Allergy, Immunity and Tolerance in Early Childhood

The First Steps of the Atopic March

1st Edition - September 10, 2015
Imprint: Academic Press
Editors: Hans Ulrich Wahn, Hugh A. Sampson
Language: English
Hardback ISBN:
9 7 8 - 0 - 1 2 - 4 2 0 2 2 6 - 9
eBook ISBN:
9 7 8 - 0 - 1 2 - 7 9 9 9 3 0 - 2

Allergy, Immunity and Tolerance in Early Childhood: The First Steps of the Atopic March provides valuable insights on the atopic diseases, including asthma, allergic rhinitis,… Read more

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Allergy, Immunity and Tolerance in Early Childhood: The First Steps of the Atopic March
provides valuable insights on the atopic diseases, including asthma, allergic rhinitis, atopic dermatitis, and food allergies, which have developed into major health problems in most parts of the world.

As the natural history of these chronic diseases has been extensively studied, including their major genetic, environmental, and lifestyle determinants and potential protective factors, the book presents tactics on how pediatric allergists can provide early intervention. In addition, the book unites key, global experts in the field who summarize their collective, and current, knowledge of the early stage of the "Atopic March", along with novel ideas for potential options of prevention.

List of Contributors
Introduction
1. The Maturation of Immune Function in Pregnancy and Early Childhood
- Introduction
- Immune development in health and disease
- Interplay of innate and adaptive immune regulation in organ-specific responses
- Key influences and determinants of early immune function and regulation
- Modulating early immune development to promote immune regulation
- Conclusion
2. Immunological Aspects of the Atopic March
- Introduction
- Global inventory of the developmental pattern of allergen-specific antibody
- Tentative interpretation of phases observed in the serological picture
- The trends of IgE levels to allergenic sources
- Immunoglobulin E trends examined at a molecular level
- Discussion
3. Atopic Dermatitis in Infancy and Childhood
- Definition
- Family history and genetics
- Natural history of disease
- Allergic sensitization and allergy as comorbidity
- Rhinitis and asthma as comorbidity
- Urticaria as comorbidity
- Determinants of the disease
- Key elements of treatment
- Prevention
- Long-term outcome in adulthood
4. Adverse Reactions to Food
- Clinical presentation of food allergy in infancy
- Epidemiology and natural course
- Pathogenesis
- Diagnostic
- Therapy
- Immunotherapy for food allergy
5. Viral-Induced Wheeze and Asthma Development
- Introduction
- Longitudinal studies of childhood wheezing
- Etiology of wheezing illnesses in infancy
- Risk factors for virus-induced wheezing
- Progression from virus-induced wheezing to asthma
- Do severe viral respiratory infections in infancy cause asthma?
- Conclusions
6. Infantile Lung Function and Airway Hyperresponsiveness
- Introduction
- Lung development
- Lung function measurements
- Lung function development
- Postnatal impact on lung function development
- Factors that may influence in utero lung function development
- Infantile AHR
- Summary and conclusion
7. The Development of Allergic Rhinitis in Childhood
- Incidence
- Period prevalence
- Sex differences
- Comorbidity
- The role of sensitization
- Early predictors
- Protective factors
- Principles of therapy
- Options for prevention
8. Genes and Atopic Phenotypes
- Introduction
- Tools for disentangling the genetics of atopy
- Do genes co-associated with multiple childhood atopy phenotypes represent atopic march candidate genes?
- Summary and conclusions
9. Epigenetic Factors Before and After Birth
- Introduction
- Principles of epigenetic mechanisms
- Epigenetics in T-cell development as a decisive mechanism for allergy development
- Epigenetic control in fetal immune development
- Environmental factors and epigenetic modifications in early allergy development
- Allergens as triggers for Th2 responses are associated with epigenetic modifications in target cells
- Microbes in the human environment are capable to protect against allergy development via epigenetic mechanisms
- Airborne, xenobiotic exposures act though epigenetic modulation and enhance early allergic development
- Dietary and metabolic factors are capable to modify epigenetic programs
- Conclusion
- Abbreviations
10. The Physiological Induction of Tolerance to Allergens
- Introduction
- Mechanisms of oral tolerance
- Mechanisms of airway tolerance
- Mechanisms of action of iTreg in mediating oral and airway tolerance
- Early-life exposures can influence immune programming of tolerance
- Summary
11. Microbiome and the Effect on Immune Response
- Introduction
- Coevolutionary interdependency of the microbiome and the immune system
- Microbiome acquisition and development
- Effects of the microbiome on immune development
- Influence of the microbiome on allergy development
- Future perspectives
12. Indoor Allergen Exposure
- Pet exposure
- Preventive measures reducing pet allergen exposure
- House dust mite
- House dust mite avoidance
- Cockroaches
- Molds
- Other allergens
- Summary
13. Microbial Influences on the Development of Atopy
14. Role of Vaccines
- Introduction
- Allergens that may be contained in vaccines
- Allergic immune responses to vaccines
- Immunization and development of allergy
- Considerations for some specific vaccines
- Diagnostic aspects
- Identification of patients at heightened risk
- Immunization of patients at heightened risk
- Conclusion
15. Breast—Always Best?
- Introduction
- Historical aspects
- Challenges with studies
- Evidence for breastfeeding in allergy prevention
- Possible mechanisms by which breastfeeding may protect against allergies
- Impact of maternal interventions during breastfeeding on prevention of allergy
- Conclusions
- Abbreviations
16. Dietary Interventions in Infancy
- Introduction
- The gut, the diet, and oral tolerance in early life
- Allergens in the diet: from avoidance toward tolerance induction
- Immunomodulation via dietary interventions
- Conclusion
- Abbreviations
17. Allergen Exposure and Avoidance as Part of Early Intervention and Prevention
- Allergen avoidance
- Allergen exposure, sensitization, and disease
- House dust mite allergen avoidance in primary prevention
- Avoidance of other allergens
- Why environmental allergen avoidance in primary prevention is not effective
- Secondary avoidance
- Studies involving moving patients to a sanatorium or hospital
- Secondary allergen avoidance by making changes in the patient’s own home
18. Pharmacotherapies Early in Life to Prevent the Atopic March
- Introduction
- Adverse effects of pharmacotherapies on allergy outcomes
- Prevention strategies
- Conclusions
19. The Role of Antiviral Strategies for the Prevention of Childhood Asthma
- Introduction/Background
- General antiviral strategies to consider
- Lessons learned from antiviral strategies focused on RSV
- Antiviral strategies for rhinovirus
- Specific antivirals
- Asthma exacerbations provoked by rhinovirus in the atopic population
- Conclusions
20. Prevention of Allergy/Asthma—New Strategies
- Introduction
- Asthma initiation during childhood
21. Antiallergic Strategies: Induction of Tolerance to Food
- Introduction
- Definition of oral tolerance
- Immunological mechanisms of oral tolerance
- Clinical phenotypes of oral tolerance
- Risk and protective factors for food allergy
- Tolerance induction in the prevention of food allergy
- Allergen-specific immunotherapy in the management of food allergy
- Conclusion
Index

