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Karvonen AM, Lampi J, Keski-Nisula L, Auvinen J, Toppila-Salmi S, Järvelin M, Pekkanen J. Farm Environment During Pregnancy and Childhood and Polysensitization at the Age of 31: Prospective Birth Cohort Study in Finland. J Investig Allergol Clin Immunol 2019; 31:44-51. [PMID: 31589143 DOI: 10.18176/jiaci.0455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The farm environment, especially contact with farm animals in early childhood, may prevent allergic sensitization during adulthood. However, prospective associations between exposure to the farm environment and polysensitization have not been studied. Polysensitization is a risk factor for asthma and asthma-related morbidity. Objective: To investigate whether exposure to a farming environment in early childhood, especially exposure to animals, is associated with sensitization to specific allergens and polysensitization at the age of 31. METHODS In a prospective birth cohort study, 5509 individuals born in northern Finland in 1966 underwent skin prick testing against birch, timothy, cat, and house dust mite at the age of 31. Prenatal exposure to the farming environment was documented at birth, whereas information on childhood exposure to pets was only collected retrospectively at the age of 31. Data were analyzed using logistic regression. RESULTS Being born to a family with farm animals was associated with a reduced risk of sensitization to birch, timothy, and cat (adjusted odds ratio [aOR], 0.55 [95%CI, 0.43-0.70]; aOR, 0.62 [95%CI, 0.48-0.79]; aOR, 0.60 [95%CI, 0.47-0.75]) and polysensitization at the age of 31 (aOR, 0.62 [95%CI, 0.48-0.80]). The number of animal species present during childhood was dose-dependently associated with a reduced risk of sensitization to birch, timothy, and cat, as well as of polysensitization. No association was found with sensitization to house dust mite. CONCLUSIONS Growing up on a farm and contact with higher numbers of animal species in childhood are associated with less frequent sensitization to birch, timothy, and cat allergens and polysensitization in adulthood, but not with sensitization to house dust mite.
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Affiliation(s)
- A M Karvonen
- Environmental Health Unit, Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - J Lampi
- Environmental Health Unit, Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - L Keski-Nisula
- Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland.,Department of Health Sciences, Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - J Auvinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Oulunkaari Health Center, Ii, Finland
| | - S Toppila-Salmi
- Haartman Institute, University of Helsinki, Helsinki, Finland.,Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - M Järvelin
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, UK.,Unit of Primary Care, Oulu University Hospital, Oulu, Finland.,Biocenter Oulu, University of Oulu, Oulu, Finland
| | - J Pekkanen
- Environmental Health Unit, Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
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2
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Santos S, Voerman E, Amiano P, Barros H, Beilin LJ, Bergström A, Charles MA, Chatzi L, Chevrier C, Chrousos GP, Corpeleijn E, Costa O, Costet N, Crozier S, Devereux G, Doyon M, Eggesbø M, Fantini MP, Farchi S, Forastiere F, Georgiu V, Godfrey KM, Gori D, Grote V, Hanke W, Hertz-Picciotto I, Heude B, Hivert MF, Hryhorczuk D, Huang RC, Inskip H, Karvonen AM, Kenny LC, Koletzko B, Küpers LK, Lagström H, Lehmann I, Magnus P, Majewska R, Mäkelä J, Manios Y, McAuliffe FM, McDonald SW, Mehegan J, Melén E, Mommers M, Morgen CS, Moschonis G, Murray D, Ní Chaoimh C, Nohr EA, Nybo Andersen AM, Oken E, Oostvogels A, Pac A, Papadopoulou E, Pekkanen J, Pizzi C, Polanska K, Porta D, Richiardi L, Rifas-Shiman SL, Roeleveld N, Ronfani L, Santos AC, Standl M, Stigum H, Stoltenberg C, Thiering E, Thijs C, Torrent M, Tough SC, Trnovec T, Turner S, van Gelder M, van Rossem L, von Berg A, Vrijheid M, Vrijkotte T, West J, Wijga AH, Wright J, Zvinchuk O, Sørensen T, Lawlor DA, Gaillard R, Jaddoe V. Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of European, North American and Australian cohorts. BJOG 2019; 126:984-995. [PMID: 30786138 DOI: 10.1111/1471-0528.15661] [Citation(s) in RCA: 211] [Impact Index Per Article: 42.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To assess the separate and combined associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain with the risks of pregnancy complications and their population impact. DESIGN Individual participant data meta-analysis of 39 cohorts. SETTING Europe, North America, and Oceania. POPULATION 265 270 births. METHODS Information on maternal pre-pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used. MAIN OUTCOME MEASURES Gestational hypertension, pre-eclampsia, gestational diabetes, preterm birth, small and large for gestational age at birth. RESULTS Higher maternal pre-pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes, and large for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (odds ratio 2.51, 95% CI 2.31- 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large for gestational age infants was attributable to excessive gestational weight gain. CONCLUSIONS Maternal pre-pregnancy BMI and gestational weight gain are, across their full ranges, associated with risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre-pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity. TWEETABLE ABSTRACT Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.
