4-weeks each, with 48-hour air sampling conducted prior to and during the end of each treatment period. The concentrations measured for BC, PM2.5 , UVPM, and fungal spores were significantly reduced following HEPA filtration, but not following the dummy period. The indoor fraction of BC/PM2.5 was significantly reduced due to the HEPA cleaner, indicating that black carbon was particularly impacted by HEPA filtration. This study demonstrates that HEPA air purification can result in a significant reduction of traffic-related and other aerosols in diverse residential settings.
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Affiliation(s)
- Jennie Cox
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Kelechi Isiugo
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Patrick Ryan
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Sergey A Grinshpun
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Michael Yermakov
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Colleen Desmond
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Roman Jandarov
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Stephen Vesper
- United States Environmental Protection Agency, Cincinnati, Ohio
| | - James Ross
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, New York
| | - Steven Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, New York
| | - Karen Dannemiller
- Civil, Environmental & Geodetic Engineering, College of Engineering, The Ohio State University, Columbus, Ohio
- Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
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28
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Michels KR, Lukacs NW, Fonseca W. TLR Activation and Allergic Disease: Early Life Microbiome and Treatment. Curr Allergy Asthma Rep 2018; 18:61. [PMID: 30259206 DOI: 10.1007/s11882-018-0815-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Allergy and asthma are growing problems in the developed world. The accelerated increase of these diseases may be related to microbiome modification that leads to aberrant activation of Toll-like receptors (TLRs). Current research supports the concept that changes in microbial communities in early life impact TLR activation, resulting in an altered risk for the development of asthma and allergies. RECENT FINDINGS Prenatal and early childhood events that generate microbiome modification are closely related with TLR activation. Early childhood exposure to a rich array of TLR agonists, particularly lipopolysaccharide, strongly predicts protection against allergic disease later in life even when other lifestyle factors are accounted for. Genetic deletion of TLR signaling components in mice results in reduced function of tolerogenic cell populations in the gut. In contrast, weak TLR signaling can promote allergic sensitization later in life. This review summarizes the role of TLR signaling in microbiome-mediated protection against allergy.
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Affiliation(s)
- Kathryn R Michels
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.
| | - Nicholas W Lukacs
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, MI, USA
| | - Wendy Fonseca
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
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29
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Oluwole O, Rennie DC, Senthilselvan A, Dyck R, Afanasieva A, Kirychuk S, Katselis G, Lawson JA. The association between endotoxin in house dust with atopy and exercise-induced bronchospasm in children with asthma. ENVIRONMENTAL RESEARCH 2018; 164:302-309. [PMID: 29554621 DOI: 10.1016/j.envres.2018.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 03/05/2018] [Accepted: 03/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Studies have reported protective and adverse associations between microbial exposure and childhood asthma. However, among children with asthma the relationships between endotoxin and exercise-induced bronchospasm (EIB) is less clear. OBJECTIVE We investigated the association between exposure to endotoxin in house dust with atopy and EIB in children with asthma. METHODS A cross-sectional survey was conducted among schoolchildren (aged 7-17 years) in the province of Saskatchewan, Canada. A subpopulation with asthma (n = 116) were identified from 335 participants using a validated asthma algorithm. We determined atopy among the asthma subpopulation by skin prick testing (SPT) while EIB was evaluated using exercise challenge testing (ECT). Dust samples were collected from mattress and play area floors, and endotoxin was measured in dust extracts. Logistic regression analyses were used to explore associations between endotoxin with atopy and EIB. RESULTS Among the 116 children with asthma, 99 completed SPT and all had completed ECT. Of these, 71/99 (71.7%) were atopic and 26/116 (22.4%) had EIB. Exposure to high play area endotoxin concentration [adjusted odds ratio (aOR) = 0.15, 95% CI: 0.03-0.85] and load (aOR = 0.11, 95% CI: 0.02-0.73) were negatively associated with atopy. In contrast, EIB was positively associated with high mattress endotoxin concentration (aOR = 6.01, 95% CI: 1.20-30.13). CONCLUSION Indoor microbial endotoxin exposure has varied associations with atopy and exercise-induced bronchospasm among children with asthma.
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Affiliation(s)
- Oluwafemi Oluwole
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, Canada S7N 2Z4; Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4.
| | - Donna C Rennie
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, Canada S7N 2Z4.
| | | | - Roland Dyck
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
| | - Anna Afanasieva
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4.
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
| | - George Katselis
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
| | - Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
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30
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Caillaud D, Leynaert B, Keirsbulck M, Nadif R. Indoor mould exposure, asthma and rhinitis: findings from systematic reviews and recent longitudinal studies. Eur Respir Rev 2018; 27:27/148/170137. [PMID: 29769295 DOI: 10.1183/16000617.0137-2017] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/15/2018] [Indexed: 12/22/2022] Open
Abstract
Starting from the Institute of Medicine (IOM) and World Health Organization (WHO) reports, this review provides an overview of the literature published from 2006 to 2017 on the associations between indoor mould exposure and asthma and rhinitis separately in children and adults with a focus on longitudinal epidemiological studies.A systematic search of peer-reviewed literature was performed, including systematic reviews and meta-analyses, longitudinal, incident case-control and panel studies. 61 publications were identified reporting visible mould or mould odour or quantitative assessment of culturable fungi or mould species.In children, visible mould and mould odour were associated with the development and exacerbations of asthma, providing sufficient evidence of a causal relationship. Results from population-based studies in adults were too few and divergent to conclude at more than a limited level of evidence. Exposure to mould in a work building was associated with the incidence and exacerbations of occupational asthma, and we concluded at a sufficient evidence for an association. Systematic reviews, meta-analyses and longitudinal studies on the relationships between mould exposure and allergic rhinitis provide sufficient evidence of an association.This review extended the conclusions of the IOM and WHO reports, and highlighted the need for further longitudinal studies on asthma in adults, and on rhinitis.
