Environmental determinants of allergy and asthma in early life

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Presentation transcript:

Environmental determinants of allergy and asthma in early life Allison J. Burbank, MD, Amika K. Sood, MD, Matthew J. Kesic, PhD, David B. Peden, MD, MS, Michelle L. Hernandez, MD Journal of Allergy and Clinical Immunology Volume 140, Issue 1, Pages 1-12 (July 2017) DOI: 10.1016/j.jaci.2017.05.010 Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Interplay of early-life exposures that affect allergic disease development. Allergic disease development is influenced by many different factors. This figure displays several of the identified environmental triggers that increase susceptibility to allergic disease. A, Common behaviors and determinants that influence a subject's microbiome and external microbial environment, thereby influencing susceptibility to allergic disease. B, Allergens that have been linked to development of atopy. C, Air pollution exposures that not only influence lung function but also contribute to the immune response. Collectively, this Venn diagram demonstrates the overlapping contributions of each exposure. The center of the figure shows the questions that have yet to be elucidated, including how any of the numerous combinations of these common exposures influence the onset of disease or affect disease severity. Journal of Allergy and Clinical Immunology 2017 140, 1-12DOI: (10.1016/j.jaci.2017.05.010) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Potential interventions reducing the risk of allergic disease development. A, Certain modifications can positively influence a subject's microbiome or select for a protective external microbial environment. B, Reducing the quantity of allergen exposure might reduce development of allergic disease. C, Although the highest pollutant exposures occur from exposure to ETS, mitigating industrial and TRAP exposures will have to come from national and local regulatory agencies throughout the world. The center of the figure highlights the questions that have yet to be elucidated. Could these interventions affect the incidence of allergic disease, and if so, which are the most pragmatic and cost-effective and have the highest potential effect in different societies? C-section, Caesarian section. Journal of Allergy and Clinical Immunology 2017 140, 1-12DOI: (10.1016/j.jaci.2017.05.010) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions