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Yong GJM, Porsche CE, Sitarik AR, Fujimura KE, McCauley K, Nguyen DT, Levin AM, Woodcroft KJ, Ownby DR, Rundle AG, Johnson CC, Cassidy-Bushrow A, Lynch SV. Precocious infant fecal microbiome promotes enterocyte barrier dysfuction, altered neuroendocrine signaling and associates with increased childhood obesity risk. Gut Microbes 2024; 16:2290661. [PMID: 38117587 PMCID: PMC10761186 DOI: 10.1080/19490976.2023.2290661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/29/2023] [Indexed: 12/22/2023] Open
Abstract
Early life gut microbiome composition has been correlated with childhood obesity, though microbial functional contributions to disease origins remain unclear. Here, using an infant birth cohort (n = 349) we identify a distinct fecal microbiota composition in 1-month-old infants with the lowest rate of exclusive breastfeeding, that relates with higher relative risk for obesity and overweight phenotypes at two years. Higher-risk infant fecal microbiomes exhibited accelerated taxonomic and functional maturation and broad-ranging metabolic reprogramming, including reduced concentrations of neuro-endocrine signals. In vitro, exposure of enterocytes to fecal extracts from higher-risk infants led to upregulation of genes associated with obesity and with expansion of nutrient sensing enteroendocrine progenitor cells. Fecal extracts from higher-risk infants also promoted enterocyte barrier dysfunction. These data implicate dysregulation of infant microbiome functional development, and more specifically promotion of enteroendocrine signaling and epithelial barrier impairment in the early-life developmental origins of childhood obesity.
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Affiliation(s)
- Germaine J. M. Yong
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA
- Asian Microbiome Library Pte Ltd, Singapore and Singapore Institute of Food and Biotechnology Innovation, Singapore, Singapore
| | - Cara E. Porsche
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Alexandra R. Sitarik
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Kei E. Fujimura
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA
- Genetic Disease Laboratory, California Department of Public Health, San Francisco, CA, USA
| | - Kathryn McCauley
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Dat T. Nguyen
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Albert M. Levin
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | | | - Dennis R. Ownby
- Division of Allergy and Clinical Immunology, Department of Pediatrics, Augusta University, Augusta, GA, USA
| | - Andrew G. Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Christine C. Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | | | - Susan V. Lynch
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA
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Shipton EV, Foxcroft K, Dekker Nitert M, McIntyre HD, Barrett H, Tang M, Callaway L. OFFSPRING: A SPRING Follow-Up Study Assessing the Efficacy of Maternal Probiotics and Allergic Disease in the Child. Int Arch Allergy Immunol 2023; 185:212-217. [PMID: 38104554 PMCID: PMC10911140 DOI: 10.1159/000535179] [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: 10/03/2023] [Accepted: 11/02/2023] [Indexed: 12/19/2023] Open
Abstract
INTRODUCTION There are a variety of factors that contribute to the development of allergic diseases in children, including environmental exposures during the maternal prenatal period. It has been proposed that probiotic supplementation during pregnancy could be used as a possible preventative measure to target childhood allergic disease. METHODS Participants from a previously conducted prospective double-blind randomised control trial of probiotics versus placebo study (Study of PRrobiotics IN Gestation) were sent electronic questionnaires to complete about their child, who are now between 3 and 7 years of age. Demographic data and rates of allergic diseases were compared between the two groups. RESULTS One hundred and seven women responded to the questionnaires. Between the two groups, there was no difference in the frequency of allergic diseases, with similar rates of eczema, asthma, and hospital presentations seen. CONCLUSION In this follow-up study, infants of mothers who were exposed to probiotics during their pregnancy do not appear to have any paediatric health advantages in terms of allergic diseases.
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Affiliation(s)
- Emma V. Shipton
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Katie Foxcroft
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Marloes Dekker Nitert
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
| | - H. David McIntyre
- Mater Medical Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Helen Barrett
- Mater Medical Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Obstetric Medicine, The Royal Hospital for Women, Sydney, NSW, Australia
| | - Mimi Tang
- Allergy Immunology, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Department of Allergy Immunology, Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Leonie Callaway
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia
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Biagini JM, Martin LJ, He H, Bacharier LB, Gebretsadik T, Hartert TV, Jackson DJ, Kim H, Miller RL, Rivera-Spoljaric K, Schauberger EM, Singh AM, Visness CM, Wegienka G, Ownby DR, Gold DR, Martinez FD, Johnson CC, Wright AL, Gern JE, Khurana Hershey GK. Performance of the Pediatric Asthma Risk Score across Diverse Populations. NEJM EVIDENCE 2023; 2:EVIDoa2300026. [PMID: 38320177 DOI: 10.1056/evidoa2300026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
BACKGROUND: Methods to determine whether a toddler is likely to develop asthma are of value to parents and clinical trialists testing primary prevention strategies. The Pediatric Asthma Risk Score (PARS) is a 14-point score of six factors designed to predict asthma in early life. PARS was developed and validated in relatively homogenous populations, so its generalizability is unknown. METHODS: We computed PARS using the six factors of self-declared race (parent-reported as “Black” or “not Black”), parental asthma, eczema, any wheezing, wheezing without a cold, and polysensitization in 5634 children from birth to 3 years of age. The primary outcome of our analysis was the ability of PARS to predict asthma development at 5 to 10 years of age using the area under the receiver operating curve in each cohort and across all cohorts with varying ethnicity, sex, cohort type, birth decades, missing PARS factors, and polysensitization definition. We also performed a meta-analysis across all the cohorts. Finally, we compared PARS predictive ability with the binary Asthma Predictive Index (API). RESULTS: Across 10 cohorts, the area under the receiver operating curve for PARS was 0.76. PARS performance did not differ by ethnicity, sex, cohort type, enrollment decade, missing PARS factors, or polysensitization definition (all P>0.05). The weights of each factor in the meta-analysis were similar to the original PARS weights. PARS and API equally identified children at high risk for developing asthma or not; API missed 31% of children at moderate asthma risk. CONCLUSIONS: PARS provided robust estimates of asthma risk in children from a wide range of ethnicities, backgrounds, and susceptibility. (Funded by the National Institute of Allergy and Infectious Diseases and others.)
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Affiliation(s)
- Jocelyn M Biagini
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati
| | - Lisa J Martin
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati
| | - Hua He
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati
| | | | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville
| | - Tina V Hartert
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville
| | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | - Haejin Kim
- Department of Internal Medicine, Henry Ford Health, Detroit
| | - Rachel L Miller
- Department of Medicine, Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York
| | | | - Eric M Schauberger
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | | | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit
| | - Dennis R Ownby
- Department of Public Health Sciences, Henry Ford Health System, Detroit
| | - Diane R Gold
- The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston
| | - Fernando D Martinez
- Asthma and Airways Disease Research Center, Department of Pediatrics, College of Medicine, University of Arizona, Tucson
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Arizona, Tucson
| | | | - Anne L Wright
- Asthma and Airways Disease Research Center, Department of Pediatrics, College of Medicine, University of Arizona, Tucson
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Arizona, Tucson
| | - James E Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | - Gurjit K Khurana Hershey
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati
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Panzer AR, Sitarik AR, Fadrosh D, Havstad SL, Jones K, Davidson B, Finazzo S, Wegienka GR, Woodcroft K, Lukacs NW, Levin AM, Ownby DR, Johnson CC, Lynch SV, Zoratti EM. The impact of prenatal dog keeping on infant gut microbiota development. Clin Exp Allergy 2023; 53:833-845. [PMID: 36916778 PMCID: PMC11163251 DOI: 10.1111/cea.14303] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/15/2023]
Abstract
INTRODUCTION Prenatal and early-life dog exposure has been linked to reduced childhood allergy and asthma. A potential mechanism includes altered early immune development in response to changes in the gut microbiome among dog-exposed infants. We thus sought to determine whether infants born into homes with indoor dog(s) exhibit altered gut microbiome development. METHODS Pregnant women living in homes with dogs or in pet-free homes were recruited in southeast Michigan. Infant stool samples were collected at intervals between 1 week and 18 months after birth and microbiome was assessed using 16S ribosomal sequencing. Perinatal maternal vaginal/rectal swabs and stool samples were sequenced from a limited number of mothers. Mixed effect adjusted models were used to assess stool microbial community trajectories comparing infants from dog-keeping versus pet-free homes with adjustment for relevant covariates. RESULTS Infant gut microbial composition among vaginally born babies became less similar to the maternal vaginal/rectal microbiota and more similar to the maternal gut microbiota with age-related accumulation of bacterial species with advancing age. Stool samples from dog-exposed infants were microbially more diverse (p = .041) through age 18 months with enhanced diversity most apparent between 3 and 6 months of age. Statistically significant effects of dog exposure on β-diversity metrics were restricted to formula-fed children. Across the sample collection period, dog exposure was associated with Fusobacterium genera enrichment, as well as enrichment of Collinsella, Ruminococcus, Clostridaceae and Lachnospiraceae OTUs. CONCLUSION Prenatal/early-life dog exposure is associated with an altered gut microbiome during infancy and supports a potential mechanism explaining lessened atopy and asthma risk. Further research directly linking specific dog-attributable changes in the infant gut microbiome to the risk of allergic disorders is needed.
