1
|
Pantazi AC, Mihai CM, Balasa AL, Chisnoiu T, Lupu A, Frecus CE, Mihai L, Ungureanu A, Kassim MAK, Andrusca A, Nicolae M, Cuzic V, Lupu VV, Cambrea SC. Relationship between Gut Microbiota and Allergies in Children: A Literature Review. Nutrients 2023; 15:nu15112529. [PMID: 37299492 DOI: 10.3390/nu15112529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
The intestinal microbiota is a diverse and complex microecosystem that lives and thrives within the human body. The microbiota stabilizes by the age of three. This microecosystem plays a crucial role in human health, particularly in the early years of life. Dysbiosis has been linked to the development of various allergic diseases with potential long-term implications. Next-generation sequencing methods have established that allergic diseases are associated with dysbiosis. These methods can help to improve the knowledge of the relationship between dysbiosis and allergic diseases. The aim of this review paper is to synthesize the current understanding on the development of the intestinal microbiota in children, the long-term impact on health, and the relationship between dysbiosis and allergic diseases. Furthermore, we examine the connection between the microbiome and specific allergies such as atopic dermatitis, asthma, and food allergies, and which mechanisms could determine the induction of these diseases. Furthermore, we will review how factors such as mode of delivery, antibiotic use, breastfeeding, and the environment influence the development of the intestinal flora, as well as review various interventions for the prevention and treatment of gut microbiota-related allergies.
Collapse
Affiliation(s)
- Alexandru Cosmin Pantazi
- Pediatrics, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
- Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Cristina Maria Mihai
- Pediatrics, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
- Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Adriana Luminita Balasa
- Pediatrics, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
- Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Tatiana Chisnoiu
- Pediatrics, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
- Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Ancuta Lupu
- Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Corina Elena Frecus
- Pediatrics, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
- Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Larisia Mihai
- Pediatrics, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
- Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Adina Ungureanu
- Pediatrics, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
| | | | - Antonio Andrusca
- Pediatrics, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
- Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Maria Nicolae
- Pediatrics, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
- Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Viviana Cuzic
- Pediatrics, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
- Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Vasile Valeriu Lupu
- Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Simona Claudia Cambrea
- Infectious Diseases, Faculty of General Medicine, "Ovidius" University, 900470 Constanta, Romania
| |
Collapse
|
2
|
Han P, Gu JQ, Li LS, Wang XY, Wang HT, Wang Y, Chang C, Sun JL. The Association Between Intestinal Bacteria and Allergic Diseases-Cause or Consequence? Front Cell Infect Microbiol 2021; 11:650893. [PMID: 33937097 PMCID: PMC8083053 DOI: 10.3389/fcimb.2021.650893] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/22/2021] [Indexed: 12/17/2022] Open
Abstract
The incidence of allergic disorders has been increasing over the past few decades, especially in industrialized countries. Allergies can affect people of any age. The pathogenesis of allergic diseases is complex and involves genetic, epigenetic, and environmental factors, and the response to medication is very variable. For some patients, avoidance is the sole effective therapy, and only when the triggers are identifiable. In recent years, the intestinal microbiota has emerged as a significant contributor to the development of allergic diseases. However, the precise mechanisms related to the effects of the microbiome on the pathogenesis of allergic diseases are unknown. This review summarizes the recent association between allergic disorders and intestinal bacterial dysbiosis, describes the function of gut microbes in allergic disease development from both preclinical and clinical studies, discusses the factors that influence gut microbial diversity and advanced techniques used in microbial analysis. Ultimately, more studies are required to define the host-microbial relationship relevant to allergic disorders and amenable to new therapeutic interventions.
