Problemi correnti
Asma: il gatto fa bene, il latte materno fa male?
EFFECTS OF EXPOSURE TO CAT AND TO BREAST MILK ON DEVELOPMENT OF ASTHMA: NEW EVIDENCE ON OLD DILEMMAS
GIORGIO LONGO1, FRANCO PANIZON2
1Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
2Professore Emerito, Dipartimento di Scienze della Rirpoduzione e dello Sviluppo, Università di Trieste
Gennaio 2003 - pagg. 35 -41
Abstract
A series of cross sectional and prospective studies have shown that, differently from older beliefs,
early exposure to cat has a protective effect on the development of allergy and asthma
in adult age. This effect, which is true for high and low concentration of cat antigens but not
for the intermediate ones has two possible explanations: the induction of tolerance or the
coexistence of cat allergens with bacterial endotoxins which are able to shift the immunological
balance towards Th1 response. Recent studies have also shown that breastfeeding is associated
to higher risk of developing allergy and asthma in adult life, but this evidence is conflicting
with protective effects shown in the first years of life. The biological rationale of these
conflicting effects is still obscure.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
Cani e gatti
1. Murray CS, Woodcock A, Custovic A. The role of indoor allergen exposure in the development of sensitization and asthma. Curr Opin Allergy Clin Immunol. 2001;1(5):407-12.
2. Wahn U, Lau S, Bergmann R, Kulig M, et al. Indoor allergen exposure is a risk factor for sensitization during the first three years of life. J Allergy Clin Immunol 1997 Jun;99(6 Pt 1):763-9.
3. Lau S, Illi S, Sommerfeld C, Niggemann B, Bergmann R, von Mutius E, Wahn U. Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study. Multicentre Allergy Study Group. Lancet 2000;356(9239):1392-7.
4. Hesselmar R, Aberg N, Aberg B, et al. Does early exposure to cat or dog protect against later allergy development? Clin Exp Allergy 1999;29:611.
5. Roost HP, Kunzli N, Schindler C, et al. Role of current and childhood exposure to cat and atopic sensitization. J Allergy Clin Immunol 1999;26:211.
6. Nafstad P, Magnus P, Gaarder PI, Jaakkola JJK. Exposure to pets and atopy-related diseases in the first 4 years of life. Allergy 2001;36: 307.
7. Remes ST, Castro-Rodriguez JA, Holberg CJ, et al. Dog exposure in infancy decreases the subsequent risk of frequent wheeze but not of atopy. J Allergy Clin Immunol 2001;108: 509.
8. Custovic A, Hallam CL, Simpson BM, et al. Decreased prevalence of sensitization to cats with high exposure to cat allergen. J Allergy Clin Immunol 2001:108:537.
9. Ownby DR, Exposure to cats and dogs during the first year of life reduces atopy and improve lung function in boys. ATS 2001, San Francisco. 97° Internat Conference, Abst 126228.
10. Platts-Mills TEA, Vaughan J, Squillace S, et al. Sensitization, asthma, and a modified Th2 response in children exposed to cat allergen: a population-based cross-sectional study. Lancet 2001;357:752.
11. Platt-Mills TAE, Perzanowski M, Woodfolk JA, Lunback B. Relevance of early or current pet ownership to the prevalence of allergic disease. Clin Exp Allergy 2002;32:335.
12. Anyo G, Brunekreef B, de Meer G, et al. Early, current and past per ownership: associations with sensitization, bronchial responsivness and allergic symptoms in school children. Clin Exp Allergy 2002;32:361.
13. Marks GB. What should we tell allergic families about pets? J Allergy Clin Immunol 2001;108:500.
14. Gereda JB, Leung DYM, Tathayatikon A, et al. Relation between house-dust endotoxin exposure, type 1 cell development, and allergen sensitisation in infants at high risk of asthma. Lancet 2000;355:1680.
15. Reed CE, Milton DK. Endotoxin-stimulated innate immunity: a contributing factor for asthma. J Allergy Clin Immunol 2001;108:157.
16. Almqvist C, Wickman M, Perfetti L, et al. Worsening of asthma in children allergic to cats after indirect exposure to cat at school. Amer J Respir Crit Care Med 2001;163:694.
17. Wan H, Winton HL, Soeller C, et al. Der p1 facilitates transepithelial allergen delivery by disruption of tight junctions. J Clin Invest 1999;104(1):123-33. Latte
18. Blair H. Natural history of childhood asthma 20 years follow up. Arch Dis Child 1977; 52:613.
19. McConockie KM, Roghmann KJ. Breastfeeding and maternal smocking as predictors of wheezing in children ages 6 to 10 years. Pediatr Pulmonol 1986;2:260.
20. Saarinen UM, Kajosaari M. Breast-feeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet 1995;346:1065.
21. Wright AL, Holbrg CJ, Taussig LM, Martinez FD. Relationship of infant feeding to recurrent wheezing at age 6 years. Arch Padiatr Adolesc Med 1995;149:758.
