Innate Immune Training for Prevention of Recurrent Wheeze in Early Childhood

Holt, Patrick G.; Strickland, Deborah H.

doi:10.1164/rccm.202103-0698ed

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Thus, our data might be interpreted as support for the recent preliminary proposed explanation that the COVID-19 virus and its consequences may play a role in the regulation of the immune system and affect the habitat for other respiratory viruses. 33,34 The relatively "sterile" conditions generated during lockdowns and restrictions, might impair the normal process of innate immune memory system training, [34][35][36][37][38] leaving the children in a more vulnerable state. This might contribute to the subsequent unexpected rise in morbidities.…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID‐19 pandemic on respiratory morbidity during infancy: A birth‐cohort study

Rosenfeld

Mandelberg

Dalal

et al. 2022

Pediatric Pulmonology

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Objective: To evaluate the incidence of wheezing and overall respiratory morbidity in healthy infants born during the first peak of the coronavirus disease-2019 (COVID-19) pandemic, compared with infants born during the preceding year.Methods: This was a single-center retrospective birth cohort study to compare a cohort of children born between February and March 2020 (COVID-19 group) to a control group of children born between February and March 2019 (pre-COVID-19 group). At 1 year of age, we collected respiratory data using parental and telephone questionnaires. Primary outcome: wheezing incidence and/or bronchodilator use.Secondary outcomes: recurrent wheezing, emergency-room visits, hospital admissions, pneumonia diagnosis, and admissions due to lower-respiratory-tractinfections (LRTI). We included the following covariate risk factors in the logistic regression models; atopy, daycare attendance, breastmilk feeding, parental smoking, C-section, siblings, and gestational age.Results: We enrolled 588 infants, 294 in each group (48% males). Demographic, perinatal, and atopic characteristics were similar between the groups. Compared to the pre-COVID-19 group, infants born during the COVID-19 period were significantly less likely to report wheezing and/or bronchodilator use (adjusted-odds ratio [OR], 0.4; 95% confidence interval [CI] 0.28-0.59), systemic steroid use,

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Section: Discussionmentioning

confidence: 99%

The impact of the COVID‐19 pandemic on respiratory morbidity during infancy: A birth‐cohort study

Rosenfeld

Mandelberg

Dalal

et al. 2022

Pediatric Pulmonology

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“…During the last decade, the roles of microbial exposure in the environment as well as mucosal microbial colonization in populations have attracted the interest of many researchers 46,81 …”

Section: Microbesmentioning

confidence: 99%

“…During the last decade, the roles of microbial exposure in the environment as well as mucosal microbial colonization in populations have attracted the interest of many researchers. 46,81 F I G U R E 2 The microbial environment, its relevance for the host and for asthma prevention in early life (reproduced from Mutius E 81 by authorization of the publisher)…”

Section: Microbe Smentioning

confidence: 99%

Early priming of asthma and respiratory allergies: Future aspects of prevention

Wahn

Lau

Eigenmann

et al. 2022

Pediatric Allergy Immunology

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“…All of the evidence from birth cohorts and companion mechanistic studies indicate that the early microbiome shapes immune system development, and may increase or reduce susceptibility to respiratory diseases, including childhood asthma. This new paradigm has been conceptualized under the emergent model of "Innate Immune Training (IIT)", in which microbiota and epigenetic influences are convergent drivers and mediators of the asthma trajectory from pregnancy to childhood [6][7][8][9][10]. In the same way that pathogenic bacteria during early life may increase the risk for respiratory disorders, exposure to protective bacteria may serve as a primary prevention.…”

Section: Microbiome-driven Interventions and Early Respiratory Health: The Novel Notion Of Innate Immune Trainingmentioning

confidence: 99%

“…More recently, translational studies have confirmed that microbial exposure taking place during early life is essential in order to shape innate immune responses and modulate the risk of childhood asthma [4]. The contemporary view of these findings is conceptualized under the term innate immune training (IIT) [5][6][7][8], which refers to the environmental programming of immune responses of the epithelium and innate immune cells [5]. In contrast to adaptive immune responses, epigenetic reprogramming-rather than gene recombination-is believed to be the primary molecular mechanism of IIT [5].…”

Section: Introductionmentioning

confidence: 99%

Early Microbial–Immune Interactions and Innate Immune Training of the Respiratory System during Health and Disease

2021

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Over the past two decades, several studies have positioned early-life microbial exposure as a key factor for protection or susceptibility to respiratory diseases. Birth cohorts have identified a strong link between neonatal bacterial colonization of the nasal airway and gut with the risk for respiratory infections and childhood asthma. Translational studies have provided companion mechanistic insights on how viral and bacterial exposures in early life affect immune development at the respiratory mucosal barrier. In this review, we summarize and discuss our current understanding of how early microbial–immune interactions occur during infancy, with a particular focus on the emergent paradigm of “innate immune training”. Future human-based studies including newborns and infants are needed to inform the timing and key pathways implicated in the development, maturation, and innate training of the airway immune response, and how early microbiota and virus exposures modulate these processes in the respiratory system during health and disease.

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Innate Immune Training for Prevention of Recurrent Wheeze in Early Childhood

Cited by 6 publications

References 16 publications

The impact of the COVID‐19 pandemic on respiratory morbidity during infancy: A birth‐cohort study

The impact of the COVID‐19 pandemic on respiratory morbidity during infancy: A birth‐cohort study

Early priming of asthma and respiratory allergies: Future aspects of prevention

Early Microbial–Immune Interactions and Innate Immune Training of the Respiratory System during Health and Disease

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