Collapse
Affiliation(s)
- Pei Han
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Jian-Qing Gu
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li-Sha Li
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xue-Yan Wang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Hong-Tian Wang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yan Wang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Christopher Chang
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Davis, CA, United States.,Division of Pediatric Immunology and Allergy, Joe DiMaggio Children's Hospital, Hollywood, FL, United States
| | - Jin-Lyu Sun
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
3
|
Björkstén B, Warner J, Wahn U, Eigenmann P. Pediatric Allergy and Immunology, building the future on 30 years of existence. Pediatr Allergy Immunol 2020; 31:732-734. [PMID: 33463767 DOI: 10.1111/pai.13333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Bengt Björkstén
- Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland
| | - John Warner
- Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland
| | - Ulrich Wahn
- Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland
| | - Philippe Eigenmann
- Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland
| |
Collapse
|
4
|
Roduit C, Frei R, Ferstl R, Loeliger S, Westermann P, Rhyner C, Schiavi E, Barcik W, Rodriguez‐Perez N, Wawrzyniak M, Chassard C, Lacroix C, Schmausser‐Hechfellner E, Depner M, Mutius E, Braun‐Fahrländer C, Karvonen AM, Kirjavainen PV, Pekkanen J, Dalphin J, Riedler J, Akdis C, Lauener R, O'Mahony L, Hyvärinen A, Remes S, Roponen M, Chauveau A, Dalphin ML, Kaulek V, Ege M, Genuneit J, Illi S, Kabesch M, Schaub B, Pfefferle P, Doekes G. High levels of butyrate and propionate in early life are associated with protection against atopy. Allergy 2019; 74:799-809. [PMID: 30390309 DOI: 10.1111/all.13660] [Citation(s) in RCA: 279] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/30/2018] [Accepted: 10/02/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Dietary changes are suggested to play a role in the increasing prevalence of allergic diseases and asthma. Short-chain fatty acids (SCFAs) are metabolites present in certain foods and are produced by microbes in the gut following fermentation of fibers. SCFAs have been shown to have anti-inflammatory properties in animal models. Our objective was to investigate the potential role of SCFAs in the prevention of allergy and asthma. METHODS We analyzed SCFA levels by high-performance liquid chromatography (HPLC) in fecal samples from 301 one-year-old children from a birth cohort and examined their association with early life exposures, especially diet, and allergy and asthma later in life. Data on exposures and allergic diseases were collected by questionnaires. In addition, we treated mice with SCFAs to examine their effect on allergic airway inflammation. RESULTS Significant associations between the levels of SCFAs and the infant's diet were identified. Children with the highest levels of butyrate and propionate (≥95th percentile) in feces at the age of one year had significantly less atopic sensitization and were less likely to have asthma between 3 and 6 years. Children with the highest levels of butyrate were also less likely to have a reported diagnosis of food allergy or allergic rhinitis. Oral administration of SCFAs to mice significantly reduced the severity of allergic airway inflammation. CONCLUSION Our results suggest that strategies to increase SCFA levels could be a new dietary preventive option for allergic diseases in children.
Collapse
Affiliation(s)
- Caroline Roduit
- University Children's Hospital Zurich Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Children's Hospital St Gallen St Gallen Switzerland
| | - Remo Frei
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Ruth Ferstl
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Susanne Loeliger
- University Children's Hospital Zurich Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - Patrick Westermann
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Claudio Rhyner
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Elisa Schiavi
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Weronika Barcik
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Noelia Rodriguez‐Perez
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Marcin Wawrzyniak
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | - Christophe Lacroix
- Department of Health Sciences and Technology ETH‐Zurich Zurich Switzerland
| | - Elisabeth Schmausser‐Hechfellner
- Institute for Asthma and Allergy Prevention Helmholtz Zentrum Munich German Research Center for Environmental Health Munich Germany
| | - Martin Depner
- Institute for Asthma and Allergy Prevention Helmholtz Zentrum Munich German Research Center for Environmental Health Munich Germany
| | - Erika Mutius
- Institute for Asthma and Allergy Prevention Helmholtz Zentrum Munich German Research Center for Environmental Health Munich Germany
- Dr von Hauner Children's Hospital of Ludwig Maximilian University of Munich Comprehensive Pneumology Center Munich (CPC‐M) Munich Germany
| | | | - Anne M. Karvonen
- Department of Health Security National Institute for Health and Welfare Kuopio Finland
| | - Pirkka V. Kirjavainen
- Department of Health Security National Institute for Health and Welfare Kuopio Finland
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Juha Pekkanen
- Department of Health Security National Institute for Health and Welfare Kuopio Finland
- Department of Public Health University of Helsinki Helsinki Finland
| | - Jean‐Charles Dalphin
- Department of Respiratory Disease University of Besançon UMR/CNRS 6249 Chrono‐environment University Hospital Besançon France
| | | | - Cezmi Akdis
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Roger Lauener
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Children's Hospital St Gallen St Gallen Switzerland
