Environmental conditions, immunologic phenotypes, atopy, and asthma: New evidence of how the hygiene hypothesis operates in Latin America

Camila Alexandrina Figueiredo; Leila D. Amorim; Neuza M. Alcantara-Neves; Sheila M.A. Matos; Philip Cooper; Laura C. Rodrigues; Mauricio L. Barreto

doi:10.1016/j.jaci.2013.01.016

Environmental conditions, immunologic phenotypes, atopy, and asthma: New evidence of how the hygiene hypothesis operates in Latin America

Camila Alexandrina Figueiredo, Leila D. Amorim, Neuza M. Alcantara-Neves, Sheila M.A. Matos, Philip Cooper, Laura C. Rodrigues, Mauricio L. Barreto

Tropical Disease Biology

Liverpool School of Tropical Medicine

Research output: Contribution to journal › Article › peer-review

39 Citations (Scopus)

Abstract

Background

It has been proposed that improved hygiene and reduced experience of infections in childhood influences the development of allergic diseases. The mechanisms by which the hygiene operates are not well established but are underpinned by two apparently incompatible immunologic paradigms, the balance of TH1 versus TH2 cytokines and IL-10–mediated regulation of TH2 cytokines.

Objective

This study defined immunologic phenotypes with the use of latent class analysis and investigated their associations with environmental factors, markers of allergy and asthma, in a Latin American population.

Methods

We studied 1127 children living in urban Brazil. Data on wheeze and environmental exposures were collected with standardized questionnaires. Atopy was measured by specific IgE in serum and skin prick test reactivity to aeroallergens. Cytokines were measured in culture after the stimulation of peripheral blood leukocytes with mitogen. Infections with pathogens were assessed by serology and stool examinations. Children were classified as having high or low burden of infection. Latent class analysis was used to identify immune phenotypes on the basis of cytokine production. Logistic regression was used to evaluate the adjusted effects of environment and burden of infection on the immunologic phenotypes and the effect of the phenotypes on atopy and asthma.

Results

Three phenotypes were identified, labeled underresponsive, intermediate, and responsive. Children of more educated mothers, living in improved environmental conditions, and with a low burden of infection were significantly more likely to have the responsive phenotype. The responsive phenotype was significantly associated with an increased prevalence of atopy but not asthma.

Conclusion

Our findings contribute to a better understanding of the immune mechanisms by which the hygiene hypothesis operates in urban Latin America.

Original language	English
Pages (from-to)	1064-1068.e1
Journal	Journal of Allergy and Clinical Immunology
Volume	131
Issue number	4
DOIs	https://doi.org/10.1016/j.jaci.2013.01.016
Publication status	Published - 1 Apr 2013

Keywords

children
environment
hygiene hypothesis
immune phenotypes
infections
LCA
SCAALA

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10.1016/j.jaci.2013.01.016

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Figueiredo, C. A., Amorim, L. D., Alcantara-Neves, N. M., Matos, S. M. A., Cooper, P., Rodrigues, L. C., & Barreto, M. L. (2013). Environmental conditions, immunologic phenotypes, atopy, and asthma: New evidence of how the hygiene hypothesis operates in Latin America. Journal of Allergy and Clinical Immunology, 131(4), 1064-1068.e1. https://doi.org/10.1016/j.jaci.2013.01.016

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title = "Environmental conditions, immunologic phenotypes, atopy, and asthma: New evidence of how the hygiene hypothesis operates in Latin America",

abstract = "BackgroundIt has been proposed that improved hygiene and reduced experience of infections in childhood influences the development of allergic diseases. The mechanisms by which the hygiene operates are not well established but are underpinned by two apparently incompatible immunologic paradigms, the balance of TH1 versus TH2 cytokines and IL-10–mediated regulation of TH2 cytokines.ObjectiveThis study defined immunologic phenotypes with the use of latent class analysis and investigated their associations with environmental factors, markers of allergy and asthma, in a Latin American population.MethodsWe studied 1127 children living in urban Brazil. Data on wheeze and environmental exposures were collected with standardized questionnaires. Atopy was measured by specific IgE in serum and skin prick test reactivity to aeroallergens. Cytokines were measured in culture after the stimulation of peripheral blood leukocytes with mitogen. Infections with pathogens were assessed by serology and stool examinations. Children were classified as having high or low burden of infection. Latent class analysis was used to identify immune phenotypes on the basis of cytokine production. Logistic regression was used to evaluate the adjusted effects of environment and burden of infection on the immunologic phenotypes and the effect of the phenotypes on atopy and asthma.ResultsThree phenotypes were identified, labeled underresponsive, intermediate, and responsive. Children of more educated mothers, living in improved environmental conditions, and with a low burden of infection were significantly more likely to have the responsive phenotype. The responsive phenotype was significantly associated with an increased prevalence of atopy but not asthma.ConclusionOur findings contribute to a better understanding of the immune mechanisms by which the hygiene hypothesis operates in urban Latin America.",

keywords = "children, environment, hygiene hypothesis, immune phenotypes, infections, LCA, SCAALA",

author = "Figueiredo, \{Camila Alexandrina\} and Amorim, \{Leila D.\} and Alcantara-Neves, \{Neuza M.\} and Matos, \{Sheila M.A.\} and Philip Cooper and Rodrigues, \{Laura C.\} and Barreto, \{Mauricio L.\}",

