Gabriele Bolte

Allergens and endotoxin on mothers' mattresses and total immunoglobulin E in cord blood of neonates

The current authors examined whether mite and cat allergen and bacterial endotoxin levels in dust of the mothers mattresses were associated with cord blood immunoglobulin (Ig)E (CB-IgE) levels in newborns. Data from 1,332 term and normal weight neonates, from an ongoing birth cohort study, Influences of life-style related factors on the immune system and the development of allergies in childhood (LISA), with complete information on exposure to biocontaminants in mattress dust and CB-IgE were analysed. Two thirds of CB-IgE were undetectable (<0.35u2005kU·L−1). Thus, 0.35 and 0.45u2005kU·L−1 (4th quartile) were chosen as cut-offs. Nonparametric smoothing (generalised additive models) showed statistically significant confounder-adjusted associations between elevated CB-IgE levels (≥0.45u2005kU·L−1) and log-transformed exposures to cat (linear), mite (inverse u-shaped), and endotoxin (u-shaped). After adjustment for covariables, elevated CB-IgE levels (logistic regression using the 1st–4th quartiles of exposure) were positively associated with high cat-allergen exposure and medium exposure to mite allergen, but were inversely associated with exposure to endotoxin. The associations were similar, but somewhat weaker, when 0.35u2005kU·L−1 was used as cut-off. These results, showing an association between prenatal allergen and endotoxin exposures and immunoglobulin E production, suggest that the development of foetal immune responses may be affected.

Mode of delivery and development of atopic disease during the first 2 years of life.

It has been hypothesized that cesarean delivery might have an impact on the development of atopic diseases because of its gut flora modulating properties. In the present study, we analysed the association between cesarean delivery and atopic diseases using data of 2500 infants enrolled in the LISA‐Study, a German prospective multicenter birth cohort study. Data on symptoms and physician‐diagnosed atopic diseases were gathered by questionnaires shortly after birth and at infants age 6, 12, 18, and 24u2003months. In addition, sensitization to common food and inhalant allergens was assessed by measuring specific immunoglobulin E (IgE) using the CAP‐RAST FEIA method at the age of 2u2003yr. Confounder‐adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated by multiple logistic regression. We found a positive association between cesarean delivery and occurrence of at least one episode of wheezing [aOR 1.31 (95% CI 1.02–1.68)] and of recurrent wheezing [1.41 (1.02–1.96)] during the first 2u2003yr of life. Furthermore, effect estimates for allergic sensitization defined as at least one specific IgE ≥0.70u2003kU/l against any allergen [1.48 (0.98–2.24)], against food allergens [1.64 (1.03–2.63)], and against inhalant allergens [1.75 (0.98–3.12)] were increased. Symptoms of atopic dermatitis [1.21 (0.92–1.59)], physician‐diagnosed atopic dermatitis [1.04 (0.79–1.39)], and symptoms of allergic rhinoconjunctivitis [1.40 (0.80–2.44)] were only marginally increased in children delivered by cesarean section. In conclusion, our results suggest that cesarean delivery may be an additional risk factor for wheezing and allergic sensitization at least to food allergens up to the age of 2u2003yr. This should be considered when cesarean section is done for other than medical reasons.

Early endotoxin exposure and atopy development in infants: results of a birth cohort study

Background Exposure to endotoxin in childhood is currently discussed to protect from the development of allergic diseases.

The relation of markers of fetal growth with asthma, allergies and serum immunoglobulin E levels in children at age 5–7 years

Background It has been suggested that fetal growth and maturation have an impact on the development of allergic diseases later in life.

T cell reactivity in neonates from an East and a West German city – results of the LISA study

Background:u2002Within an ongoing birth cohort study (LISA) the cytokine production of cord blood Tu2003cells was compared between neonates from Leipzig (East Germany) and Munich (West Germany). The aim of this study was to analyse regional differences and influencing factors of the immune status.