22. Zeiger RS, Heller S. The development and prediction of atopy in high-risk children: follow- up at age seven years in a prospective randomized study of combined maternal and infant food allergen avoidance. J Allergy Clin Immunol 1995;95:1179.
23. Vandenplas Y. Myths and facts about breastfeeding. Does it prevent later atopic disease? Acta Paediatr 1997;86:1283.
24. Gdalevich M, Mimouni D, Mimouni M. Breast-feeding and the risk of bronchial asthma in childhood: a systematic review with meta- analysis of prospective studies. J Pediatr 2001;139(2):261-6.
25. Rusconi F, Galassi C, Corbo GM, et al. Risk factors for early, persistent, and late-onset wheezing in young children. Am J Respir Crit Care Med 1999;160:1617.
26. Wright AQJ, Holberg CJ, Taussig LM, Martinez FD. Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood. Thorax 2001;56:192.
27. Wright AL, Sherrill D, Holberg J, et al. Breast-feeding, maternal IgE, and total serum IgE in childhood. J Allergy Clin Immunol 1999;104:589.
28. Boettcher MF, Jenmalm MC, Garofalo RP, et al. Cytokines in breast milk from allergic and nonallergic mothers. Pediatric Research 2000;47:157.
29. Hansen AE. Serum lipids in eczema and other pathologic conditions. Am J Dis Child 1937;53:933.
30. Galli E, Picardo M, Chini L, et al. Analysis of polyunsaturated fatty acid in newborn sere: a screeening tool for atopic disease? Br J Dermatol 1994;130:755.
31. Yu G, Kijllmenn N-IM, Bjorksten B. Phospholypid fatty acids in cord blood: family history and development of allergy. Acta Paediatr 1996;85:579.
32. Harrobin DF. Fatty acid metabolism in health and disease: the role of Δ-6-desaturasis. Am J Clin Nutr 1993;57:S372.
33. Yu G, Duchen K, Bjorksten B. Fatty acid composition in colostrum and mature milk from non-atopic and atopic mothers during the first 6 months of lactation. Acta Paediatr 1998;87(7):729-36.
34. Wright S, Bolton C. Breastmilk fatty acids in mothers of children with atopic eczema. Br J Nutr 1989;62:693.
35. Businco L, Ioppi M, Morse NL, et al. Breastmilk from mothers of children with newly developed eczema has low levels of long chain polyunsaturated fatty acids. J Allergy Clin Immunol 1993;91:1134.
36. Hamosh M. Atopic disease and milk fatty acid composition. Acta Paediatr 1998;87:719.
37. Sears MR, Greene JM, Willan AR, et al. Long-term relation between breastfeeding and development of atopy and asthma in children and young adults: a longitudinal study. Lancet 2002;360:901.
38. Bergmann RL, Diepgen TL, Kuss O. Breastfeeding duration in a risk factor for atopic eczema. Clin Exp Allergy 2002;32:205.
1. Murray CS, Woodcock A, Custovic A. The role of indoor allergen exposure in the development of sensitization and asthma. Curr Opin Allergy Clin Immunol. 2001;1(5):407-12.
2. Wahn U, Lau S, Bergmann R, Kulig M, et al. Indoor allergen exposure is a risk factor for sensitization during the first three years of life. J Allergy Clin Immunol 1997 Jun;99(6 Pt 1):763-9.
3. Lau S, Illi S, Sommerfeld C, Niggemann B, Bergmann R, von Mutius E, Wahn U. Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study. Multicentre Allergy Study Group. Lancet 2000;356(9239):1392-7.
4. Hesselmar R, Aberg N, Aberg B, et al. Does early exposure to cat or dog protect against later allergy development? Clin Exp Allergy 1999;29:611.
5. Roost HP, Kunzli N, Schindler C, et al. Role of current and childhood exposure to cat and atopic sensitization. J Allergy Clin Immunol 1999;26:211.
6. Nafstad P, Magnus P, Gaarder PI, Jaakkola JJK. Exposure to pets and atopy-related diseases in the first 4 years of life. Allergy 2001;36: 307.
7. Remes ST, Castro-Rodriguez JA, Holberg CJ, et al. Dog exposure in infancy decreases the subsequent risk of frequent wheeze but not of atopy. J Allergy Clin Immunol 2001;108: 509.
8. Custovic A, Hallam CL, Simpson BM, et al. Decreased prevalence of sensitization to cats with high exposure to cat allergen. J Allergy Clin Immunol 2001:108:537.
9. Ownby DR, Exposure to cats and dogs during the first year of life reduces atopy and improve lung function in boys. ATS 2001, San Francisco. 97° Internat Conference, Abst 126228.
10. Platts-Mills TEA, Vaughan J, Squillace S, et al. Sensitization, asthma, and a modified Th2 response in children exposed to cat allergen: a population-based cross-sectional study. Lancet 2001;357:752.
