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Review
. 2020 Dec;75(12):3077-3086.
doi: 10.1111/all.14624. Epub 2020 Oct 30.

Advances and novel developments in environmental influences on the development of atopic diseases

Affiliations
Review

Advances and novel developments in environmental influences on the development of atopic diseases

Shifaa Suhayl Alkotob et al. Allergy. 2020 Dec.

Abstract

Although genetic factors play a role in the etiology of atopic disease, the rapid increases in the prevalence of these diseases over the last few decades suggest that environmental, rather than genetic factors are the driving force behind the increasing prevalence. In modern societies, there is increased time spent indoors, use of antibiotics, and consumption of processed foods and decreased contact with farm animals and pets, which limit exposure to environmental allergens, infectious parasitic worms, and microbes. The lack of exposure to these factors is thought to prevent proper education and training of the immune system. Increased industrialization and urbanization have brought about increases in organic and inorganic pollutants. In addition, Caesarian birth, birth order, increased use of soaps and detergents, tobacco smoke exposure and psychosomatic factors are other factors that have been associated with increased rate of allergic diseases. Here, we review current knowledge on the environmental factors that have been shown to affect the development of allergic diseases and the recent developments in the field.

Keywords: allergy; atopic disease; environment; exposome; pollution.

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Conflict of interest statement

Conflict of Interest:

Shifaa Alkotob, Vanitha Sampath, Cade Cannedy, Katharina Harter, Hesam Movassagh, Qi Zhao, Bibek Paudel, Mary Prunicki, Eric Smith, and Tamara Schikowski declare no conflict of interest. Claudia Traidl-Hoffmann reports grants for research and development of CK-CARE, Sebapharma, Töpfer, Traidl-Hoffmann is involved in Clinical trials with Assana; Data and Safety Monitoring Board member at Novartis Personal fees from Novartis, Töpfer, Sebapharma; Consultant and Advisory Board Member at Novartis, Sanofi, Lilly Pharma; Dr. Nadeau reports grants from National Institute of Allergy and Infectious Diseases (NIAID), National Heart, Lung, and Blood Institute (NHLBI), and National Institute of Environmental Health Sciences (NIEHS); Food Allergy Research & Education (FARE), Director of World Allergy Organization (WAO) Center of Excellence at Stanford; Advisor at Cour Pharma; Co-founder of Before Brands, Alladapt, Latitude, and IgGenix; National Scientific Committee member at Immune Tolerance Network (ITN) and National Institutes of Health (NIH) clinical research centers; DSMB member for NHLBI, US patents for basophil testing, multifood immunotherapy and prevention, monoclonal antibody from plasmoblasts, and device for diagnostics.

Figures

Figure 1:
Figure 1:
A number of environmental factors affect the development of allergy and tolerance in infants. The hygiene hypothesis suggests that increased hygiene and lack of exposure to microbes and parasitic infections at an early age prevents the necessary stimulus to train the developing immune system to develop tolerogenic responses. In modern societies, there is increased time spent indoors, use of antibiotics, and decreased contact with farm animals and pets, which limit exposure to environmental allergens, infectious parasitic worms, and microbes
Figure 2:
Figure 2:
High throughput omics technologies enable generation of large amounts of data that are analyzed and interpreted by sophisticated bioinformatics and computational tools to give us mechanistic information on immune pathways at the DNA, RNA, and protein level. This can allow for personalized medicine.

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