| | - Liam O'Mahony
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Departments of Medicine and Microbiology APC Microbiome Ireland National University of Ireland Cork Ireland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Moldaver DM, Bharhani MS, Rudulier CD, Wattie J, Inman MD, Larché M. Induction of bystander tolerance and immune deviation after Fel d 1 peptide immunotherapy. J Allergy Clin Immunol 2018; 143:1087-1099.e4. [PMID: 29906527 DOI: 10.1016/j.jaci.2018.03.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 02/08/2018] [Accepted: 03/28/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Treatment of patients with cat allergy with peptides derived from Fel d 1 (the major cat allergen) ameliorated symptoms of cat allergy in phase 2 clinical trials. OBJECTIVE We sought to demonstrate that the tolerance induced by Fel d 1 peptide immunotherapy can be exploited to reduce allergic responses to a second allergen, ovalbumin (OVA), in mice sensitized dually to OVA and Fel d 1. METHODS Induction of tolerance to OVA was achieved through simultaneous exposure to both allergens after peptide treatment. Functional tolerance to each allergen was assessed in a model of allergic airways disease in which treated mice were protected from eosinophilia, goblet cell hyperplasia, and TH2 cell infiltration. RESULTS Suppression of allergic responses to cat allergen challenge was associated with significant increases in numbers of CD4+CD25+Foxp3+ T cells, IL-10+ cells, and CD19+IL-10+ B cells, whereas the response to OVA was associated with a marked reduction in numbers of TH2 cytokine-secreting T cells and less prominent changes in outcomes associated with immune regulation. CONCLUSIONS These observations suggest that immune tolerance induced by peptide immunotherapy can be used experimentally to treat an allergic response to another allergen and that the molecular mechanisms underlying induction of tolerance to a treatment-specific allergen and a bystander allergen might be different.
Collapse
Affiliation(s)
- Daniel M Moldaver
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, Divisions of Respirology, and Clinical Immunology & Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mantej S Bharhani
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, Divisions of Respirology, and Clinical Immunology & Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Christopher D Rudulier
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, Divisions of Respirology, and Clinical Immunology & Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Division of Respirology, Critical Care and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jennifer Wattie
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, Divisions of Respirology, and Clinical Immunology & Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mark D Inman
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, Divisions of Respirology, and Clinical Immunology & Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mark Larché
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, Divisions of Respirology, and Clinical Immunology & Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
| |
Collapse
|
6
|
Jeurink PV, Knipping K, Wiens F, Barańska K, Stahl B, Garssen J, Krolak-Olejnik B. Importance of maternal diet in the training of the infant's immune system during gestation and lactation. Crit Rev Food Sci Nutr 2018; 59:1311-1319. [PMID: 29393671 DOI: 10.1080/10408398.2017.1405907] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Latest forecasts predict that half of the European population will be allergic within the coming 15 years, with food allergies contributing substantially to the total burden; preventive measures are urgently needed. Unfortunately, all attempted alimentary strategies for primary prevention of allergic diseases through allergen avoidance so far have failed. This also holds true for the prevention of food allergies in breastfed infants by the common practice of excluding certain foods with allergenic potential from the maternal diet. As a preventive measure, therefore, exclusion diets should be discouraged. They can exhaust nursing mothers and negatively impact both their nutritional status as well as their motivation to breastfeed. A prolonged exclusion diet may be indicated solely in cases of doctor-diagnosed food allergy following rigid medical tests (e.g. double-blind placebo-controlled food challenges). Indicated cases usually involve exclusion of only a few food items. Continued breastfeeding is generally important for many aspects of the infant's health, including the training of the infant's immune responses to foreign compounds and avoidance of overshooting inflammatory responses. Recent studies suggest that the presence of maternal dietary proteins in amniotic fluid, cord blood, and human milk might support the induction of tolerance towards solid foods in infants. These are exactly the same species of proteins or remnants thereof that, in comparatively few cases, trigger allergic responses. However, the insight that the proteins of maternal dietary origin in human milk are more likely to be cure (or, more precise, directing prevention) than curse has still largely evaded the attention of health care professionals consulted by worried breastfeeding mothers. In this paper, we summarize recent literature on the importance of exposure to dietary proteins in the establishment of immunological tolerance and hence prevention of allergic disease. Multiple organizations have used the scientific knowledge to build (local) guidelines (e.g. AAAAI, EAACI, BSACI) that can support health care professionals to provide the best strategy to prevent the onset of allergic diseases. We thus hope to clarify existing confusion about the allergenic propensities of dietary proteins during early life, which has contributed to exaggerated fears around the diet of pregnant and breastfeeding mothers.
