TY - JOUR
T1 - Effects of early-life exposure to allergens and bacteria on recurrent wheeze and atopy in urban children
AU - Lynch, Susan V.
AU - Wood, Robert A.
AU - Boushey, Homer
AU - Bacharier, Leonard B.
AU - Bloomberg, Gordon R.
AU - Kattan, Meyer
AU - O'Connor, George T.
AU - Sandel, Megan T.
AU - Calatroni, Agustin
AU - Matsui, Elizabeth
AU - Johnson, Christine C.
AU - Lynn, Henry
AU - Visness, Cynthia M.
AU - Jaffee, Katy F.
AU - Gergen, Peter J.
AU - Gold, Diane R.
AU - Wright, Rosalind J.
AU - Fujimura, Kei
AU - Rauch, Marcus
AU - Busse, William W.
AU - Gern, James E.
N1 - Funding Information:
Disclosure of potential conflict of interest: S. V. Lynch has received research support from National Institutes of Health (NIH)/National Institute of Allergy and Infectious Diseases (NIAID) ; is a board member for Second Genome; has received consultancy fees from Jannsen and Regeneron; has received lecture fees from the American Academy of Allergy, Asthma & Immunology (AAAAI), the American Thoracic Society (ATS), and the ACR; has a patent with and has received royalties from KaloBios; and has received payment for development of educational presentations from Georgia Regents University. R. A. Wood has received research support from the NIH; has received consultancy fees from the Asthma and Allergy Foundation of America; is employed by Johns Hopkins University; and has received royalties from UpToDate. H. Boushey has received research support from the NIH/NIAID; has received consultancy fees from Merck, GlaxoSmithKline, Genentech, Kalbios, Pharmaxis, and Johnson & Johnson; has received research support from GlaxoSmithKline and Genentech; has received lecture fees from AAIFNC (a nonprofit local allergy society) and for the Sam Sills Lecture “Breathe California” (from a non-profit 501c3 concerned about health); and has received royalties from the McGraw-Hill Companies. L. B. Bacharier has received research support from the NIAID/Inner City Asthma Consortium; has received consultancy fees from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Merck, Schering, Cephalon, DBV Technologies, and Teva; has received research support from the National Heart, Lung, and Blood Institute (NHLBI)/NIH AsthmaNet, and VDAART Trial; and has received lecture fees from Aerocrine, AstraZeneca, Genentech/Novartis, GlaxoSmithKline, Merck, Schering, and Teva. G. R. Bloomberg and D. R. Gold have received research support and travel support from the NIH/NIAID. M. Kattan and G. T. O'Connor have received research support from the NIH. A. Calatroni, H. Lynn, C. M. Visness, K. F. Jaffee, K. Fujimura, and M. Rauch have received research support from the NIH/NIAID. E. Matsui has received research support from the NIH and is a member of the US Environmental Protection Agency (EPA)'s Science Advisory Board. C. C. Johnson has received research support from the NIH and has received consultancy fees from McNeill. W. W. Busse has been supported by the NIH/NIAID; is a board member for Merck; has consultancy arrangements with Novartis, GlaxoSmithKline, Genentech, Boston Scientific, Circassia, and ICON; and has received royalties from Elsevier. J. E. Gern has received research support from the NIH, GlaxoSmithKline, and Merck and has received consultancy fees from GlaxoSmithKline, Johnson & Johnson, Merck, MedImmune, Boehringer Ingelheim, and Gilead. The rest of the authors declare that they have no relevant conflicts of interest.
Funding Information:
This project has been supported in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases , National Institutes of Health , under contract numbers NO1-AI-25496 , NO1-AI-25482 , HHSN272200900052C , and HHSN272201000052I . Additional support was provided by the National Center for Advancing Translational Sciences , National Institutes of Health , under grants RR00052 , M01RR00533 , 1UL1RR025771 , M01RR00071 , 1UL1RR024156 , and 5UL1RR024992-02 .
PY - 2014/9
Y1 - 2014/9
N2 - Background Wheezing illnesses cause major morbidity in infants and are frequent precursors to asthma. Objective We sought to examine environmental factors associated with recurrent wheezing in inner-city environments. Methods The Urban Environment and Childhood Asthma study examined a birth cohort at high risk for asthma (n = 560) in Baltimore, Boston, New York, and St Louis. Environmental assessments included allergen exposure and, in a nested case-control study of 104 children, the bacterial content of house dust collected in the first year of life. Associations were determined among environmental factors, aeroallergen sensitization, and recurrent wheezing at age 3 years. Results Cumulative allergen exposure over the first 3 years was associated with allergic sensitization, and sensitization at age 3 years was related to recurrent wheeze. In contrast, first-year exposure to cockroach, mouse, and cat allergens was negatively associated with recurrent wheeze (odds ratio, 0.60, 0.65, and 0.75, respectively; P ≤.01). Differences in house dust bacterial content in the first year, especially reduced exposure to specific Firmicutes and Bacteriodetes, was associated with atopy and atopic wheeze. Exposure to high levels of both allergens and this subset of bacteria in the first year of life was most common among children without atopy or wheeze. Conclusions In inner-city environments children with the highest exposure to specific allergens and bacteria during their first year were least likely to have recurrent wheeze and allergic sensitization. These findings suggest that concomitant exposure to high levels of certain allergens and bacteria in early life might be beneficial and suggest new preventive strategies for wheezing and allergic diseases.
AB - Background Wheezing illnesses cause major morbidity in infants and are frequent precursors to asthma. Objective We sought to examine environmental factors associated with recurrent wheezing in inner-city environments. Methods The Urban Environment and Childhood Asthma study examined a birth cohort at high risk for asthma (n = 560) in Baltimore, Boston, New York, and St Louis. Environmental assessments included allergen exposure and, in a nested case-control study of 104 children, the bacterial content of house dust collected in the first year of life. Associations were determined among environmental factors, aeroallergen sensitization, and recurrent wheezing at age 3 years. Results Cumulative allergen exposure over the first 3 years was associated with allergic sensitization, and sensitization at age 3 years was related to recurrent wheeze. In contrast, first-year exposure to cockroach, mouse, and cat allergens was negatively associated with recurrent wheeze (odds ratio, 0.60, 0.65, and 0.75, respectively; P ≤.01). Differences in house dust bacterial content in the first year, especially reduced exposure to specific Firmicutes and Bacteriodetes, was associated with atopy and atopic wheeze. Exposure to high levels of both allergens and this subset of bacteria in the first year of life was most common among children without atopy or wheeze. Conclusions In inner-city environments children with the highest exposure to specific allergens and bacteria during their first year were least likely to have recurrent wheeze and allergic sensitization. These findings suggest that concomitant exposure to high levels of certain allergens and bacteria in early life might be beneficial and suggest new preventive strategies for wheezing and allergic diseases.
KW - Asthma
KW - allergen exposure
KW - atopy
KW - inner city
KW - microbial exposure
UR - http://www.scopus.com/inward/record.url?scp=84906944544&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2014.04.018
DO - 10.1016/j.jaci.2014.04.018
M3 - Article
C2 - 24908147
AN - SCOPUS:84906944544
VL - 134
SP - 593-601.e12
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
SN - 0091-6749
IS - 3
ER -