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Affiliation(s)
- Ariane R Panzer
- Department of Medicine, University of California, San Francisco, California, USA
| | - Alexandra R Sitarik
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
| | - Doug Fadrosh
- Department of Medicine, University of California, San Francisco, California, USA
| | - Suzanne L Havstad
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
| | - Kyra Jones
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
| | - Brent Davidson
- Department of Women's Health, Henry Ford Health System, Detroit, Michigan, USA
| | - Salvatore Finazzo
- Department of Obstetrics and Gynecology, Henry Ford Wyandotte Hospital, Wyandotte, Michigan, USA
| | - Ganesa R Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
| | - Kimberley Woodcroft
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
| | - Nicholas W Lukacs
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Albert M Levin
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
- Center for Bioinformatics, Henry Ford Health System, Detroit, Michigan, USA
| | - Dennis R Ownby
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
- Department of Pediatrics, Augusta University, Augusta, Georgia, USA
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
| | - Susan V Lynch
- Department of Medicine, University of California, San Francisco, California, USA
| | - Edward M Zoratti
- Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA
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García-Serna AM, Martín-Orozco E, Hernández-Caselles T, Morales E. Prenatal and Perinatal Environmental Influences Shaping the Neonatal Immune System: A Focus on Asthma and Allergy Origins. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083962. [PMID: 33918723 PMCID: PMC8069583 DOI: 10.3390/ijerph18083962] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 01/04/2023]
Abstract
It is suggested that programming of the immune system starts before birth and is shaped by environmental influences acting during critical windows of susceptibility for human development. Prenatal and perinatal exposure to physiological, biological, physical, or chemical factors can trigger permanent, irreversible changes to the developing immune system, which may be reflected in cord blood of neonates. The aim of this narrative review is to summarize the evidence on the role of the prenatal and perinatal environment, including season of birth, mode of delivery, exposure to common allergens, a farming environment, pet ownership, and exposure to tobacco smoking and pollutants, in shaping the immune cell populations and cytokines at birth in humans. We also discuss how reported disruptions in the immune system at birth might contribute to the development of asthma and related allergic manifestations later in life.
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Affiliation(s)
- Azahara María García-Serna
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.M.G.-S.); (E.M.-O.); (T.H.-C.)
- Department of Biochemistry and Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
| | - Elena Martín-Orozco
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.M.G.-S.); (E.M.-O.); (T.H.-C.)
- Department of Biochemistry and Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
- Network of Asthma and Adverse and Allergic Reactions (ARADyAL), 28029 Madrid, Spain
| | - Trinidad Hernández-Caselles
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.M.G.-S.); (E.M.-O.); (T.H.-C.)
- Department of Biochemistry and Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
- Network of Asthma and Adverse and Allergic Reactions (ARADyAL), 28029 Madrid, Spain
| | - Eva Morales
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.M.G.-S.); (E.M.-O.); (T.H.-C.)
- Department of Public Health Sciences, University of Murcia, 30100 Murcia, Spain
- Correspondence: ; Tel.: +34-868883691
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Sitarik AR, Kerver JM, Havstad SL, Zoratti EM, Ownby DR, Wegienka G, Johnson CC, Cassidy-Bushrow AE. Infant Feeding Practices and Subsequent Dietary Patterns of School-Aged Children in a US Birth Cohort. J Acad Nutr Diet 2020; 121:1064-1079. [PMID: 33544667 DOI: 10.1016/j.jand.2020.08.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/13/2020] [Accepted: 08/21/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Infant feeding practices are thought to shape food acceptance and preferences. However, few studies have evaluated whether these affect child diet later in life. OBJECTIVE The study objective was to examine the association between infant feeding practices and dietary patterns (DPs) in school-aged children. DESIGN A secondary analysis of data from a diverse prospective birth cohort with 10 years of follow-up (WHEALS [Wayne County Health Environment Allergy and Asthma Longitudinal Study]) was conducted. PARTICIPANTS/SETTING Children from the WHEALS (Detroit, MI, born 2003 through 2007) who completed a food screener at age 10 years were included (471 of 1,258 original participants). MAIN OUTCOME MEASURES The main outcome was DPs at age 10 years, identified using the Block Kids Food Screener. STATISTICAL ANALYSIS PERFORMED Latent class analysis was applied for DP identification. Breastfeeding and age at solid food introduction were associated with DPs using a 3-step approach for latent class modeling based on multinomial logistic regression models. RESULTS The following childhood DPs were identified: processed/energy-dense food (35%), variety plus high intake (41%), and healthy (24%). After weighting for loss to follow-up and covariate adjustment, compared with formula-fed children at 1 month, breastfed children had 0.41 times lower odds of the processed/energy-dense food DP vs the healthy DP (95% CI 0.14 to 1.25) and 0.53 times lower odds of the variety plus high intake DP (95% CI 0.17 to 1.61), neither of which were statistically significant. Results were similar, but more imprecise, for breastfeeding at 6 months. In addition, the association between age at solid food introduction and DP was nonsignificant, with each 1-month increase in age at solid food introduction associated with 0.81 times lower odds of the processed/energy-dense food DP relative to the healthy DP (95% CI 0.64 to 1.02). CONCLUSIONS A significant association between early life feeding practices and dietary patterns at school age was not detected. Large studies with follow-up beyond early childhood that can also adjust for the multitude of potential confounders associated with breastfeeding are needed.
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Zhang HL, Wang BY, Luo Y, Li Y, Cai CS, Huang LL, He BH, Cai J, Li ZY, Mai AD, Guo Y. Association of pet-keeping in home with self-reported asthma and asthma-related symptoms in 11611 school children from China. J Asthma 2020; 58:1555-1564. [PMID: 32985283 DOI: 10.1080/02770903.2020.1818772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We conducted a cross-sectional study to investigate the associations between domestic pets and respiratory health in children. METHODS We randomly recruited 11,611 school children from Zhongshan, a southern city in China. Information about the respiratory symptoms and disease history of the recruited children, the status of domestic pets, and other related risk factors were collected from March to July 2016. RESULTS We identified cat-keeping at home increases the risk of persistent cough (OR, 1.77; 95%CI, 1.03-3.05); poultry-keeping at home increases the risk of current asthma (OR, 3.87; 95%CI, 1.08-13.92) and allergic rhinitis (OR, 1.84; 95%CI, 1.01-3.37); sleeping with pets increases the risk of persistent phlegm (OR, 5.04; 95%CI, 1.05-24.28), doctor-diagnosed asthma (OR, 3.35; 95%CI, 1.31-8.57) and current asthma (OR, 4.94; 95%CI, 1.05-23.31) in children. CONCLUSIONS Cat-keeping and molds on the wall of the house had the multiplicative and additive interaction in doctor-diagnosed asthma. In conclusion, pet-keeping increased the risk of respiratory symptoms in children.
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Affiliation(s)
- Hao-Ling Zhang
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Bo-Yuan Wang
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Yun Luo
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Yu Li
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Chun-Sheng Cai
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Li-Li Huang
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Bin-Hong He
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Jian Cai
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
| | - Zi-Ying Li
- Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Ai-Die Mai
- Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Yan Guo
- Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong Province, China
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Sitarik AR, Havstad SL, Johnson CC, Jones K, Levin AM, Lynch SV, Ownby DR, Rundle AG, Straughen JK, Wegienka G, Woodcroft KJ, Yong GJM, Cassidy-Bushrow AE. Association between cesarean delivery types and obesity in preadolescence. Int J Obes (Lond) 2020; 44:2023-2034. [PMID: 32873910 PMCID: PMC7530127 DOI: 10.1038/s41366-020-00663-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 08/10/2020] [Accepted: 08/19/2020] [Indexed: 01/04/2023]
Abstract
Background/Objectives: The association between mode of delivery and childhood obesity remains inconclusive. Because few studies have separated C-section types (planned or unplanned C-section), our objective was to assess how these subtypes relate to pre-adolescent obesity. Subjects/Methods: The study consisted of 570 maternal-child pairs drawn from the WHEALS birth cohort based in Detroit, Michigan. Children were followed-up at 10 years of age where a variety of anthropometric measurements were collected. Obesity was defined based on BMI percentile (≥95th percentile), as well as through gaussian finite mixture modeling on the anthropometric measurements. Risk ratios (RRs) and 95% confidence intervals (CIs) for obesity comparing planned and unplanned C-sections to vaginal deliveries were computed, which utilized inverse probability weights to account for loss to follow-up and multiple imputation for covariate missingness. Mediation models were fit to examine the mediation role of breastfeeding. Results: After adjusting for marital status, maternal race, prenatal tobacco smoke exposure, maternal age, maternal BMI, any hypertensive disorders during pregnancy, gestational diabetes, prenatal antibiotic use, child sex, parity, and birthweight z-score, children born via planned C-section had 1.77 times higher risk of obesity (≥95th percentile), relative to those delivered vaginally ((95% CI)=(1.16,2.72); p=0.009). No association was found comparing unplanned C-section to vaginal delivery (RR (95% CI)=0.75 (0.45, 1.23); p=0.25). Results were similar but slightly stronger when obesity was defined by anthropometric class (RR (95% CI)=2.78 (1.47, 5.26); p=0.002). Breastfeeding did not mediate the association between mode of delivery and obesity. Conclusions: These findings indicate that children delivered via planned C-section—but not unplanned C-section—have a higher risk of pre-adolescent obesity, suggesting that partial labor or membrane rupture (typically experienced during unplanned C-section delivery) may offer protection. Additional research is needed to understand the biological mechanisms behind this effect, including whether microbiological differences fully or partially account for the association.
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Affiliation(s)
- Alexandra R Sitarik
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.
| | - Suzanne L Havstad
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Kyra Jones
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Albert M Levin
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Susan V Lynch
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Dennis R Ownby
- Division of Allergy & Immunology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jennifer K Straughen
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | | | - Germaine J M Yong
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA
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Dog keeping at home before and during pregnancy decreased the risk of food allergy in 1-year-old children. Postepy Dermatol Alergol 2020; 37:255-261. [PMID: 32489363 PMCID: PMC7262798 DOI: 10.5114/ada.2018.80584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 10/31/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction The relationship between allergen exposure to animals in pregnancy and the development of allergic symptoms is not clear. Aim To evaluate the association between prenatal and postnatal exposure to pet ownership and development of atopic dermatitis, food allergy and wheezing in children at the age of 1 and 2. Material and methods The mother-child pairs included in this study were part of the Polish Mother and Child Cohort. Mothers in each trimester of pregnancy and 1 year after childbirth have completed a questionnaire on animal exposure. Children's health status was assessed at around one year and two years of age. Results Keeping a dog at home before and during pregnancy (every trimester) decreased the risk of food allergy in the first year of life. On the other hand, keeping any animal other than a dog (cat, hamster, guinea pig, rabbit) before pregnancy and during each trimester separately increased the risk of food allergy in the first year of life of children. Keeping a guinea pig in the first trimester of pregnancy increased the risk of wheezing in the first year of life. The analysis did not show any significant associations between keeping animals at home before and during pregnancy and the occurrence of atopic dermatitis in the second year of life. Conclusions Keeping a dog at home before and during pregnancy decreased the risk of food allergy in 1-year-old children. This effect was eliminated in case of having a cat, hamster, guinea pig, or rabbit.
