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Cord blood mononuclear cell responsiveness to beta-lactoglobulin: T-cell activity in 'atopy-prone' and 'non-atopy-prone' newborns.

We have studied the T-cell-mediated response to the major allergen of cow's milk, in a group of newborns at risk of developing cow's milk allergy, and in a control group. Before any atopic status has developed, we observe beta-lactoglobulin-specific primary proliferation only in the group at risk for food-related allergies. In this group, the capability to proliferate is not due to placental transmission of 'factors' from allergic mothers. The recognition of the tested beta-lactoglobulin peptides does not show major differences between the responder and nonresponder populations. In the responder population, the response to p145-161 appears linked to a primary response to ovalbumin, another frequent food allergen. On the basis of our findings, we propose a model in which development of allergic diseases is linked to an alteration of T-cell activation through the engagement by the antigen; the HLA phenotype determines the allergen(s) involved, and other genetic or environmental factors dictate the clinical characteristics of the disease.

Epitopes↗

The human dander atopy. I. The prototype of auto-atopy.

Human dander is shown to be a true allergen giving skin reactions most frequently in atopic patients. The clinical importance of human dander is discussed and data of a group of patients atopic only to human dander are given. It seems probable that human dander is an auto allergen and that there are many more auto allergens to which the atopic organism produces IgE-type antibodies.

Adolescent↗

Prevalence and predictors of atopy among young Danish adults.

BACKGROUND: The prevalence of atopic diseases is increasing in western countries, and environmental exposures in childhood may influence development of atopic sensitization. OBJECTIVE: To investigate the prevalence and predictors of atopy among young Danish adults. METHODS: Of 940 invited subjects, aged 19-29 years, complete data were obtained from 525 (56%) subjects. All completed a questionnaire concerning asthma, rhinitis, preschool nursery care, smoking habits, family size, education and employment. A skin prick test was performed, and pulmonary function was measured using standard techniques. Atopy was defined as a positive skin prick test. RESULTS: The frequency of atopy was 32% (males 43% vs. females 23%, P < 0.001). We found a positive association between atopy and atopic dermatitis (P < 0.05), rhinitis (P < 0.001), itching when eating nuts (P < 0.001) and current asthma (P < 0.001). There was an inverse relation between atopy and having furred pets in childhood (P < 0.05), passive smoking in childhood (P < 0.01) and current passive smoking (P < 0.05). An increasing number of siblings was inversely related to atopy to grass (P < 0.05); however, only an increasing number of older siblings seemed to protect from atopy to grass (P < 0.05). Subjects who had never attended a day-care centre had significantly more atopy to grass (P < 0.05). No significant association was found between atopy and airway infections requiring hospitalization before the age of 5 years, or between atopy and bedroom sharing in childhood. CONCLUSION: Atopy is common among young Danish adults, especially in males. Participants were less likely to be atopic, especially to grass allergen, if they came from large families, had kept furred pets as children, and had been exposed to tobacco smoke.

Adult↗

Which factors explain the lower prevalence of atopy amongst farmers' children?

BACKGROUND: The inverse association between farming and atopy in children has been attributed to microbial exposure, especially through livestock. Very little is known about other potential explanatory factors. OBJECTIVE: To explore potential differences in lifestyle and environmental factors between farmer and non-farmer families, and whether these factors could explain the association between farming and childhood atopy. METHODS: A cross-sectional study, including 366 farmers' and 344 non-farmers' children in eastern Finland. Information regarding exposure and background characteristics was gathered by a written questionnaire. Atopy was defined as having one or more positive skin prick test reactions (> 3 mm) against the six common aeroallergens. RESULTS: Regardless of the current farming type, atopy was less frequent among the farmers' children than the non-farmers' children (aOR 0.56, 95% CI 0.40-0.78). Remarkable differences were seen in many lifestyle factors (including diet) between the farmer and non-farmer families, but only a few of the explored factors were associated with atopy. The frequency of current livestock contacts seemed to have an inverse, dose-dependent association with atopy (aOR 0.46, 95% CI 0.22-0.97 for daily vs. no contact). Having lived on a dairy farm in infancy (aOR 0.51, 95% CI 0.28-0.93), or having had cats or dogs in infancy (aOR 0.60, 95% CI 0.42-0.85), decreased the risk of atopy at school age. The inverse association between farming and atopy was not explained by the sociodemographic factors, or by differences in conventional risk factors of atopy. Animal contacts explained partially, but not completely, the association. CONCLUSION: Higher frequency of animal contacts is one factor, but probably not the only one, explaining the inverse association of farming and atopy in children. The importance of early life exposures may have recently been over-emphasized, and current exposures discounted, when studying the risk factors of childhood atopy.

