Farming environments and childhood atopy, wheeze, lung function, and exhaled nitric oxide Oliver Fuchs, MD, Jon Genuneit, MD, Philipp Latzin, MD, PhD,

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Presentation transcript:

Farming environments and childhood atopy, wheeze, lung function, and exhaled nitric oxide Oliver Fuchs, MD, Jon Genuneit, MD, Philipp Latzin, MD, PhD, Gisela Büchele, PhD, Elisabeth Horak, MD, Georg Loss, MSc, Barbara Sozanska, MD, Juliane Weber, MD, Andrzej Boznanski, MD, Dick Heederik, PhD, Charlotte Braun-Fahrländer, MD, Urs Frey, MD, PhD, Erika von Mutius, MD Journal of Allergy and Clinical Immunology Volume 130, Issue 2, Pages 382-388.e6 (August 2012) DOI: 10.1016/j.jaci.2012.04.049 Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Farm exposure and current wheeze. This figure shows the association of farm exposure with current wheeze across levels of exposure to farming environments stratified by atopic sensitization in the phase 2 population. The line represents the level of unexposed nonfarm children without atopic sensitization as a reference. Left (circles), Children without atopic sensitization; right (squares), children with atopic sensitization. *Adjusted for center, sex, age, and family history of allergic diseases. Journal of Allergy and Clinical Immunology 2012 130, 382-388.e6DOI: (10.1016/j.jaci.2012.04.049) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Farm exposure and objective outcomes. This figure shows the effect of farm exposure on crude estimates and their respective SEs for spirometry (gray symbols and gray scale on right, mean z-score FEV1/FVC ratio) and of Feno levels (black symbols and black scale on left, geometric means) stratified by atopic sensitization in the phase 3 study population. The dashed line represents the level of unexposed nonfarm children without atopic sensitization as a reference. Left (circles), Children without atopic sensitization; right (squares), children with atopic sensitization. Valid spirometry before bronchodilator test, n = 711; Feno data, n = 795. Journal of Allergy and Clinical Immunology 2012 130, 382-388.e6DOI: (10.1016/j.jaci.2012.04.049) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Different protective farming effects identified in the GABRIEL Advanced Studies population. This figure shows the protective farming effects (P) together with their respective magnitudes (1) on the prevalence of transient early wheeze and (2) on the prevalence of current wheeze among children without atopic sensitization in addition to the already known protective effect on the presence of atopic sensitization (3) also on its degree. Among children with atopic sensitization, we detected (4) less increased exhaled nitric oxide levels as a marker of reduced eosinophilic airway inflammation and (5) less impaired lung function. aGMR, Adjusted geometric means ratio; aOR, adjusted OR. Journal of Allergy and Clinical Immunology 2012 130, 382-388.e6DOI: (10.1016/j.jaci.2012.04.049) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Farm exposure and persistent or late-onset wheeze. This figure shows the association of farm exposure with persistent wheeze (A; Pint = .098) and late-onset wheeze (B; Pint = .126) across levels of exposure to farming environments stratified by atopic sensitization in the phase 2 population. The line represents the level of unexposed nonfarm children without atopic sensitization as a reference. Left (circles), Children without atopic sensitization; right (squares), children with atopic sensitization. *Adjusted for center, sex, age, and family history of allergic diseases. Journal of Allergy and Clinical Immunology 2012 130, 382-388.e6DOI: (10.1016/j.jaci.2012.04.049) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions