Balance between early life tolerance and sensitization in allergy: dependence on the timing and intensity of prenatal and postnatal allergen exposure of the mother Introduction Early childhood is a phase of life with a high risk of allergic sensitization -it is the time when initial allergen sensitization frequently occurs.1,2 The immature status of the immune system in early life, 3,4 and the predisposition towards T helper type 2 (Th2) skewing of immune function during fetal and neonatal periods 5,6 may collectively contribute to the initial development of an allergic response subsequent to allergen exposure. Maternal allergen exposure seems to be a risk factor for early atopic disorders, influenced by genetic and environmental factors. 7,8 Therefore, it is important to understand the relationship between the amount and timing of initial allergen exposure as a factor in the early development of sensitization.Maternally derived dietary allergen exposure has been associated with the presence of the allergen in fetal circulation, implying that the fetus may be exposed to dietary allergen during pregnancy transplacentally or
SummaryAllergens can be maternally transferred to the fetus or neonate, though it is uncertain how this initial allergen exposure may impact the development of allergy responses. To evaluate the roles of timing and level of maternal allergen exposure in the early life sensitization of progeny, female BALB/c mice were given ovalbumin (OVA) orally during pregnancy, lactation or weekly at each stage to investigate the immunoglobulin E (IgE) antibody production and cellular responsiveness of their offspring. Exposure to OVA during pregnancy was also evaluated in OVA-specific T-cell receptor (TCR) transgenic (DO11.10) mice. The effect of prenatal antigen exposure on offspring sensitization was dependent on antigen intake, with low-dose OVA inducing tolerance followed by neonatal immunization that was sustained even when pups were immunized when 3 weeks old. These offspring received high levels of transforming growth factor-b via breastfeeding. High-dose exposure during the first week of pregnancy or perinatal period induced transient inhibition of IgE production following neonatal immunization; although for later immunization IgE production was enhanced in these offspring. Postnatal maternal antigen exposure provided OVA transference via breastfeeding, which consequently induced increased offspring susceptibility to IgE antibody production according to week post-birth. The effect of low-dose maternal exposure during pregnancy was further evaluated using OVA transgenic TCR dams as a model. These progeny presented pronounced entry of CD4 + T cells into the S phase of the cell cycle with a skewed T helper type 2 response early in life, revealing the occurrence of allergen priming in utero. The balance between tolerance and sensitization depended on the amount and timing of maternal allergen intake during pregnancy.Keywords: breastfeeding; immunoglobulin E antibodies; in utero priming; maternal allerg...