Agriculture↗

Prolonged exclusive breast feeding and heredity as determinants in infantile atopy.

We followed 183 infants for two years, 31 of whom were breast fed less than three and a half months (median 70 days; short breast feeding group) and a further 31 of whom were exclusively breast fed for more than nine months (long breast feeding group). We assessed heredity for atopy, number of infections, and duration of breast feeding as determinants of atopy. During the first year of life 14 infants has signs of atopy. During the second year parents reported signs of atopy in a further 31. Heredity was the only significant predictor of atopy. Atopy was seen in 33% of infants with a positive heredity and in 16% without family history for atopy. The duration of breast feeding affected the incidence of atopy only among the infants without family history for atopy: fewer in the short breast feeding group (1/18) had atopy than in the long breast feeding group (5/13). Duration of breast feeding did not associate with incidence of respiratory infections. Diarrhoea was more common in the short breast feeding group than in the long breast feeding group during the first year of life. We conclude that prolonging exclusive breast feeding from the median of 70 days to nine months did not contribute to the prevention of infantile atopy and respiratory tract infections.

Breast Feeding↗

Atopy in patients with bronchiectasis: more than coincidence.

Bronchiectasis is common in developing countries, but its precise underlying mechanism can be detected in only about 40% of the cases. The studies reporting the frequency of atopy and its relation to radiological findings and lung function in bronchiectasis are limited in number, and the results are controversial. The present study was designed to investigate the relationship between atopy and bronchiectasis by means of high resolution computed tomography (HRCT) and pulmonary function tests. Skin prick test, HRCT and pulmonary function tests, including spirometric values of forced expiratory volume in one second (FEV1), FEV1/FVC (forced vital capacity) ratio were performed in 121 bronchiectatic patients of unknown etiology and in 68 healthy controls. Atopy and HRCT scores for the severity of atopy and extent of bronchiectasis respectively were determined for each patient. The rate of atopy (48.8% vs 11.8%) and mean atopy score (14.3 +/- 10.1 mm vs 5.5 +/- 2.1 mm) were significantly higher in patients with bronchiectasis than those in controls. Atopic patients had significantly worse spirometric values and more extended bronchiectasis than non-atopics. There is a significant correlation between atopy and HRCT scores (r = 0.54, p < 0.001), indicating that the more severe atopy is the more extended bronchiectasis. In conclusion, we suggest that the rate of atopy is higher in bronchiectatic patients than that in healthy controls. Bronchiectatic patients with atopy have lower spirometric values and higher HRCT scores. Atopy might be considered as a deteriorating and/or a causative or contributing factor for development of bronchiectasis.

Adult↗

Atopy patch test reaction to airborne allergens in the diagnosis of atopic dermatitis.

The aim of the study was to evaluate the possible use of atopy patch test in the diagnosis of atopic dermatitis and to characterize an optimal standardized system for atopy patch test in terms of allergen concentrations and time of allergen exposure. The study included 36 patients with atopic dermatitis and IgE-mediated airborne allergy. Patients presented positive results of skin prick tests and serum antigen specific IgE against house dust mite allergens and/or selected grass pollen allergens. Control groups consisted either of patients with allergic rhinitis (control group 1) or healthy volunteers with no signs or symptoms of atopy (control group 2). Allergologic diagnostic workup consisted of skin prick test, serum antigen specific IgE and total IgE evaluation, atopy patch test with selected airborne allergens of different concentrations (0.1xSPT, 1xSPT and 10xSPT), time of allergen exposure (8, 24 and 48 h), and readings of the results (8, 24, 48 and 72 h). Positive results of atopy patch test with airborne allergens were obtained in 47.2% of atopic dermatitis patients and none of control subjects. Contact reaction itself and the intensity of reaction were demonstrated to correlate with allergen concentration and time of allergen exposure on atopy patch test. The dose and time response analysis showed the optimal concentration of allergens for atopy patch test to be 10xSPT, 500000 SBE/ml, and optimal evaluation time 24 and 48 h of allergen application. There was no correlation between atopy patch test results and mean serum concentrations of total or antigen specific IgE. Atopy patch test results did not correlate with localization of skin lesions, severity and extensiveness of skin inflammation. A significantly higher contact reactivity to airborne allergens was recorded in the group of atopic dermatitis patients with polyvalent allergy in comparison with atopic dermatitis patients allergic to only one aeroallergen. It is concluded that atopy patch test is the only provocation test currently available with clinical relevance for contact IgE-mediated sensitization in atopic dermatitis patients. Using petrolatum as a vehicle, allergen concentration of 500000 SBE/ml and evaluation time of 24 and 48 h of allergen application may lead to improved atopy patch test results.

