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J Heinrich,
I Brüske,
M Schnappinger,
M Standl,
C Flexeder,
E Thiering,
C Tischer,
C M T Tiesler,
G Kohlböck,
C M Wenig, [......],
A von Berg,
D Berdel, U Krämer,
C Cramer,
I Lehmann,
O Herbarth,
H Behrendt,
J Ring,
J Kühnisch,
S Koletzko
[show abstract]
[hide abstract]
ABSTRACT: Numerous chronic diseases in childhood and adulthood have their origins in perinatal life and are potentially influenced by trans-generational epigenetic processes. Therefore, prospective birth cohorts can substantially contribute to our knowledge about the etiology of diseases including modifiable risk factors. The two population-based German birth cohorts GINIplus and LISAplus aim to describe the natural course of chronic diseases and intermediate phenotypes in childhood and its determinants, and to identify potential genetic effect modifications. In the mid-1990s, 5,991 (GINIplus) and 3,097 (LISAplus) healthy, term newborns were recruited for long-term follow-up in four regions of Germany. The follow-up rate for the first 10 years was about 55%. We analyzed the growth and development of overweight, infections and allergic diseases, mental and oral health, metabolic and inflammatory parameters and the role of potential risk factors including genetics. The results of these two birth cohorts substantially contribute to the current knowledge about the natural course of these health parameters. These data were included in many international projects and consortia for purposes of international comparisons of prevalence and consistency of findings, and to increase the power of the analyses.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 06/2012; 55(6-7):864-74. · 0.66 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: Für viele Länder Europas ist belegt, dass Allergien in den letzten Jahrzehnten zugenommen haben. Die Datenlage in Deutschland
ist nicht ausreichend. Es werden daher die Ergebnisse von Studien an sechsjährigen Kindern aus Westdeutschland vorgelegt,
die eine Zunahme von Allergien für den Zeitraum von 1985 bis 1995 nahe legen. In dieser Zeit steigt bei Jungen die Lebenszeitprävalenz
von Bronchialasthma von 1,5% auf 4% und bei allen Kindern die Lebenszeitprävalenz des Ekzems von 6% auf 12% an. In Ostdeutschland
nimmt die Prävalenz von Allergien bei Kindern, die nach der Wende geboren wurden, zu. Mögliche Ursachen werden diskutiert:
Zunahme von Aeroallergenen im Außenluft- und Innenraumbereich: Früh blühende Bäume blühen immer früher im Jahr und tendenziell
steigen die Pollenmengen an. Hausstaubmilbenkonzentrationen steigen durch zunehmende Feuchte von Wohnungen an.
Auftreten neuer Allergene: Beispielhaft werden Naturgummilatex und Platinsalze diskutiert. Diese kommen zunehmend in die Umwelt,
sind jedoch nur für einige Berufsgruppen relevant.
Allergiefördernde Wirkung von Umweltverunreinigungen: Schadstoffe aus dem Straßenverkehr können adjuvante Wirkungen haben
und Allergenträger modifizieren.
Geringere Stimulation des (früh-)kindlichen Immunsystems (weniger Infektionen, Parasiten, Impfungen etc.)
Welcher von diesen Faktoren, die unter “westlichem” Lebensstil zusammengefasst werden, für die Zunahme von Allergien verantwortlich
ist, ist bisher nicht eindeutig geklauml;rt.
For many countries in Europe it was shown that allergies increased in the last decades. Data from Germany are not sufficient.
Therefore results from studies in six years old children from West Germany are given which demonstrate an increase of allergies
between 1985 and 1995. In this time the lifetime prevalence of bronchial asthma in boys rose from 1.5% to 4% and the lifetime
prevalence of eczema rose from 6% to 12%. In East Germany the prevalence of allergies is on the increase. Possible causes
are discussed:
Increase of aeroallergens outdoors an indoors: Early flowering trees release pollen earlier every year and pollen concentrations
increase in tendency. Concentrations of house dust mites increase because of increasing dampness in homes.
Introduction of new allergens: As an example latex and salts of platinum are discussed. Their release is increasing but they
are most relevant for some professional groups.
Adjuvant activity of pollutants: Traffic related pollutants can exhibit an adjuvant activity and modify allergen carriers.
Less stimulation of the immune system in early childhood (less infections, parasites, vaccination...)