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Affiliation(s)
- S Santos
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - E Voerman
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - P Amiano
- Public Health Division of Gipuzkoa, San Sebastián, Spain.,BioDonostia Research Institute, San Sebastián, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - H Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Department of Public Health and Forensic Sciences and Medical Education, Unit of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - L J Beilin
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia
| | - A Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - M-A Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Villejuif, France.,Paris Descartes University, Villejuif, France
| | - L Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Faculty of Medicine, Department of Social Medicine, University of Crete, Heraklion, Greece.,Department of Genetics and Cell Biology, Maastricht University, Maastricht, the Netherlands
| | - C Chevrier
- Inserm UMR 1085, Irset - Research Institute for Environmental and Occupational Health, Rennes, France
| | - G P Chrousos
- First Department of Pediatrics, Athens University Medical School, 'Aghia Sophia' Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - O Costa
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - N Costet
- Inserm UMR 1085, Irset - Research Institute for Environmental and Occupational Health, Rennes, France
| | - S Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - G Devereux
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - M Doyon
- Centre de Recherche du Centre Hospitalier de l'Universite de Sherbrooke, Sherbrooke, QC, Canada
| | - M Eggesbø
- Department of Exposure and Environmental Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - M P Fantini
- The Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - S Farchi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - F Forastiere
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - V Georgiu
- Faculty of Medicine, Department of Social Medicine, University of Crete, Heraklion, Greece
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - D Gori
- The Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - V Grote
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-Universität Munich, Munich, Germany
| | - W Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - I Hertz-Picciotto
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - B Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Villejuif, France.,Paris Descartes University, Villejuif, France
| | - M-F Hivert
- Centre de Recherche du Centre Hospitalier de l'Universite de Sherbrooke, Sherbrooke, QC, Canada.,Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.,Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - D Hryhorczuk
- Center for Global Health, University of Illinois College of Medicine, Chicago, IL, USA
| | - R-C Huang
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - H Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A M Karvonen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - L C Kenny
- Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, University College Cork, Cork, Ireland.,Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - B Koletzko
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-Universität Munich, Munich, Germany
| | - L K Küpers
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, University of Bristol, Bristol, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - H Lagström
- Department of Public Health, University of Turku, Turku, Finland
| | - I Lehmann
- Department of Environmental Immunology/Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - P Magnus
- Division of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway
| | - R Majewska
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - J Mäkelä
- Turku Centre for Biotechnology, University of Turku and Abo Akademi University, Turku, Finland
| | - Y Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - F M McAuliffe
- UCD Perinatal Research Centre, Obstetrics& Gynaecology, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - S W McDonald
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - J Mehegan
- UCD Perinatal Research Centre, School of Public Health and Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - E Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Sach's Children Hospital, Stockholm, Sweden
| | - M Mommers
- Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - C S Morgen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - G Moschonis
- Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Vic, Australia
| | - D Murray
- Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, University College Cork, Cork, Ireland.,Paediatrics & Child Health, University College Cork, Cork, Ireland
| | - C Ní Chaoimh
- Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, University College Cork, Cork, Ireland.,Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - E A Nohr
- Research Unit for Gynaecology and Obstetrics, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark
| | - A-M Nybo Andersen
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - E Oken
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Ajjm Oostvogels
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam, the Netherlands
| | - A Pac
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - E Papadopoulou
- Department of Environmental Exposures and Epidemiology, Domain of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - J Pekkanen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - C Pizzi
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - K Polanska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - D Porta
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - L Richiardi
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - S L Rifas-Shiman
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - N Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - L Ronfani
- Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | - A C Santos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Department of Public Health and Forensic Sciences and Medical Education, Unit of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - M Standl
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - H Stigum
- Department of Non-communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - C Stoltenberg
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - E Thiering
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.,Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - C Thijs
- Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - M Torrent
- Ib-salut, Area de Salut de Menorca, Menorca, Spain
| | - S C Tough
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - T Trnovec
- Department of Environmental Medicine, Slovak Medical University, Bratislava, Slovak Republic
| | - S Turner
- Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK
| | - Mmhj van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.,Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - L van Rossem
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - A von Berg
- Department of Pediatrics, Research Institute, Marien-Hospital Wesel, Wesel, Germany
| | - M Vrijheid
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal, Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Tgm Vrijkotte
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam, the Netherlands
| | - J West
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - A H Wijga
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - J Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - O Zvinchuk
- Department of Medical and Social Problems of Family Health, Institute of Pediatrics, Obstetrics and Gynecology, Kyiv, Ukraine
| | - Tia Sørensen
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark.,Section of Metabolic Genetics, Faculty of Health and Medical Sciences, The Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - D A Lawlor
- MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, University of Bristol, Bristol, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - R Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Vwv Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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3
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Karvonen AM, Tischer C, Kirjavainen PV, Roponen M, Hyvärinen A, Illi S, Mustonen K, Pfefferle PI, Renz H, Remes S, Schaub B, von Mutius E, Pekkanen J. Early age exposure to moisture damage and systemic inflammation at the age of 6 years. Indoor Air 2018; 28:450-458. [PMID: 29450910 DOI: 10.1111/ina.12454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 02/09/2018] [Indexed: 06/08/2023]
Abstract
Cross-sectional studies have shown that exposure to indoor moisture damage and mold may be associated with subclinical inflammation. Our aim was to determine whether early age exposure to moisture damage or mold is prospectively associated with subclinical systemic inflammation or with immune responsiveness in later childhood. Home inspections were performed in children's homes in the first year of life. At age 6 years, subclinical systemic inflammation was measured by serum C-reactive protein (CRP) and blood leukocytes and immune responsiveness by ex vivo production of interleukin 1-beta (IL-1β), IL-6, and tumor necrosis factor alpha (TNF-α) in whole blood cultures without stimulation or after 24 hours stimulation with phorbol 12-myristate 13-acetate and ionomycin (PI), lipopolysaccharide (LPS), or peptidoglycan (PPG) in 251-270 children. Moisture damage in child's main living areas in infancy was not significantly associated with elevated levels of CRP or leukocytes at 6 years. In contrast, there was some suggestion for an effect on immune responsiveness, as moisture damage with visible mold was positively associated with LPS-stimulated production of TNF-α and minor moisture damage was inversely associated with PI-stimulated IL-1β. While early life exposure to mold damage may have some influence on later immune responsiveness, it does not seem to increase subclinical systemic inflammation in later life.
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Affiliation(s)
- A M Karvonen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - C Tischer
- ISGlobal, Barcelona Institute for Global Health - Campus MAR, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - P V Kirjavainen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - M Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - A Hyvärinen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - S Illi
- Helmholtz Zentrum Muenchen - Deutsches Forschungszentrum fuer Gesundheit und Umwelt (GmbH), Institute for Asthma and Allergy Prevention, Neuherberg, Germany
| | - K Mustonen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - P I Pfefferle
- Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University of Marburg, Marburg, Germany
| | - H Renz
- Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University of Marburg, Marburg, Germany
| | - S Remes
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - B Schaub
- Dr. von Hauner Childrens Hospital, Ludwig Maximilians University Munich, Munich, Germany
- Member of the German Centre for Lung Research, Munich, Germany
| | - E von Mutius
- Helmholtz Zentrum Muenchen - Deutsches Forschungszentrum fuer Gesundheit und Umwelt (GmbH), Institute for Asthma and Allergy Prevention, Neuherberg, Germany
- Dr. von Hauner Childrens Hospital, Ludwig Maximilians University Munich, Munich, Germany
- Member of the German Centre for Lung Research, Munich, Germany
| | - J Pekkanen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
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4
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Järvi K, Hyvärinen A, Täubel M, Karvonen AM, Turunen M, Jalkanen K, Patovirta R, Syrjänen T, Pirinen J, Salonen H, Nevalainen A, Pekkanen J. Microbial growth in building material samples and occupants' health in severely moisture-damaged homes. Indoor Air 2018; 28:287-297. [PMID: 29151276 DOI: 10.1111/ina.12440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 11/09/2017] [Indexed: 06/07/2023]
Abstract
There is no commonly approved approach to detect and quantify the health-relevant microbial exposure in moisture-damaged buildings. In 39 single-family homes with severe moisture damage, we studied whether concentrations of viable microbes in building material samples are associated with health among 71 adults and 68 children, and assessed with symptoms questionnaires, exhaled NO, and peak expiratory flow (PEF) variability. Symptoms were grouped into three scores: upper respiratory symptoms, lower respiratory symptoms, and general symptoms. The homes were divided into three groups based on viable counts of fungi, actinomycetes, and total bacteria cultivated from building material samples. Highest group of actinomycete counts was associated with more general symptoms, worse perceived health, and higher daily PEF variability (aOR 12.51; 1.10-141.90 as compared to the lowest group) among adults, and with an increase in lower respiratory symptoms in children, but the confidence intervals were wide. We observed significant associations of fungal counts and total microbial score with worse perceived health in adults. No associations with exhaled NO were observed.
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Affiliation(s)
- K Järvi
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- School of Engineering, Aalto University, Espoo, Finland
| | - A Hyvärinen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - M Täubel
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - A M Karvonen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - M Turunen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - K Jalkanen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - R Patovirta
- Department of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland
| | - T Syrjänen
- The Organisation for Respiratory Health in Finland, Helsinki, Finland
| | - J Pirinen
- The Organisation for Respiratory Health in Finland, Helsinki, Finland
- Ministry of Environment, Helsinki, Finland
| | - H Salonen
- School of Engineering, Aalto University, Espoo, Finland
| | - A Nevalainen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - J Pekkanen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
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5
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Chauveau A, Dalphin ML, Mauny F, Kaulek V, Schmausser-Hechfellner E, Renz H, Riedler J, Pekkanen J, Karvonen AM, Lauener R, Roduit C, Vuitton DA, von Mutius E, Dalphin JC. Skin prick tests and specific IgE in 10-year-old children: Agreement and association with allergic diseases. Allergy 2017; 72:1365-1373. [PMID: 28235151 DOI: 10.1111/all.13148] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Accurate assessment of atopic sensitization is pivotal to clinical practice and research. Skin prick test (SPT) and specific IgE (sIgE) are often used interchangeably. Some studies have suggested a disagreement between these two methods, and little is known about their association with allergic diseases. The aims of our study were to evaluate agreement between SPT and sIgE, and to compare their association with allergic diseases in 10-year-old children. METHODS Skin prick test, sIgE measurements, and assessment of allergic diseases were performed in children aged 10 years in the Protection against Allergy: STUdy in Rural Environments (PASTURE) cohort. The agreement between SPT and sIgE was assessed by Cohen's kappa coefficient with different cutoff values. RESULTS Skin prick tests and sIgE were performed in 529 children. The highest agreement (κ=.44) was found with a cutoff value of 3 and 5 mm for SPT, and 3.5 IU/mL for sIgE. The area under the curve (AUC) obtained with SPT was not significantly different from that obtained with sIgE. For asthma and hay fever, SPT (cutoff value at 3 mm) had a significantly higher specificity (P<.0001) than sIgE (cutoff value at 0.35 IU/mL) and the specificity was not different between both tests (P=.1088). CONCLUSION Skin prick test and sIgE display moderate agreement, but have a similar AUC for allergic diseases. At the cutoff value of 3 mm for SPT and 0.35 IU/mL for sIgE, SPT has a higher specificity for asthma and hay fever than sIgE without difference for sensitivity.
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Affiliation(s)
- A. Chauveau
- Pediatrics Department; University Hospital of Besançon; Besançon France
- Pediatric Allergy Department; University Hospital of Nancy; Nancy France
- UMR 6249 Chrono-Environment; CNRS and University of Franche-Comté; Besançon France
| | - M.-L. Dalphin
- Pediatrics Department; University Hospital of Besançon; Besançon France
| | - F. Mauny
- UMR 6249 Chrono-Environment; CNRS and University of Franche-Comté; Besançon France
- Clinical Methodology Center; University Hospital of Besançon; Besançon France
| | - V. Kaulek
- UMR 6249 Chrono-Environment; CNRS and University of Franche-Comté; Besançon France
- Respiratory Diseases Department; University Hospital of Besançon; Besançon France
| | | | - H. Renz
- Institute for Laboratory Medicine, Pathobiochemistry and Molecular Diagnostics; Philipps University of Marburg; Marburg Germany
| | - J. Riedler
- Children's Hospital Schwarzach; Salzburg Austria
| | - J. Pekkanen
- Department of Health Protection; National Institute for Health and Welfare; Kuopio Finland
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - A. M. Karvonen
- Department of Health Protection; National Institute for Health and Welfare; Kuopio Finland
| | - R. Lauener
- Christine Kühne Center for Allergy Research and Education (CK-CARE); Davos Switzerland
- Children's Hospital of Eastern Switzerland; St. Gallen Switzerland
| | - C. Roduit
- Christine Kühne Center for Allergy Research and Education (CK-CARE); Davos Switzerland
- University Children's Hospital Zurich; Zurich Switzerland
| | - D. A. Vuitton
- EA 3181; University of Franche-Comté; Besançon France
| | - E. von Mutius
- Dr. von Hauner Children's Hospital; Ludwig Maximilians University Munich; Munich Germany
- CPC-M; Member of the German Center for Lung Research; Giessen Germany
| | - J.-C. Dalphin
- UMR 6249 Chrono-Environment; CNRS and University of Franche-Comté; Besançon France
- Respiratory Diseases Department; University Hospital of Besançon; Besançon France
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6
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Kääriö H, Huttunen K, Karvonen AM, Schaub B, von Mutius E, Pekkanen J, Hirvonen MR, Roponen M. Exposure to a farm environment is associated with T helper 1 and regulatory cytokines at age 4.5 years. Clin Exp Allergy 2016; 46:71-7. [PMID: 26362849 DOI: 10.1111/cea.12636] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/21/2015] [Accepted: 08/23/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Farm exposure has been shown to protect from childhood asthma and allergic diseases, but underlying immunological mechanisms are not clear yet. OBJECTIVE To explore whether farming lifestyle determines cytokine profile of peripheral blood mononuclear cells (PBMCs) of 4.5-year-old children (n = 88) from the Finnish PASTURE birth cohort study. METHODS We analysed regulatory (IL-10, IL-2), T helper 1 (Th1)-associated (IL-12, IFN-γ), inflammatory (IL-1β, TNF, CXCL8) and Th2-associated (IL-13) cytokines in unstimulated PBMCs and after a short-term (5 h) stimulation with lipopolysaccharide (LPS). Specific farm exposures (stables, hay barn, farm milk) at age 4 years were assessed from questionnaires. RESULTS The unstimulated PBMCs of farm children produced more IL-10 (GMR 1.22, P = 0.032), IL-12 (GMR 1.24, P = 0.012) and IFN-γ (GMR 1.24, P = 0.024) than those of non-farm children. Also, specific farm exposures were associated with higher spontaneous production of cytokines. The number of specific farm exposures tended to be dose dependently associated with higher spontaneous production of IFN-γ (test for trends, P = 0.013) and lower LPS-induced production of TNF (test for trends, P = 0.025). CONCLUSION AND CLINICAL RELEVANCE Farming lifestyle seemed to be associated with increased spontaneous production of Th1 and regulatory cytokines. Decreased TNF responses to short-term LPS stimulation in farm-exposed children may imply tolerogenic immune mechanisms. These novel findings might contribute to the asthma and allergy protection in farm environment.
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Affiliation(s)
- H Kääriö
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
| | - K Huttunen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
| | - A M Karvonen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - B Schaub
- Department of Pulmonary and Allergy, University Children's Hospital Munich, LMU Munich, Munich, Germany
| | - E von Mutius
- Department of Pulmonary and Allergy, University Children's Hospital Munich, LMU Munich, Munich, Germany
| | - J Pekkanen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - M-R Hirvonen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland.,Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - M Roponen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
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7
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Kirjavainen PV, Täubel M, Karvonen AM, Sulyok M, Tiittanen P, Krska R, Hyvärinen A, Pekkanen J. Microbial secondary metabolites in homes in association with moisture damage and asthma. Indoor Air 2016; 26:448-456. [PMID: 25913237 DOI: 10.1111/ina.12213] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 04/22/2015] [Indexed: 06/04/2023]
Abstract
We aimed to characterize the presence of microbial secondary metabolites in homes and their association with moisture damage, mold, and asthma development. Living room floor dust was analyzed by LC-MS/MS for 333 secondary metabolites from 93 homes of 1-year-old children. Moisture damage was present in 15 living rooms. At 6 years, 8 children had active and 15 lifetime doctor-diagnosed asthma. The median number of different metabolites per house was 17 (range 8-29) and median sum load 65 (4-865) ng/m(2) . Overall 42 different metabolites were detected. The number of metabolites present tended to be higher in homes with mold odor or moisture damage. The higher sum loads and number of metabolites with loads over 10 ng/m(2) were associated with lower prevalence of active asthma at 6 years (aOR 0.06 (95% CI <0.001-0.96) and 0.05 (<0.001-0.56), respectively). None of the individual metabolites, which presence tended (P < 0.2) to be increased by moisture damage or mold, were associated with increased risk of asthma. Microbial secondary metabolites are ubiquitously present in home floor dust. Moisture damage and mold tend to increase their numbers and amount. There was no evidence indicating that the secondary metabolites determined would explain the association between moisture damage, mold, and the development of asthma.