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10
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Sitarik A, Havstad S, Kim H, Zoratti EM, Ownby D, Johnson CC, Wegienka G. Racial disparities in allergic outcomes persist to age 10 years in black and white children. Ann Allergy Asthma Immunol 2020; 124:342-349. [PMID: 31945477 DOI: 10.1016/j.anai.2020.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/06/2019] [Accepted: 01/02/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Previous analyses in the WHEALS birth cohort demonstrated that black children are more likely to experience allergic outcomes than white children by age 2 years. The results could not be explained by a host of variables. OBJECTIVE Assess whether racial disparities persisted to age 10 years and determine whether any differences could be explained by a panel of variables related to early life exposures in WHEALS. METHODS At age 10 years, WHEALS children (n = 481) completed skin prick testing, spirometry and methacholine challenge, and a physician examination for eczema and asthma. Allergen-specific immunoglobulin Es (sIgE) and total IgE were measured. Inverse probability weighting with logistic and linear regression models was used to assess associations between race (black or white) and the outcomes. RESULTS Black children fared worse than white children with respect to each outcome. Black children were more likely to have eczema, asthma, sensitization (≥1 sIgE ≥ 0.35 IU/L) and at least 1 positive skin pick test; however, some variability was present in the magnitudes of association within subgroups defined by delivery mode, sex of the child, prenatal indoor dog exposure, and firstborn status. In some subgroups, black children were also more likely to have higher total IgE and worse pulmonary function test measures (PC 20 ≤ 25 mg/mL, % predicted forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1]/FVC, forced expiratory flow from 25% to 75% of vital capacity [FEF25-75]). Confounding did not explain these differences. CONCLUSION Racial differences persisted in this cohort through age 10 years. Future studies should include potentially important, but rarely studied factors such as segregation and structural racism, because these factors could explain the observed racial differences.
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Affiliation(s)
- Alexandra Sitarik
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan; In Vivo: Planetary Health: an affiliate of the World Universities Network (WUN), West New York, New Jersey
| | - Suzanne Havstad
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan; In Vivo: Planetary Health: an affiliate of the World Universities Network (WUN), West New York, New Jersey
| | - Haejin Kim
- Division of Allergy and Clinical Immunology, Henry Ford Health System, Detroit, Michigan
| | - Edward M Zoratti
- Division of Allergy and Clinical Immunology, Henry Ford Health System, Detroit, Michigan
| | - Dennis Ownby
- Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Christine Cole Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan; In Vivo: Planetary Health: an affiliate of the World Universities Network (WUN), West New York, New Jersey; Center for Urban Responses to Environmental Stressors (CURES), Detroit, Michigan
| | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan; In Vivo: Planetary Health: an affiliate of the World Universities Network (WUN), West New York, New Jersey; Center for Urban Responses to Environmental Stressors (CURES), Detroit, Michigan.
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11
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Yolken R, Stallings C, Origoni A, Katsafanas E, Sweeney K, Squire A, Dickerson F. Exposure to household pet cats and dogs in childhood and risk of subsequent diagnosis of schizophrenia or bipolar disorder. PLoS One 2019; 14:e0225320. [PMID: 31790431 PMCID: PMC6886852 DOI: 10.1371/journal.pone.0225320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/02/2019] [Indexed: 12/19/2022] Open
Abstract
Background Serious psychiatric disorders such as schizophrenia and bipolar disorder have been associated with environmental exposures in early life. Contact with household pets such as cats and dogs can serve as a source of environmental exposure during these time periods. Methods We investigated the relationship between exposure to a household pet cat or dog during the first 12 years of life and having a subsequent diagnosis of schizophrenia or bipolar disorder. These studies were performed in a cohort of 396 individuals with schizophrenia, 381 with bipolar disorder, and 594 controls. The hazards of developing schizophrenia or bipolar disorder associated with first exposure to a household pet cat or dog were calculated using Cox Proportional Hazard and multivariate logistic regression models including socio-demographic covariates. Results We found that exposure to a household pet dog was associated with a significantly decreased hazard of having a subsequent diagnosis of schizophrenia (Hazard Ratio .75, p < .002) Furthermore, a significant decreased relative risk of schizophrenia was detected following exposure at birth and during the first years of life. There was no significant relationship between household exposure to a pet dog and bipolar disorder. There were no significant associations between exposure to a household pet cat and subsequent risk of either a schizophrenia or bipolar disorder diagnosis. However, there were trends towards an increased risk of both disorders at defined periods of exposure. Conclusions Exposure to household pets during infancy and childhood may be associated with altered rates of development of psychiatric disorders in later life.
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Affiliation(s)
- Robert Yolken
- Stanley Division of Developmental Neurovirology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
| | - Cassie Stallings
- Sheppard Pratt Health System, Baltimore, Maryland, United States of America
| | - Andrea Origoni
- Sheppard Pratt Health System, Baltimore, Maryland, United States of America
| | - Emily Katsafanas
- Sheppard Pratt Health System, Baltimore, Maryland, United States of America
| | - Kevin Sweeney
- Sheppard Pratt Health System, Baltimore, Maryland, United States of America
| | - Amalia Squire
- Sheppard Pratt Health System, Baltimore, Maryland, United States of America
| | - Faith Dickerson
- Sheppard Pratt Health System, Baltimore, Maryland, United States of America
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12
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Bunyavanich S, Berin MC. Food allergy and the microbiome: Current understandings and future directions. J Allergy Clin Immunol 2019; 144:1468-1477. [PMID: 31812181 PMCID: PMC6905201 DOI: 10.1016/j.jaci.2019.10.019] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/21/2019] [Accepted: 10/23/2019] [Indexed: 02/07/2023]
Abstract
Growing evidence points to an important role for the commensal microbiota in susceptibility to food allergy. Epidemiologic studies demonstrate associations between exposures known to modify the microbiome and risk of food allergy. Direct profiling of the gut microbiome in human cohort studies has demonstrated that individuals with food allergy have distinct gut microbiomes compared to healthy control subjects, and dysbiosis precedes the development of food allergy. Mechanistic studies in mouse models of food allergy have confirmed that the composition of the intestinal microbiota can imprint susceptibility or resistance to food allergy on the host and have identified a unique population of microbially responsive RORγt-positive FOXp3-positive regulatory T cells as critical for the maintenance of tolerance to foods. Armed with this new understanding of the role of the microbiota in food allergy and tolerance, therapeutics aimed at modifying the gastrointestinal microbiota are in development. In this article we review key milestones in the development of our current understanding of how the gastrointestinal microbiota contributes to food allergy and discuss our vision for the future of the field.
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Affiliation(s)
- Supinda Bunyavanich
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - M Cecilia Berin
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; PRIISM Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
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13
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Elevated faecal 12,13-diHOME concentration in neonates at high risk for asthma is produced by gut bacteria and impedes immune tolerance. Nat Microbiol 2019; 4:1851-1861. [PMID: 31332384 DOI: 10.1038/s41564-019-0498-2] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/29/2019] [Indexed: 01/20/2023]
Abstract
Neonates at risk of childhood atopy and asthma exhibit perturbation of the gut microbiome, metabolic dysfunction and increased concentrations of 12,13-diHOME in their faeces. However, the mechanism, source and contribution of this lipid to allergic inflammation remain unknown. Here, we show that intra-abdominal treatment of mice with 12,13-diHOME increased pulmonary inflammation and decreased the number of regulatory T (Treg) cells in the lungs. Treatment of human dendritic cells with 12,13-diHOME altered expression of PPARγ-regulated genes and reduced anti-inflammatory cytokine secretion and the number of Treg cells in vitro. Shotgun metagenomic sequencing of neonatal faeces indicated that bacterial epoxide hydrolase (EH) genes are more abundant in the gut microbiome of neonates who develop atopy and/or asthma during childhood. Three of these bacterial EH genes (3EH) specifically produce 12,13-diHOME, and treatment of mice with bacterial strains expressing 3EH caused a decrease in the number of lung Treg cells in an allergen challenge model. In two small birth cohorts, an increase in the copy number of 3EH or the concentration of 12,13-diHOME in the faeces of neonates was found to be associated with an increased probability of developing atopy, eczema or asthma during childhood. Our data indicate that elevated 12,13-diHOME concentrations impede immune tolerance and may be produced by bacterial EHs in the neonatal gut, offering a mechanistic link between perturbation of the gut microbiome during early life and atopy and asthma during childhood.
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14
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Comberiati P, Costagliola G, D'Elios S, Peroni D. Prevention of Food Allergy: The Significance of Early Introduction. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E323. [PMID: 31261990 PMCID: PMC6681183 DOI: 10.3390/medicina55070323] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 12/25/2022]
Abstract
Over the last two decades, the prevalence of food allergies has registered a significant increase in Westernized societies, potentially due to changes in environmental exposure and lifestyle. The pathogenesis of food allergies is complex and includes genetic, epigenetic and environmental factors. New evidence has highlighted the role of the intestinal microbiome in the maintenance of the immune tolerance to foods and the potential pathogenic role of early percutaneous exposure to allergens. The recent increase in food allergy rates has led to a reconsideration of prevention strategies for atopic diseases, mainly targeting the timing of the introduction of solid foods into infants' diet. Early recommendation for high atopy risk infants to delay the introduction of potential food allergens, such as cow's milk, egg, and peanut, until after the first year of life, has been rescinded, as emerging evidence has shown that these approaches are not effective in preventing food allergies. More recently, high-quality clinical trials have suggested an opposite approach, which promotes early introduction of potential food allergens into infants' diet as a means to prevent food allergies. This evidence has led to the production of new guidelines recommending early introduction of peanut as a preventive strategy for peanut allergy. However, clinical trials investigating whether this preventive dietary approach could also apply to other types of food allergens have reported ambiguous results. This review focuses on the latest high-quality evidence from randomized controlled clinical trials examining the timing of solid food introduction as a strategy to prevent food allergies and also discusses the possible implications of early complementary feeding on both the benefits and the total duration of breastfeeding.