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Affiliation(s)
- Denis Caillaud
- Pulmonary and Allergology Dept, CHU Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Benedicte Leynaert
- INSERM, UMR1152, Pathophysiology and Epidemiology of Respiratory Diseases. Epidemiology, Paris, France.,Univ Paris Diderot Paris 7, UMR 1152, Paris, France
| | - Marion Keirsbulck
- ANSES (French Agency for Food, Environmental and Occupational Health and Safety), Maisons-Alfort, France
| | - Rachel Nadif
- INSERM, U1168, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.,Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
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31
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Karvonen AM, Tischer C, Kirjavainen PV, Roponen M, Hyvärinen A, Illi S, Mustonen K, Pfefferle PI, Renz H, Remes S, Schaub B, von Mutius E, Pekkanen J. Early age exposure to moisture damage and systemic inflammation at the age of 6 years. INDOOR AIR 2018; 28:450-458. [PMID: 29450910 DOI: 10.1111/ina.12454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 02/09/2018] [Indexed: 06/08/2023]
Abstract
Cross-sectional studies have shown that exposure to indoor moisture damage and mold may be associated with subclinical inflammation. Our aim was to determine whether early age exposure to moisture damage or mold is prospectively associated with subclinical systemic inflammation or with immune responsiveness in later childhood. Home inspections were performed in children's homes in the first year of life. At age 6 years, subclinical systemic inflammation was measured by serum C-reactive protein (CRP) and blood leukocytes and immune responsiveness by ex vivo production of interleukin 1-beta (IL-1β), IL-6, and tumor necrosis factor alpha (TNF-α) in whole blood cultures without stimulation or after 24 hours stimulation with phorbol 12-myristate 13-acetate and ionomycin (PI), lipopolysaccharide (LPS), or peptidoglycan (PPG) in 251-270 children. Moisture damage in child's main living areas in infancy was not significantly associated with elevated levels of CRP or leukocytes at 6 years. In contrast, there was some suggestion for an effect on immune responsiveness, as moisture damage with visible mold was positively associated with LPS-stimulated production of TNF-α and minor moisture damage was inversely associated with PI-stimulated IL-1β. While early life exposure to mold damage may have some influence on later immune responsiveness, it does not seem to increase subclinical systemic inflammation in later life.
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Affiliation(s)
- A M Karvonen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - C Tischer
- ISGlobal, Barcelona Institute for Global Health - Campus MAR, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - P V Kirjavainen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - M Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - A Hyvärinen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - S Illi
- Helmholtz Zentrum Muenchen - Deutsches Forschungszentrum fuer Gesundheit und Umwelt (GmbH), Institute for Asthma and Allergy Prevention, Neuherberg, Germany
| | - K Mustonen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - P I Pfefferle
- Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University of Marburg, Marburg, Germany
| | - H Renz
- Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University of Marburg, Marburg, Germany
| | - S Remes
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - B Schaub
- Dr. von Hauner Childrens Hospital, Ludwig Maximilians University Munich, Munich, Germany
- Member of the German Centre for Lung Research, Munich, Germany
| | - E von Mutius
- Helmholtz Zentrum Muenchen - Deutsches Forschungszentrum fuer Gesundheit und Umwelt (GmbH), Institute for Asthma and Allergy Prevention, Neuherberg, Germany
- Dr. von Hauner Childrens Hospital, Ludwig Maximilians University Munich, Munich, Germany
- Member of the German Centre for Lung Research, Munich, Germany
| | - J Pekkanen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Borlée F, Yzermans CJ, Krop EJM, Maassen CBM, Schellevis FG, Heederik DJJ, Smit LAM. Residential proximity to livestock farms is associated with a lower prevalence of atopy. Occup Environ Med 2018; 75:453-460. [DOI: 10.1136/oemed-2017-104769] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 02/16/2018] [Accepted: 03/12/2018] [Indexed: 11/03/2022]
Abstract
ObjectivesExposure to farm environments during childhood and adult life seems to reduce the risk of atopic sensitisation. Most studies have been conducted among farmers, but people living in rural areas may have similar protective effects for atopy. This study aims to investigate the association between residential proximity to livestock farms and atopy among non-farming adults living in a rural area in the Netherlands.MethodsWe conducted a cross-sectional study among 2443 adults (20–72 years). Atopy was defined as specific IgE to common allergens and/or total IgE ≥100 IU/mL. Residential proximity to livestock farms was assessed as 1) distance to the nearest pig, poultry, cattle or any farm, 2) number of farms within 500 m and 1000 m, and 3) modelled annual average fine dust emissions from farms within 500 m and 1000 m. Data were analysed with multiple logistic regression and generalised additive models.ResultsThe prevalence of atopy was 29.8%. Subjects living at short distances from farms (<327 m, first tertile) had a lower odds for atopy compared with subjects living further away (>527 m, third tertile) (OR 0.79, 95% CI 0.63 to 0.98). Significant associations in the same direction were found with distance to the nearest pig or cattle farm. The associations between atopy and livestock farm exposure were somewhat stronger in subjects who grew up on a farm.ConclusionsLiving in close proximity to livestock farms seems to protect against atopy. This study provides evidence that protective effects of early-life and adult farm exposures may extend beyond farming populations.
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Pekkanen J, Valkonen M, Täubel M, Tischer C, Leppänen H, Kärkkäinen PM, Rintala H, Zock JP, Casas L, Probst-Hensch N, Forsberg B, Holm M, Janson C, Pin I, Gislason T, Jarvis D, Heinrich J, Hyvärinen A. Indoor bacteria and asthma in adults: a multicentre case-control study within ECRHS II. Eur Respir J 2018; 51:51/2/1701241. [PMID: 29437937 DOI: 10.1183/13993003.01241-2017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 11/18/2017] [Indexed: 11/05/2022]
Abstract
Both protective and adverse effects of indoor microbial exposure on asthma have been reported, but mostly in children. To date, no study in adults has used non-targeted methods for detection of indoor bacteria followed by quantitative confirmation.A cross-sectional study of 198 asthmatic and 199 controls was conducted within the European Community Respiratory Health Survey (ECRHS) II. DNA was extracted from mattress dust for bacterial analysis using denaturing gradient gel electrophoresis (DGGE). Selected bands were sequenced and associations with asthma confirmed with four quantitative PCR (qPCR) assays.15 out of 37 bands detected with DGGE, which had at least a suggestive association (p<0.25) with asthma, were sequenced. Of the four targeted qPCRs, Clostridium cluster XI confirmed the protective association with asthma. The association was dose dependent (aOR 0.43 (95% CI 0.22-0.84) for the fourth versus first quartile, p for trend 0.009) and independent of other microbial markers. Few significant associations were observed for the three other qPCRs used.In this large international study, the level of Clostridium cluster XI was independently associated with a lower risk of prevalent asthma. Results suggest the importance of environmental bacteria also in adult asthma, but need to be confirmed in future studies.