Which of these factors, which are summarised by “western lifestyle” is responsible for the increase is not known up to now.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 04/2012; 44(7):633-642. · 0.66 Impact Factor
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C Flexeder,
E Thiering,
I Brüske,
S Koletzko,
C-P Bauer,
H-E Wichmann,
U Mansmann,
A von Berg,
D Berdel, U Krämer,
B Schaaf,
I Lehmann,
O Herbarth,
J Heinrich
[show abstract]
[hide abstract]
ABSTRACT: Growth velocities during infancy might affect the risk of asthma in childhood. This study examines the association between peak height and weight velocities during the first 2 years of life and onset of asthma and wheeze up to 10 years of age.
Data from 9086 children who participated in the GINIplus and LISAplus birth cohorts were analyzed. Information on asthma was requested annually from 1 to 10 years and information on wheeze at 1, 2, 4, 6, and 10 years. Peak height and weight velocities were calculated using height and weight measurements obtained between birth and 2 years of age. Cox proportional hazards models and generalized linear mixed models were calculated after adjustment for potential confounding factors including birth weight and body mass index at 10 years of age.
Per interquartile range increase in peak weight velocity (PWV), the risk of asthma increased significantly (adjHR: 1.22; CI: 1.02-1.47). The relationship between peak height velocity (PHV) and onset of asthma was nonsignificant (adjHR: 1.08; CI: 0.88-1.31). Wheeze was not significantly associated with PHV or with PWV (adjOR: 1.07; CI: 0.64-1.77 and adjOR: 1.11; CI: 0.68-1.79, respectively).
Weight gain during infancy is positively associated with physician-diagnosed asthma in school-aged children.
Allergy 11/2011; 67(2):257-64. · 6.27 Impact Factor
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D Jarvis,
R Newson,
J Lotvall,
D Hastan,
P Tomassen,
T Keil,
M Gjomarkaj,
B Forsberg,
M Gunnbjornsdottir,
J Minov, [......],
P Howarth, U Krämer,
J Baelum,
C Loureiro,
L Kasper,
P J Bousquet,
J Bousquet,
C Bachert,
W Fokkens,
P Burney
[show abstract]
[hide abstract]
ABSTRACT: The prevalence of asthma and its association with chronic rhinosinusitis (CRS) have not been widely studied in population-based epidemiological surveys.
The Global Allergy and Asthma Network of Excellence (GA(2) LEN) conducted a postal questionnaire in representative samples of adults living in Europe to assess the presence of asthma and CRS defined by the European Position Paper on Rhinosinusitis and Nasal Polyps. The prevalence of self-reported current asthma by age group was determined. The association of asthma with CRS in each participating centre was assessed using logistic regression analyses, controlling for age, sex and smoking, and the effect estimates were combined using standard methods of meta-analysis.
Over 52,000 adults aged 18-75 years and living in 19 centres in 12 countries took part. In most centres, and overall, the reported prevalence of asthma was lower in older adults (adjusted OR for 65-74 years compared with 15-24 years: 0.72; 95% CI: 0.63-0.81). In all centres, there was a strong association of asthma with CRS (adjusted OR: 3.47; 95% CI: 3.20-3.76) at all ages. The association with asthma was stronger in those reporting both CRS and allergic rhinitis (adjusted OR: 11.85; 95% CI: 10.57-13.17). CRS in the absence of nasal allergies was positively associated with late-onset asthma.
Geographical variation in the prevalence of self-reported asthma was observed across Europe, but overall, self-reported asthma was more common in young adults, women and smokers. In all age groups, men and women, and irrespective of smoking behaviour, asthma was also associated with CRS.
Allergy 11/2011; 67(1):91-8. · 6.27 Impact Factor
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M Standl,
S Sausenthaler,
E Lattka,
S Koletzko,
C-P Bauer,
H-E Wichmann,
A von Berg,
D Berdel, U Krämer,
B Schaaf,
I Lehmann,
O Herbarth,
N Klopp,
B Koletzko,
J Heinrich
[show abstract]
[hide abstract]
ABSTRACT: The protective effect of breastfeeding (BF) on the development of asthma has been widely recognized, even if not all results have been consistent. Gene variants of the FADS gene cluster have a major impact on fatty acid composition in blood and in breast milk. Therefore, we evaluated the influence of the FADS1 FADS2 gene cluster polymorphisms on the association between BF and asthma.
The analysis was based on data (N=2245) from two German prospective birth cohort studies. Information on asthma and BF during the first 6 months was collected using questionnaires completed by the parents. Logistic regression modelling was used to analyse the association between exclusive BF and ever having asthma stratified by genotype.