Allergic sensitization and diet: ecological analysis in selected European cities

It has been postulated that the prevalence of atopic diseases and their increase over time are associated with regional differences in diet and trends. The results of an ecological correlation study comparing the mean daily intake of selected dietary constituents and the prevalence of allergic sensitization in adults in Europe is presented. Prevalence data from the European Community Respiratory Health Survey (ECRHS) were used. For eight out of 37 ECRHS centres (including 3,872 subjects), comparable dietary data could be obtained. The effect for each dietary constituent was modelled using logistic regression analyses with a term for over dispersion. Inverse associations between the prevalence of allergic sensitization and the energy adjusted intake of fruit were found (odds ratio (OR) = 0.68, p = 0.034). Furthermore OR for energy adjusted intake of vitamin A (OR = 0.73, p = 0.057), vitamin C (OR = 0.83, p = 0.338) and riboflavin (OR = 0.72, p = 0.077) were consistently < 1, but confidence intervals were wider. Daily intake of monounsaturated fatty acids (energy adjusted) was positively associated with sensitization prevalence (OR = 1.59, p = 0.035). These results support the hypothesis that a high intake of monounsaturated fatty acids might promote the development of allergic sensitization.

Association of fatty acids in serum phospholipids with lung function and bronchial hyperresponsiveness in adults

Background The dietary intake of certain fatty acids might have an impact on inflammatory processes in the lung and therefore contribute to the development of lung diseases like asthma or COPD. Methods In this study data from a population based cross-sectional study on respirator y health including measurement of fatty acids in serum phospholipids of 593 adults between 20 and 64xa0years of age were analyzed. Results Statistically significant positive associations were found between percentage predicted FEV1 (Pxa0=xa00.0085) and FVC (Pxa0=xa00.0267) and docosahexaenoic acid concentration in serum phospholipids in men. Dihomo-γ-linolenic acid content in serum phospholipids was significantly negatively associated with percentage predicted FEV1 (Pxa0=xa00.0003) and FVC (Pxa0=xa00.0045) and transformed dose-response slopes (Pxa0=xa00.0488) in men. Palmitoleic acid was negatively associated with percentage predicted FEV1 (Pxa0=xa00.0037) and FVC (Pxa0=xa00.0029) in men. Other fatty acids in serum phospholipids did not consistently affect lung function parameters or bronchial hyperreactivity. Conclusion A high concentration of docosahexaenoic acid in serum phospholipids may have a protective effect on lung function. Because this long-chain n-3 polyunsaturated fatty acid is almost exclusively derived from marine oils, fish might have a beneficial effect on lung diseases.

Fatty acids in serum cholesteryl esters in relation to asthma and lung function in children

Background Dietary fatty acid intake has been proposed to contribute to asthma development with n‐6 polyunsaturated fatty acids (PUFA) having a detrimental and n‐3 PUFA a protective effect.

Association of fatty acids in serum phospholipids with hay fever, specific and total immunoglobulin E

The dietary intake of certain fatty acids might contribute to the development of allergic diseases such as hay fever and asthma. We investigated the association between the concentrations of fifteen fatty acids in serum phospholipids, as a marker of dietary intake and metabolism, and hay fever, allergic sensitisation and total IgE in adults. Data from a population-based cross-sectional study on respiratory health, including the measurement of fatty acids in the serum phospholipids of 740 adults between 20 and 64 years of age, were analysed. Positive associations were found between hay fever and arachidonic acid, and allergic sensitisation and oleic acid. No other fatty acids showed any association with hay fever or allergic sensitisation. Elevated levels of total IgE were not related to fatty acids. Concentrations of long-chain n-3 fatty acids, trans fatty acids or saturated fatty acids in serum phospholipids were not associated with allergic diseases in adults in this study. The present result on the association between hay fever and arachidonic acid is consistent with current hypotheses but warrants further research.

Health impacts of second-hand exposure to cat allergen Fel d 1 in infants.

Background: Recent cross‐sectional studies suggested that highest sensitization prevalences occur with moderate cat allergen exposures. We aimed to assess the impact of moderate levels of second‐hand cat allergen exposure on the incidence of specific sensitization and wheezing in the framework of a birth cohort study. Therefore we restricted our analysis to infants without a cat at home since birth.