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Affiliation(s)
- Juha Pekkanen
- Dept of Public Health, University of Helsinki, Helsinki, Finland .,National Institute for Health and Welfare, Living Environment and Health Unit, Kuopio, Finland
| | - Maria Valkonen
- National Institute for Health and Welfare, Living Environment and Health Unit, Kuopio, Finland.,Dept of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Martin Täubel
- National Institute for Health and Welfare, Living Environment and Health Unit, Kuopio, Finland
| | - Christina Tischer
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Hanna Leppänen
- National Institute for Health and Welfare, Living Environment and Health Unit, Kuopio, Finland
| | - Päivi M Kärkkäinen
- National Institute for Health and Welfare, Living Environment and Health Unit, Kuopio, Finland
| | - Helena Rintala
- National Institute for Health and Welfare, Living Environment and Health Unit, Kuopio, Finland
| | - Jan-Paul Zock
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lidia Casas
- Centre for Environment and Health - Dept of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Nicole Probst-Hensch
- Dept of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Dept of Public Health, University of Basel, Basel, Switzerland
| | - Bertil Forsberg
- Dept of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Mathias Holm
- Dept of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christer Janson
- Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Isabelle Pin
- CHU de Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Thorarinn Gislason
- Dept of Respiratory Medicine and Sleep, Landspitali University Hospital (E7), Reykjavik, Iceland.,University of Iceland, Faculty of Medicine, Reykjavik, Iceland
| | - Debbie Jarvis
- Population Health and Occupational Disease, Imperial College, National Heart and Lung Institute, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College, London, UK
| | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximillians University Munich, Munich, Germany.,Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Anne Hyvärinen
- Dept of Public Health, University of Helsinki, Helsinki, Finland
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34
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Casas L, Tischer C, Täubel M. Pediatric Asthma and the Indoor Microbial Environment. Curr Environ Health Rep 2018; 3:238-49. [PMID: 27230430 DOI: 10.1007/s40572-016-0095-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The global increase in the prevalence of asthma has been related to several risk factors; many of them linked to the "westernization" process and the characteristics of the indoor microbial environment during early life may play an important role. Living in moisture damaged homes contributes to the exacerbation and development of asthma. However, living in homes with a rich variety and high levels of microbes (e.g., traditional farming environments) may confer protection. While the results of previous research are rather consistent when it comes to observation/report of indoor moisture damage or when comparing farming versus non-farming homes, when actual measures targeting indoor microbial exposure are included, the picture becomes less clear and the associations appear inconsistent. This may partly be due to limitations of sampling and measurement techniques that make comparisons difficult and provide an incomplete picture of the indoor microbial environment and in particular also human exposure. In this regard, new generation sequencing techniques represent a potential revolution in better understanding the impact of the indoor microbiome on human health.
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Affiliation(s)
- Lidia Casas
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Herestraat 49, 3000, Leuven, Belgium. .,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Dr Aiguader 88, 08003, Barcelona, Spain. .,University Pompeu Fabra (UPF), Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Christina Tischer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Dr Aiguader 88, 08003, Barcelona, Spain.,University Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Martin Täubel
- Living Environment and Health Unit, National Institute for Health and Welfare, Neulaniementie 4, 70210, Kuopio, Finland
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35
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Valkonen M, Täubel M, Pekkanen J, Tischer C, Rintala H, Zock JP, Casas L, Probst-Hensch N, Forsberg B, Holm M, Janson C, Pin I, Gislason T, Jarvis D, Heinrich J, Hyvärinen A. Microbial characteristics in homes of asthmatic and non-asthmatic adults in the ECRHS cohort. INDOOR AIR 2018; 28:16-27. [PMID: 28960492 DOI: 10.1111/ina.12427] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 09/21/2017] [Indexed: 06/07/2023]
Abstract
Microbial exposures in homes of asthmatic adults have been rarely investigated; specificities and implications for respiratory health are not well understood. The objectives of this study were to investigate associations of microbial levels with asthma status, asthma symptoms, bronchial hyperresponsiveness (BHR), and atopy. Mattress dust samples of 199 asthmatics and 198 control subjects from 7 European countries participating in the European Community Respiratory Health Survey II study were analyzed for fungal and bacterial cell wall components and individual taxa. We observed trends for protective associations of higher levels of mostly bacterial markers. Increased levels of muramic acid, a cell wall component predominant in Gram-positive bacteria, tended to be inversely associated with asthma (OR's for different quartiles: II 0.71 [0.39-1.30], III 0.44 [0.23-0.82], and IV 0.60 [0.31-1.18] P for trend .07) and with asthma score (P for trend .06) and with atopy (P for trend .02). These associations were more pronounced in northern Europe. This study among adults across Europe supports a potential protective effect of Gram-positive bacteria in mattress dust and points out that this may be more pronounced in areas where microbial exposure levels are generally lower.
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Affiliation(s)
- M Valkonen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - M Täubel
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - J Pekkanen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - C Tischer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - H Rintala
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - J-P Zock
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - L Casas
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - N Probst-Hensch
- Head Department Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Department of Public Health, University of Basel, Basel, Switzerland
| | - B Forsberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - M Holm
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C Janson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - I Pin
- CHU de Grenoble Alpes, INSERM U 1209, Université Grenoble Alpes, Grenoble, France
| | - T Gislason
- Department of Respiratory Medicine and Sleep, Landspitali University Hospital (E7), Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - D Jarvis
- Population Health and Occupational Disease, Imperial College, National Heart and Lung Institute, London, UK
- MRC-PHE Centre for Environment and Health, Imperial College, London, UK
| | - J Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximillians University Munich, Member of German Center for Lung Research (DZL), Munich, Germany
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - A Hyvärinen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
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36
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Zhang Z, Reponen T, Hershey GKK. Fungal Exposure and Asthma: IgE and Non-IgE-Mediated Mechanisms. Curr Allergy Asthma Rep 2017; 16:86. [PMID: 27943046 DOI: 10.1007/s11882-016-0667-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Fungi are ubiquitous in indoor and outdoor environments and have been associated with respiratory disease including childhood and adult asthma. A growing body of evidence from human and animal studies has revealed a link between fungal exposure, especially indoor fungal exposure, with asthma initiation, persistence, and exacerbation. Despite the overwhelming evidence linking mold exposure and asthma, the mechanistic basis for the association has remained elusive. It is now clear that fungi need not be intact to impart negative health effects. Fungal components and fungal fragments are biologically active and contribute to asthma development and severity. Recent mechanistic studies have demonstrated that fungi are potent immunomodulators and have powerful effects on asthma independent of their potential to act as antigens. This paper will review the connection between fungal exposure and asthma with a focus on the immunological mechanisms underlying this relationship.