In the stratified analyses, BF for 3 or 4 months after birth had a protective effect for heterozygous and homozygous carriers of the minor allele (adjusted odds ratio between 0.37 (95% CI: 0.18-0.80) and 0.42 (95% CI: 0.20-0.88). Interaction terms of BF with genotype were significant and ranged from -1.17 (P-value: 0.015) to -1.33 (0.0066). Moreover, heterozygous and homozygous carriers of the minor allele who were exclusively breastfed for 5 or 6 months after birth had a reduced risk of asthma [0.32 (0.18-0.57) to 0.47 (0.27-0.81)] in the stratified analyses. For individuals carrying the homozygous major allele, BF showed no significant effect on the development of asthma.
The association between exclusive BF and asthma is modified by the genetic variants of FADS genotypes in children.
Allergy 09/2011; 67(1):83-90. · 6.27 Impact Factor
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M Standl,
S Sausenthaler,
E Lattka,
S Koletzko,
C-P Bauer,
H-E Wichmann,
A von Berg,
D Berdel, U Krämer,
B Schaaf,
S Röder,
O Herbarth,
N Klopp,
B Koletzko,
J Heinrich
[show abstract]
[hide abstract]
ABSTRACT: The association between dietary fatty acid intake and the development of atopic diseases has been inconsistent. This could be due to inter-individual genetic differences in fatty acid metabolism.
The aim of the current study was to assess the influence of FADS1 FADS2 gene cluster polymorphisms on the association between dietary fatty acid intake and atopic diseases and allergic sensitization in 10-year-old children.
The analysis was based on data from two German prospective birth cohort studies. Data on margarine and fatty acid intake were collected using a food frequency questionnaire. Information on atopic diseases was collected using a questionnaire completed by the parents. Specific IgE against common food and inhalant allergens were measured. Six variants of the FADS1 FADS2 gene cluster (rs174545, rs174546, rs174556, rs174561, rs174575 and rs3834458) were tested. Logistic regression modelling, adjusted for gender, age, maternal education level and study centre, was used to analyse the association between fatty acid intake and atopic diseases stratified by genotype.
No significant association was found between the six FADS single nucleotide polymorphisms (SNPs) and allergic diseases or atopic sensitization. The total n-3/total n-6 ratio was positive associated with an increased risk of hayfever in homozygous major allele carriers ranging from an adjusted odds ratios of 1.25 (95%-CI: 1.00-1.57) to 1.31 (95%-CI: 1.01-1.69) across the six tested SNPs although this association was not significant anymore after correcting for multiple testing. Daily margarine intake was significantly associated with asthma [1.17 (1.03-1.34) to 1.22 (1.06-1.40)] in individuals carrying the homozygous major allele. This association was also significant after correcting for multiple testing. CONCLUSIONS & CLINICAL RELEVANCE: The association between dietary intake of fatty acids and allergic diseases might be modulated by FADS gene variants in children.
Clinical & Experimental Allergy 07/2011; 41(12):1757-66. · 5.03 Impact Factor
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D Hastan,
W J Fokkens,
C Bachert,
R B Newson,
J Bislimovska,
A Bockelbrink,
P J Bousquet,
G Brozek,
A Bruno,
S E Dahlén, [......],
B Lundbäck,
E Salagean,
A Todo-Bom,
P Tomassen,
E Toskala,
C M van Drunen,
J Bousquet,
T Zuberbier,
D Jarvis,
P Burney
[show abstract]
[hide abstract]
ABSTRACT: Chronic rhinosinusitis (CRS) is a common health problem, with significant medical costs and impact on general health. Even so, prevalence figures for Europe are unavailable. In this study, conducted by the GA²LEN network of excellence, the European Position Paper on Rhinosinusitis and nasal Polyps (EP³OS) diagnostic criteria are applied to estimate variation in the prevalence of Chronic rhinosinusitis (CRS) for Europe.
A postal questionnaire was sent to a random sample of adults aged 15-75 years in 19 centres in Europe. Participants reported symptoms of CRS, and doctor diagnosed CRS, allergic rhinitis, age, gender and smoking history. Definition of CRS was based on the EP³OS diagnostic criteria: the presence of more than two of the symptoms: (i) nasal blockage, (ii) nasal discharge, (iii) facial pain/pressure or (iv) reduction in sense of smell, for >12 weeks in the past year--with at least one symptom being nasal blockage or discharge.
Information was obtained from 57,128 responders living in 19 centres in 12 countries. The overall prevalence of CRS by EP³OS criteria was 10.9% (range 6.9-27.1). CRS was more common in smokers than in nonsmokers (OR 1.7: 95% CI 1.6-1.9). The prevalence of self-reported physician-diagnosed CRS within centres was highly correlated with the prevalence of EP³OS-diagnosed CRS.
