The effect of single and multiple infections on atopy and wheezing in children

Alcantara-Neves, Neuza Maria; Veiga, Rafael Valente; Dattoli, Vitor Camilo Cavalcante; Fiaccone, Rosimeire Leovigildo; Esquivel, Renata Miranda; Cruz, Álvaro Augusto; Cooper, Philip J.; Rodrigues, Laura C.; Barreto, Maurício Lima

doi:10.1016/j.jaci.2011.09.015

Cited by 80 publications

(117 citation statements)

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“…We used SPT rather than allergen specific IgE to measure atopy and cannot comment on the effects of the study exposures on this latter marker. However, SPT, a measure of allergic effector responses rather than allergic sensitisation per se, may be more appropriate for the exploration of such effects in a population in which the two atopic markers are dissociated 23 26…”

Section: Discussionmentioning

confidence: 99%

Hygiene, atopy and wheeze–eczema–rhinitis symptoms in schoolchildren from urban and rural Ecuador

Cooper¹,

Vaca²,

Rodríguez³

et al. 2013

Thorax

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BackgroundRural residence is protective against atopy and wheeze–rhinitis–eczema symptoms in developed countries, an effect attributed to farming and poor hygiene exposures. There are few data from developing countries addressing this question. We compared atopy and wheeze–rhinitis–eczema symptoms between urban and rural Ecuador, and explored the effects of farming and poor hygiene exposures.MethodsWe performed cross sectional studies of schoolchildren living in rural and urban Ecuador. Data on symptoms and farming/hygiene exposures were collected by parental questionnaire, atopy by allergen skin prick test reactivity and geohelminth infections by stool examinations.ResultsAmong 2526 urban and 4295 rural schoolchildren, prevalence was: atopy (10.0% vs 12.5%, p=0.06), wheeze (9.4% vs 10.1%, p=0.05), rhinitis (8.1% vs 6.4%, p=0.02) and eczema (5.9% vs 4.7%, p=0.06). A small proportion of symptoms were attributable to atopy (range 3.9–10.7%) with greater attributable fractions for respiratory symptoms observed in urban schoolchildren. Respiratory symptoms were associated with poor hygiene/farming exposures: wheeze with lack of access to potable water; and rhinitis with household pets, no bathroom facilities and contact with large farm animals. Birth order was inversely associated with respiratory symptoms. Area of residence and atopy had few effects on these associations.ConclusionsUrban schoolchildren living in Ecuador have a similar prevalence of atopy, eczema and wheeze but a higher prevalence of rhinitis compared with rural children. Some farming and poor hygiene exposures were associated with an increase in the prevalence of wheeze or rhinitis while birth order was inversely associated with these symptoms.

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Section: Discussionmentioning

confidence: 99%

Hygiene, atopy and wheeze–eczema–rhinitis symptoms in schoolchildren from urban and rural Ecuador

Cooper¹,

Vaca²,

Rodríguez³

et al. 2013

Thorax

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“…Helminth-induced immunomodulation in humans is now a well-known phenomenon that depends on several factors such as intensity and chronicity of infection, host genetic background, type of parasite, and probably polyparasitism [21]. The immunosuppressive effects of chronic, heavy helminth infections have been found stronger than any described immunomodulatory phenomenon accompanying bacterial or viral infections excepting that by human immunodeficiency virus.…”

Section: Helminth-driven Immunomodulationmentioning

confidence: 99%

The tropics, helminth infections and hygiene hypotheses

Caraballo

2018

Expert Review of Clinical Immunology

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The Tropics is very appropriate to test the hypotheses raised to explain the increasing trends of allergy and other inflammatory diseases worldwide. The absence of parasite infection as a possible cause of the increase of allergic diseases was proposed by J. Gerrard a long time ago; however, the idea that helminth infections, which induce a strong Th2 could reduce allergy symptoms seems counterintuitive; but the fact is that they have a dual effect: they increase the Th2 responses but also exert immunosuppression and both effects influence the symptoms of allergy. Basic experimentation has provided valuable information about the mechanisms of allergic inflammation and more recently, about its control by helminth induced immunomodulation, discovering helminth molecules with anti-inflammatory properties that are meant to replace the live helminth therapeutic approaches. The immunosuppressive power of helminths makes them excellent candidates to be considered in the hygiene hypotheses. Future comprehensive studies evaluating simultaneously the role of microbial infections, helminth infections, microbiota, pollution and biodiversity will help to elucidate the causes of the increasing trends of allergic disorders. Doing this in the tropics, where all these variables are still present could be difficult but no doubt that will be more informative. ARTICLE HISTORY

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“…Asthma symptoms were defined and classified as reported in a previous publication of SCAALA Salvador studies. 24 Briefly, children were classified as having current wheeze as previously described 25,26 by using phase II International Study of Asthma and Allergies in Childhood questionnaire (wheezing in the last 12 months) and were considered to have current wheeze plus symptoms if parents reported wheezing in the previous 12 months and at least one of the following: (1) diagnosis of asthma ever; (2) wheezing with exercise in the last 12 months; (3) four or more episodes of wheezing in the last 12 months; and (4) waking up at night because of wheezing in the last 12 months. Ethical approval for this study was obtained from the Brazilian National Ethical Council, and written informed consent was obtained from the guardian of each child.…”

Section: Study Design and Population Characterizationmentioning

confidence: 99%

Suggestive association between variants in IL1RAPL and asthma symptoms in Latin American children

et al. 2017

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Several genome-wide association studies have been conducted to investigate the influence of genetic polymorphisms in the development of allergic diseases, but few of them have included the X chromosome. The aim of present study was to perform an X chromosome-wide association study (X-WAS) for asthma symptoms. The study included 1307 children of which 294 were asthma cases. DNA was genotyped using 2.5 HumanOmni Beadchip from Illumina. Statistical analyses were performed in PLINK 1.9, MACH 1.0 and Minimac2. The variant rs12007907 (g.29483892C4A) in IL1RAPL gene was suggestively associated with asthma symptoms in discovery set (odds ratio (OR) = 0.49, 95% confidence interval (CI): 0.37-0.67; P = 3.33 × 10 −6 ). This result was replicated in the ProAr cohort in men only (OR = 0.45, 95% CI: 0.21-0.95; P = 0.038). Furthermore, investigating the functional role of the rs12007907 on the production a Th2-type cytokine, IL-13, we found a negative association between the minor allele A with IL-13 production in the discovery set (P = 0.044). Gene-based analysis revealed that NUDT10 was the most consistently associated with asthma symptoms in discovery sample. In conclusion, the rs12007907 variant in IL1RAPL gene was negatively associated with asthma and IL-13 production in our study and a sex-specific association was observed in one of the validation samples. It suggests an effect on asthma susceptibility and may explain differences in severe asthma frequency between women and men.

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The effect of single and multiple infections on atopy and wheezing in children

Cited by 80 publications

References 50 publications

Hygiene, atopy and wheeze–eczema–rhinitis symptoms in schoolchildren from urban and rural Ecuador

Hygiene, atopy and wheeze–eczema–rhinitis symptoms in schoolchildren from urban and rural Ecuador

The tropics, helminth infections and hygiene hypotheses

Suggestive association between variants in IL1RAPL and asthma symptoms in Latin American children

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