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Affiliation(s)
- Zhonghua Zhang
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 7037, Cincinnati, OH, 45229, USA
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA
| | - Gurjit K Khurana Hershey
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 7037, Cincinnati, OH, 45229, USA. .,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA.
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37
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Prevention of allergies in childhood - where are we now? Allergol Select 2017; 1:200-213. [PMID: 30402617 PMCID: PMC6040005 DOI: 10.5414/alx01807e] [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: 07/16/2015] [Accepted: 07/27/2015] [Indexed: 11/18/2022] Open
Abstract
Allergic diseases represent an increasing health problem for children worldwide. Along with allergic airway diseases, food allergy comes to the fore and herewith closely intertwined the hypothesis that an early allergic sensitization might occur via skin barrier defect(s). The importance of the skin barrier has been documented by several studies meanwhile. Not only genetic studies screen the associations between Filaggrin loss-of-function mutations, atopic dermatitis, allergic sensitization, food allergy and even airway diseases, but also epidemiological studies cast new light on the hypothesis of the atopic march. As another focus in context of the development of an allergic phenotype, the specific microbial exposure with all its diversities has been crystallized as it shapes the immune system in (early) infancy. Studies explored both, the role of human intestinal microbiota as well as the external microbial diversity. Unfortunately suitable markers for atopic predictors are still rare. New studies point out that specific IgE antibodies (e.g., IgE to Phl p 1) in children without allergic symptoms so far, might function as a pre-clinical biomarker, which may help to identify candidates for primary (allergen non-specific) or secondary (allergen-specific) prevention in terms of specific immunoprophylaxis. These manifold research activities document a complex increase in knowledge. Nevertheless new assumptions need to be substantively confirmed in order to finally generate the urgently needed preventive strategies for allergic diseases in childhood.
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38
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Rocchi S, Reboux G. [European birth cohorts: Early life exposure to microorganisms and health impact]. Rev Mal Respir 2017; 34:635-644. [PMID: 28688758 DOI: 10.1016/j.rmr.2016.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 06/30/2016] [Indexed: 12/22/2022]
Abstract
In recent years, many birth cohorts have been initiated in Europe, to assess the early life microbiological exposure of children in the indoor environment and better understanding the different effects (adverse/protectors) on health. The results of 12 European cohorts, with different methodologies for exposure and allergic risk assessment are summarized in this review. Four meta-analyzes of cohort are presented too. Microbiological researches in indoor environment seem to turn to a metrology of microbiological exposure, but few studies provide real quantitative data. Thus, the establishment of dose-effect relationship is not possible and can only be done by having a global view of the situation, provided by an identical metrological approach in the different studies, in a large-scale, in the context of large birth cohorts with children followed with strict criteria to establish the clinical diagnosis.
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Affiliation(s)
- S Rocchi
- Laboratoire de parasitologie-mycologie, centre hospitalier régional universitaire Jean-Minjoz, 25000 Besançon, France; UMR 6249 CNRS chrono-environnement, université Bourgogne Franche-Comté, 25000 Besançon, France.
| | - G Reboux
- Laboratoire de parasitologie-mycologie, centre hospitalier régional universitaire Jean-Minjoz, 25000 Besançon, France; UMR 6249 CNRS chrono-environnement, université Bourgogne Franche-Comté, 25000 Besançon, France
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39
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Qian LJ, Kang SM, Xie JL, Huang L, Wen Q, Fan YY, Lu LJ, Jiang L. Early-life gut microbial colonization shapes Th1/Th2 balance in asthma model in BALB/c mice. BMC Microbiol 2017; 17:135. [PMID: 28623898 PMCID: PMC5473985 DOI: 10.1186/s12866-017-1044-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/09/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND We aimed to investigate the effect of early-life diverse microbial exposures on gut microbial colonization in an OVA-induced asthma model in BALB/c mice. METHODS BALB/c mice were divided into 4 groups: A, offsprings were kept in a SPF environment during fetal, lactation, and childhood periods; B, offsprings were kept in the SPF environment during fetal and lactation periods, and kept in the general environment during childhood; C, offsprings were kept in the SPF environment only during fetal period, and then kept in the general environment; and D, offsprings were kept in the general environment during whole periods. The diversity of intestinal flora was analyzed using denaturing gradient gel electrophoresis. Mice were sensitized with OVA to establish an animal model of asthma. Then asthma-related inflammatory cytokines and histological analysis were performed. RESULTS The diversity of intestinal microflora in group D was significantly higher than groups A, B and C at three days and three weeks after birth, and the diversity of intestinal microflora in groups C and D were significantly higher than groups A and B at five weeks after birth. The pathologic scores of OVA-induced asthmatic mice in group D were significantly lower than group A, and serum IFN-γ levels and the IFN-γ/IL-4 ratio in group D were significantly higher than group A. CONCLUSIONS Exposure to diverse microbial environments in early life affects gut microbial colonization in BALB/c mice. The diversity of the intestinal flora in early life may prevent airway inflammation in asthma via regulating the Th1/Th2 balance.
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Affiliation(s)
- Li-Juan Qian
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu 210009 China
| | - Shu-Min Kang
- Department of Pediatrics, Zhangjiagang First Peoples Hospital, Suzhou, Jiangsu 100142 China
| | - Jia-Li Xie
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu 210009 China
| | - Li Huang
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu 210009 China
| | - Quan Wen
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu 210009 China
| | - Yuan-Yuan Fan
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu 210009 China
| | - Li-Jun Lu
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu 210009 China
| | - Li Jiang
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu 210009 China
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40
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Cavaleiro Rufo J, Madureira J, Paciência I, Aguiar L, Pereira C, Silva D, Padrão P, Moreira P, Delgado L, Annesi-Maesano I, Oliveira Fernandes E, Teixeira JP, Moreira A. Indoor fungal diversity in primary schools may differently influence allergic sensitization and asthma in children. Pediatr Allergy Immunol 2017; 28:332-339. [PMID: 28208225 DOI: 10.1111/pai.12704] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Childhood exposure to microbiologic agents may influence the development of allergic and respiratory diseases. Apart from home, children spend most of their time at school, which represents an environment of significant exposure to indoor air microbes. Therefore, we aimed to assess how the prevalence of allergic sensitization and asthma in schoolchildren is affected by microbiologic exposure within classrooms. METHODS Spirometry with bronchodilation, exhaled nitric oxide measurements and skin-prick tests data were retrieved from 858 children aged 8-10 years attending 71 classrooms in 20 primary schools. Air samples were collected in all classrooms using a single-stage microbiologic air impactor through agar plates. Gram-negative endotoxins were collected using flow control pumps and analysed by limulus amebocyte lysate assay. Diversity scores were established as the number of different fungal species found in each classroom. RESULTS Classrooms with increased diversity scores showed a significantly lower prevalence of children with atopic sensitization, but not asthma. The risk of sensitization increased with increasing endotoxin exposure in classrooms. Similarly, significantly higher concentrations of Penicillium spp were found in classrooms with a higher number of children with atopic sensitization. CONCLUSIONS Although no causal relationships could be established, exposure to higher fungal diversity was protective against allergic sensitization but this was not seen for asthma. In contrast, higher exposure to Gram-negative endotoxins and Penicillium spp in primary school's classrooms was associated with increasing odds of allergic sensitization in children.
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Affiliation(s)
- João Cavaleiro Rufo
- Basic and Clinical Immunology, Faculty of Medicine, University of Porto, Porto, Portugal.,Centro Hospitalar São João, Porto, Portugal.,INEGI - Institute of Science and Innovation in Mechanical Engineering and Industrial Management, Porto, Portugal.,Epidemiology Research Unit, Institute of Public Health (EPIUnit), University of Porto, Porto, Portugal
| | - Joana Madureira
- INEGI - Institute of Science and Innovation in Mechanical Engineering and Industrial Management, Porto, Portugal
| | - Inês Paciência
- Basic and Clinical Immunology, Faculty of Medicine, University of Porto, Porto, Portugal.,Centro Hospitalar São João, Porto, Portugal.,INEGI - Institute of Science and Innovation in Mechanical Engineering and Industrial Management, Porto, Portugal.,Epidemiology Research Unit, Institute of Public Health (EPIUnit), University of Porto, Porto, Portugal
| | - Lívia Aguiar
- Epidemiology Research Unit, Institute of Public Health (EPIUnit), University of Porto, Porto, Portugal.,National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Cristiana Pereira
- Epidemiology Research Unit, Institute of Public Health (EPIUnit), University of Porto, Porto, Portugal.,National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Diana Silva
- Basic and Clinical Immunology, Faculty of Medicine, University of Porto, Porto, Portugal.,Centro Hospitalar São João, Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Luís Delgado
- Basic and Clinical Immunology, Faculty of Medicine, University of Porto, Porto, Portugal.,Centro Hospitalar São João, Porto, Portugal
| | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases Department, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM and UPC, Paris, France
| | - Eduardo Oliveira Fernandes
- INEGI - Institute of Science and Innovation in Mechanical Engineering and Industrial Management, Porto, Portugal
| | - João Paulo Teixeira
- Epidemiology Research Unit, Institute of Public Health (EPIUnit), University of Porto, Porto, Portugal.,National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - André Moreira
- Basic and Clinical Immunology, Faculty of Medicine, University of Porto, Porto, Portugal.,Centro Hospitalar São João, Porto, Portugal.,Epidemiology Research Unit, Institute of Public Health (EPIUnit), University of Porto, Porto, Portugal.,Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
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41
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Rocchi S, Valot B, Reboux G, Millon L. DNA metabarcoding to assess indoor fungal communities: Electrostatic dust collectors and Illumina sequencing. J Microbiol Methods 2017; 139:107-112. [PMID: 28559161 DOI: 10.1016/j.mimet.2017.05.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 05/23/2017] [Accepted: 05/25/2017] [Indexed: 10/19/2022]
Abstract
DNA metabarcoding is increasingly being used to characterize the microbiological composition of both the indoor and outdoor environments of dwellings. Our study aimed to evaluate metabarcoding and bioinformatic analysis resulting from calibrated samples and samples collected by an electrostatic dust collector (EDC) in dwellings with no moisture problems. Thus, the fungal communities of 14 dwellings (eastern France, Franche-Comté region) were analyzed by Illumina MiSeq technology after amplification of the ITS2 region. Using the standard samples of 11 species of yeasts and molds allowed us to validate the Operational taxonomic units (OTU) assignment. These calibrated samples also showed a low amplification bias, a low rate of sequencing errors and the semi-quantitative nature of the technique. Only one species from the calibrated samples (Lichtheimia corymbifera) was less amplified probably due to the presence of two mismatches in its3 primer. EDC analysis identified 3594OTU with 75% of reads corresponding to 30 genera. The main genera are those usually found by culture techniques (Penicillium, Aspergillus and Cladosporium), but findings also indicate others less commonly isolated in culture such as Epicoccum, the fourth detected genus in our study. The type of heating systems was correlated with fungal diversity. We found less diversity in the dwellings with wood heating and larger quantities of Epicoccum nigrum verified by qPCR. DNA metabarcoding analysis applied to EDC seems promising. However, we think that it must be used along with qPCR, to obtain a more global view of microbial ecology and relative quantification of species of interest within communities.
