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Does early indoor microbial exposure reduce the risk of asthma? The Prevention and Incidence of Asthma and Mite Allergy birth cohort study.
J Allergy Clin Immunol. 2006 May; 117(5):1067-73.JA

Abstract

BACKGROUND

Exposure to microbial agents might inhibit the development of atopy and asthma.

OBJECTIVE

We measured the association between microbial exposure assessed at 3 months and the development of atopic sensitization and doctor-diagnosed (DD) asthma and wheeze in the first 4 years in a birth cohort study of children with atopic mothers.

METHODS

Endotoxin, fungal (1-->3)-beta-D-glucans, extracellular polysaccharides from the genera Penicillium and Aspergillus (EPS-Pen/Asp), and dust on living room floors were measured at 3 months of age. Serum IgE levels against common allergens were determined at 1 and 4 years, and questionnaire information about respiratory morbidity was collected yearly.

RESULTS

Microbial levels in mattresses were low and not associated with serum IgE levels, DD asthma, and wheeze. Floor levels of biocontaminants and dust, on the other hand, were inversely associated with DD asthma, being most pronounced for endotoxin (odds ratio [OR], 0.40; 95% CI, 0.21-0.77) and EPS-Pen/Asp (OR, 0.42; 95% CI, 0.18-0.99). Mutual adjustment for other exposures did not significantly alter the results for endotoxin and only moderately affected the results for EPS-Pen/Asp. Persistent wheeze was also consistently less common in the high-exposure group, being significant only for EPS-Pen/Asp (OR, 0.37; 95% CI, 0.15-0.96). Transient wheeze and wheeze in the past 12 months were also reduced, but effects were smaller and not significant. Relationships with serum-specific IgE levels, which could only be assessed in 41% at age 4 years, were less pronounced and statistically significant only for EPS-Pen/Asp.

CONCLUSIONS

Early exposure to common microbial contaminants, including fungal agents, might protect against asthma.

CLINICAL IMPLICATIONS

Microbial exposure in early life might protect against asthma and might constitute a novel target for prevention.

Authors+Show Affiliations

Institute for Risk Assessment Sciences (IRAS), Utrecht University, Amsterdam.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16675334

Citation

Douwes, Jeroen, et al. "Does Early Indoor Microbial Exposure Reduce the Risk of Asthma? the Prevention and Incidence of Asthma and Mite Allergy Birth Cohort Study." The Journal of Allergy and Clinical Immunology, vol. 117, no. 5, 2006, pp. 1067-73.
Douwes J, van Strien R, Doekes G, et al. Does early indoor microbial exposure reduce the risk of asthma? The Prevention and Incidence of Asthma and Mite Allergy birth cohort study. J Allergy Clin Immunol. 2006;117(5):1067-73.
Douwes, J., van Strien, R., Doekes, G., Smit, J., Kerkhof, M., Gerritsen, J., Postma, D., de Jongste, J., Travier, N., & Brunekreef, B. (2006). Does early indoor microbial exposure reduce the risk of asthma? The Prevention and Incidence of Asthma and Mite Allergy birth cohort study. The Journal of Allergy and Clinical Immunology, 117(5), 1067-73.
Douwes J, et al. Does Early Indoor Microbial Exposure Reduce the Risk of Asthma? the Prevention and Incidence of Asthma and Mite Allergy Birth Cohort Study. J Allergy Clin Immunol. 2006;117(5):1067-73. PubMed PMID: 16675334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does early indoor microbial exposure reduce the risk of asthma? The Prevention and Incidence of Asthma and Mite Allergy birth cohort study. AU - Douwes,Jeroen, AU - van Strien,Rob, AU - Doekes,Gert, AU - Smit,Jet, AU - Kerkhof,Marjan, AU - Gerritsen,Jorrit, AU - Postma,Dirkje, AU - de Jongste,Johan, AU - Travier,Noemie, AU - Brunekreef,Bert, Y1 - 2006/03/31/ PY - 2005/07/05/received PY - 2006/01/29/revised PY - 2006/02/01/accepted PY - 2006/5/6/pubmed PY - 2006/6/8/medline PY - 2006/5/6/entrez SP - 1067 EP - 73 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 117 IS - 5 N2 - BACKGROUND: Exposure to microbial agents might inhibit the development of atopy and asthma. OBJECTIVE: We measured the association between microbial exposure assessed at 3 months and the development of atopic sensitization and doctor-diagnosed (DD) asthma and wheeze in the first 4 years in a birth cohort study of children with atopic mothers. METHODS: Endotoxin, fungal (1-->3)-beta-D-glucans, extracellular polysaccharides from the genera Penicillium and Aspergillus (EPS-Pen/Asp), and dust on living room floors were measured at 3 months of age. Serum IgE levels against common allergens were determined at 1 and 4 years, and questionnaire information about respiratory morbidity was collected yearly. RESULTS: Microbial levels in mattresses were low and not associated with serum IgE levels, DD asthma, and wheeze. Floor levels of biocontaminants and dust, on the other hand, were inversely associated with DD asthma, being most pronounced for endotoxin (odds ratio [OR], 0.40; 95% CI, 0.21-0.77) and EPS-Pen/Asp (OR, 0.42; 95% CI, 0.18-0.99). Mutual adjustment for other exposures did not significantly alter the results for endotoxin and only moderately affected the results for EPS-Pen/Asp. Persistent wheeze was also consistently less common in the high-exposure group, being significant only for EPS-Pen/Asp (OR, 0.37; 95% CI, 0.15-0.96). Transient wheeze and wheeze in the past 12 months were also reduced, but effects were smaller and not significant. Relationships with serum-specific IgE levels, which could only be assessed in 41% at age 4 years, were less pronounced and statistically significant only for EPS-Pen/Asp. CONCLUSIONS: Early exposure to common microbial contaminants, including fungal agents, might protect against asthma. CLINICAL IMPLICATIONS: Microbial exposure in early life might protect against asthma and might constitute a novel target for prevention. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/16675334/Does_early_indoor_microbial_exposure_reduce_the_risk_of_asthma_The_Prevention_and_Incidence_of_Asthma_and_Mite_Allergy_birth_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(06)00311-3 DB - PRIME DP - Unbound Medicine ER -