Collapse
Affiliation(s)
- P V Jeurink
- a Nutricia Research , Utrecht , the Netherlands.,b Division of Pharmacology, Department of Pharmaceutical Sciences , Faculty of Science, Utrecht University , the Netherlands
| | - K Knipping
- a Nutricia Research , Utrecht , the Netherlands.,b Division of Pharmacology, Department of Pharmaceutical Sciences , Faculty of Science, Utrecht University , the Netherlands
| | - F Wiens
- a Nutricia Research , Utrecht , the Netherlands
| | - K Barańska
- c Department of Neonatology , Wroclaw Medical University , Wroclaw , Poland
| | - B Stahl
- a Nutricia Research , Utrecht , the Netherlands
| | - J Garssen
- a Nutricia Research , Utrecht , the Netherlands.,b Division of Pharmacology, Department of Pharmaceutical Sciences , Faculty of Science, Utrecht University , the Netherlands
| | - B Krolak-Olejnik
- c Department of Neonatology , Wroclaw Medical University , Wroclaw , Poland
| |
Collapse
|
7
|
Prevention of allergies in childhood - where are we now? Allergol Select 2017; 1:200-213. [PMID: 30402617 PMCID: PMC6040005 DOI: 10.5414/alx01807e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 07/27/2015] [Indexed: 11/18/2022] Open
Abstract
Allergic diseases represent an increasing health problem for children worldwide. Along with allergic airway diseases, food allergy comes to the fore and herewith closely intertwined the hypothesis that an early allergic sensitization might occur via skin barrier defect(s). The importance of the skin barrier has been documented by several studies meanwhile. Not only genetic studies screen the associations between Filaggrin loss-of-function mutations, atopic dermatitis, allergic sensitization, food allergy and even airway diseases, but also epidemiological studies cast new light on the hypothesis of the atopic march. As another focus in context of the development of an allergic phenotype, the specific microbial exposure with all its diversities has been crystallized as it shapes the immune system in (early) infancy. Studies explored both, the role of human intestinal microbiota as well as the external microbial diversity. Unfortunately suitable markers for atopic predictors are still rare. New studies point out that specific IgE antibodies (e.g., IgE to Phl p 1) in children without allergic symptoms so far, might function as a pre-clinical biomarker, which may help to identify candidates for primary (allergen non-specific) or secondary (allergen-specific) prevention in terms of specific immunoprophylaxis. These manifold research activities document a complex increase in knowledge. Nevertheless new assumptions need to be substantively confirmed in order to finally generate the urgently needed preventive strategies for allergic diseases in childhood.