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Affiliation(s)
- Steffi Rocchi
- UMR CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France; Service de parasitologie mycologie, CHRU Jean Minjoz, Besançon, France.
| | - Benoit Valot
- UMR CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France
| | - Gabriel Reboux
- UMR CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France; Service de parasitologie mycologie, CHRU Jean Minjoz, Besançon, France
| | - Laurence Millon
- UMR CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France; Service de parasitologie mycologie, CHRU Jean Minjoz, Besançon, France
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42
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Park JH, Cox-Ganser JM, White SK, Laney AS, Caulfield SM, Turner WA, Sumner AD, Kreiss K. Bacteria in a water-damaged building: associations of actinomycetes and non-tuberculous mycobacteria with respiratory health in occupants. INDOOR AIR 2017; 27:24-33. [PMID: 26717439 PMCID: PMC5035226 DOI: 10.1111/ina.12278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/23/2015] [Indexed: 05/31/2023]
Abstract
We examined microbial correlates of health outcomes in building occupants with a sarcoidosis cluster and excess asthma. We offered employees a questionnaire and pulmonary function testing and collected floor dust and liquid/sludge from drain tubing traps of heat pumps that were analyzed for various microbial agents. Forty-nine percent of participants reported any symptom reflecting possible granulomatous disease (shortness of breath on exertion, flu-like achiness, or fever and chills) weekly in the last 4 weeks. In multivariate regressions, thermophilic actinomycetes (median = 529 CFU/m2 ) in dust were associated with FEV1 /FVC [coefficient = -2.8 per interquartile range change, P = 0.02], percent predicted FEF25-75% (coefficient = -12.9, P = 0.01), and any granulomatous disease-like symptom [odds ratio (OR) = 3.1, 95% confidence interval (CI) = 1.45-6.73]. Mycobacteria (median = 658 CFU/m2 ) were positively associated with asthma symptoms (OR = 1.5, 95% CI = 0.97-2.43). Composite score (median = 11.5) of total bacteria from heat pumps was negatively associated with asthma (0.8, 0.71-1.00) and positively associated with FEV1 /FVC (coefficient = 0.44, P = 0.095). Endotoxin (median score = 12.0) was negatively associated with two or more granulomatous disease-like symptoms (OR = 0.8, 95% CI = 0.67-0.98) and asthma (0.8, 0.67-0.96). Fungi or (1→3)-β-D-glucan in dust or heat pump traps was not associated with any health outcomes. Thermophilic actinomycetes and non-tuberculous mycobacteria may have played a role in the occupants' respiratory outcomes in this water-damaged building.
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Affiliation(s)
- J-H Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - J M Cox-Ganser
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - S K White
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - A S Laney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
- Vermont Department of Health, Burlington, VT, USA
| | - S M Caulfield
- Turner Building Science & Design, LLC, Harrison, ME, USA
| | - W A Turner
- Turner Building Science & Design, LLC, Harrison, ME, USA
| | - A D Sumner
- Vermont Department of Health, Burlington, VT, USA
- University of Vermont Health Network Occupational Medicine, Berlin, VT, USA
| | - K Kreiss
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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Holst GJ, Høst A, Doekes G, Meyer HW, Madsen AM, Plesner KB, Sigsgaard T. Allergy and respiratory health effects of dampness and dampness-related agents in schools and homes: a cross-sectional study in Danish pupils. INDOOR AIR 2016; 26:880-891. [PMID: 26643593 DOI: 10.1111/ina.12275] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/24/2015] [Indexed: 05/16/2023]
Affiliation(s)
- G. J. Holst
- Section of Environment, Occupation and Health; Aarhus University; Aarhus C Denmark
| | - A. Høst
- H.C. Andersen Children's Hospital; Odense University Hospital; Odense Denmark
| | - G. Doekes
- Institute for Risk Assessment Sciences; Utrecht University; Utrecht The Netherlands
| | - H. W. Meyer
- Department of Occupational and Environmental Medicine; Copenhagen University Hospital; Bispebjerg Denmark
| | - A. M. Madsen
- National Research Centre for the Working Environment; Copenhagen Denmark
| | - K. B. Plesner
- Department of Anaesthesiology and Intensive Care; Odense University Hospital; Odense Denmark
| | - T. Sigsgaard
- Section of Environment, Occupation and Health; Aarhus University; Aarhus C Denmark
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Adami AJ, Bracken SJ. Breathing Better Through Bugs: Asthma and the Microbiome. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2016; 89:309-324. [PMID: 27698615 PMCID: PMC5045140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Asthma is a highly heterogeneous disease characterized by inflammation of the airways, which invokes symptoms such as wheeze, dyspnea, and chest tightness. Asthma is the product of multiple interconnected immunological processes and represents a constellation of related, but distinct, disease phenotypes. The prevalence of asthma has more than doubled since the 1980s, and efforts to understand this increase have inspired consideration of the microbiome as a key player in the pathophysiology and regulation of this disease. While recent years have seen an explosion of new research in this area, researchers are only beginning to untangle to mechanisms by which the microbiome may influence asthma. This review will focus on the relationship between the microbiome and the immune system and how this influences development of asthma. This review will also highlight evidence that may point the way toward new therapies and potential cures for this ancient respiratory foe.
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Affiliation(s)
- Alexander J. Adami
- To whom all correspondence should be addressed: Alexander J. Adami, MD/PhD Student, University of Connecticut Health Center, Department of Immunology, 263 Farmington Avenue, MC 1319, Farmington, CT 06030, , Phone: 1-860-679-1995, Fax: 1-860-679-1047
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45
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Naegele A, Reboux G, Vacheyrou M, Valot B, Millon L, Roussel S. Microbiological consequences of indoor composting. INDOOR AIR 2016; 26:605-613. [PMID: 26299932 DOI: 10.1111/ina.12242] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 08/15/2015] [Indexed: 06/04/2023]
Abstract
Recycling of organic waste appeals to more and more people. The aim of this study was to evaluate the microbiological contamination around organic waste bins at three distances over a 12-month period. Contamination near the customary trash of control households was evaluated at the beginning to ensure that there is no recruitment bias. Air samples using the MAS 100 impactor were carried out in 38 dwellings that do household waste composting and in 10 dwellings of controls. Collection of particles by CIP 10 rotating cup sampler and dust samples collected by electrostatic dust collector cloths were acquired in dwellings that do household waste composting. Samples were analyzed by culture and by real-time quantitative PCR. Information about dwelling characteristics and inhabitant practices was obtained by a standardized questionnaire. The genera most often isolated were Penicillium, Aspergillus, Cladosporium and Streptomyces. Near the organic waste bins, bioaerosol samples showed an increase of Acarus siro (P = 0.001). Sedimented dust analyses highlighted an increase of A. siro, Wallemia sebi, Aspergillus versicolor, and Cladosporium sphaerospermum concentrations after a 12-month survey compared to the beginning. Composting favors microorganism development over time, but does not seem to have an effect on the bioaerosol levels and the surface microbiota beyond 0.5 m from the waste bin.
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Affiliation(s)
- A Naegele
- UMR/CNRS 6249 Chrono-Environnement, University of Bourgogne - Franche-Comté, Besançon, France
| | - G Reboux
- UMR/CNRS 6249 Chrono-Environnement, University of Bourgogne - Franche-Comté, Besançon, France
- Laboratory of Parasitology-Mycology, University Hospital, Besançon, France
| | - M Vacheyrou
- UMR/CNRS 6249 Chrono-Environnement, University of Bourgogne - Franche-Comté, Besançon, France
| | - B Valot
- UMR/CNRS 6249 Chrono-Environnement, University of Bourgogne - Franche-Comté, Besançon, France
| | - L Millon
- UMR/CNRS 6249 Chrono-Environnement, University of Bourgogne - Franche-Comté, Besançon, France
- Laboratory of Parasitology-Mycology, University Hospital, Besançon, France
| | - S Roussel
- UMR/CNRS 6249 Chrono-Environnement, University of Bourgogne - Franche-Comté, Besançon, France
- Laboratory of Parasitology-Mycology, University Hospital, Besançon, France
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Kirjavainen PV, Täubel M, Karvonen AM, Sulyok M, Tiittanen P, Krska R, Hyvärinen A, Pekkanen J. Microbial secondary metabolites in homes in association with moisture damage and asthma. INDOOR AIR 2016; 26:448-456. [PMID: 25913237 DOI: 10.1111/ina.12213] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 04/22/2015] [Indexed: 06/04/2023]
Abstract
We aimed to characterize the presence of microbial secondary metabolites in homes and their association with moisture damage, mold, and asthma development. Living room floor dust was analyzed by LC-MS/MS for 333 secondary metabolites from 93 homes of 1-year-old children. Moisture damage was present in 15 living rooms. At 6 years, 8 children had active and 15 lifetime doctor-diagnosed asthma. The median number of different metabolites per house was 17 (range 8-29) and median sum load 65 (4-865) ng/m(2) . Overall 42 different metabolites were detected. The number of metabolites present tended to be higher in homes with mold odor or moisture damage. The higher sum loads and number of metabolites with loads over 10 ng/m(2) were associated with lower prevalence of active asthma at 6 years (aOR 0.06 (95% CI <0.001-0.96) and 0.05 (<0.001-0.56), respectively). None of the individual metabolites, which presence tended (P < 0.2) to be increased by moisture damage or mold, were associated with increased risk of asthma. Microbial secondary metabolites are ubiquitously present in home floor dust. Moisture damage and mold tend to increase their numbers and amount. There was no evidence indicating that the secondary metabolites determined would explain the association between moisture damage, mold, and the development of asthma.
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Affiliation(s)
- P V Kirjavainen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - M Täubel
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
| | - A M Karvonen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
| | - M Sulyok
- Department IFA-Tulln, University of Natural Resources and Life Sciences, Vienna, Austria
| | - P Tiittanen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
| | - R Krska
- Department IFA-Tulln, University of Natural Resources and Life Sciences, Vienna, Austria
| | - A Hyvärinen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
| | - J Pekkanen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Hjelt Institute, University of Helsinki, Helsinki, Finland
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Huttunen K, Tirkkonen J, Täubel M, Krop E, Mikkonen S, Pekkanen J, Heederik D, Zock JP, Hyvärinen A, Hirvonen MR. Inflammatory potential in relation to the microbial content of settled dust samples collected from moisture-damaged and reference schools: results of HITEA study. INDOOR AIR 2016; 26:380-390. [PMID: 25967114 DOI: 10.1111/ina.12223] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 05/07/2015] [Indexed: 06/04/2023]
Abstract
Aiming to identify factors causing the adverse health effects associated with moisture-damaged indoor environments, we analyzed immunotoxicological potential of settled dust from moisture-damaged and reference schools in relation to their microbiological composition. Mouse RAW264.7 macrophages were exposed to settled dust samples (n = 25) collected from moisture-damaged and reference schools in Spain, the Netherlands, and Finland. After exposure, we analyzed production of inflammatory markers [nitric oxide (NO), tumor necrosis factor-α (TNF-)α, interleukin (IL)-6, and macrophage inflammatory protein (MIP)2] as well as mitochondrial activity, viability, apoptosis, and cell cycle arrest. Furthermore, particle counts, concentration of selected microbial groups as well as chemical markers such as ergosterol, 3-hydroxy fatty acids, muramic acid, endotoxins, and glucans were measured as markers of exposure. Dust from moisture-damaged schools in Spain and the Netherlands induced stronger immunotoxicological responses compared to samples from reference schools; the responses to Finnish samples were generally lower with no difference between the schools. In multivariate analysis, IL-6 and apoptosis responses were most strongly associated with moisture status of the school. The measured responses correlated with several microbial markers and numbers of particles, but the most important predictor of the immunotoxicological potential of settled dust was muramic acid concentration, a marker of Gram-positive bacteria.