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Affiliation(s)
- Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, Italy
| | - Giorgio Costagliola
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, Italy
| | - Sofia D'Elios
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, Italy.
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15
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Gern JE, Jackson DJ, Lemanske RF, Seroogy CM, Tachinardi U, Craven M, Hwang SY, Hamilton CM, Huggins W, O’Connor GT, Gold DR, Miller R, Kattan M, Johnson CC, Ownby D, Zoratti EM, Wood RA, Visness CM, Martinez F, Wright A, Lynch S, Ober C, Khurana Hershey GK, Ryan P, Hartert T, Bacharier LB. The Children's Respiratory and Environmental Workgroup (CREW) birth cohort consortium: design, methods, and study population. Respir Res 2019; 20:115. [PMID: 31182091 PMCID: PMC6558735 DOI: 10.1186/s12931-019-1088-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 06/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Single birth cohort studies have been the basis for many discoveries about early life risk factors for childhood asthma but are limited in scope by sample size and characteristics of the local environment and population. The Children's Respiratory and Environmental Workgroup (CREW) was established to integrate multiple established asthma birth cohorts and to investigate asthma phenotypes and associated causal pathways (endotypes), focusing on how they are influenced by interactions between genetics, lifestyle, and environmental exposures during the prenatal period and early childhood. METHODS AND RESULTS CREW is funded by the NIH Environmental influences on Child Health Outcomes (ECHO) program, and consists of 12 individual cohorts and three additional scientific centers. The CREW study population is diverse in terms of race, ethnicity, geographical distribution, and year of recruitment. We hypothesize that there are phenotypes in childhood asthma that differ based on clinical characteristics and underlying molecular mechanisms. Furthermore, we propose that asthma endotypes and their defining biomarkers can be identified based on personal and early life environmental risk factors. CREW has three phases: 1) to pool and harmonize existing data from each cohort, 2) to collect new data using standardized procedures, and 3) to enroll new families during the prenatal period to supplement and enrich extant data and enable unified systems approaches for identifying asthma phenotypes and endotypes. CONCLUSIONS The overall goal of CREW program is to develop a better understanding of how early life environmental exposures and host factors interact to promote the development of specific asthma endotypes.
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Affiliation(s)
- James E. Gern
- University of Wisconsin School of Medicine and Public Health, Madison, WI 53706 USA
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Clinical Science Center-K4/918, 600 Highland Ave, Madison, WI 53792-9988 USA
| | - Daniel J. Jackson
- University of Wisconsin School of Medicine and Public Health, Madison, WI 53706 USA
| | - Robert F. Lemanske
- University of Wisconsin School of Medicine and Public Health, Madison, WI 53706 USA
| | - Christine M. Seroogy
- University of Wisconsin School of Medicine and Public Health, Madison, WI 53706 USA
| | - Umberto Tachinardi
- University of Wisconsin School of Medicine and Public Health, Madison, WI 53706 USA
| | - Mark Craven
- University of Wisconsin School of Medicine and Public Health, Madison, WI 53706 USA
| | - Stephen Y. Hwang
- RTI International, East Cornwallis Road, Post Office Box 12194, Raleigh, Research Triangle Park, NC 27709-2194 USA
| | - Carol M. Hamilton
- RTI International, East Cornwallis Road, Post Office Box 12194, Raleigh, Research Triangle Park, NC 27709-2194 USA
| | - Wayne Huggins
- RTI International, East Cornwallis Road, Post Office Box 12194, Raleigh, Research Triangle Park, NC 27709-2194 USA
| | - George T. O’Connor
- Boston University School of Medicine, 72 E Concord St, Boston, MA 02118 USA
| | - Diane R. Gold
- Channing Laboratory, Brigham and Women’s Hospital, Boston, MA 02115 USA
| | - Rachel Miller
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY 10032 USA
| | - Meyer Kattan
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY 10032 USA
| | | | | | | | - Robert A. Wood
- Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | | | | | | | - Susan Lynch
- University of California, San Francisco, CA 94143 USA
| | - Carole Ober
- University of Chicago, Chicago, IL 60637 USA
| | | | - Patrick Ryan
- University of Cincinnati, Cincinnati, OH 45220 USA
| | - Tina Hartert
- Vanderbilt University School of Medicine, Nashville, TN 37232 USA
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16
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Wegienka G, Sitarik A, Levin AM, Zoratti EM, Ownby D, Johnson CC, Havstad S. Exploring latent classes to identify prenatal and early-life sources of racial disparities in allergic disease. Ann Allergy Asthma Immunol 2019; 122:650-652.e1. [PMID: 30953785 DOI: 10.1016/j.anai.2019.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/20/2019] [Accepted: 03/29/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan; in Vivo: Planetary Health: an affiliate of the World Universities Network (WUN), West New York, New Jersey; Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, Michigan.
| | - Alexandra Sitarik
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan; in Vivo: Planetary Health: an affiliate of the World Universities Network (WUN), West New York, New Jersey
| | - Albert M Levin
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
| | - Edward M Zoratti
- Division of Allergy and Clinical Immunology, Henry Ford Health System, Detroit, Michigan
| | - Dennis Ownby
- Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Christine Cole Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan; in Vivo: Planetary Health: an affiliate of the World Universities Network (WUN), West New York, New Jersey; Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, Michigan
| | - Suzanne Havstad
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan; in Vivo: Planetary Health: an affiliate of the World Universities Network (WUN), West New York, New Jersey
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Abstract
PURPOSE OF REVIEW Resident microbial communities likely modify risk for allergic disorders, including food allergy. We review epidemiologic studies linking microbial exposures to food allergy risk and discuss the mechanisms by which the microbiome may modulate oral tolerance. We additionally address ongoing translational efforts in human microbiome studies. RECENT FINDINGS Epidemiologic studies and murine models support that altered microbial exposures and colonization in early life modify food allergy risk. Differential microbiota confer protection or susceptibility to food allergy by modulating the regulatory tone of the mucosal immune system. Recent efforts are focused on the identification of bacterial strains necessary for oral tolerance in human and microbial-based clinical trials. Early childhood appears to be critical for the colonization of a diverse microbiota necessary for the induction and maintenance of oral tolerance. Identification and functional evaluation of protective commensal microbes will inform strategies for the prevention and treatment of food allergy.
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Affiliation(s)
- Hsi-En Ho
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Supinda Bunyavanich
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Icahn Institute for Genomics and Multiscale Biology, Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1498, New York, NY, 10029, USA.
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18
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Bloomfield SF, Rook GA, Scott EA, Shanahan F, Stanwell-Smith R, Turner P. Time to abandon the hygiene hypothesis: new perspectives on allergic disease, the human microbiome, infectious disease prevention and the role of targeted hygiene. Perspect Public Health 2018; 136:213-24. [PMID: 27354505 PMCID: PMC4966430 DOI: 10.1177/1757913916650225] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Aims: To review the burden of allergic and infectious diseases and the evidence for
a link to microbial exposure, the human microbiome and immune system, and to
assess whether we could develop lifestyles which reconnect us with exposures
which could reduce the risk of allergic disease while also protecting
against infectious disease. Methods: Using methodology based on the Delphi technique, six experts in infectious
and allergic disease were surveyed to allow for elicitation of group
judgement and consensus view on issues pertinent to the aim. Results: Key themes emerged where evidence shows that interaction with microbes that
inhabit the natural environment and human microbiome plays an essential role
in immune regulation. Changes in lifestyle and environmental exposure, rapid
urbanisation, altered diet and antibiotic use have had profound effects on
the human microbiome, leading to failure of immunotolerance and increased
risk of allergic disease. Although evidence supports the concept of immune
regulation driven by microbe–host interactions, the term ‘hygiene
hypothesis’ is a misleading misnomer. There is no good evidence that
hygiene, as the public understands, is responsible for the clinically
relevant changes to microbial exposures. Conclusion: Evidence suggests a combination of strategies, including natural childbirth,
breast feeding, increased social exposure through sport, other outdoor
activities, less time spent indoors, diet and appropriate antibiotic use,
may help restore the microbiome and perhaps reduce risks of allergic
disease. Preventive efforts must focus on early life. The term ‘hygiene
hypothesis’ must be abandoned. Promotion of a risk assessment approach
(targeted hygiene) provides a framework for maximising protection against
pathogen exposure while allowing spread of essential microbes between family
members. To build on these findings, we must change public, public health
and professional perceptions about the microbiome and about hygiene. We need
to restore public understanding of hygiene as a means to prevent infectious
disease.
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Affiliation(s)
- Sally F Bloomfield
- London School of Hygiene & Tropical Medicine and International Scientific Forum on Home Hygiene, The Old Dairy Cottage, Montacute, Somerset TA15 6XL, UK
| | - Graham Aw Rook
- Centre for Clinical Microbiology, Department of Infection, University College London (UCL), London, UK
| | - Elizabeth A Scott
- Center for Hygiene and Health, Department of Biology, Simmons College, Boston, MA, USA
| | - Fergus Shanahan
- APC Microbiome Institute, University College Cork - National University of Ireland, Cork, Ireland
| | | | - Paul Turner
- Section of Paediatrics (Allergy & Infectious Diseases) and MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, UK; Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, NSW, Australia
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Fonseca W, Lucey K, Jang S, Fujimura KE, Rasky A, Ting HA, Petersen J, Johnson CC, Boushey HA, Zoratti E, Ownby DR, Levine AM, Bobbit KR, Lynch SV, Lukacs NW. Lactobacillus johnsonii supplementation attenuates respiratory viral infection via metabolic reprogramming and immune cell modulation. Mucosal Immunol 2017; 10:1569-1580. [PMID: 28295020 PMCID: PMC5599307 DOI: 10.1038/mi.2017.13] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 01/10/2017] [Indexed: 02/04/2023]
Abstract
Regulation of respiratory mucosal immunity by microbial-derived metabolites has been a proposed mechanism that may provide airway protection. Here we examine the effect of oral Lactobacillus johnsonii supplementation on metabolic and immune response dynamics during respiratory syncytial virus (RSV) infection. L. johnsonii supplementation reduced airway T helper type 2 cytokines and dendritic cell (DC) function, increased regulatory T cells, and was associated with a reprogrammed circulating metabolic environment, including docosahexanoic acid (DHA) enrichment. RSV-infected bone marrow-derived DCs (BMDCs) from L. johnsonii-supplemented mice had altered cytokine secretion, reduced expression of co-stimulatory molecules, and modified CD4+ T-cell cytokines. This was replicated upon co-incubation of wild-type BMDCs with either plasma from L. johnsonii-supplemented mice or DHA. Finally, airway transfer of BMDCs from L. johnsonii-supplemented mice or with wild-type derived BMDCs pretreated with plasma from L. johnsonii-supplemented mice reduced airway pathological responses to infection in recipient animals. Thus L. johnsonii supplementation mediates airway mucosal protection via immunomodulatory metabolites and altered immune function.