Adolescent↗

The relationship between atopy and non-specific bronchial responsiveness.

Atopy is often regarded as a risk factor for the development of asthma, particularly childhood asthma and occupational asthma. This could reflect an association with non-specific bronchial responsiveness (NSBR), though atopy could influence asthma independently. We have evaluated the possible relationship between atopy and NSBR (PD20FEV1 to methacholine) in the siblings of 59 probands with atopic asthma. Thirty-four (58%) were atopic (greater than or equal to 1 prick test with weal diameter greater than or equal to that of a 0.1% histamine control) and 28 (47%) showed NSBR. Atopy and NSBR occurred together more frequently than would be expected by chance (P less than 0.05); both variables being observed in 20 subjects, neither in 17, and only one in 22. A significant association was also noted when atopy was defined by a serum total IgE greater than 150 IU (or greater than 50 IU), but when atopy was defined by other commonly used criteria (greater than or equal to 2 prick tests with weal diameter greater than or equal to histamine control; or weal diameter 2 mm or more greater than a saline control), no significant association was demonstrated. Furthermore, linear logistic regression and multiple regression analyses showed that both the presence and the degree of NSBR were influenced much more by the baseline level of FEV1 than by atopic status. At best, atopy accounted for 10% of the variance of the PD20 measurements. We conclude that atopy is associated with NSBR but not strongly; that the relationship may be readily obscured according to the defining criteria used for atopy; and that atopy should not be used as a marker for NSBR.

Adolescent↗

[Passive smoking, atopy and respiratory health in schoolchildren].

Aim of the study was to verify the hypothesis that the effect of passive smoking exposure on the occurrence of respiratory symptoms and diseases is higher in children with increased individual susceptibility defined on the basis of occurrence of symptoms of atopy. Project was performed as the cross-sectional epidemiological study which comprised population of 1,534 children attending primary schools in Swietochłowice, Kedzierzyn-Koźle, Pszczyna and Kielce. On the basis of standard questionnaire an information regarding occurrence of wheezing, attacks of dyspnea with wheezing, asthma and spastic bronchitis was collected. Atopy in child was defined on the basis of occurrence of symptoms of allergy to at least one of the following allergens: house dust mites, animal dander, pollens or symptoms of food allergy confirmed by physician's diagnosis. Exposure to tobacco smoke was assessed also on the basis of the information regarding smoking given by the parents in the questionnaire. The effect of interaction atopy * passive smoking was assessed on the basis of variable called "interaction" which had three levels: level A: when exposure to passive smoking and atopy = 0, level B: when exposure to passive smoking or atopy =1 and level C: when exposure to passive smoking and atopy =1. The results of our study revealed that statistically significant relationship between interaction atopy * passive smoking on the occurrence of analyses symptoms and diseases. The occurrence of symptom/disease increased with the presence of either atopy or exposure to passive smoking and was the highest when atopy and exposure to passive smoking was present. The results of simple analyses were conformed by multivariate analyses. The results of our study suggest that the effect of environmental exposures could be higher in children with atopy.

Asthma↗

Perinatal risk factors for bronchial hyperresponsiveness and atopy after a follow-up of 20 years.

BACKGROUND: Perinatal risk factors are associated with lung function and respiratory symptoms in adult life. Whether the same holds for distinctive asthma features, such as bronchial hyperresponsiveness (BHR) and atopy, has scarcely been studied. OBJECTIVE: We sought to identify the perinatal risk factors for the development of BHR and atopy. METHODS: BHR and atopy were measured after 20 years' follow-up in 597 of 3162 babies born from 1975 through 1978. Factors directly related to delivery of these children were studied in association with the presence of BHR and atopy. RESULTS: Twenty-five percent had BHR, and 47% had atopy. Delivery duration of longer than 12 hours was associated with the development of atopy (odds ratio [OR], 2.24; 95% CI, 1.30-3.86), and severe respiratory infection in the first year of life was associated with the development of BHR (OR, 2.69; 95% CI, 1.41-5.16). Nonatopic subjects born after induced labor and current smokers were more likely to have BHR (ORs of 2.41 [95% CI, 1.07-5.41] and 2.50 [95% CI, 1.12-5.59], respectively). Prenatal smoke exposure and childhood pet keeping decreased the risk for atopy, especially in BHR-positive subjects (ORs of 0.51 [95% CI, 0.27-0.99] and 0.46 [95% CI, 0.24-0.88], respectively). CONCLUSIONS: It has been shown that events before or during birth still have an effect on respiratory health 20 years later. We put forward that an extreme hormonal status during delivery primes the fetal immune system toward atopy development. Furthermore, a severe respiratory infection in the first year of life appears associated with BHR development, and prenatal smoke exposure might be protective for the development of atopy, yet explanatory mechanisms are lacking thus far.