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Affiliation(s)
- K Huttunen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
- School of Bioscience, Cardiff University, Cardiff, UK
| | - J Tirkkonen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
| | - M Täubel
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - E Krop
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - S Mikkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - J Pekkanen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - D Heederik
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - J-P Zock
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - A Hyvärinen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - M-R Hirvonen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
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48
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Lemas DJ, Young BE, Baker PR, Tomczik AC, Soderborg TK, Hernandez TL, de la Houssaye BA, Robertson CE, Rudolph MC, Ir D, Patinkin ZW, Krebs NF, Santorico SA, Weir T, Barbour LA, Frank DN, Friedman JE. Alterations in human milk leptin and insulin are associated with early changes in the infant intestinal microbiome. Am J Clin Nutr 2016; 103:1291-300. [PMID: 27140533 PMCID: PMC4841936 DOI: 10.3945/ajcn.115.126375] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/08/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Increased maternal body mass index (BMI) is a robust risk factor for later pediatric obesity. Accumulating evidence suggests that human milk (HM) may attenuate the transfer of obesity from mother to offspring, potentially through its effects on early development of the infant microbiome. OBJECTIVES Our objective was to identify early differences in intestinal microbiota in a cohort of breastfeeding infants born to obese compared with normal-weight (NW) mothers. We also investigated relations between HM hormones (leptin and insulin) and both the taxonomic and functional potentials of the infant microbiome. DESIGN Clinical data and infant stool and fasting HM samples were collected from 18 NW [prepregnancy BMI (in kg/m(2)) <24.0] and 12 obese (prepregnancy BMI >30.0) mothers and their exclusively breastfed infants at 2 wk postpartum. Infant body composition at 2 wk was determined by air-displacement plethysmography. Infant gastrointestinal microbes were estimated by using 16S amplicon and whole-genome sequencing. HM insulin and leptin were determined by ELISA; short-chain fatty acids (SCFAs) were measured in stool samples by using gas chromatography. Power was set at 80%. RESULTS Infants born to obese mothers were exposed to 2-fold higher HM insulin and leptin concentrations (P < 0.01) and showed a significant reduction in the early pioneering bacteria Gammaproteobacteria (P = 0.03) and exhibited a trend for elevated total SCFA content (P < 0.06). Independent of maternal prepregnancy BMI, HM insulin was positively associated with both microbial taxonomic diversity (P = 0.03) and Gammaproteobacteria (e.g., Enterobacteriaceae; P = 0.04) and was negatively associated with Lactobacillales (e.g., Streptococcaceae; P = 0.05). Metagenomic analysis showed that HM leptin and insulin were associated with decreased bacterial proteases, which are implicated in intestinal permeability, and reduced concentrations of pyruvate kinase, a biomarker of pediatric gastrointestinal inflammation. CONCLUSION Our results indicate that, although maternal obesity may adversely affect the early infant intestinal microbiome, HM insulin and leptin are independently associated with beneficial microbial metabolic pathways predicted to increase intestinal barrier function and reduce intestinal inflammation. This trial was registered at clinicaltrials.gov as NCT01693406.
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Affiliation(s)
| | | | - Peter R Baker
- Clinical Genetics and Metabolism, Department of Pediatrics
| | | | | | - Teri L Hernandez
- Divisions of Endocrinology, Metabolism, and Diabetes and College of Nursing
| | | | | | | | - Diana Ir
- Infectious Diseases, Department of Medicine
| | | | | | - Stephanie A Santorico
- Human Medical Genetics and Genomics Program; and Department of Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO; and
| | - Tiffany Weir
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Linda A Barbour
- Divisions of Endocrinology, Metabolism, and Diabetes and Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Jacob E Friedman
- Sections of Neonatology, Divisions of Endocrinology, Metabolism, and Diabetes and
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Application of the Environmental Relative Moldiness Index in Finland. Appl Environ Microbiol 2015; 82:578-84. [PMID: 26546428 PMCID: PMC4711148 DOI: 10.1128/aem.02785-15] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 11/04/2015] [Indexed: 11/24/2022] Open
Abstract
The environmental relative moldiness index (ERMI) metric was previously developed to quantify mold contamination in U.S. homes. This study determined the applicability of the ERMI for quantifying mold and moisture damage in Finnish residences. Homes of the LUKAS2 birth cohort in Finland were visually inspected for moisture damage and mold, and vacuumed floor dust samples were collected. An ERMI analysis including 36 mold-specific quantitative PCR assays was performed on the dust samples (n = 144), and the ERMI metric was analyzed against inspection-based observations of moisture damage and mold. Our results show that the ERMI was significantly associated with certain observations of visible mold in Finnish homes but not with moisture damage. Several mold species occurred more frequently and at higher levels in Finnish than in U.S. homes. Modification of the ERMI toward Finnish conditions, using a subsample of LUKAS2 homes with and without moisture damage, resulted in a simplified metric based on 10 mold species. The Finnish ERMI (FERMI) performed substantially better in quantifying moisture and mold damage in Finnish homes, showing significant associations with various observations of visible mold, strongest when the damage was located in the child's main living area, as well as with mold odor and moisture damage. As shown in Finland, the ERMI as such is not equally well usable in different climates and geographic regions but may be remodeled to account for local outdoor and indoor fungal conditions as well as for moisture damage characteristics in a given country.
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50
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Toppila-Salmi S, Huhtala H, Karjalainen J, Renkonen R, Mäkelä MJ, Wang DY, Pekkanen J. Sensitization pattern affects the asthma risk in Finnish adult population. Allergy 2015; 70:1112-20. [PMID: 26095518 DOI: 10.1111/all.12670] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND There is a large global variation in the sensitization pattern and its association with allergic diseases. In temperate and tropical urban environments, mite monosensitization can be the predominant cause of allergic airway diseases, whereas in other environments, polysensitization is more typical. Sensitization to mite allergens associates with asthma. However, it is suggested that mite sensitization might play a minor role in Northern Europe. The aim of the study was to analyze how sensitization pattern affects the asthma risk in Finnish adults, with a special focus on mites. METHODS A population-based case-control data (N = 523) from Finnish adult asthma patients with one or two matched controls were used. Asthma was diagnosed based on a typical history of asthmatic symptoms and lung function tests. The allergic sensitization was determined based on skin prick test (SPT) of five mites, three molds, and nine other aeroallergens. Information on demographics was obtained by a questionnaire. RESULTS The proportion of sensitization to any allergen was 55% in the asthma group and 39% in the control group (P = 0.001, OR 2.06, 95% CI = 1.35-3.14). Sensitization to animal dander, pollen, or Aspergillus fumigatus was associated with asthma. Polysensitization to more than one allergen types and the number of SPT-positive reactions associated with asthma, whereas sensitization to only one allergen type was not associated with asthma. CONCLUSIONS The large number of sensitizations to several types of allergens distinguishes subjects with asthma. Mite sensitization had little independent association with asthma in Finland.
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Affiliation(s)
- S. Toppila-Salmi
- Haartman Institute; University of Helsinki; Helsinki Finland
- Department of Allergy; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - H. Huhtala
- School of Health Sciences; University of Tampere; Tampere Finland
| | - J. Karjalainen
- Allergy Centre; Tampere University Hospital; Tampere Finland
| | - R. Renkonen
- Haartman Institute; University of Helsinki; Helsinki Finland
- HUSLAB; Helsinki University Hospital; Helsinki Finland
| | - M. J. Mäkelä
- Department of Allergy; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - D. Y. Wang
- Department of Otorhinolaryngology; National University of Singapore; Singapore Singapore
| | - J. Pekkanen
- Department of Public Health; Hjelt Institute; University of Helsinki; Helsinki Finland
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