Breast-feeding, aeroallergen sensitization, and environmental exposures during infancy are determinants of childhood allergic rhinitis

Abstract

Background Infant predictors of early childhood allergic rhinitis (AR) are poorly understood. Objective Identify environmental exposures and host factors during infancy that predicts AR at age three. Methods High risk children from Greater Cincinnati were followed annually from ages one to three. Allergic rhinitis (AR) was defined as sneezing, runny or blocked nose in the prior 12 months and positive skin prick test (SPT) to one or more aeroallergens. Environmental and standardized medical questionnaires determined exposures and clinical outcomes. Primary activity area dust samples were analyzed for house dust endotoxin (HDE) and (1-3)-β-D-glucan. Fine particulate matter (PM2.5) sampled at 27 monitoring stations was used to estimate personal elemental carbon attributable to traffic (ECAT) exposure by land use regression model. Results Of 361 children in this analysis, 116 had AR and 245 were non-atopic, non-symptomatic. Prolonged breastfeeding in African-American children (aOR 0.8; 95% CI 0.6–0.9) and multiple children in the home during infancy was protective of AR (aOR 0.4; 95% CI 0.2–0.8). Food SPT positivity and tree SPT positivity in infancy increased the risk of AR at age three (aOR 4.4; 95% CI 2.1–9.2) and (aOR 6.8; 95% CI 2.5–18.7), respectively. HDE exposure was associated with AR; the effect was dependent on exposure level. ECAT and ETS exposure showed no effect on AR. Conclusion Prolonged breastfeeding in African-Americans and multiple children in the home during infancy reduced the risk of AR at age three. SPT positivity to food and tree allergens enhanced risk. The HDE effect on AR was related to exposure.

Prediction of the incidence and persistence of allergic rhinitis in adolescence: A prospective cohort study

“…35 However, several studies have shown a positive effect of having been breast-fed exclusively for some time in children, and breast-feeding has been recommended for the prevention of atopic diseases. 12,14 Neither atopic dermatitis nor asthma showed significant associations with the course of AR over puberty. It might have been expected that at least atopic dermatitis would be a risk factor for the development of AR because, according to the atopic march theory, it usually precedes rhinitis and asthma.…”

“…9 Not only do hereditary factors and sex seem to play an important role in the development of AR 10,11 but also many environmental and lifestyle factors have been associated with increased risk of AR as well. 11 While breast-feeding, having siblings, and higher socioeconomic status have been shown to be inversely associated with the incidence of AR, [12][13][14] exposure to environmental tobacco smoke during pregnancy, as well as in infancy, might increase the risk of AR. 15 Thus far, there is a lack of predictive models for the course of AR, especially during the period of transition from childhood to adulthood.…”

Correlation Between Prevalence of Allergic Rhinitis and Certain Diseases

“…And similarly the prevalence in urban areas is higher than that of rural areas [2][3][4][5][6]. Perhaps more importantly, these studies show that the international patterns of disease prevalence cannot be explained by the current understanding of the etiology of these conditions [7].…”

Flagellin suppresses experimental asthma by generating regulatory dendritic cells and T cells

“…19 Recently, house dust LPS was reported to be either negatively or positively associated with the prevalence of allergic rhinitis, depending on the exposure level. 20 The immunomodulatory effects of flagellin are primarily mediated through stimulation of TLR5 on dendritic cells (DCs). 21 In the present study we show that a therapeutic dose of FlaB functioned as a tolerogenic adjuvant to generate regulatory dendritic cells (rDCs) and Treg cells and ameliorated asthma in 2 experimental models.…”