Place of upbringing in early childhood as related to inflammatory bowel diseases in adulthood: a population-based cohort study in Northern Europe

BackgroundThe protective effect of farm upbringing on allergic rhinitis is well known, but how upbringing in other environments influences the development of allergic rhinitis is scarcely investigated. The aim of this study was to investigate the association between place of upbringing and pet keeping in childhood and allergic rhinitis and nasal symptoms in adulthood.MethodsThe population-based Respiratory Health in Northern Europe study includes subjects from Denmark, Norway, Sweden, Iceland, and Estonia born in 1945–1973. This paper analyses 13,376 participants of the third study wave. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb, and inner city. Pets in the home at birth and during childhood were recorded. Data were analysed using adjusted logistic regression models.ResultsLivestock farm upbringing predicted less adult allergic rhinitis [odds ratio (OR) 0.68, 0.54–0.85] and nasal symptoms (OR 0.82, 0.68–0.99) than city upbringing, and an urban–rural gradient with decreasing risk per level of urbanisation was observed (OR 0.92, 0.88–0.94). Pets in the home at birth (OR 0.78, 0.68–0.88) and during childhood (OR 0.83, 0.74–0.93) were associated with less subsequent allergic rhinitis. Pet keeping did not explain the protective effect of place of upbringing.ConclusionRisk of allergic rhinitis and nasal symptoms in adulthood was inversely associated with the level of urbanisation during upbringing. Pets at birth decreased the risk further, but did not explain the urban–rural gradient. Persistent beneficial effects of microbial diversity in early life might be an explanation for the findings.

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“…Furthermore, an urban–rural gradient has been suggested in the RHINE cohort for inflammatory bowel diseases (18) and asthma (19). …”

Section: Discussionmentioning

confidence: 99%

A clear urban–rural gradient of allergic rhinitis in a population-based study in Northern Europe

Christensen

Timm

Janson

et al. 2016

European Clinical Respiratory Journal

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“…Furthermore, farm upbringing has been inversely associated with the prevalence of inflammatory bowel disease and systemic lupus erythematosus in children and adults. [82][83][84] In turn, no relation was found with juvenile type 1 diabetes and oligoarticular juvenile idiopathic arthritis. 85,86 Environmental microbial exposures in farm studies It has long been known that air in animal sheds is highly contaminated with numerous species of molds and bacteria, which are transported indoors, as described above.…”

Section: The Microbial Environment and Asthma Developmentmentioning

confidence: 94%

The microbial environment and its influence on asthma prevention in early life

Mutius

2016

Journal of Allergy and Clinical Immunology

173

157

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There is accumulating evidence to suggest that the environmental microbiome plays a significant role in asthma development. The very low prevalence of asthma in populations highly exposed to microbial environments (farm children and Amish populations) highlights its preventive potential. This microbial diversity might be necessary to instruct a well-adapted immune response and regulated inflammatory responses to other inhaled and ingested environmental elements, such as allergens, particles, and viruses. Like the internal gut microbiome, which is increasingly recognized as an important instructor of immune maturation, the external environmental microbiome might shape immune responses on the skin, airway mucosal surfaces, and potentially also the gut early in life. The diversity of the external microbial world will ensure that of the many maladapted pathways leading to asthma development, most, if not all, will be counterbalanced. Likewise, important contributors to asthma, such as allergen sensitization and allergic manifestations early in life, are being suppressed. Thus the facets of innate immunity targeted by microbes and their compounds and metabolites might be the master switch to asthma and allergy protection, which has been found in environments rich in microbial exposures.

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“…For additional EJE references see [153,[371][372][373][374][375][376][377][378][379][380][381][382][383][384].…”

Section: Major Findingsmentioning

confidence: 99%

The Rotterdam Study: 2014 objectives and design update

et al. 2013

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The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over a 1,000 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy ). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.

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Place of upbringing in early childhood as related to inflammatory bowel diseases in adulthood: a population-based cohort study in Northern Europe

Cited by 51 publications

References 59 publications

A clear urban–rural gradient of allergic rhinitis in a population-based study in Northern Europe

A clear urban–rural gradient of allergic rhinitis in a population-based study in Northern Europe

The microbial environment and its influence on asthma prevention in early life

The Rotterdam Study: 2014 objectives and design update

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