The Two Sides of the “Endotoxin Coin”

Radon, Katja

doi:10.1136/oem.2004.017616

Cited by 70 publications

(65 citation statements)

References 56 publications

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“…For each study, the size of the box is proportional to the precision (inverse of variance) of the study. The combined estimate from the meta-analysis is indicated by the diamond-shaped box (labelled ''Summary'') at the bottom of the figure. early exposure to indoor microbial elements may have strong immune-stimulatory properties, as has been suggested for endotoxin in several studies [74][75][76]. The present review revealed that there are still not enough data on exposure to mould-derived components to perform combined analyses, which would be required to make a more definite statement on the impact of exposure to these components.…”

Section: Discussionmentioning

confidence: 86%

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Association between domestic mould and mould components, and asthma and allergy in children: a systematic review

Tischer¹,

Cm²,

Heinrich³

2011

Eur Respir J

146

108

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Critical reviews over the past 10 yrs have found increased respiratory and allergic health outcomes for children living in damp and mouldy environments. However, recent studies have suggested that early childhood exposure to specific mould components may actually protect children from developing allergy.We conducted a systematic review of observational studies published in English from January 1980 to July 2010. This review was conducted according to systematic guidelines for Metaanalyses of Observational Studies in Epidemiology (MOOSE). The literature was searched using a computerised bibliographic database, PubMed. In order to increase the quality of the reviewed studies, meta-analyses of the effects of visible mould exposure on allergic health outcomes were performed and we evaluated the findings according to the Bradford Hill criteria for evidence of causation.The literature search identified 1,398 peer-reviewed scientific publications, and 61 studies that fulfilled the inclusion criteria were included in this review. We observed increased risks of allergic respiratory health outcomes in children exposed to visible mould and mould spores. These findings were confirmed by the results of the meta-analysis and in line with the evaluation criteria according to Bradford Hill. Visible mould was positively associated with asthma (OR 1.49 (95% CI 1.28-1.72)), wheeze (OR 1.68 (95% CI 1.48-1.90)) and allergic rhinitis (OR 1.39 (95% CI 1.28-1.51)). However, there was a tendency of lower risk for allergic health outcomes in children exposed to mouldderived components such as (1,3)-b-D-glucan and extracellular polysaccharides.These findings suggest that home environments with visible mould and mould spore exposure increase the risk of allergic respiratory health outcomes in children. However, further investigations are needed to examine the effects of exposure to mould-derived components as the current literature is inconclusive. In order to disentangle the different effects of overall microbial exposure on children's health, research should focus on specific microbial markers in the home, in combination with new assessment techniques including molecular methods.

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Section: Discussionmentioning

confidence: 86%

“…Furthermore, the incidence of allergic diseases in adults may be provoked by different triggers, for example due to occupational exposure and causing nonallergic rather than allergic responses [76].…”

Section: Study Populationmentioning

confidence: 99%

Association between domestic mould and mould components, and asthma and allergy in children: a systematic review

Tischer¹,

Cm²,

Heinrich³

2011

Eur Respir J

146

108

View full text Add to dashboard Cite

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“…It may therefore be capable of enhancing the Th1-dominated immune response and suppress the Th2-dominated allergic response in newborns and infants [16,17]. Being born and growing up on a farm was protective against the risk of developing hayfever and allergic sensitisation early in life and some recent studies suggested that these protective effects are persistent until adulthood [29,31]. A protective effect on respiratory and atopic disorders in children was also observed for domestic endotoxin exposure in nonfarming environments.…”

Section: Discussionmentioning

confidence: 88%

“…In support of the ''hygiene hypothesis'', which postulates an inverse effect of household size and siblings on the risk of hayfever [18,19], there was a considerable number of epidemiological studies in the past investigating the effect of living on a farm and the risk of allergic disorders (for a review, see [29]). The farm environment contains large amounts of microbial products, including endotoxin [30].…”

Section: Discussionmentioning

confidence: 99%

Respiratory health in children, and indoor exposure to (1,3)-β-d-glucan, EPS mould components and endotoxin

Tischer¹,

Gehring²,

Chen³

et al. 2010

Eur Respir J

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For a long time, exposure to mould and dampness-derived microbial components was considered a risk factor for the development of respiratory diseases and symptoms. Some recent studies suggested that early childhood exposure to mould components, such as (1,3)-b-Dglucan and extracellular polysaccharides (EPSs), may protect children from developing allergy. We investigated the association of exposure to (1,3)-b-D-glucan, EPS and endotoxin with asthma and allergies in 6-yr-old children.This investigation was the follow-up to a nested case-control study among three European birth cohorts. Children from two ongoing birth cohort studies performed in Germany (n5358) and one in the Netherlands (n5338) were selected. Levels of (1,3)-b-D-glucan, EPS and endotoxin were measured in settled house dust sampled from children's mattresses and living-room floors when the children were, on average, 5 yrs of age. At the age of 6 yrs, health outcome information was available for 678 children.In the two German subsets, domestic EPS and endotoxin exposure from children's mattresses were significantly negatively associated with physician-diagnosed asthma (OR per interquartile range increase 0.60 (95% CI 0.39-0.92) and 0.55 (95% CI 0.31-0.97), respectively). In addition, EPS exposure was inversely related to physician-diagnosed allergic rhinitis (OR 0.50, 95% CI 0.31-0.81). For the Dutch population, no associations were observed between exposure to microbial agents and respiratory health outcomes.We found inverse associations between domestic exposure to EPS and endotoxin from children's mattresses, and doctor-diagnosed asthma and rhinitis in German, but not in Dutch, school children. The reasons for the differences between countries are not clear.

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“…One review concluded that dog keeping may reduce development of allergic disease in children (Lodge et al, 2012) and one prospective birth cohort study demonstrated that FeNO at school age was lower in children exposed to endotoxin at age 2-3 months (Casas et al, 2013). The effect of endotoxin depends on genetic disposition and timing so observed effects of endotoxin exposure in early childhood may not be comparable with effects in adults (Radon, 2006). One study among office worker in a tropical area did not find any association between endotoxin levels in office dust and FeNO (Lim et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Cat, Dog and Horse Allergens in Swedish Day Care Centres-Associations with Fractional Exhaled Nitric Oxide (FeNO) among Day Care Centre Staff

Norbäck

Cai

Kreft

et al. 2016

GJHS

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Purpose: To study associations between cat, dog and horse allergens in day care centres and fractional exhaled nitric oxide (FeNO), eosinophilic cationic protein (ECP) in serum, lung function (FEV 1 ) and dyspnoea in day care centre staff. Totally 62 subjects, all females, from five Swedish day care centres participated (participation rate 90%). (Fel d 1), dog (Can f 1) and horse (Ecu cx) allergens by ELISA. Dyspnoea was measured on an analogue rating scale. FeNO, serum ECP and symptom ratings were log-transformed. Associations were analysed by linear mixed models, adjusting for personal and home environment factors. Methods: Dust was collected by vacuum cleaning and Petri dish sampling and analysed for cat

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The Two Sides of the “Endotoxin Coin”

Cited by 70 publications

References 56 publications

Association between domestic mould and mould components, and asthma and allergy in children: a systematic review

Association between domestic mould and mould components, and asthma and allergy in children: a systematic review

Respiratory health in children, and indoor exposure to (1,3)-β-d-glucan, EPS mould components and endotoxin

Cat, Dog and Horse Allergens in Swedish Day Care Centres-Associations with Fractional Exhaled Nitric Oxide (FeNO) among Day Care Centre Staff

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