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Environmental conditions, immunologic phenotypes, atopy, and asthma: New evidence of how the hygiene hypothesis operates in Latin America. / Figueiredo, Camila Alexandrina; Amorim, Leila D.; Alcantara-Neves, Neuza M. et al.
In: Journal of Allergy and Clinical Immunology, Vol. 131, No. 4, 01.04.2013, p. 1064-1068.e1.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Environmental conditions, immunologic phenotypes, atopy, and asthma: New evidence of how the hygiene hypothesis operates in Latin America

AU - Figueiredo, Camila Alexandrina

AU - Amorim, Leila D.

AU - Alcantara-Neves, Neuza M.

AU - Matos, Sheila M.A.

AU - Cooper, Philip

AU - Rodrigues, Laura C.

AU - Barreto, Mauricio L.

PY - 2013/4/1

Y1 - 2013/4/1

N2 - BackgroundIt has been proposed that improved hygiene and reduced experience of infections in childhood influences the development of allergic diseases. The mechanisms by which the hygiene operates are not well established but are underpinned by two apparently incompatible immunologic paradigms, the balance of TH1 versus TH2 cytokines and IL-10–mediated regulation of TH2 cytokines.ObjectiveThis study defined immunologic phenotypes with the use of latent class analysis and investigated their associations with environmental factors, markers of allergy and asthma, in a Latin American population.MethodsWe studied 1127 children living in urban Brazil. Data on wheeze and environmental exposures were collected with standardized questionnaires. Atopy was measured by specific IgE in serum and skin prick test reactivity to aeroallergens. Cytokines were measured in culture after the stimulation of peripheral blood leukocytes with mitogen. Infections with pathogens were assessed by serology and stool examinations. Children were classified as having high or low burden of infection. Latent class analysis was used to identify immune phenotypes on the basis of cytokine production. Logistic regression was used to evaluate the adjusted effects of environment and burden of infection on the immunologic phenotypes and the effect of the phenotypes on atopy and asthma.ResultsThree phenotypes were identified, labeled underresponsive, intermediate, and responsive. Children of more educated mothers, living in improved environmental conditions, and with a low burden of infection were significantly more likely to have the responsive phenotype. The responsive phenotype was significantly associated with an increased prevalence of atopy but not asthma.ConclusionOur findings contribute to a better understanding of the immune mechanisms by which the hygiene hypothesis operates in urban Latin America.

AB - BackgroundIt has been proposed that improved hygiene and reduced experience of infections in childhood influences the development of allergic diseases. The mechanisms by which the hygiene operates are not well established but are underpinned by two apparently incompatible immunologic paradigms, the balance of TH1 versus TH2 cytokines and IL-10–mediated regulation of TH2 cytokines.ObjectiveThis study defined immunologic phenotypes with the use of latent class analysis and investigated their associations with environmental factors, markers of allergy and asthma, in a Latin American population.MethodsWe studied 1127 children living in urban Brazil. Data on wheeze and environmental exposures were collected with standardized questionnaires. Atopy was measured by specific IgE in serum and skin prick test reactivity to aeroallergens. Cytokines were measured in culture after the stimulation of peripheral blood leukocytes with mitogen. Infections with pathogens were assessed by serology and stool examinations. Children were classified as having high or low burden of infection. Latent class analysis was used to identify immune phenotypes on the basis of cytokine production. Logistic regression was used to evaluate the adjusted effects of environment and burden of infection on the immunologic phenotypes and the effect of the phenotypes on atopy and asthma.ResultsThree phenotypes were identified, labeled underresponsive, intermediate, and responsive. Children of more educated mothers, living in improved environmental conditions, and with a low burden of infection were significantly more likely to have the responsive phenotype. The responsive phenotype was significantly associated with an increased prevalence of atopy but not asthma.ConclusionOur findings contribute to a better understanding of the immune mechanisms by which the hygiene hypothesis operates in urban Latin America.

KW - children

KW - environment

KW - hygiene hypothesis

KW - immune phenotypes

KW - infections

KW - LCA

KW - SCAALA

U2 - 10.1016/j.jaci.2013.01.016

DO - 10.1016/j.jaci.2013.01.016

M3 - Article

SN - 0091-6749

VL - 131

SP - 1064-1068.e1

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

IS - 4

ER -

Environmental conditions, immunologic phenotypes, atopy, and asthma: New evidence of how the hygiene hypothesis operates in Latin America

Abstract

Keywords

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