Adult↗

Relationship of asthma, atopy, and bronchial responsiveness to serum eosinophil cationic proteins in early childhood.

BACKGROUND: The relationship between atopy, asthma, and eosinophilic inflammation is less clear in early childhood than later in life. OBJECTIVE: We sought to determine the relationships between asthma, atopy, and serum eosinophil cationic protein (ECP), a biomarker of eosinophil activation, in 6-year-old children. METHODS: Serum ECP levels were available from 968 six-year-old children who were part of a longitudinal birth cohort being assessed for asthma and atopy. Detailed clinical history and examination, lung function testing, methacholine challenge, and skin prick testing to 4 common allergens were undertaken. Subgroups of the children were compared by using t tests, ANOVA, chi 2 tests, and regression analysis. RESULTS: One hundred ninety-one (19.7%) children had current asthma, with 114 (59.7%) of these being atopic. The mean serum ECP level for the entire group was 18.0 mug/L (range, 2.0-146.0 mug/L), with no difference between male and female patients. Serum ECP was higher in atopic children (20.5 +/- 18.4), those with asthma (22.4 +/- 19.6), and those with asthma and atopy (26.6 +/- 22.4; all P < .001 compared with children with no asthma or atopy [16.1 +/- 15.9]). Serum ECP levels were highest in children with severe asthma ( P < .001), especially in those with concurrent atopy. Severity of atopy, judged on the basis of wheal size or derived variables combining wheal size and the number of positive skin tests, was a major determinant of serum ECP. Heightened methacholine responsiveness was not associated with increased serum ECP levels. CONCLUSION: The higher serum ECP levels seen in 6-year-old children with current asthma and more severe atopy suggest that atopy and eosinophilic inflammation are important in driving this clinical phenotype and that this might represent asthma that persists.

Asthma↗

Maternal atopy and parity.

BACKGROUND: Family size and high birth order were related to the prevalence of hayfever and positive skin prick test. However, this association may be explained by maternal atopy. We examined the relationship between maternal atopy and the number of offspring in three European cohorts of pregnant women. METHODS: The mothers and their children (n = 1487) were recruited for the Asthma Multi-centre Infants Cohort Study (AMICS). The three concurrent cohorts (Ashford, Kent (UK); Menorca island (Spain) and Barcelona city (Spain) followed the same research protocol. Maternal and paternal atopy was identified by skin prick tests at different times at the three centres. RESULTS: Maternal atopy was inversely related to the number of offspring, an association which occurred in each of the three cohorts and remained when atopy was defined separately for individual allergens (a positive response to testing with either Der p 1 or grass pollen) and which was not confounded by maternal age, smoking nor social class (the adjusted odds ratios were 0.71, 0.79 and 0.26 for increasing number of offspring, P = 0.002). Neither maternal asthma (P = 0.43) nor paternal atopy (P = 0.58) were associated with the number of offspring. Maternal atopy was not related to reproductive outcomes. CONCLUSIONS: The association between maternal atopy and parity challenges the role of family size on child atopy, which should be studied in other populations.

Adult↗

Atopy patch test reactions to house dust mites in patients with scabies.

It is well known that the house dust and the scabies mites are related phylogenetically. We therefore performed atopy patch tests with house dust mite antigens (Dermatophagoides pteronyssinus (Dp) and/or Dermatophagoides farinae (Df)) in scabies patients without atopy and healthy controls. We studied 25 men with active scabies and 25 healthy controls. Skin prick tests with standardized house dust mite extract were performed for all patients and controls. An intradermal test procedure was carried out in skin prick test-negative patients, and for controls showing positive atopy patch test to Dp and/or Df. While atopy patch tests were performed directly in all healthy controls, patients with scabies were first treated and on the next day, atopy patch tests were performed. Twenty-two of 25 patients with scabies (88%) had skin prick test and/or intradermal test positivity against house dust mites, whereas 17/25 patients (68%) had atopy patch test positivity against house dust mites (Dp and/or Df). There was no statistically significant difference between skin prick test and/or intradermal test positivity and atopy patch test positivity in a regression analysis (p=0.222). The only statistically significant correlation was between atopy patch test positivity and the extent of scabies involvement (p<0.05). Only few of the healthy controls had positive tests. In this study, we have shown that a positive atopy patch test to house dust mite antigens is not specific for patients with atopic dermatitis, but also occurs in scabies patients without a history of atopic dermatitis.