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Affiliation(s)
| | - Kaitlyn Lucey
- University of California San Francisco, San Francisco, CA
| | | | | | | | | | | | | | | | | | | | | | | | - Susan V. Lynch
- University of California San Francisco, San Francisco, CA
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20
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Abstract
BACKGROUND AND OBJECTIVES Breast milk is a complex bioactive fluid that varies across numerous maternal and environmental conditions. Although breast-feeding is known to affect neonatal gut microbiome, the milk components responsible for this effect are not well-characterized. Given the wide range of immunological activity breast milk cytokines engage in, we investigated 3 essential breast milk cytokines and their association with early life gut microbiota. METHODS A total of 52 maternal-child pairs were drawn from a racially diverse birth cohort based in Detroit, Michigan. Breast milk and neonatal stool specimens were collected at 1-month postpartum. Breast milk transforming growth factor (TGF)β1, TGFβ2, and IL-10 were assayed using enzyme-linked immunosorbent assays, whereas neonatal gut microbiome was profiled using 16S rRNA sequencing. RESULTS Individually, immunomodulators TGFβ1 and TGFβ2 were significantly associated with neonatal gut microbial composition (R = 0.024, P = 0.041; R = 0.026, P = 0.012, respectively) and increased richness, evenness, and diversity, but IL-10 was not. The effects of TGFβ1 and TGFβ2, however, were not independent of one another, and the effect of TGFβ2 was stronger than that of TGFβ1. Higher levels of TGFβ2 were associated with the increased relative abundance of several bacteria, including members of Streptococcaceae and Ruminococcaceae, and lower relative abundance of distinct Staphylococcaceae taxa. CONCLUSIONS Breast milk TGFβ concentration explains a portion of variability in gut bacterial microbiota composition among breast-fed neonates. Whether TGFβ acts in isolation or jointly with other bioactive components to alter bacterial composition requires further investigation. These findings contribute to an increased understanding of how breast-feeding affects the gut microbiome-and potentially immune development-in early life.
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Neonatal gut microbiota associates with childhood multisensitized atopy and T cell differentiation. Nat Med 2016; 22:1187-1191. [PMID: 27618652 PMCID: PMC5053876 DOI: 10.1038/nm.4176] [Citation(s) in RCA: 724] [Impact Index Per Article: 90.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 07/29/2016] [Indexed: 12/16/2022]
Abstract
Gut microbiota bacterial depletions and altered metabolic activity at 3 months are implicated in childhood atopy and asthma. We hypothesized that compositionally distinct human neonatal gut microbiota (NGM) exist, and are differentially related to relative risk (RR) of childhood atopy and asthma. Using stool samples (n = 298; aged 1-11 months) from a US birth cohort and 16S rRNA sequencing, neonates (median age, 35 d) were divisible into three microbiota composition states (NGM1-3). Each incurred a substantially different RR for multisensitized atopy at age 2 years and doctor-diagnosed asthma at age 4 years. The highest risk group, labeled NGM3, showed lower relative abundance of certain bacteria (for example, Bifidobacterium, Akkermansia and Faecalibacterium), higher relative abundance of particular fungi (Candida and Rhodotorula) and a distinct fecal metabolome enriched for pro-inflammatory metabolites. Ex vivo culture of human adult peripheral T cells with sterile fecal water from NGM3 subjects increased the proportion of CD4+ cells producing interleukin (IL)-4 and reduced the relative abundance of CD4+CD25+FOXP3+ cells. 12,13-DiHOME, enriched in NGM3 versus lower-risk NGM states, recapitulated the effect of NGM3 fecal water on relative CD4+CD25+FOXP3+ cell abundance. These findings suggest that neonatal gut microbiome dysbiosis might promote CD4+ T cell dysfunction associated with childhood atopy.
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Maternal-Cord Blood Vitamin D Correlations Vary by Maternal Levels. J Pregnancy 2016; 2016:7474192. [PMID: 27066272 PMCID: PMC4811107 DOI: 10.1155/2016/7474192] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 02/15/2016] [Indexed: 01/18/2023] Open
Abstract
Vitamin D levels of pregnant women and their neonates tend to be related; however, it is unknown whether there are any subgroups in which they are not related. 25-Hydroxyvitamin D [25(OH)D] was measured in prenatal maternal and child cord blood samples of participants (n = 241 pairs) in a birth cohort. Spearman correlations were examined within subgroups defined by prenatal and delivery factors. Cord blood as a percentage of prenatal 25(OH)D level was calculated and characteristics compared between those who did and did not have ≥25% and ≥50% of the maternal level and those who did and did not have a detectable 25(OH)D level. The correlation among Black children was lower than in White children. When the maternal 25(OH)D level was <15 ng/mL, the overall correlation was r = 0.16. Most children had a 25(OH)D cord blood level less than half of their mother's; 15.4% had a level that was <25% of their mother's. Winter birth and maternal level were associated with the level being less than 25%. Children with undetectable levels were more likely to be Black and less likely to be firstborn. These data suggest mothers may reduce their contribution to the fetus's 25(OH)D supply once their own level becomes low.
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Meason-Smith C, Diesel A, Patterson AP, Older CE, Mansell JM, Suchodolski JS, Rodrigues Hoffmann A. What is living on your dog's skin? Characterization of the canine cutaneous mycobiota and fungal dysbiosis in canine allergic dermatitis. FEMS Microbiol Ecol 2015; 91:fiv139. [PMID: 26542075 PMCID: PMC4657189 DOI: 10.1093/femsec/fiv139] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2015] [Indexed: 12/11/2022] Open
Abstract
To characterize the skin-associated fungal microbiota (mycobiota) in dogs, and to evaluate the influence of body site, individual dog or health status on the distribution of fungi, next-generation sequencing was performed targeting the internal transcribed spacer region. A total of 10 dogs with no history of skin disease were sampled at 10 distinct body sites consisting of haired and mucosal skin, and 8 dogs with diagnosed skin allergies were sampled at six body sites commonly affected by allergic disease. Analysis of similarities revealed that body site was not an influencing factor on membership or structure of fungal communities in healthy skin; however, the mucosal sites were significantly reduced in fungal richness. The mycobiota from body sites in healthy dogs tended to be similar within a dog, which was visualized in principle coordinates analysis (PCoA) by clustering of all sites from one dog separate from other dogs. The mycobiota of allergic skin was significantly less rich than that of healthy skin, and all sites sampled clustered by health status in PCoA. Interestingly, the most abundant fungi present on canine skin, across all body sites and health statuses, were Alternaria and Cladosporium—two of the most common fungal allergens in human environmental allergies. The skin-associated fungal microbiota were characterized in healthy dogs and those with skin allergies using next-generation sequencing, and the authors identified significant influences of the dog and health status on the distribution and diversity of fungal communities.
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Affiliation(s)
- Courtney Meason-Smith
- Dermatopathology Specialty Service, Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4467, USA
| | - Alison Diesel
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA
| | - Adam P Patterson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA
| | - Caitlin E Older
- Dermatopathology Specialty Service, Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4467, USA
| | - Joanne M Mansell
- Dermatopathology Specialty Service, Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4467, USA
| | - Jan S Suchodolski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA
| | - Aline Rodrigues Hoffmann
- Dermatopathology Specialty Service, Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4467, USA
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Wegienka G, Havstad S, Zoratti EM, Kim H, Ownby DR, Johnson CC. Association between vitamin D levels and allergy-related outcomes vary by race and other factors. J Allergy Clin Immunol 2015; 136:1309-14.e1-4. [PMID: 26078105 PMCID: PMC4640935 DOI: 10.1016/j.jaci.2015.04.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 04/03/2015] [Accepted: 04/08/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND Allergy-related studies that include biological measurements of vitamin D preceding well-measured outcomes are needed. OBJECTIVE We sought to examine the associations between early-life vitamin D levels and the development of allergy-related outcomes in the racially diverse Wayne County Health, Environment, Allergy, and Asthma Longitudinal Study birth cohort. METHODS 25-Hydroxyvitamin D (25[OH]D) levels were measured in stored blood samples from pregnancy, cord blood, and age 2 years. Logistic regression models were used to calculate odds ratios (ORs) with 95% CIs for a 5 ng/mL increase in 25(OH)D levels for the following outcomes at age 2 years: eczema, skin prick tests (SPTs), increased allergen-specific IgE level (≥ 0.35 IU/mL), and doctor's diagnosis of asthma (3-6 years). RESULTS Prenatal 25(OH)D levels were inversely associated with eczema (OR, 0.85; 95% CI, 0.75-0.96). The association was stronger in white children (white children: OR, 0.79; 95% CI, 0.57-1.09; black children: OR, 0.96; 95% CI, 0.82-1.12), although this was not statistically significant. Cord blood 25(OH)D levels were inversely associated with having 1 or more positive SPT responses and aeroallergen sensitization. Both associations were statistically significant in white children (positive SPT response: OR, 0.50; 95% CI, 0.32-0.80; ≥ 1 aeroallergen sensitization: OR, 0.50; 95% CI, 0.28-0.92) in contrast with black children (positive SPT response: OR, 0.88; 95% CI, 0.68-1.14; ≥ 1 aeroallergen sensitization: OR, 0.85; 95% CI, 0.65-1.11). 25(OH)D levels measured concurrently with outcome assessment were inversely associated with aeroallergen sensitization (OR, 0.79; 95% CI, 0.66-0.96) only among black children (white children: OR, 1.21; 95% CI, 0.87-1.69). CONCLUSIONS Prenatal and cord blood 25(OH)D levels were associated with some allergy-related outcomes, with a general pattern indicating that children with higher 25(OH)D levels tend to have fewer allergy-related outcomes.