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Affiliation(s)
- P V Kirjavainen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - M Täubel
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
| | - A M Karvonen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
| | - M Sulyok
- Department IFA-Tulln, University of Natural Resources and Life Sciences, Vienna, Austria
| | - P Tiittanen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
| | - R Krska
- Department IFA-Tulln, University of Natural Resources and Life Sciences, Vienna, Austria
| | - A Hyvärinen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
| | - J Pekkanen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Hjelt Institute, University of Helsinki, Helsinki, Finland
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8
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Mustonen K, Karvonen AM, Kirjavainen P, Roponen M, Schaub B, Hyvärinen A, Frey U, Renz H, Pfefferle PI, Genuneit J, Vaarala O, Pekkanen J. Moisture damage in home associates with systemic inflammation in children. Indoor Air 2016; 26:439-447. [PMID: 25924948 DOI: 10.1111/ina.12216] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 04/23/2015] [Indexed: 06/04/2023]
Abstract
This study investigated the association between confirmed moisture damage in homes and systemic subclinical inflammation in children. Home inspections were performed in homes of 291 children at the age of 6 years. Subclinical inflammation at the age of 6 years was assessed by measuring the circulating levels of C-reactive protein (CRP) and leukocytes in peripheral blood and fractional exhaled nitric oxide (FeNO). Proinflammatory cytokines interleukin (IL)-1β and IL-6 and tumor necrosis factor (TNF)-α were measured in unstimulated, and in phorbol 12-myristate 13-acetate and ionomycin (PI), lipopolysaccharide (LPS), or peptidoglycan (PPG)-stimulated whole blood. Major moisture damage in the child's main living areas (living room, kitchen, or child's bedroom) and moisture damage with mold in the bathroom were associated with increased levels of CRP and stimulated production of several proinflammatory cytokines. There were no significant associations between moisture damage/visible mold and leukocyte or FeNO values. The results suggest that moisture damage or mold in home may be associated with increased systemic subclinical inflammation and proinflammatory cytokine responsiveness.
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Affiliation(s)
- K Mustonen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - A M Karvonen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - P Kirjavainen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - M Roponen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
| | - B Schaub
- LMU Munich, University Children's Hospital, Munich, Germany
| | - A Hyvärinen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - U Frey
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - H Renz
- Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University of Marburg, Marburg, Germany
| | - P I Pfefferle
- Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University of Marburg, Marburg, Germany
| | - J Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - O Vaarala
- Department of Vaccinations and Immune Protection, National Institute of Health and Welfare, Helsinki, Finland
| | - J Pekkanen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
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9
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Kääriö H, Nieminen JK, Karvonen AM, Huttunen K, Schröder PC, Vaarala O, von Mutius E, Pfefferle PI, Schaub B, Pekkanen J, Hirvonen MR, Roponen M. Circulating Dendritic Cells, Farm Exposure and Asthma at Early Age. Scand J Immunol 2016; 83:18-25. [PMID: 26368653 DOI: 10.1111/sji.12389] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/09/2015] [Indexed: 12/23/2022]
Abstract
Farm environment has been shown to protect from childhood asthma. Underlying immunological mechanisms are not clear yet, including the role of dendritic cells (DCs). The aim was to explore whether asthma and farm exposures are associated with the proportions and functional properties of DCs from 4.5-year-old children in a subgroup of the Finnish PASTURE birth cohort study. Myeloid DCs (mDCs), plasmacytoid DCs (pDCs) and CD86 expression on mDCs ex vivo (n = 100) identified from peripheral blood mononuclear cells (PBMCs) were analysed using flow cytometry. MDCs and production of interleukin (IL)-6 and tumour necrosis factor alpha (TNF-α) by mDCs were analysed after 5 h in vitro stimulation with lipopolysaccharide (LPS) (n = 88). Prenatal and current farm exposures (farming, stables, hay barn and farm milk) were assessed from questionnaires. Asthma at age 6 years was defined as a doctor's diagnosis and symptoms; atopic sensitization was defined by antigen-specific IgE measurements. Asthma was positively associated with CD86 expression on mDCs ex vivo [adjusted odds ratio (aOR) 4.83, 95% confidence interval (CI) 1.51-15.4] and inversely with IL-6 production in mDCs after in vitro stimulation with LPS (aOR 0.19, 95% CI 0.04-0.82). In vitro stimulation with LPS resulted in lower percentage of mDCs in the farm PBMC cultures as compared to non-farm PBMC cultures. Our results suggest an association between childhood asthma and functional properties of DCs. Farm exposure may have immunomodulatory effects by decreasing mDC proportions.