11. Platt-Mills TAE, Perzanowski M, Woodfolk JA, Lunback B. Relevance of early or current pet ownership to the prevalence of allergic disease. Clin Exp Allergy 2002;32:335.
12. Anyo G, Brunekreef B, de Meer G, et al. Early, current and past per ownership: associations with sensitization, bronchial responsivness and allergic symptoms in school children. Clin Exp Allergy 2002;32:361.
13. Marks GB. What should we tell allergic families about pets? J Allergy Clin Immunol 2001;108:500.
14. Gereda JB, Leung DYM, Tathayatikon A, et al. Relation between house-dust endotoxin exposure, type 1 cell development, and allergen sensitisation in infants at high risk of asthma. Lancet 2000;355:1680.
15. Reed CE, Milton DK. Endotoxin-stimulated innate immunity: a contributing factor for asthma. J Allergy Clin Immunol 2001;108:157.
16. Almqvist C, Wickman M, Perfetti L, et al. Worsening of asthma in children allergic to cats after indirect exposure to cat at school. Amer J Respir Crit Care Med 2001;163:694.
17. Wan H, Winton HL, Soeller C, et al. Der p1 facilitates transepithelial allergen delivery by disruption of tight junctions. J Clin Invest 1999;104(1):123-33. Latte
18. Blair H. Natural history of childhood asthma 20 years follow up. Arch Dis Child 1977; 52:613.
19. McConockie KM, Roghmann KJ. Breastfeeding and maternal smocking as predictors of wheezing in children ages 6 to 10 years. Pediatr Pulmonol 1986;2:260.
20. Saarinen UM, Kajosaari M. Breast-feeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet 1995;346:1065.
21. Wright AL, Holbrg CJ, Taussig LM, Martinez FD. Relationship of infant feeding to recurrent wheezing at age 6 years. Arch Padiatr Adolesc Med 1995;149:758.
22. Zeiger RS, Heller S. The development and prediction of atopy in high-risk children: follow- up at age seven years in a prospective randomized study of combined maternal and infant food allergen avoidance. J Allergy Clin Immunol 1995;95:1179.
23. Vandenplas Y. Myths and facts about breastfeeding. Does it prevent later atopic disease? Acta Paediatr 1997;86:1283.
24. Gdalevich M, Mimouni D, Mimouni M. Breast-feeding and the risk of bronchial asthma in childhood: a systematic review with meta- analysis of prospective studies. J Pediatr 2001;139(2):261-6.
25. Rusconi F, Galassi C, Corbo GM, et al. Risk factors for early, persistent, and late-onset wheezing in young children. Am J Respir Crit Care Med 1999;160:1617.
26. Wright AQJ, Holberg CJ, Taussig LM, Martinez FD. Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood. Thorax 2001;56:192.
27. Wright AL, Sherrill D, Holberg J, et al. Breast-feeding, maternal IgE, and total serum IgE in childhood. J Allergy Clin Immunol 1999;104:589.
28. Boettcher MF, Jenmalm MC, Garofalo RP, et al. Cytokines in breast milk from allergic and nonallergic mothers. Pediatric Research 2000;47:157.
29. Hansen AE. Serum lipids in eczema and other pathologic conditions. Am J Dis Child 1937;53:933.
30. Galli E, Picardo M, Chini L, et al. Analysis of polyunsaturated fatty acid in newborn sere: a screeening tool for atopic disease? Br J Dermatol 1994;130:755.
31. Yu G, Kijllmenn N-IM, Bjorksten B. Phospholypid fatty acids in cord blood: family history and development of allergy. Acta Paediatr 1996;85:579.
32. Harrobin DF. Fatty acid metabolism in health and disease: the role of Δ-6-desaturasis. Am J Clin Nutr 1993;57:S372.
33. Yu G, Duchen K, Bjorksten B. Fatty acid composition in colostrum and mature milk from non-atopic and atopic mothers during the first 6 months of lactation. Acta Paediatr 1998;87(7):729-36.
34. Wright S, Bolton C. Breastmilk fatty acids in mothers of children with atopic eczema. Br J Nutr 1989;62:693.
35. Businco L, Ioppi M, Morse NL, et al. Breastmilk from mothers of children with newly developed eczema has low levels of long chain polyunsaturated fatty acids. J Allergy Clin Immunol 1993;91:1134.
36. Hamosh M. Atopic disease and milk fatty acid composition. Acta Paediatr 1998;87:719.
37. Sears MR, Greene JM, Willan AR, et al. Long-term relation between breastfeeding and development of atopy and asthma in children and young adults: a longitudinal study. Lancet 2002;360:901.
38. Bergmann RL, Diepgen TL, Kuss O. Breastfeeding duration in a risk factor for atopic eczema. Clin Exp Allergy 2002;32:205.