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Affiliation(s)
- Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, Mich.
| | - Suzanne Havstad
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, Mich
| | - Edward M Zoratti
- Department of Internal Medicine, Division of Allergy, Henry Ford Hospital, Detroit, Mich
| | - Haejin Kim
- Department of Internal Medicine, Division of Allergy, Henry Ford Hospital, Detroit, Mich
| | - Dennis R Ownby
- Department of Pediatrics, Georgia Regents University, Augusta, Ga
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Gürbüz T, Karakol B, Önal ZE, Tabak Y, Nuhoğlu Ç, Ceran Ö. Evaluation of in utero sensitization by screening antigen-specific immunoglobulin E levels in umbilical cord blood. Postepy Dermatol Alergol 2015; 32:184-8. [PMID: 26161059 PMCID: PMC4495114 DOI: 10.5114/pdia.2015.48051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 06/12/2014] [Accepted: 09/10/2014] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The incidence of asthma and atopic reactions is increasing worldwide. Previous reports have suggested that maternal exposure to allergens during pregnancy may have potential effects on allergic sensitization in infants. AIM To evaluate the effects of maternal exposure to environmental allergens during pregnancy on in-utero sensitization. MATERIAL AND METHODS Two hundred mothers and their infants were analyzed in this cross-sectional study. Mothers were given a questionnaire that had a series of questions to evaluate the maternal allergic status and environmental exposures during pregnancy. Plasma specific immunoglobulin E (IgE) levels to pets, grass, food (nuts) of all mothers and their infants were analyzed by an immune-enzymatic assay. RESULTS There was no significant correlation between plasma specific IgE positivity in mothers, with regard to keeping indoor domestic pets, living in grass habitat, eating nuts in diet. A significant correlation was found between specific IgE presence in mothers and allergic reactions; however, there was no correlation between plasma specific IgE positivity of mothers and infants. CONCLUSIONS We concluded that prenatal maternal sensitivity to environmental allergens could not be evaluated as a predictive factor for in-utero sensitization.
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Affiliation(s)
- Tamay Gürbüz
- Department of Pediatrics, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. Head of the Department: Çağatay Nuhoğlu MD, Assoc. Prof
| | - Burcu Karakol
- Department of Pediatrics, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. Head of the Department: Çağatay Nuhoğlu MD, Assoc. Prof
| | - Zehra Esra Önal
- Department of Pediatrics, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. Head of the Department: Çağatay Nuhoğlu MD, Assoc. Prof
| | - Yonca Tabak
- Department of Pediatrics, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. Head of the Department: Çağatay Nuhoğlu MD, Assoc. Prof
| | - Çağatay Nuhoğlu
- Department of Pediatrics, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. Head of the Department: Çağatay Nuhoğlu MD, Assoc. Prof
| | - Ömer Ceran
- Department of Pediatrics, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. Head of the Department: Çağatay Nuhoğlu MD, Assoc. Prof
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Abstract
The prevalence of asthma and allergy has been constantly increasing in Westernized countries in the last decades. Asthma and allergies are complex diseases with a local tissue inflammation that are determined by genetic and environmental factors. Because the commensal microflora is crucial to maintain inflammatory homeostasis and to induce immune regulation, the microbiome may play an important role for the development of allergic conditions. New techniques such as next-generation sequencing methods give the opportunity to explore the microbial community structure of the human body comprehensively. In this review, we will discuss the available literature concerning the human microbiota and asthma and allergy development and occurrence. The focus is on studies of the local microbiome of the place of inflammation, the gastrointestinal microbiome, and the influence of intrinsic factors relating to the host and extrinsic factors relating to the external environment on the microbiome.
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Rook GAW, Raison CL, Lowry CA. Microbial 'old friends', immunoregulation and socioeconomic status. Clin Exp Immunol 2014; 177:1-12. [PMID: 24401109 PMCID: PMC4089149 DOI: 10.1111/cei.12269] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 12/13/2022] Open
Abstract
The immune system evolved to require input from at least three sources that we collectively term the ‘old friends’: (i) the commensal microbiotas transmitted by mothers and other family members; (ii) organisms from the natural environment that modulate and diversify the commensal microbiotas; and (iii) the ‘old’ infections that could persist in small isolated hunter-gatherer groups as relatively harmless subclinical infections or carrier states. These categories of organism had to be tolerated and co-evolved roles in the development and regulation of the immune system. By contrast, the ‘crowd infections’ (such as childhood virus infections) evolved later, when urbanization led to large communities. They did not evolve immunoregulatory roles because they either killed the host or induced solid immunity, and could not persist in hunter-gatherer groups. Because the western lifestyle and medical practice deplete the ‘old’ infections (for example helminths), immunoregulatory disorders have increased, and the immune system has become more dependent upon microbiotas and the natural environment. However, urbanization maintains exposure to the crowd infections that lack immunoregulatory roles, while accelerating loss of exposure to the natural environment. This effect is most pronounced in individuals of low socioeconomic status (SES) who lack rural second homes and rural holidays. Interestingly, large epidemiological studies indicate that the health benefits of living close to green spaces are most pronounced for individuals of low SES. Here we discuss the immunoregulatory role of the natural environment, and how this may interact with, and modulate, the proinflammatory effects of psychosocial stressors in low SES individuals.
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Affiliation(s)
- G A W Rook
- Centre for Clinical Microbiology, Department of Infection, University College London (UCL), London, UK
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Joseph CLM, Havstad S, Bobbitt K, Woodcroft K, Zoratti EM, Nageotte C, Misiak R, Enberg R, Nicholas C, Ezell JM, Ownby DR, Johnson CC. Transforming growth factor beta (TGFβ1) in breast milk and indicators of infant atopy in a birth cohort. Pediatr Allergy Immunol 2014; 25:257-63. [PMID: 24520941 PMCID: PMC3997590 DOI: 10.1111/pai.12205] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND The infant gut's ability to suppress immunologic reactions to food proteins could be influenced by levels of TGFβ in breast milk. We hypothesized that lower levels of TGFβ(1) in the breast milk (BM) of mothers in the WHEALS birth cohort are associated with atopy at infant age 2-3 yrs. METHODS We used data collected during infancy in addition to the results of skin prick tests (SPT+) and measures of specific IgE >0.35 IU/ml (spIgE) to milk, egg, and peanut at infant age 2-3 years. Infants were classified as food allergic (FA) based on parental report of infant symptoms/diagnoses and information from clinical assessments. RESULTS Data for 304 cohort members were analyzed. Among non-black infants, BM-TGFβ(1) was lower for those classified as FA (vs. no FA) and those SPT+ (vs., SPT-), geometric mean = 1100 pg/ml vs. 1417pg/ml, p = 0.081; and 1100 pg/ml vs. 1415pg/ml, p = 0.064, respectively. Among infants of non-atopic mothers, BM-TGFβ(1) was lower for those with elevated (vs. not elevated) sIgE, geometric mean = 1347 pg/ml vs. 1651 pg/ml, p = 0.047. Using logistic regression, adjusted odds ratios describing the association of BM-TGFβ1 to the presence of atopic indicators in the infant were in the hypothesized direction only for non-black infants of non-atopic mothers: aORs for FA, sIgE and SPT+ were 0.08, 0.34, and 0.26 respectively; p = 0.091, 0.13, and 0.23. CONCLUSION Immune benefit of BM-TGFβ(1) could inform prevention strategies. Evidence of an association appears greatly influenced by infant race and maternal atopy. More research can determine if these relationships represent a modifiable risk factor for the development of food allergy in certain subgroups.
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Affiliation(s)
- Christine LM Joseph
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI
- Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit MI
| | - Suzanne Havstad
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI
- Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit MI
| | - Kevin Bobbitt
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI
- Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit MI
| | - Kimberley Woodcroft
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI
- Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit MI
| | - Edward M. Zoratti
- Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit MI
- Division of Allergy and Immunology, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI
| | - Christian Nageotte
- Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit MI
- Division of Allergy and Immunology, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI
| | - Rana Misiak
- Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit MI
- Division of Allergy and Immunology, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI
| | - Robert Enberg
- Division of Allergy and Immunology, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI
| | | | - Jerel M. Ezell
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI
- Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit MI
| | - Dennis R. Ownby
- Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit MI
- Division of Allergy and Immunology, Department of Pediatrics, Georgia Regents University, Augusta, GA
| | - Christine Cole Johnson
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI
- Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit MI
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Ezell JM, Cassidy-Bushrow AE, Havstad S, Joseph CLM, Wegienka G, Jones K, Ownby DR, Johnson CC. Prenatal dog-keeping practices vary by race: speculations on implications for disparities in childhood health and disease. Ethn Dis 2014; 24:104-109. [PMID: 24620456 PMCID: PMC3978783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE There is consistent evidence demonstrating that pet-keeping, particularly of dogs, is beneficial to human health. We explored relationships between maternal race and prenatal dog-keeping, accounting for measures of socioeconomic status that could affect the choice of owning a pet, in a demographically diverse, unselected birth cohort. DESIGN Self-reported data on mothers' race, socioeconomic characteristics and dog-keeping practices were obtained during prenatal interviews and analyzed cross-sectionally. Robust methods of covariate balancing via propensity score analysis were utilized to examine if race (Black vs White), independent of other participant traits, influenced prenatal dog-keeping. SETTING A birth cohort study conducted in a health care system in metropolitan Detroit, Michigan between September 2003 and November 2007. PARTICIPANTS 1065 pregnant women (n=775 or 72.8% Black), between ages 21 and 45, receiving prenatal care. MAIN OUTCOME MEASURES Participant's self-report of race/ethnicity and prenatal dog-keeping, which was defined as her owning or caring for > or =1 dog for more than 1 week at her home since learning of her pregnancy, regardless of whether the dog was kept inside or outside of her home. RESULTS In total, 294 women (27.6%) reported prenatal dog-keeping. Prenatal dog-keeping was significantly lower among Black women as compared to White women (20.9% vs 45.5%, P<.001), and remained significantly different even after propensity score analysis was applied. CONCLUSION Findings suggest that there are persistent racial differences in dog-keeping not fully explained by measures of socioeconomic status. Racial differences in prenatal dog-keeping may contribute to childhood health disparities.