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Affiliation(s)
- H Kääriö
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
| | - J K Nieminen
- Immune Response Unit, Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland
| | - A M Karvonen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - K Huttunen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
| | - P C Schröder
- Department of Pulmonary and Allergy, LMU Munich, University Children's Hospital, Munich, Germany
| | - O Vaarala
- Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
| | - E von Mutius
- Department of Pulmonary and Allergy, LMU Munich, University Children's Hospital, Munich, Germany
| | - P I Pfefferle
- Institute of Laboratory Medicine, Pathobiochemistry and Molecular Diagnostics, Philipps University, Marburg, Germany
| | - B Schaub
- Department of Pulmonary and Allergy, LMU Munich, University Children's Hospital, Munich, Germany
| | - J Pekkanen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - M-R Hirvonen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland.,Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - M Roponen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
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10
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Ruokolainen L, Hertzen L, Fyhrquist N, Laatikainen T, Lehtomäki J, Auvinen P, Karvonen AM, Hyvärinen A, Tillmann V, Niemelä O, Knip M, Haahtela T, Pekkanen J, Hanski I. Green areas around homes reduce atopic sensitization in children. Allergy 2015; 70:195-202. [PMID: 25388016 PMCID: PMC4303942 DOI: 10.1111/all.12545] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2014] [Indexed: 12/13/2022]
Abstract
Background Western lifestyle is associated with high prevalence of allergy, asthma and other chronic inflammatory disorders. To explain this association, we tested the ‘biodiversity hypothesis’, which posits that reduced contact of children with environmental biodiversity, including environmental microbiota in natural habitats, has adverse consequences on the assembly of human commensal microbiota and its contribution to immune tolerance. Methods We analysed four study cohorts from Finland and Estonia (n = 1044) comprising children and adolescents aged 0.5–20 years. The prevalence of atopic sensitization was assessed by measuring serum IgE specific to inhalant allergens. We calculated the proportion of five land-use types – forest, agricultural land, built areas, wetlands and water bodies – in the landscape around the homes using the CORINE2006 classification. Results The cover of forest and agricultural land within 2–5 km from the home was inversely and significantly associated with atopic sensitization. This relationship was observed for children 6 years of age and older. Land-use pattern explained 20% of the variation in the relative abundance of Proteobacteria on the skin of healthy individuals, supporting the hypothesis of a strong environmental effect on the commensal microbiota. Conclusions The amount of green environment (forest and agricultural land) around homes was inversely associated with the risk of atopic sensitization in children. The results indicate that early-life exposure to green environments is especially important. The environmental effect may be mediated via the effect of environmental microbiota on the commensal microbiota influencing immunotolerance.
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Affiliation(s)
- L. Ruokolainen
- Department of Biosciences University of Helsinki Helsinki Finland
| | - L. Hertzen
- Allergy Department, Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
| | - N. Fyhrquist
- Finnish Institute of Occupational Health Helsinki Finland
| | - T. Laatikainen
- Department of Chronic Disease Prevention National Institute for Health and Welfare Helsinki Finland
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - J. Lehtomäki
- Department of Biosciences University of Helsinki Helsinki Finland
| | - P. Auvinen
- Institute of Biotechnology University of Helsinki Helsinki Finland
| | - A. M. Karvonen
- Department of Environmental Health National Institute for Health and Welfare Kuopio Finland
| | - A. Hyvärinen
- Department of Environmental Health National Institute for Health and Welfare Kuopio Finland
| | - V. Tillmann
- Department of Pediatrics University of Tartu Tartu Estonia
- Tartu University Hospital Tartu Estonia
| | - O. Niemelä
- Department of Laboratory Medicine and Medical Research Unit Seinäjoki Central Hospital and University of Tampere Tampere Finland
| | - M. Knip
- Children's Hospital University of Helsinki and Helsinki University Central Hospital Helsinki Finland
- Diabetes and Obesity Research Program University of Helsinki Helsinki Finland
- Folkhälsan Research Center Helsinki Finland
- Department of Pediatrics Tampere University Hospital Tampere Finland
| | - T. Haahtela
- Allergy Department, Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
| | - J. Pekkanen
- Department of Environmental Health National Institute for Health and Welfare Kuopio Finland
- Department of Public Health University of Helsinki Helsinki Finland
| | - I. Hanski
- Department of Biosciences University of Helsinki Helsinki Finland
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11
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Karvonen AM, Hyvärinen A, Rintala H, Korppi M, Täubel M, Doekes G, Gehring U, Renz H, Pfefferle PI, Genuneit J, Keski‐Nisula L, Remes S, Lampi J, Mutius E, Pekkanen J. Quantity and diversity of environmental microbial exposure and development of asthma: a birth cohort study. Allergy 2014; 69:1092-101. [PMID: 24931137 PMCID: PMC4143956 DOI: 10.1111/all.12439] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2014] [Indexed: 11/30/2022]
Abstract
Background Early-life exposure to environmental microbial agents may be associated with the development of allergies. The aim of the study was to identify better ways to characterize microbial exposure as a predictor of respiratory symptoms and allergies. Methods A birth cohort of 410 children was followed up until 6 years of age. Bacterial endotoxin, 3-hydroxy fatty acids, N-acetyl-muramic acid, fungal extracellular polysaccharides (EPS) from Penicillium and Aspergillus spp., β-D-glucan, ergosterol, and bacterial or fungal quantitative polymerase chain reactions (qPCRs) were analyzed from dust samples collected at 2 months of age. Asthma, wheezing, cough, and atopic dermatitis were assessed using repeated questionnaires. Specific IgEs were determined at the age of 1 and 6 years. Results Only few associations were found between single microbial markers and the studied outcomes. In contrast, a score for the total quantity of microbial exposure, that is, sum of indicators for fungi (ergosterol), Gram-positive (muramic acid) bacteria, and Gram-negative (endotoxin) bacteria, was significantly (inverted-U shape) associated with asthma incidence (P < 0.001): the highest risk was found at medium levels (adjusted odds ratio (aOR) 2.24, 95% confidence interval (95% CI) 0.87–5.75 for 3rd quintile) and the lowest risk at the highest level (aOR 0.34, 95% CI 0.09–1.36 for 5th quintile). The microbial diversity score, that is, sum of detected qPCRs, was inversely associated with risk of wheezing and was significantly (inverted-U shape) associated with sensitization to inhalant allergens. Conclusion Score for quantity of microbial exposure predicted asthma better than single microbial markers independently of microbial diversity and amount of dust. Better indicators of total quantity and diversity of microbial exposure are needed in studies on the development of asthma.