Adult↗

Familial atopy in Australian pedigrees: adventitious linkage to chromosome 8 is not confirmed nor is there evidence of linkage to the high affinity IgE receptor.

Atopy frequently displays autosomal dominant inheritance and recent studies have favoured genetic linkage between atopy and the human chromosome 11q13. We have studied 12 extended families with aggregation of atopy consistent with autosomal dominant inheritance. The families have been studied for linkage of asthma and atopy to loci on chromosome 8p following the observation that one family suggested preliminary evidence of linkage to an anonymous hypervariable locus cloned from a DNA fingerprint and mapped to 8pter-p22. Subsequent analysis shows this putative linkage to be adventitious as the remaining 11 families do not support linkage between atopy and 8p. We have analysed the same families for evidence of linkage of atopy to loci on 11q13. In these families there is no evidence of association between atopy and the 11q loci stronger than that expected by chance alone; furthermore there is no suggestion that a subpopulation of these families display linkage between atopy and the loci. In addition neither the 8p loci nor the 11q loci exhibit evidence of linkage to atopy by affected sib-pair analysis. This also conflicts with previously published data for 11q.

Adolescent↗

Airway responsiveness and atopy in families of patients with asthma.

OBJECTIVE: To determine whether there is an increased prevalence and degree of airway hyperresponsiveness (AHR) and atopy in families of patients with asthma. DESIGN: Case-control study. SETTING: Asthma clinic and surrounding community. PATIENTS: A group of 28 families (n = 122) with one member who had attended the asthma clinic and a control group of 28 families (n = 122) from the same community. INTERVENTIONS: Each family member completed a questionnaire and underwent expiratory flow measurement, skin prick tests for allergies, methacholine tests and measurement of total serum IgE level and blood eosinophil count. OUTCOME MEASURES: Presence of atopy and AHR and relations between asymptomatic AHR or asthma and atopy, serum IgE levels or blood eosinophil counts. RESULTS: The group of families with a member with asthma had an increased prevalence of atopy and AHR, lower PC20 methacholine and higher serum IgE levels in comparison with controls, even when the first identified family members with asthma and their matched controls were not included. The subjects with atopy in the group with a patient with asthma had higher atopic indices and serum IgE levels than those in the control group, in whom asymptomatic AHR was less closely related to atopy. There was a significant correlation between PC20 methacholine level and atopic index, between blood eosinophil count and serum IgE level, and between atopic index and serum IgE level, for all groups. The proportion of women with asymptomatic AHR was almost twice as high as that of men. CONCLUSION: First-degree relatives of subjects with asthma have a higher prevalence of AHR, atopy and elevated serum IgE levels than controls from nonasthmatic families. Subjects with atopy in families of patients with asthma have higher atopic indices and degree of AHR than controls with atopy.

Adult↗

Daycare attendance before the age of two protects against atopy in preschool age children.

Early attendance at daycare has been shown to protect against atopy, as defined by a positive skin prick test. One proposed hypothesis for this association is that early exposure to other children protects against atopy by facilitating the spread of infections among children. An alternative hypothesis is that children attending daycare centers have less atopy due to lower levels of exposure to indoor allergens. Our aim was to determine whether attendance at daycare before age 2 years protects against atopy in Australian preschool age children and to test the two alternative hypotheses, as well as a number of potential confounding factors. We conducted a cross-sectional study of children aged 3-5 years living in one humid coastal city (Lismore, n = 286) and one dry, inland city (Wagga Wagga, n = 364) in New South Wales, Australia, in 1995. Atopy was assessed by skin prick tests to six common allergens. Daycare attendance and other possible risk factors for atopy were measured by a parent-completed questionnaire. Children who attended daycare before age 2 years had a reduced risk of atopy at 3-5 years. The greatest effect was seen in children who attended a daycare center (odds ratio (OR), 0.26; 95% CI, 0.14-0.50) rather than family daycare (OR, 0.66; 95% CI, 0.41-1.04). The results of this study do not support either of the proposed hypotheses, nor can the effect be explained by any of the other potential confounders measured. Further work is needed to determine the exposure that is responsible for the protective effect of daycare attendance on atopy.

Age Factors↗