How exposures to biologics influence the induction and incidence of asthma

Abstract

A number of environmental factors can affect the development and severity of allergy and asthma; however, it can be argued that the most significant inhaled agents that modulate the development of these conditions are biologics. Sensitization to environmental allergens is an important risk factor for the development of asthma. Innate immune responses are often mediated by receptors on mononuclear cells whose primary ligands arise from microorganisms. Many pathogens, especially viruses, target epithelial cells and affect the host immune response to those pathogens. The acquired immune response to an allergen is influenced by the nature of the innate immune system. Products of innate immune responses to microbes promote T(H)1-acquired responses. In the absence of T(H)1 responses, T(H)2 responses can dominate. Central to T(H)1/T(H)2 balance is the composition of contaminants that derive from microbes. In this review we examine the biology of the response to allergens, viruses, and bacterial products in the context of the development of allergy and asthma.

Figure 1

Biological effects of Der p 1. Reproduced with permission of Blackwell Publishing Ltd. (Sharma et al. 2003).

Figure 2

Viral infection and neuroimmune interactions. Abbreviations: RSV, respiratory syncytial virus; NGF, nerve growth factor; PPT-A, pre-protachykinin A; NK1, neurokinin 1; TRPV, transient receptor potential vanilloid.

Figure 3

LPS recognition system. Abbreviation: LPS, lipopolysaccharide; LBP, lipopolysaccharide binding protein; CD, cluster of differentiation; sCD14, soluble CD14; TLR4, toll-like receptor 4; Mφ, macrophage.