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Regulation of the immune system by biodiversity from the natural environment: an ecosystem service essential to health. Proc Natl Acad Sci U S A 2013; 110:18360-7. [PMID: 24154724 DOI: 10.1073/pnas.1313731110] [Citation(s) in RCA: 373] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Epidemiological studies suggest that living close to the natural environment is associated with long-term health benefits including reduced death rates, reduced cardiovascular disease, and reduced psychiatric problems. This is often attributed to psychological mechanisms, boosted by exercise, social interactions, and sunlight. Compared with urban environments, exposure to green spaces does indeed trigger rapid psychological, physiological, and endocrinological effects. However, there is little evidence that these rapid transient effects cause long-term health benefits or even that they are a specific property of natural environments. Meanwhile, the illnesses that are increasing in high-income countries are associated with failing immunoregulation and poorly regulated inflammatory responses, manifested as chronically raised C-reactive protein and proinflammatory cytokines. This failure of immunoregulation is partly attributable to a lack of exposure to organisms ("Old Friends") from mankind's evolutionary past that needed to be tolerated and therefore evolved roles in driving immunoregulatory mechanisms. Some Old Friends (such as helminths and infections picked up at birth that established carrier states) are almost eliminated from the urban environment. This increases our dependence on Old Friends derived from our mothers, other people, animals, and the environment. It is suggested that the requirement for microbial input from the environment to drive immunoregulation is a major component of the beneficial effect of green space, and a neglected ecosystem service that is essential for our well-being. This insight will allow green spaces to be designed to optimize health benefits and will provide impetus from health systems for the preservation of ecosystem biodiversity.
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Ownby DR, Peterson EL, Wegienka G, Woodcroft KJ, Nicholas C, Zoratti E, Johnson CC. Are cats and dogs the major source of endotoxin in homes? INDOOR AIR 2013; 23:219-226. [PMID: 23167871 PMCID: PMC4005287 DOI: 10.1111/ina.12016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 11/13/2012] [Indexed: 05/31/2023]
Abstract
UNLABELLED Previous studies have suggested that exposure to cats and dogs during early childhood reduces the risk of allergic disease, possibly by increasing home endotoxin exposure. This study asked the question of whether cats and dogs are the dominant influence on dust endotoxin concentrations in homes after considering other variables reportedly associated with endotoxin. The presence of cats or dogs in homes, household and home characteristics, and dust endotoxin concentrations from 5 locations were assessed in 966 urban and suburban homes. Whether considered together as pets or as cats and dogs separately, the presence of cats and dogs significantly contributed to living room and bedroom floor endotoxin concentrations, but not to bed endotoxin concentrations. However, the two variables consistently related to endotoxin in all home sites were the home occupant density (occupants/room) and cleanliness of the home. Our data suggest that reducing occupant density and improving home cleanliness would reduce home endotoxin concentrations more than removing pet cats or dogs from the home. PRACTICAL IMPLICATIONS Many studies have shown that early childhood exposure to indoor cats or dogs is associated with a reduced risk of later allergic disease and asthma. An important question is whether alteration in allergic risk associated with cat and dog exposure results from increased endotoxin exposure or from some other associated exposure. Our findings show that cats and dogs are not the dominant source of endotoxin in homes; rather, the density of human occupation and poor cleaning contribute more consistently to higher home endotoxin concentrations especially in the beds.
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Affiliation(s)
- D R Ownby
- Division of Allergy, Immunology, Rheumatology, Department of Pediatrics, Georgia Health Sciences University, Augusta, GA 30912-3790, USA.
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Dunn RR, Fierer N, Henley JB, Leff JW, Menninger HL. Home life: factors structuring the bacterial diversity found within and between homes. PLoS One 2013; 8:e64133. [PMID: 23717552 PMCID: PMC3661444 DOI: 10.1371/journal.pone.0064133] [Citation(s) in RCA: 211] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 04/09/2013] [Indexed: 02/03/2023] Open
Abstract
Most of our time is spent indoors where we are exposed to a wide array of different microorganisms living on surfaces and in the air of our homes. Despite their ubiquity and abundance, we have a limited understanding of the microbial diversity found within homes and how the composition and diversity of microbial communities change across different locations within the home. Here we examined the diversity of bacterial communities found in nine distinct locations within each of forty homes in the Raleigh-Durham area of North Carolina, USA, using high-throughput sequencing of the bacterial 16S rRNA gene. We found that each of the sampled locations harbored bacterial communities that were distinct from one another with surfaces that are regularly cleaned typically harboring lower levels of diversity than surfaces that are cleaned infrequently. These location-specific differences in bacterial communities could be directly related to usage patterns and differences in the likely sources of bacteria dispersed onto these locations. Finally, we examined whether the variability across homes in bacterial diversity could be attributed to outdoor environmental factors, indoor habitat structure, or the occupants of the home. We found that the presence of dogs had a significant effect on bacterial community composition in multiple locations within homes as the homes occupied by dogs harbored more diverse communities and higher relative abundances of dog-associated bacterial taxa. Furthermore, we found a significant correlation between the types of bacteria deposited on surfaces outside the home and those found inside the home, highlighting that microbes from outside the home can have a direct effect on the microbial communities living on surfaces within our homes. Together this work provides the first comprehensive analysis of the microbial communities found in the home and the factors that shape the structure of these communities both within and between homes.
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Affiliation(s)
- Robert R Dunn
- Department of Biology and Keck Center for Behavioral Biology, North Carolina State University, Raleigh, North Carolina, United States of America.
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Dunn RR, Fierer N, Henley JB, Leff JW, Menninger HL. Home life: factors structuring the bacterial diversity found within and between homes. PLoS One 2013; 8:e64133. [PMID: 23717552 DOI: 10.1371/journal.pone.0064133.s005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 04/09/2013] [Indexed: 05/22/2023] Open
Abstract
Most of our time is spent indoors where we are exposed to a wide array of different microorganisms living on surfaces and in the air of our homes. Despite their ubiquity and abundance, we have a limited understanding of the microbial diversity found within homes and how the composition and diversity of microbial communities change across different locations within the home. Here we examined the diversity of bacterial communities found in nine distinct locations within each of forty homes in the Raleigh-Durham area of North Carolina, USA, using high-throughput sequencing of the bacterial 16S rRNA gene. We found that each of the sampled locations harbored bacterial communities that were distinct from one another with surfaces that are regularly cleaned typically harboring lower levels of diversity than surfaces that are cleaned infrequently. These location-specific differences in bacterial communities could be directly related to usage patterns and differences in the likely sources of bacteria dispersed onto these locations. Finally, we examined whether the variability across homes in bacterial diversity could be attributed to outdoor environmental factors, indoor habitat structure, or the occupants of the home. We found that the presence of dogs had a significant effect on bacterial community composition in multiple locations within homes as the homes occupied by dogs harbored more diverse communities and higher relative abundances of dog-associated bacterial taxa. Furthermore, we found a significant correlation between the types of bacteria deposited on surfaces outside the home and those found inside the home, highlighting that microbes from outside the home can have a direct effect on the microbial communities living on surfaces within our homes. Together this work provides the first comprehensive analysis of the microbial communities found in the home and the factors that shape the structure of these communities both within and between homes.
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Affiliation(s)
- Robert R Dunn
- Department of Biology and Keck Center for Behavioral Biology, North Carolina State University, Raleigh, North Carolina, United States of America.
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Wegienka G, Havstad S, Joseph CL, Zoratti E, Ownby D, Johnson CC. Allergic sensitization frequency and wheezing differences in early life between black and white children. Allergy Asthma Proc 2012; 33:493-9. [PMID: 23394507 DOI: 10.2500/aap.2012.33.3600] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Asthma is more common in black children than in white children. Allergic sensitization has been shown to be associated with increased likelihood of asthma. This study was designed to determine whether there are racial differences in the allergens to which children are sensitized in the Detroit metropolitan area and determine whether sensitization was associated with wheeze outcomes. Pregnant women were recruited for the Wayne County Health, Environment, Allergy, and Asthma Longitudinal Study birth cohort to follow the health of their children in the Detroit metropolitan area. Specific IgE (sIgE) was measured for Alternaria, cat, cockroach, dog, Dermatophagoides farinae, short ragweed, timothy grass, egg, milk, and peanut in blood samples from the children at age 2 years. A positive allergen sIgE was defined as ≥0.35 IU/mL. Mothers reported their child's race and completed interviews at age 2 years about characteristics of wheezing episodes in their child (frequency, medication, acute care, or emergency department visit). Black children (n = 384) were more likely than white children (n = 180) to have been positive for each of the allergens tested and also tended to have positive responses to a greater number of allergens (four or more allergens: 9.2% versus 3.5%). Children who had two or more positive sIgEs (adjusted odds ratio [aOR] = 2.68; 95% 95% confidence interval [CI], 1.33, 5.46) or three or more positive sIgEs (aOR = 2.67, 95% CI, 1.19, 6.01) were more likely to have wheezed four or more times in the last 12 months. Racial differences in sensitization at this young age may contribute to the racial difference in asthma prevalence at later ages.
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Affiliation(s)
- Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, Michigan, USA
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Abstract
Throughout the twentieth century, there were striking increases in the incidences of many chronic inflammatory disorders in the rich developed countries. These included autoimmune disorders such as Type 1 diabetes and multiple sclerosis. Although genetics and specific triggering mechanisms such as molecular mimicry and viruses are likely to be involved, the increases have been so rapid that any explanation that omits environmental change is incomplete. This chapter suggests that a series of environmental factors, most of them microbial, have led to a decrease in the efficiency of our immunoregulatory mechanisms because we are in a state of evolved dependence on organisms with which we co-evolved (and that had to be tolerated) as inducers of immunoregulatory circuits. These organisms ("Old Friends") are depleted from the modern urban environment. Rather than considering fetal programming by maternal microbial exposures, neonatal programming, the hygiene hypothesis, gut microbiota, and diet as separate and competing hypotheses, I attempt here to integrate these ideas under a single umbrella concept that can provide the missing immunoregulatory environmental factor that is needed to explain the recent increases in autoimmune disease.