Hans Ulrich Wahn

1970 Graduation at University of Heidelberg, MD-thesis

1971 - 1972 Postdoc at German Cancer Research Institute, Heidelberg

1972 - 1978 Clinical Training for Pediatrics and Allergology at University Children’s Hospital Heidelberg

1978 - 1979 Research Fellow at National Institutes of Health (Clinical Immunology Section) in Bethesda, USA

1979 - 1981 University Children’s Hospital, Heidelberg Habilitation (Member of the Faculty) Heidelberg, Senior Staff, Member at Children’s Hospital Ruhr-University Bochum

1986 - 1998 Professor for Pediatric Pneumology and Immunology (C3) at Children’s Hospital of Free University Berlin, Chief of Pediatric Pneumology Department, Chest Clinic Heckeshorn

1998 - 2012 Chair and Head of the department für Pediatric Pneumology and Immunology (C4), Charité, Berlin

Functions:

2003 - 2005 President of the European Academy of Allergy and Clinical Immunology

2003 - 2007 Associate Editor: European Respiratory Journal

2003 - 2009 Fachkollegiat of the Deutsche Forschungsgemeinschaft

2010 - 2012 Labor Berlin, Director for Allergy and Immunology

From 2010 Chief Editor: Pediatric Allergy and Immunology (PAI)

Publications: 450 original papers in peer reviewed journals, 30 books/book chapters

Affiliations and expertise

Chief Editor, Pediatric Allergy and Immunology, Charite - Ped. Pneumology and Immunology, Berlin, Germany

Hugh A. Sampson

Hugh A Sampson, MD, is the Kurt Hirschhorn Professor of Pediatrics, the Dean for Translational Biomedical Sciences, PI and Director of Conduits; Institutes for Translational Sciences (CTSA), and the Director of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai in New York City. Dr. Sampson completed his allergy/immunology fellowship training at Duke University in 1980 and was a faculty member in the Division of Allergy/Immunology at Duke University and then Johns Hopkins University before coming to Mount Sinai. Dr. Sampson’s research interests have focused primarily on food allergic disorders including the immunopathogenic role of food hypersensitivity in atopic dermatitis and anaphylaxis, characterization of food allergens, and improved diagnostic tests and immunotherapeutic strategies for treating food allergies. Dr. Sampson is the PI of the NIH-sponsored Consortium on Food Allergy Research and an AADCRC program project conducting a number of clinical trials investigating novel therapies for the treatment of food allergy and investigating basic immunologic mechanisms associated with desensitization and the eventual development of tolerance. He has published over 400 articles and 60 book chapters on food allergic disorders and co-edited four books, and was elected to membership in the Institute of Medicine of the National Academies in 2003 for his research in food allergies. Dr. Sampson is past chairman of the Section on Allergy & Immunology of the American Academy of Pediatrics and the past-president of the American Academy of Allergy, Asthma and Immunology.

Affiliations and expertise

Mount Sinai School of Medicine, New York, NY, USA

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