Reviews and feature articleEnvironmental determinants of allergy and asthma in early life
Section snippets
Microbial exposure
The increase in the prevalence of allergic disease, particularly in the Western world, has coincided with significant environmental changes that have reduced microbial exposure in early life, such as improved sanitation and increased rates of immunization. Many have proposed that among genetically susceptible subjects, these changes in environmental conditions might alter normal development of the immune system and thus affect susceptibility to allergic disease, the basis of the hygiene
Indoor allergen exposure
The indoor environmental allergen milieu is of particular interest in the study of the determinants of allergic disease because of constant exposure during early childhood and the potential for intervention. In samples taken from 831 homes across the United States, at least 6 detectable allergens were found in more than 50% of homes.50 Allergens from house dust mite (HDM), furred pets (cats and dogs), mice, cockroaches, and fungi comprise the most common indoor allergens implicated in patients
Ambient air pollution exposure
Great strides have been made in understanding the effects of environmental air pollutants on population health, which has affected environmental health policy and consequently improved public health. However, despite overall improvements in air quality, indoor and outdoor air pollutants continue to cause adverse health effects and have been shown recently to promote the onset of atopic disease.
The World Health Organization reported in 2016 that 92% of the world's population lives in places
Conclusions and future directions
The effect of microbial, allergen, and air pollutant exposures has been artificially subdivided in this review; in reality, these exposures and many others interact simultaneously with each other to promote or prevent allergic disease (Fig 1). For example, air pollution and climate change can promote oxidative stress in pollen-producing plants, increasing both the amounts and allergenicity of pollen grains.150 Individual factors identified in this review as protective for or promoting the
References (153)
- et al.
Is meconium from healthy newborns actually sterile?
Res Microbiol
(2008) - et al.
Advances in mechanisms of asthma, allergy, and immunology in 2011
J Allergy Clin Immunol
(2012) - et al.
Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing
J Allergy Clin Immunol
(2001) - et al.
Establishment of the intestinal microbiota and its role for atopic dermatitis in early childhood
J Allergy Clin Immunol
(2013) - et al.
The infant nasopharyngeal microbiome impacts severity of lower respiratory infection and risk of asthma development
Cell Host Microbe
(2015) - et al.
Factors influencing the infant gut microbiome at age 3-6 months: findings from the ethnically diverse Vitamin D Antenatal Asthma Reduction Trial (VDAART)
J Allergy Clin Immunol
(2017) - et al.
Relation between house-dust endotoxin exposure, type 1 T-cell development, and allergen sensitisation in infants at high risk of asthma
Lancet
(2000) - et al.
Endotoxin exposure, serum vitamin D, asthma and wheeze outcomes
Respir Med
(2016) - et al.
Protection from childhood asthma and allergy in Alpine farm environments-the GABRIEL Advanced Studies
J Allergy Clin Immunol
(2012) - et al.
omega-3 fatty acids contribute to the asthma-protective effect of unprocessed cow's milk
J Allergy Clin Immunol
(2016)
The protective effect of farm milk consumption on childhood asthma and atopy: the GABRIELA study
J Allergy Clin Immunol
Rhinovirus-induced wheezing in infancy—the first sign of childhood asthma?
