Infections in asthma and allergy

Sa, Lewis

doi:10.1136/thx.53.11.911

Cited by 11 publications

(9 citation statements)

References 22 publications

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“…The problem with current epidemiological studies in the developed world is that they may not be helpful for investigating the onset of asthma because common childhood infections such as measles now occur rarely and most children are prescribed antibiotics at some time in early childhood. The more convincing answers therefore seem likely to come from similar studies in the developing world,14 although the high frequency of parasite infestation introduces complexities in the maturation of the immune system and its relation with asthma in these regions 15…”

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confidence: 99%

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Prenatal risk factors of wheezing at the age of four years in Tanzania

Sunyer

2001

Thorax

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Background-A study was undertaken to assess the interactions between prenatal exposures, early life infections, atopic predisposition, and allergen exposures in the development of wheezing up to the age of 4 years in a tropical region of Africa. Methods-The study subjects comprised children born at the district hospital in Ifakara, Tanzania during a 1 year period who were participating in a trial of iron supplementation and malaria chemoprophylaxis during the first year of life and followed for up to 4 years. From this group of subjects, 658 (79%) participated in the interview at 18 months and 528 (64%) in a second interview at 4 years. Wheezing was measured with the ISAAC questionnaire. A hospital based inpatient and outpatient surveillance system was set up to document all attendance by study children for any cause, including episodes of clinical malaria and lower respiratory tract infections. Total IgE levels and malaria parasites were measured in maternal and cord blood. Total IgE was also measured at 18 months of age. Indoor environmental levels of Der p I and Fel d I were determined using an enzyme linked immunosorbent assay at the same time as the interview at the age of 18 months. Results-The prevalence of wheezing at 4 years is common in Ifakara (14%, range 13-15%). The presence of malaria parasites in cord blood (odds ratio, OR = 6.84, 95% CI 1.84 to 24.0) and maternal asthma (OR = 8.47, 95% CI 2.72 to 26.2) were positively associated with wheezing at the age of 4 years, and cord blood total IgE was negatively associated (OR = 0.24, 95% CI 0.07 to 0.85) (all p<0.05). Parasitaemia at birth was not related to total IgE levels in cord blood (p=0.6). Clinical episodes of malaria during infancy were not associated with wheezing, and nor were levels of indoor aeroallergens. Conclusion-These findings suggest that events occurring during pregnancy may play a role in the future appearance of wheezing, although the results must be interpreted with caution because of the small numbers studied. (Thorax 2001;56:290-295)

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confidence: 99%

“…It is widely accepted that exposure to common aeroallergens in the very early years of life is important in determining subsequent development of IgE sensitisation16and that IgE sensitisation is strongly linked with development of respiratory symptoms and asthma 14. However, this evidence is not without disagreement 17…”

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confidence: 99%

Prenatal risk factors of wheezing at the age of four years in Tanzania

Sunyer

2001

Thorax

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“…Supporting some previous literature examining the association between infections and atopic disorders, particularly asthma (Proud, ), a positive association was found between infections and atopic disorders. Increased number of respiratory infections may result in high levels of damage at the cellular level, resulting in increased susceptibility to asthma (Proud, ); however, mechanisms supporting the opposite association have been posited (see Lewis, ), suggesting the need for more research in this area.…”

Section: Conclusion and Discussionmentioning

confidence: 99%

“…Increased number of respiratory infections may result in high levels of damage at the cellular level, resulting in increased susceptibility to asthma (Proud, 2011); however, mechanisms supporting the opposite association have been posited (see Lewis, 1998), suggesting the need for more research in this area. Increased visits to healthcare facilities for infections were specifically associated with high CARs.…”

Section: Developmental Psychobiologymentioning

confidence: 99%

Longitudinal associations between infections and atopic disorders across childhood and dysregulated adrenocortical functioning in early adolescence

Ruttle

Serbin

Martin‐Storey

et al. 2013

Developmental Psychobiology

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The present study sought to determine if exposure to common childhood medical problems (i.e., infections and atopic disorders [e.g., allergies, asthma]) may dysregulate the hypothalamic-pituitary-adrenal (HPA) axis. Longitudinal data from 96 youth were used to examine this possibility. Medical records were drawn from government databases indicating the frequency of visits to healthcare facilities for infections and atopic disorders from infancy to early adolescence. During early adolescence, participants provided salivary cortisol samples from awakening until bedtime over 2 consecutive days. Individuals with a history of increased number visits for infections across childhood displayed elevated levels of cortisol at awakening whereas individuals with childhood histories of visits for atopic disorders displayed blunted diurnal cortisol slopes. These findings build on previous research documenting associations between infections and atopic disorders and cortisol by identifying longitudinal linkages from early health problems to later HPA axis functioning.

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“…The establishment of the TH1/TH2 balance during early childhood and the ®nal tuning at an age of 4±5 years [14] implies that children are especially vulnerable to environmental and lifestyle stressors affecting the TH1/TH2 balance. We hypothesize that during life time the TH1/TH2 balance may be skewed by these factors, alone or in concert, resulting in increased respiratory diseases and allergy.…”

Section: Hypothesismentioning

confidence: 99%