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Affiliation(s)
- A. M. Karvonen
- Department of Environmental Health National Institute for Health and Welfare Kuopio Finland
| | - A. Hyvärinen
- Department of Environmental Health National Institute for Health and Welfare Kuopio Finland
| | - H. Rintala
- Department of Environmental Health National Institute for Health and Welfare Kuopio Finland
| | - M. Korppi
- Pediatric Research Center University of Tampere and University Hospital Tampere Finland
| | - M. Täubel
- Department of Environmental Health National Institute for Health and Welfare Kuopio Finland
| | - G. Doekes
- Institute for Risk Assessment Sciences Utrecht University Utrecht the Netherlands
| | - U. Gehring
- Institute for Risk Assessment Sciences Utrecht University Utrecht the Netherlands
| | - H. Renz
- Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics Philipps‐University Marburg Marburg Germany
| | - P. I. Pfefferle
- Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics Philipps‐University Marburg Marburg Germany
| | - J. Genuneit
- Institute of Epidemiology and Medical Biometry Ulm University Ulm Germany
| | - L. Keski‐Nisula
- Department of Environmental Health National Institute for Health and Welfare Kuopio Finland
- Departments of Obstetrics and Gynecology Kuopio University Hospital Kuopio Finland
| | - S. Remes
- Department of Pediatrics Kuopio University Hospital Kuopio Finland
| | - J. Lampi
- Department of Environmental Health National Institute for Health and Welfare Kuopio Finland
- Unit of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - E. Mutius
- Children's Hospital University of Munich Munich Germany
| | - J. Pekkanen
- Department of Environmental Health National Institute for Health and Welfare Kuopio Finland
- Unit of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
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12
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Nwaru BI, Virtanen SM, Alfthan G, Karvonen AM, Genuneit J, Lauener RP, Dalphin JC, Hyvärinen A, Pfefferle P, Riedler J, Weber J, Roduit C, Kaulek V, Braun-Fahrländer C, von Mutius E, Pekkanen J. Serum vitamin E concentrations at 1 year and risk of atopy, atopic dermatitis, wheezing, and asthma in childhood: the PASTURE study. Allergy 2014; 69:87-94. [PMID: 24205866 DOI: 10.1111/all.12307] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prospective studies investigating the role of serum vitamin E concentrations during early life in the development of childhood allergies and asthma are limited. OBJECTIVE To study the associations between serum vitamin E concentrations at first year of life and longitudinal development of atopy, atopic dermatitis, wheeze, and asthma up to 6 years of age. METHODS The setting was the PASTURE study, a multicenter prospective birth cohort study in five European rural settings. Children of 1133 mothers recruited during pregnancy were followed from birth with measurement of serum vitamin E levels at year 1 and repeated assessments of serum immunoglobulin E antibodies (year 1, 4.5, 6), atopic dermatitis, wheezing symptoms, and asthma (year 1, 1.5, 2, 3, 4, 5, 6). RESULTS At 6 years of age, 66% and 82% of the original 1133 subjects underwent blood test for IgE and answered the questionnaire, respectively. We did not observe any statistically significant associations between serum vitamin E concentrations at year 1 and the endpoints, but borderline inverse associations between alpha tocopherol and wheezing without cold (OR 0.45, 95% CI 0.19-1.09) and any wheezing symptom (OR 0.52, 95% CI 0.27-1.02). CONCLUSIONS Serum vitamin E concentrations at year 1 were not associated with allergies or asthma by 6 years of age. While further prospective studies with repeated assessments of vitamin E during early life may clarify its putative role in the development of the diseases, it is also possible that the antioxidant hypothesis in the development of allergies and asthma does not hold.
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Affiliation(s)
- B. I. Nwaru
- School of Health Sciences; University of Tampere; Tampere Finland
| | - S. M. Virtanen
- School of Health Sciences; University of Tampere; Tampere Finland
- Nutrition Unit; Department of Lifestyle and Participation; National Institute for Health and Welfare; Helsinki Finland
- The Science Center of Pirkanmaa Hospital District; Tampere Finland
| | - G. Alfthan
- Disease Risk Unit; Department of Chronic Disease Prevention; National Institute for Health and Welfare; Helsinki Finland
| | - A. M. Karvonen
- Department of Environmental Health; National Institute for Health and Welfare; Kuopio Finland
| | - J. Genuneit
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm Germany
| | - R. P. Lauener
- Children's Hospital of Eastern Switzerland; St. Gallen, and Christine Kühne-Center for Allergy Research and Education; Davos Switzerland
| | - J.-C. Dalphin
- Department of Respiratory Disease; UMR/CNRS 6249 Chrono-environnement; University Hospital of Besançon; Besançon France
| | - A. Hyvärinen
- Department of Environmental Health; National Institute for Health and Welfare; Kuopio Finland
| | - P. Pfefferle
- Department of Clinical Chemistry and Molecular Diagnostics; Philipps University of Marburg; Marburg Germany
| | - J. Riedler
- Children's Hospital Schwarzach; Schwarzach Austria
| | - J. Weber
- University Children's Hospital Munich; Munich Germany
| | - C. Roduit
- Christine Kühne-Center for Allergy Research and Education; Zürich University Children's Hospital; Zurich Switzerland
| | - V. Kaulek
- Department of Respiratory Disease; UMR/CNRS 6249 Chrono-environnement; University Hospital of Besançon; Besançon France
| | - C. Braun-Fahrländer
- Swiss Tropical and Public Health Institute; Basel Switzerland
- University of Basel; Basel Switzerland
| | - E. von Mutius
- University Children's Hospital Munich; Munich Germany
| | - J. Pekkanen
- Department of Environmental Health; National Institute for Health and Welfare; Kuopio Finland