Collapse
|
8
|
Bernard A, Nickmilder M, Dumont X. Chlorinated pool attendance, airway epithelium defects and the risks of allergic diseases in adolescents: Interrelationships revealed by circulating biomarkers. ENVIRONMENTAL RESEARCH 2015; 140:119-26. [PMID: 25863185 DOI: 10.1016/j.envres.2015.03.034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/09/2015] [Accepted: 03/30/2015] [Indexed: 05/26/2023]
Abstract
It has been suggested that allergic diseases might be epithelial disorders driven by various environmental stressors but the epidemiological evidence supporting this concept is limited. In a cross-sectional study of 835 school adolescents (365 boys; mean age, 15.5 yr), we measured the serum concentrations of Club cell protein (CC16), surfactant-associated protein D (SP-D) and of total and aeroallergen-specific IgE. We used the serum CC16/SP-D concentration ratio as an index integrating changes in the permeability (SP-D) and secretory function (CC16) of the airway epithelium. In both sexes, early swimming in chlorinated pools emerged as the most consistent and strongest predictor of low CC16 and CC16/SP-D ratio in serum. Among girls, a low CC16/SP-D ratio was associated with increased odds (lowest vs. highest tertile) for pet sensitization (OR 2.97, 95% CI 1.19-8.22) and for hay fever in subjects sensitized to pollen (OR 4.12, 95% CI 1.28-14.4). Among boys, a low CC16/SP-D ratio was associated with increased odds for house-dust mite (HDM) sensitization (OR 2.01, 95% CI 1.11-3.73), for allergic rhinitis in subjects sensitized to HDM (OR 3.52, 95% CI 1.22-11.1) and for asthma in subjects sensitized to any aeroallergen (OR 3.38, 95% CI 1.17-11.0), HDM (OR 5.20, 95% CI 1.40-24.2) or pollen (OR 5.82, 95% CI 1.51-27.4). Odds for allergic sensitization or rhinitis also increased with increasing SP-D or decreasing CC16 in serum. Our findings support the hypothesis linking the development of allergic diseases to epithelial barrier defects due to host factors or environmental stressors such as early swimming in chlorinated pools.
Collapse
Affiliation(s)
- Alfred Bernard
- Louvain Centre for Toxicology and Applied Pharmacology, Faculty of Medicine, Catholic University of Louvain, Brussels, Belgium.
| | - Marc Nickmilder
- Louvain Centre for Toxicology and Applied Pharmacology, Faculty of Medicine, Catholic University of Louvain, Brussels, Belgium
| | - Xavier Dumont
- Louvain Centre for Toxicology and Applied Pharmacology, Faculty of Medicine, Catholic University of Louvain, Brussels, Belgium
| |
Collapse
|
9
|
Mondoulet L, Dioszeghy V, Puteaux E, Ligouis M, Dhelft V, Plaquet C, Dupont C, Benhamou PH. Specific epicutaneous immunotherapy prevents sensitization to new allergens in a murine model. J Allergy Clin Immunol 2015; 135:1546-57.e4. [DOI: 10.1016/j.jaci.2014.11.028] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 11/04/2014] [Accepted: 11/12/2014] [Indexed: 01/06/2023]
|
10
|
Bernard A, Nickmilder M, Dumont X. Airway epithelium defects and risks of allergic diseases: multiple associations revealed by a biomarker study among adolescents. Am J Respir Crit Care Med 2015; 191:714-7. [PMID: 25767927 DOI: 10.1164/rccm.201409-1748le] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
11
|
Cipriani F, Dondi A, Ricci G. Recent advances in epidemiology and prevention of atopic eczema. Pediatr Allergy Immunol 2014; 25:630-8. [PMID: 25406640 DOI: 10.1111/pai.12309] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2014] [Indexed: 12/22/2022]
Abstract
Atopic dermatitis (AD), named also atopic eczema, is a chronic relapsing inflammatory skin disease with a considerable social and economic burden. The primum movens of AD is in most cases a genetic and/or immune-supported defect of the skin barrier, facilitating penetration and sensitization to food or airborne allergens, as well as infections by Staphylococcus aureus, herpes simplex virus, or other microbes. New pathogenetic concepts have generated new approaches to prevention and therapy of AD. In particular, the daily use of emollients in newborns at high risk of AD has shown interesting results, with a reduction in the cumulative incidence of AD ranging from 32% to 50% of the treated infants. On the other hand, the AD preventive efficacy of food and/or inhalant allergen avoidance has been questioned, and supplementation strategies (vitamin D, probiotics, or other compounds) need to be further investigated.
Collapse
Affiliation(s)
- Francesca Cipriani
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | | |
Collapse
|
12
|
|
13
|
Affiliation(s)
- Tari Haahtela
- Department of Allergy, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.
| |
Collapse
|