J Allergy Clin Immunol
Determinants of asthma after severe respiratory syncytial virus bronchiolitis
J Allergy Clin Immunol
Rhinovirus illnesses during infancy predict subsequent childhood wheezing
J Allergy Clin Immunol
Palivizumab prophylaxis, respiratory syncytial virus, and subsequent recurrent wheezing
J Pediatr
Exposure to multiple indoor allergens in US homes and its relationship to asthma
J Allergy Clin Immunol
Perennial allergen sensitisation early in life and chronic asthma in children: a birth cohort study
Lancet
Early life rhinovirus wheezing, allergic sensitization, and asthma risk at adolescence
J Allergy Clin Immunol
Allergic rhinitis and its impact on asthma
J Allergy Clin Immunol
Association between severity of atopic eczema and degree of sensitization to aeroallergens in schoolchildren
J Allergy Clin Immunol
Relationship of house-dust mite allergen exposure in children's bedrooms in infancy to bronchial hyperresponsiveness and asthma diagnosis by age 6 to 7
Ann Allergy Asthma Immunol
Exposure to dust mite allergen and endotoxin in early life and asthma and atopy in childhood
J Allergy Clin Immunol
House dust mite sensitization in toddlers predicts current wheeze at age 12 years
J Allergy Clin Immunol
Evolution and predictive value of IgE responses toward a comprehensive panel of house dust mite allergens during the first 2 decades of life
J Allergy Clin Immunol
Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study. Multicentre Allergy Study Group
Lancet
Early oral exposure to house dust mite allergen through breast milk: a potential risk factor for allergic sensitization and respiratory allergies in children
J Allergy Clin Immunol
Association of recurrent wheezing with sensitivity to cockroach allergen in inner-city children
Ann Allergy Asthma Immunol
Anti-cockroach and anti-mouse IgE are associated with early wheeze and atopy in an inner-city birth cohort
J Allergy Clin Immunol
Exposure to cockroach allergen in the home is associated with incident doctor-diagnosed asthma and recurrent wheezing
J Allergy Clin Immunol
Household mouse allergen exposure and asthma morbidity in inner-city preschool children
Ann Allergy Asthma Immunol
Mouse exposure and wheeze in the first year of life
Ann Allergy Asthma Immunol
Sensitization to mouse and cockroach allergens and asthma morbidity in urban minority youth: Genes-environments and Admixture in Latino American (GALA-II) and Study of African-Americans, Asthma, Genes, and Environments (SAGE-II)
Ann Allergy Asthma Immunol
Dog allergen (Can f 1) and cat allergen (Fel d 1) in US homes: results from the National Survey of Lead and Allergens in Housing
J Allergy Clin Immunol
Relevance of specific IgE antibody titer to the prevalence, severity, and persistence of asthma among 19-year-olds in northern Sweden
J Allergy Clin Immunol
The role of cats and dogs in asthma and allergy—a systematic review
Int J Hyg Environ Health
Mold damage in homes and wheezing in infants
Ann Allergy Asthma Immunol
High environmental relative moldiness index during infancy as a predictor of asthma at 7 years of age
Ann Allergy Asthma Immunol
Mold exposure during infancy as a predictor of potential asthma development
Ann Allergy Asthma Immunol
Complementing the genome with an “exposome”: the outstanding challenge of environmental exposure measurement in molecular epidemiology
Cancer Epidemiol Biomarkers Prev
The hygiene hypothesis revisited: does exposure to infectious agents protect us from allergy?
Curr Opin Pediatr
Isolation of commensal bacteria from umbilical cord blood of healthy neonates born by cesarean section
Curr Microbiol
Probiotics modulate host-microbe interaction in the placenta and fetal gut: a randomized, double-blind, placebo-controlled trial
Neonatology
Low diversity of the gut microbiota in infants with atopic eczema
J Allergy Clin Immunol
Neonatal gut microbiota associates with childhood multisensitized atopy and T cell differentiation
Nat Med
Mode and place of delivery, gastrointestinal microbiota, and their influence on asthma and atopy
J Allergy Clin Immunol
Childhood asthma after bacterial colonization of the airway in neonates
N Engl J Med
Nasopharyngeal bacterial colonization during the first wheezing episode is associated with longer duration of hospitalization and higher risk of relapse in young children
Eur J Clin Microbiol Infect Dis
Correction: relative importance and additive effects of maternal and infant risk factors on childhood asthma
PLoS One
Factors influencing the composition of the intestinal microbiota in early infancy
Pediatrics
Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns
Proc Natl Acad Sci U S A
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A.J.B. is supported by grant 2T32GM086330. D.B.P. is supported by grants R01ES023349 and P30ES010126. M.L.H. is supported by the AAAAI ARTrust Gail G. Shapiro Clinical Faculty Development Award.
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These authors contributed equally to this work.