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Published on: August 7, 2017
Maternal allergen exposure as a risk factor for childhood asthma
1UWA School of Pediatrics and Child Health, Princess Margaret Hospital, Perth, WA, Australia. susanp@ichr.uwa.edu.au
Insights
Early allergen exposure during pregnancy does not prevent allergic disease. Other pregnancy exposures significantly influence infant immune development and allergy risk, necessitating further research for effective prevention strategies.
Area of Science:
- Immunology
- Allergy Research
- Pregnancy Studies
Background:
- Rising rates of allergic disease necessitate understanding early life influences.
- Pregnancy allergen exposure has been investigated for disease prevention with limited success.
- Fetal allergen exposure appears physiological, not a direct risk factor for allergic disease.
Purpose of the Study:
- To evaluate the impact of in-utero allergen exposure on allergic disease development.
- To explore alternative pregnancy exposures influencing immune development and allergy risk.
- To identify critical early developmental periods for allergy prevention strategies.
Main Methods:
- Review of existing literature on fetal allergen exposure and neonatal immune responses.
- Analysis of correlations between maternal allergen exposure and infant allergic outcomes.
- Examination of evidence for other prenatal exposures affecting immune system development.
Main Results:
- Strategies to reduce allergen exposure in pregnancy have yielded disappointing results.
- Fetal allergen exposure is likely physiological and not a risk factor for allergic disease.
- Neonatal allergen-specific responses are inconsistent and do not correlate strongly with maternal exposure.
- Other pregnancy exposures significantly impact immune development and allergy risk.
Conclusions:
- In-utero allergen avoidance is not an effective strategy for preventing allergic disease.
- Prenatal environmental factors beyond direct allergen exposure play a crucial role in immune programming.
- Further research into early developmental events is vital for developing novel allergy prevention methods.
Abstract:
The role of early allergen exposure has been a central focus in the effort to curtail the rising rates of allergic disease. Exposures in pregnancy have been of interest because the first signs of disease are often seen in early infancy. However, so far, strategies to avoid or reduce allergen exposure in pregnancy have had disappointing results in reducing disease. Although there is growing evidence that the fetus is exposed to allergens, this appears to be physiologic and not a risk factor for allergic disease. It is still not clear if this exposure has some role in the context of normal tolerance. Although infants who later develop allergic disease show some differences in neonatal allergen-specific responses, these are not consistent. Furthermore, the magnitude and frequency of responses do not correlate well with maternal allergen exposure, and it now seems likely that these responses do not reflect true immunologic "memory." Despite this, there is accumulating evidence that a number of other exposures in pregnancy have the capacity to significantly influence immune development and alter the risk for allergic responses to allergens. This underscores the importance of further defining the events in this early period, to determine causal pathways and better strategies for prevention.
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