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Published on: August 7, 2017
Early-life environment, developmental immunotoxicology, and the risk of pediatric allergic disease including asthma
Rodney R Dietert1, Judith T Zelikoff
1Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA. rrd1@cornell.edu
Insights
Environmental exposures during early development can cause immune system dysfunction, increasing the risk of childhood allergic diseases like asthma. Identifying and minimizing these exposures is crucial for prevention.
Area of Science:
- Environmental Health
- Immunology
- Pediatrics
Background:
- Childhood allergic diseases, including asthma, have increased significantly since the mid-20th century, largely due to environmental factors impacting the immune system.
- Allergic diseases are considered early-life conditions, with development influenced by prenatal and early postnatal exposures.
- Developmental immunotoxicity (DIT) describes adverse immune outcomes from exposure to environmental factors during critical developmental windows.
Purpose of the Study:
- To review critical developmental windows of immune system vulnerability to environmental exposures.
- To present a model of DIT-induced immune dysfunction skewed towards allergic disease (AD).
- To highlight the lack of safety testing for drugs and chemicals regarding DIT hazards.
Main Methods:
- Literature review focusing on developmental immunotoxicity and childhood allergic diseases.
- Analysis of prenatal and perinatal risk factors contributing to immune dysfunction.
- Examination of the influence of diet and microbial exposures on immune maturation and allergy risk.
Main Results:
- Identified prenatal-perinatal risk factors include maternal smoking, environmental tobacco smoke, traffic-related particles, heavy metals, antibiotics, endocrine disruptors, and alcohol.
- Diet and microbial exposures significantly impact immune system development and allergy risk.
- The period from mid-gestation to two years post-birth is a critical window for DIT and allergic disease-asthma (AD-A) risk.
Conclusions:
- Early-life environmental exposures can lead to DIT, resulting in immune dysfunction and increased risk of childhood allergic diseases.
- There is a need for improved safety testing of chemicals and drugs to identify DIT hazards for pregnant women and children.
- Minimizing exposure to identified risk factors during critical developmental periods is essential for preventing allergic diseases.
Abstract:
Incidence of childhood allergic disease including asthma (AD-A) has risen since the mid-20th century with much of the increase linked to changes in environment affecting the immune system. Childhood allergy is an early life disease where predisposing environmental exposures, sensitization, and onset of symptoms all occur before adulthood. Predisposition toward allergic disease (AD) is among the constellation of adverse outcomes following developmental immunotoxicity (DIT; problematic exposure of the developing immune system to xenobiotics and physical environmental factors). Because novel immune maturation events occur in early life, and the pregnancy state itself imposes certain restrictions on immune functional development, the period from mid-gestation until 2 years after birth is one of particular concern relative to DIT and AD-A. Several prenatal-perinatal risk factors have been identified as contributing to a DIT-mediated immune dysfunction and increased risk of AD. These include maternal smoking, environmental tobacco smoke, diesel exhaust and traffic-related particles, heavy metals, antibiotics, environmental estrogens and other endocrine disruptors, and alcohol. Diet and microbial exposure also significantly influence immune maturation and risk of allergy. This review considers (1) the critical developmental windows of vulnerability for the immune system that appear to be targets for risk of AD, (2) a model in which the immune system of the DIT-affected infant exhibits immune dysfunction skewed toward AD, and (3) the lack of allergy-relevant safety testing of drugs and chemicals that could identify DIT hazards and minimize problematic exposure of pregnant women and children.
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