Fetal and early postnatal life roots of asthma

Abstract

The origins of asthma might be traced back to events occurring during fetal life. Reduced lung development has been shown to be a risk factor both for viral induced wheeze and allergic asthma. The evidence for a causal relationship between exposure to environmental tobacco smoke, chemical domestic products for cleaning, outdoor pollutants, and reduction in lung function is quite strong. Reduced maternal intake of vitamin E, vitamin D, and zinc, or increased use of paracetamol during pregnancy is associated with increased wheezing outcomes in children. The odds ratio for asthma onset is also increased in infants born from mothers with oligohydramnios, chorioamnionitis, hypertension, preeclampsia, diabetes and exposed to stressful events. The risk of developing allergic asthma is increased if the child is exposed in the first months of life to synthetic bedding and is enhanced by allergen exposure and an inadequate barrier function of the skin. In conclusion, several lines of evidence support the concept of fetal programming and very early life events in the development of the different phenotypes of asthma. Since some environmental triggers can be easily avoided and some protective factors can be easily implemented all efforts should be made to prevent intrauterine insults and early sensitization.

Maternal sensitivity and social support protect against childhood atopic dermatitis

“…Given that low maternal sensitivity and anxiety are interrelated, the association with childhood AD may be similarly mediated by epigenetics or neuroendocrine dysregulation [88, 104, 110], and altered infant cytokine profiles [111]. Infant neuroendocrine and immunologic maturation is highly plastic in the face of environmental stressors [112–115], especially during the early postnatal period. For those who are already genetically susceptible to the development of atopy [116], as observed in our sample of children whose mothers reported a history of asthma, maternal sensitivity may make the difference between the development of AD or not.…”

The Vitamin D Antenatal Asthma Reduction Trial (VDAART): Rationale, design, and methods of a randomized, controlled trial of vitamin D supplementation in pregnancy for the primary prevention of asthma and allergies in children

“…5, 6 Thus, preventing the development of this disorder would be of great public health importance. Because asthma and allergies have their roots very early in life, 7–9 interventions may need to begin prenatally.…”

Vitamin D related genes in lung development and asthma pathogenesis

“…Vitamin D also regulates genes involved in the inflammation, immunity, cellular proliferation, and apoptosis associated with obstructive airways disease [13], likely via an epigenetic mechanism. Given the potential role that vitamin D plays in pregnancy, as well as the influence of maternal diet on subsequent childhood respiratory outcomes, it has been postulated that vitamin D deficiency directly affects programming within the developing fetal lung in a manner that may influence disease susceptibility [14,15]. We hypothesized that vitamin D pathway genes are transcriptionally active and temporally regulated during normal fetal lung development.…”