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. 2023 Feb;11(2):591-601.
doi: 10.1016/j.jaip.2022.10.035. Epub 2022 Nov 7.

Continuous Rather Than Solely Early Farm Exposure Protects From Hay Fever Development

Sonali Pechlivanis  1 , Martin Depner  2 , Pirkka V Kirjavainen  3 , Caroline Roduit  4 , Martin Täubel  5 , Remo Frei  6 , Chrysanthi Skevaki  7 , Alexander Hose  8 , Cindy Barnig  9 , Elisabeth Schmausser-Hechfellner  2 , Markus J Ege  10 , Bianca Schaub  11 , Amandine Divaret-Chauveau  12 , Roger Lauener  13 , Anne M Karvonen  5 , Juha Pekkanen  14 , Josef Riedler  15 , Sabina Illi  2 , Erika von Mutius  10 ; PASTURE Study Group
Collaborators, Affiliations

Continuous Rather Than Solely Early Farm Exposure Protects From Hay Fever Development

Sonali Pechlivanis et al. J Allergy Clin Immunol Pract. 2023 Feb.

Abstract

Background: An important window of opportunity for early-life exposures has been proposed for the development of atopic eczema and asthma.

Objective: However, it is unknown whether hay fever with a peak incidence around late school age to adolescence is similarly determined very early in life.

Methods: In the Protection against Allergy-Study in Rural Environments (PASTURE) birth cohort potentially relevant exposures such as farm milk consumption and exposure to animal sheds were assessed at multiple time points from infancy to age 10.5 years and classified by repeated measure latent class analyses (n = 769). Fecal samples at ages 2 and 12 months were sequenced by 16S rRNA. Hay fever was defined by parent-reported symptoms and/or physician's diagnosis of hay fever in the last 12 months using questionnaires at 10.5 years.

Results: Farm children had half the risk of hay fever at 10.5 years (adjusted odds ratio [aOR] 0.50; 95% CI 0.31-0.79) than that of nonfarm children. Whereas early life events such as gut microbiome richness at 12 months (aOR 0.66; 95% CI 0.46-0.96) and exposure to animal sheds in the first 3 years of life (aOR 0.26; 95% CI 0.06-1.15) were determinants of hay fever, the continuous consumption of farm milk from infancy up to school age was necessary to exert the protective effect (aOR 0.35; 95% CI 0.17-0.72).

Conclusions: While early life events determine the risk of subsequent hay fever, continuous exposure is necessary to achieve protection. These findings argue against the notion that only early life exposures set long-lasting trajectories.

Keywords: Animal sheds; Childhood; Farm milk; Farming; Gut microbiome; Hay fever.

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Figures

None
© Jemastock/ stock.adobe.com, © Fernando/ stock.adobe.com, © さしみ (sashimi)/ stock.adobe.com
Figure 1
Figure 1
Types of exposure classes. Solution for repeated measure latent classes defined by different exposures, which are (A) exposure to animal sheds and (B) farm milk consumption in the PASTURE children. Numbers in parentheses indicate the total number of children in each class.
Figure 2
Figure 2
Associations of farm milk exposure classes with hay fever at 10.5 years. Models are adjusted for centers, growing up on a farm, and parental atopy. The forest plot represents the aOR with 95% CI.
Figure 3
Figure 3
Association of gut microbiome richness, and Shannon index at months 2 (hay fever/total: 59/439) and 12 (hay fever/total: 79/633) with hay fever at 10.5 years. Models are adjusted for centers, growing up on a farm, and parental atopy. The association with hay fever is shown as aOR per interquartile range of the probability along with 95% CI.
Figure 4
Figure 4
Association of consumption of farm milk (n = 624), consumption of processed milk (n = 624), and exposure to animal sheds (n = 617) with richness at 12 months. Models are adjusted for centers, growing up on a farm, and parental atopy. The forest plot represents the aGMRs with 95% CI.
Figure 5
Figure 5
Mediation analysis of the protective effect of consumption of farm milk and exposure to animal sheds in infancy on hay fever mediated by gut microbiome richness at 12 months adjusting for centers (n = 466). The figure shows the direct (β1), indirect (β2), and total (β) effects as well as their respective 95% CI from the path model. The proportion of the mediated (indirect) effect was 18.4%.
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References

    1. World Allergy Organization (WAO) 2021. World Allergy Week 2016. Pollen Allergies—Adapting to a Changing Climate.https://www.worldallergy.org/UserFiles/file/waw16-slide-set.pdf Accessed October 12, 2022.
    1. Tkacz J.P., Rance K., Waddell D., Aagren M., Hammerby E. Real-world evidence costs of allergic rhinitis and allergy immunotherapy in the commercially insured United States population. Curr Med Res Opin. 2021;37:957–965. - PubMed
    1. Zuberbier T., Lotvall J., Simoens S., Subramanian S.V., Church M.K. Economic burden of inadequate management of allergic diseases in the European Union: a GA(2) LEN review. Allergy. 2014;69:1275–1279. - PubMed
    1. von Mutius E., Vercelli D. Farm living: effects on childhood asthma and allergy. Nat Rev Immunol. 2010;10:861–868. - PubMed
    1. Genuneit J. Exposure to farming environments in childhood and asthma and wheeze in rural populations: a systematic review with meta-analysis. Pediatr Allergy Immunol. 2012;23:509–518. - PubMed

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