Asthma and allergy development: contrasting influences of yeasts and other fungal exposures
Summary Background Infancy is a developmental stage with heightened susceptibility to environmental influences on the risk of chronic childhood disease. Few birth cohort studies have detailed measures of fungal diversity data in infants' bedrooms, limiting the potential to measure long‐term ass...
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| Published in: | Clinical and experimental allergy Vol. 45; no. 1; pp. 154 - 163 |
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| Main Authors: | , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Blackwell Publishing Ltd
01-01-2015
Wiley Subscription Services, Inc |
| Subjects: | |
| Online Access: | Get full text |
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Background
Infancy is a developmental stage with heightened susceptibility to environmental influences on the risk of chronic childhood disease. Few birth cohort studies have detailed measures of fungal diversity data in infants' bedrooms, limiting the potential to measure long‐term associations of these complex exposures with development of asthma or allergy.
Objective
We evaluated the relation of home fungal levels in infancy to repeated measures of wheeze and development of asthma and rhinitis by age 13, and sensitization by age 12 years.
Methods
In the Epidemiology of Home Allergens and Asthma prospective birth cohort study, we recruited 408 children with family history of allergic disease or asthma. When children were aged 2–3 months, we measured culturable fungi in bedroom air and dust, and in outdoor air. Main outcomes included ascertainment of symptoms/disease onset by questionnaire from birth through age 13. We estimated hazard ratios and, for wheeze and sensitization, odds ratios for an interquartile increase in log‐transformed fungal concentrations, adjusting for other outcome predictors and potential confounders.
Results
Elevated levels of yeasts in bedroom floor dust were associated with reduced: i) wheeze at any age; ii) fungal sensitization; and iii) asthma development by age 13 (hazard ratio (HR) = 0.86; 95% confidence interval (CI), [0.75 to 0.98]). Outdoor airborne Cladosporium and dustborne Aspergillus predicted increased rhinitis. Risk of fungal sensitization by age 12, in response to environmental Alternaria and Aspergillus, was elevated in children with a maternal history of fungal sensitization.
Conclusions and Clinical Relevance
Despite the irritant and allergenic properties of fungi, early‐life elevated dust yeast exposures or their components may be protective against allergy and asthma in children at risk for these outcomes. Ascertainment of fungal components associated with immunoprotective effects may have therapeutic relevance for asthma. |
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| Bibliography: | ark:/67375/WNG-DSRCS3F6-G istex:957D22822F8092020D0BD613BEC628E3AF2D3E0B ArticleID:CEA12401 Figure S1. The distribution of airborne (indoor/outdoor) and dustborne (bedroom floor dust) fungal concentrations by sampling season, at the homes of children (age 2-3 months) in the Epidemiology of Home Allergens and Asthma Study. Table S1. Associations between Early-Life Fungi and Dampness with Development of Asthma & Rhinitis, Repeated Measures of Wheeze by Age 13 and Sensitization by Age 12. Harvard-Cyprus Endowment Scholarship - No. R01 AI035786; No. EPA RD-83241601; No. AI-20565 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0954-7894 1365-2222 |
| DOI: | 10.1111/cea.12401 |