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Affiliation(s)
- Graham A W Rook
- Department of Infection, Centre for Clinical Microbiology, University College London (UCL), London, UK.
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Different implications of paternal and maternal atopy for perinatal IgE production and asthma development. Clin Dev Immunol 2012; 2012:132142. [PMID: 22272211 PMCID: PMC3261469 DOI: 10.1155/2012/132142] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 10/03/2011] [Indexed: 12/16/2022]
Abstract
Asthma is a hereditary disease associated with IgE-mediated reaction. Whether maternal atopy and paternal atopy have different impacts on perinatal IgE production and asthma development remains unclear. This paper reviews and summarizes the effects of maternal and paternal atopy on the developmental aspects of IgE production and asthma. Maternal atopy affects both pre- and postnatal IgE production, whereas paternal atopy mainly affects the latter. Maternally transmitted genes GSTP1 and FceRI-beta are associated with lung function and allergic sensitization, respectively. In IgE production and asthma development, the maternal influence on gene-environment interaction is greater than paternal influence. Maternal, paternal, and/or postnatal environmental modulation of allergic responses have been linked to epigenetic mechanisms, which may be good targets for early prevention of asthma.
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Lodge CJ, Allen KJ, Lowe AJ, Hill DJ, Hosking CS, Abramson MJ, Dharmage SC. Perinatal cat and dog exposure and the risk of asthma and allergy in the urban environment: a systematic review of longitudinal studies. Clin Dev Immunol 2011; 2012:176484. [PMID: 22235226 PMCID: PMC3251799 DOI: 10.1155/2012/176484] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Accepted: 08/26/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND The literature is contradictory concerning pet exposure and the risk of development of asthma and other allergic diseases. Using longitudinal studies, we aimed to systematically review the impact of pet ownership in the critical perinatal period as a risk factor for allergies in childhood. METHODS Medline database was searched for urban cohort studies with perinatal exposure to cats and/or dogs and subsequent asthma or allergic disease. RESULTS Nine articles, comprising 6498 participants, met inclusion criteria. Six found a reduction in allergic disease associated with perinatal exposure to dogs or, cats or dogs. One study found no association. Two found increased risk only in high-risk groups. CONCLUSION Longitudinal studies in urban populations suggest that perinatal pets, especially dogs, may reduce the development of allergic disease in those without a family history of allergy. Other unmeasured factors such as pet-keeping choices in allergic families may be confounding the association seen in these high-risk families, and further study is required.
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Affiliation(s)
- Caroline J Lodge
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne, Vic 3010, Australia.
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Simpson A. Effect of household pet ownership on infant immune response and subsequent sensitization. J Asthma Allergy 2010; 3:131-7. [PMID: 21437047 PMCID: PMC3047904 DOI: 10.2147/jaa.s6958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Indexed: 11/23/2022] Open
Abstract
Sensitization to pets is a major risk factor for asthma. There are many reports on the relationship between household pets, sensitization to the pet, and sensitization to other allergens, often with conflicting results. Pet ownership is not random, and household pets are associated with exposures other than pet allergens. We will review some of the evidence regarding the effects of household pets on infant immune responses, focusing on data from birth cohort studies. It remains unclear precisely why some children develop specific sensitizations to pets whilst others do not in the face of equivalent exposures, but it is likely to be due to gene-environment interactions. Further long-term follow-up of children in whom neonatal and infant immune responses have been measured is necessary to understand how these events occur and how they relate to subsequent disease.
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Affiliation(s)
- Angela Simpson
- Manchester Academic Health Science Centre, NIHR Translational Research Facility in Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
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Fujimura KE, Johnson CC, Ownby DR, Cox MJ, Brodie EL, Havstad SL, Zoratti EM, Woodcroft KJ, Bobbitt KR, Wegienka G, Boushey HA, Lynch SV. Man's best friend? The effect of pet ownership on house dust microbial communities. J Allergy Clin Immunol 2010; 126:410-2, 412.e1-3. [PMID: 20633927 DOI: 10.1016/j.jaci.2010.05.042] [Citation(s) in RCA: 170] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 04/28/2010] [Accepted: 05/24/2010] [Indexed: 12/01/2022]
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Fujimura KE, Slusher NA, Cabana MD, Lynch SV. Role of the gut microbiota in defining human health. Expert Rev Anti Infect Ther 2010; 8:435-54. [PMID: 20377338 DOI: 10.1586/eri.10.14] [Citation(s) in RCA: 271] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The human superorganism is a conglomerate of mammalian and microbial cells, with the latter estimated to outnumber the former by ten to one and the microbial genetic repertoire (microbiome) to be approximately 100-times greater than that of the human host. Given the ability of the immune response to rapidly counter infectious agents, it is striking that such a large density of microbes can exist in a state of synergy within the human host. This is particularly true of the distal gastrointestinal (GI) tract, which houses up to 1000 distinct bacterial species and an estimated excess of 1 x 10(14) microorganisms. An ever-increasing body of evidence implicates the GI microbiota in defining states of health and disease. Here, we review the literature in adult and pediatric GI microbiome studies, the emerging links between microbial community structure, function, infection and disease, and the approaches to manipulate this crucial ecosystem to improve host health.
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Affiliation(s)
- Kei E Fujimura
- Colitis and Crohn's Disease Center, Gastroenterology Division, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
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Almqvist C, Bradding PB, Chakir J, Ebo D, Grattan C, Kariyawasam HH, Savilahti E, Scadding GK, Vieths S, Wardlaw AJ, Woodfolk J. Developments in the field of allergy in 2008 through the eyes of Clinical & Experimental Allergy. Clin Exp Allergy 2010; 39:1482-98. [PMID: 19954428 DOI: 10.1111/j.1365-2222.2009.03355.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In 2008, many thousands of articles were published on the subject of allergic disease with over 200 reviews, editorials and original papers in Clinical & Experimental Allergy alone. These represent a considerable amount of data and even the most avid reader could only hope to assimilate a small fraction of this knowledge. There is therefore a pressing need for the key messages that emerge from a journal such as Clinical & Experimental Allergy to be summarized by experts in the field in a form that highlights the significance of the developments and sets them in the context of important findings in the field published in other journals. This also has the advantage of making connections between new data in conditions such as asthma, where articles often appear in different sections of the journal. As can be seen from this review, the body of work is diverse both in terms of the disease of interest and the discipline that has been used to investigate it. However, taken as a whole, we hope that the reader will gain a flavour of where the field is mature, where there remain controversies and where the cutting edge is leading.
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Wegienka G, Havstad S, Zoratti EM, Woodcroft KJ, Bobbitt KR, Ownby DR, Johnson CC. Regulatory T cells in prenatal blood samples: variability with pet exposure and sensitization. J Reprod Immunol 2009; 81:74-81. [PMID: 19545906 DOI: 10.1016/j.jri.2009.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Revised: 03/06/2009] [Accepted: 03/24/2009] [Indexed: 11/11/2022]
Abstract
Fetal exposures have come under investigation as risk factors of early life allergic disease. In this study we aimed to examine the relationships between dog or cat exposure and naturally occurring regulatory T cells (Treg cells), thought to play an important role in immune tolerance, in pregnant women. A cross-sectional analysis was conducted among 204 pregnant women who were queried regarding dog and cat exposure. Treg cells (CD4+CD25+Foxp3+ lymphocytes) and allergen-specific IgE were measured in venous blood samples. Atopy was defined as allergen-specific IgE > or =0.35kU/l reactive with common allergens including dust mite, dog, cat, Timothy grass, ragweed, Alternaria alternata, egg white or cockroach. Nonparametric Wilcoxon rank sum tests and linear regression models of log transformed Treg cell levels were used in analyses. Among women sensitized to dog, those who had a dog or cat in the home had lower Treg cell levels compared with those who had no dog or cat. However, among women not sensitized to dog, those with a dog or cat in the home had higher Treg cell levels compared with those who did not. Among women sensitized to cat, those who had a dog or cat in the home had lower Treg cell levels compared with those who had no dog or cat. Gestational age at blood draw did not affect the associations. We conclude that Treg cell levels during pregnancy vary in association with both dog and cat exposure and atopic status.
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Affiliation(s)
- Ganesa Wegienka
- Department of Biostatistics and Research Epidemiology, Henry Ford Hospital, 1 Ford Place, 3E, Detroit, MI 48202, USA
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Nicholas C, Wegienka G, Havstad S, Ownby D, Johnson CC, Zoratti E. How accurately do young adults recall childhood pets? A validation study. Am J Epidemiol 2009; 170:388-92. [PMID: 19515795 DOI: 10.1093/aje/kwp139] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Epidemiologic research shows that pets influence human health, demonstrating both protective and deleterious health risks; therefore, valid definitions of pet exposure would enhance research. The authors determined how well young adults aged 18 years report their early childhood pets. Subjects in an established birth cohort from Detroit, Michigan, born in 1987-1989 (n = 820) were asked a series of questions about pets in the home during their first 6 years of life. Pet recall was compared with annual prospectively collected parental report from 12-18 years prior. Exposure to cats was correctly reported on average 86.3% of the time (95% confidence interval: 85.0, 87.5) and dogs 79.2% (95% confidence interval: 77.7, 80.6) of the time (P < 0.01). Cats and dogs were more likely to be underreported than overreported, from as few as 1.8-fold to as many as 8.3-fold (P < 0.05). Reporting differed by sex of the respondent and current pet ownership. No differences were found in reporting by those who experienced allergy symptoms near dogs or cats. Findings suggest good reliability of young adult pet reporting for ages 0-6 years but that childhood pet exposure may need to be assessed separately depending on the participant's sex and the outcome of interest.
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Affiliation(s)
- Charlotte Nicholas
- Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, MI 48202, USA.
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