- Unit of Public Health and Clinical Nutrition; University of Eastern Finland; Kuopio Finland
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13
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Michel S, Busato F, Genuneit J, Pekkanen J, Dalphin JC, Riedler J, Mazaleyrat N, Weber J, Karvonen AM, Hirvonen MR, Braun-Fahrländer C, Lauener R, von Mutius E, Kabesch M, Tost J. Farm exposure and time trends in early childhood may influence DNA methylation in genes related to asthma and allergy. Allergy 2013; 68:355-64. [PMID: 23346934 DOI: 10.1111/all.12097] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2012] [Indexed: 01/17/2023]
Abstract
BACKGROUND Genetic susceptibility and environmental influences are important contributors to the development of asthma and atopic diseases. Epigenetic mechanisms may facilitate gene by environment interactions in these diseases. METHODS We studied the rural birth cohort PASTURE (Protection against allergy: study in rural environments) to investigate (a) whether epigenetic patterns in asthma candidate genes are influenced by farm exposure in general, (b) change over the first years of life, and (c) whether these changes may contribute to the development of asthma. DNA was extracted from cord blood and whole blood collected at the age of 4.5 years in 46 samples per time point. DNA methylation in 23 regions in ten candidate genes (ORMDL1, ORMDL2, ORMDL3, CHI3L1, RAD50, IL13, IL4, STAT6, FOXP3, and RUNX3) was assessed by pyrosequencing, and differences between strata were analyzed by nonparametric Wilcoxon-Mann-Whitney tests. RESULTS In cord blood, regions in ORMDL1 and STAT6 were hypomethylated in DNA from farmers' as compared to nonfarmers' children, while regions in RAD50 and IL13 were hypermethylated (lowest P-value (STAT6) = 0.001). Changes in methylation over time occurred in 15 gene regions (lowest P-value (IL13) = 1.57*10(-8)). Interestingly, these differences clustered in the genes highly associated with asthma (ORMDL family) and IgE regulation (RAD50, IL13, and IL4), but not in the T-regulatory genes (FOXP3, RUNX3). CONCLUSIONS In this first pilot study, DNA methylation patterns change significantly in early childhood in specific asthma- and allergy-related genes in peripheral blood cells, and early exposure to farm environment seems to influence methylation patterns in distinct genes.
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Affiliation(s)
| | - F. Busato
- Laboratory for Epigenetics; Centre National de Génotypage; CEA-Institut de Génomique; Evry; France
| | - J. Genuneit
- Ulm University; Institute of Epidemiology and Medical Biometry; Ulm; Germany
| | | | - J.-C. Dalphin
- Department of Respiratory Disease; Université de Franche-Comté; University Hospital; Besancon; France
| | - J. Riedler
- Children's Hospital Schwarzach; Schwarzach; Austria
| | - N. Mazaleyrat
- Laboratory for Epigenetics; Centre National de Génotypage; CEA-Institut de Génomique; Evry; France
| | - J. Weber
- LMU Munich; University Children's Hospital; Munich; Germany
| | - A. M. Karvonen
- Department of Environmental Health; National Institute for Health and Welfare; Kuopio; Finland
| | | | | | | | - E. von Mutius
- LMU Munich; University Children's Hospital; Munich; Germany
| | | | - J. Tost
- Laboratory for Epigenetics; Centre National de Génotypage; CEA-Institut de Génomique; Evry; France
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Karvonen AM, Hyvärinen A, Gehring U, Korppi M, Doekes G, Riedler J, Braun-Fahrländer C, Bitter S, Schmid S, Keski-Nisula L, Roponen M, Kaulek V, Dalphin JC, Pfefferle PI, Renz H, Büchele G, von Mutius E, Pekkanen J. Exposure to microbial agents in house dust and wheezing, atopic dermatitis and atopic sensitization in early childhood: a birth cohort study in rural areas. Clin Exp Allergy 2012; 42:1246-56. [PMID: 22805472 DOI: 10.1111/j.1365-2222.2012.04002.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Early-life exposure to environmental microbial agents may be associated with development of wheezing and allergic diseases. OBJECTIVE To assess the association of microbial exposure in rural homes with the risk of asthma, wheezing, atopic dermatitis and sensitization. METHODS Birth cohorts of rural children (n = 1133), half from farmer families, were followed up from birth to 2 years of age by questionnaires in five European centres. Endotoxin and extracellular polysaccharides (EPS) of Penicillium and Aspergillus spp. were determined from living room floor and mother's mattress dust samples collected at 2 months of age. Specific IgE against 19 allergens was measured at 1 year of age. Discrete-time hazard models, generalized estimations equations (GEE) and logistic regression were used for statistical analyses. RESULTS The incidence of asthma was inversely associated with the amount of dust (adjusted odds ratio (aOR) 0.73, 95% CI 0.58-0.93) and the loads (units/m(2)) of EPS (aOR 0.75, 95% CI 0.55-1.04) and endotoxin (aOR 0.79, 95% CI 0.60-1.05) in the mother's mattress. Similar associations were seen with wheezing and with living room floor dust. The microbial markers were highly correlated and their effects could not be clearly separated. The inverse associations were seen especially among non-farmers. The risk of sensitization to inhalant allergens increased with increasing endotoxin exposure from mattress dust. No associations were observed with concentrations (units/g) or with atopic dermatitis. CONCLUSION AND CLINICAL RELEVANCE The amount and microbial content of house dust were inversely associated with asthma and wheezing, but due to high correlations between microbial agents and amount of dust, it was not possible to disentangle their individual effects. New ways to better measure and represent exposure to environmental microbes, including indexes of biodiversity, are needed especially among farmers.
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Affiliation(s)
- A M Karvonen
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland.
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