This is the first European international multicentre prevalence study of CRS. In this multicentre survey of adults in Europe, about one in ten participants had CRS with marked geographical variation. Smoking was associated with having CRS in all parts of Europe.
Allergy 05/2011; 66(9):1216-23. · 6.27 Impact Factor
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C Tischer,
U Gehring,
C-M Chen,
M Kerkhof,
G Koppelman,
S Sausenthaler,
O Herbarth,
B Schaaf,
I Lehmann, U Krämer,
D Berdel,
A von Berg,
C P Bauer,
S Koletzko,
H-E Wichmann,
B Brunekreef,
J Heinrich
[show abstract]
[hide abstract]
ABSTRACT: For a long time, exposure to mould and dampness-derived microbial components was considered a risk factor for the development of respiratory diseases and symptoms. Some recent studies suggested that early childhood exposure to mould components, such as (1,3)-β-D-glucan and extracellular polysaccharides (EPSs), may protect children from developing allergy. We investigated the association of exposure to (1,3)-β-D-glucan, EPS and endotoxin with asthma and allergies in 6-yr-old children. This investigation was the follow-up to a nested case-control study among three European birth cohorts. Children from two ongoing birth cohort studies performed in Germany (n = 358) and one in the Netherlands (n = 338) were selected. Levels of (1,3)-β-D-glucan, EPS and endotoxin were measured in settled house dust sampled from children's mattresses and living-room floors when the children were, on average, 5 yrs of age. At the age of 6 yrs, health outcome information was available for 678 children. In the two German subsets, domestic EPS and endotoxin exposure from children's mattresses were significantly negatively associated with physician-diagnosed asthma (OR per interquartile range increase 0.60 (95% CI 0.39-0.92) and 0.55 (95% CI 0.31-0.97), respectively). In addition, EPS exposure was inversely related to physician-diagnosed allergic rhinitis (OR 0.50, 95% CI 0.31-0.81). For the Dutch population, no associations were observed between exposure to microbial agents and respiratory health outcomes. We found inverse associations between domestic exposure to EPS and endotoxin from children's mattresses, and doctor-diagnosed asthma and rhinitis in German, but not in Dutch, school children. The reasons for the differences between countries are not clear.
European Respiratory Journal 05/2011; 37(5):1050-9. · 5.89 Impact Factor
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C Cramer,
E Link,
C-P Bauer,
U Hoffmann,
A von Berg,
I Lehmann,
O Herbarth,
M Borte,
B Schaaf,
S Sausenthaler,
H-E Wichmann,
J Heinrich, U Krämer
[show abstract]
[hide abstract]
ABSTRACT: Day care centre attendance is much more common in East than in West Germany. Although there is evidence that early day care might be protective against atopic diseases, several studies have shown a higher prevalence of childhood eczema in East Germany compared to West Germany.
To compare prevalence and cumulative incidence of eczema in a birth cohort study in East and West Germany and to identify risk factors that are associated with eczema, which might explain regional differences.
We used data from the ongoing population-based birth cohort study Influence of Life-style factors on the development of the Immune System and Allergies in East and West Germany Plus the influence of traffic emissions and genetics. In 1997, 3097 children from study areas in East and West Germany were recruited. Cumulative incidence and 1-year prevalences of eczema up to the age of 6 years were determined from yearly questionnaires. Cox regression and generalized estimating equations/logistic regression were used to quantify regional differences and to identify risk factors that might explain them.
Prevalence and incidence of eczema were higher in children living in East Germany than those living in West Germany. We identified 11 risk factors that showed significant regional differences. From these factors, only 'day care attendance during the first 2 years of life' was significantly associated with eczema (odds ratio 1.56, 95% confidence interval CI 1.31-1.86). The regional differences in eczema could be explained by differences in early day care utilization.
Day care centre attendance is associated with an increased prevalence and incidence of eczema. Regional differences in eczema prevalence could be explained by regional differences in utilization of early day care.
Allergy 01/2011; 66(1):68-75. · 6.27 Impact Factor
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P. Tomassen,
R. B. Newson,
R. Hoffmans,
J. Lötvall,
L. O. Cardell,
M. Gunnbjörnsdóttir,
T. Thilsing,
P. Matricardi, U. Krämer,
J. S. Makowska,
G. Brozek,
M. Gjomarkaj,
P. Howarth,
C. Loureiro,
E. Toskala,
W. Fokkens,
C. Bachert,
P. Burney,
D. Jarvis
[show abstract]
[hide abstract]
ABSTRACT: To cite this article: Tomassen P, Newson RB, Hoffmans R, Lötvall J, Cardell LO, Gunnbjörnsdóttir M, Thilsing T, Matricardi P, Krämer U, Makowska JS, Brozek G, Gjomarkaj M, Howarth P, Loureiro C, Toskala E, Fokkens W, Bachert C, Burney P, Jarvis D. Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis – a GA2LEN study. Allergy 2011; 66: 556–561.AbstractBackground: The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) incorporates symptomatic, endoscopic, and radiologic criteria in the clinical diagnosis of chronic rhinosinusitis (CRS), while in epidemiological studies, the definition is based on symptoms only. We aimed to assess the reliability and validity of a symptom-based definition of CRS using data from the GA2LEN European survey.Methods: On two separate occasions, 1700 subjects from 11 centers provided information on symptoms of CRS, allergic rhinitis, and asthma. CRS was defined by the epidemiological EP3OS symptom criteria. The difference in prevalence of CRS between two study points, the standardized absolute repeatability, and the chance-corrected repeatability (kappa) were determined. In two centers, 342 participants underwent nasal endoscopy. The association of symptom-based CRS with endoscopy and self-reported doctor-diagnosed CRS was assessed.Results: There was a decrease in prevalence of CRS between the two study phases, and this was consistent across all centers (−3.0%, 95% CI: −5.0 to −1.0%, I2 = 0). There was fair to moderate agreement between the two occasions (kappa = 39.6). Symptom-based CRS was significantly associated with positive endoscopy in nonallergic subjects, and with self-reported doctor-diagnosed CRS in all subjects, irrespective of the presence of allergic rhinitis.Conclusion: Our findings suggest that a symptom-based definition of CRS, according to the epidemiological part of the EP3OS criteria, has a moderate reliability over time, is stable between study centers, is not influenced by the presence of allergic rhinitis, and is suitable for the assessment of geographic variation in prevalence of CRS.
Allergy 11/2010; 66(4):556 - 561. · 6.27 Impact Factor
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P Tomassen,
R B Newson,
R Hoffmans,
J Lötvall,
L O Cardell,
M Gunnbjörnsdóttir,
T Thilsing,
P Matricardi, U Krämer,
J S Makowska,
G Brozek,
M Gjomarkaj,
P Howarth,
C Loureiro,
E Toskala,
W Fokkens,
C Bachert,
P Burney,
D Jarvis
[show abstract]
[hide abstract]
ABSTRACT: The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) incorporates symptomatic, endoscopic, and radiologic criteria in the clinical diagnosis of chronic rhinosinusitis (CRS), while in epidemiological studies, the definition is based on symptoms only. We aimed to assess the reliability and validity of a symptom-based definition of CRS using data from the GA(2) LEN European survey.
On two separate occasions, 1700 subjects from 11 centers provided information on symptoms of CRS, allergic rhinitis, and asthma. CRS was defined by the epidemiological EP3OS symptom criteria. The difference in prevalence of CRS between two study points, the standardized absolute repeatability, and the chance-corrected repeatability (kappa) were determined. In two centers, 342 participants underwent nasal endoscopy. The association of symptom-based CRS with endoscopy and self-reported doctor-diagnosed CRS was assessed.
There was a decrease in prevalence of CRS between the two study phases, and this was consistent across all centers (-3.0%, 95% CI: -5.0 to -1.0%, I(2) = 0). There was fair to moderate agreement between the two occasions (kappa = 39.6). Symptom-based CRS was significantly associated with positive endoscopy in nonallergic subjects, and with self-reported doctor-diagnosed CRS in all subjects, irrespective of the presence of allergic rhinitis.
Our findings suggest that a symptom-based definition of CRS, according to the epidemiological part of the EP3OS criteria, has a moderate reliability over time, is stable between study centers, is not influenced by the presence of allergic rhinitis, and is suitable for the assessment of geographic variation in prevalence of CRS.
Allergy 11/2010; 66(4):556-61. · 6.27 Impact Factor
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Journal of epidemiology and community health 10/2010; 65(1):86. · 3.04 Impact Factor
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A v Berg, U Krämer,
E Link,
C Bollrath,
J Heinrich,
I Brockow,
S Koletzko,
A Grübl,
B Filipiak-Pittroff,
H-E Wichmann,
C-P Bauer,
D Reinhardt,
D Berdel
[show abstract]
[hide abstract]
ABSTRACT: Nutritional intervention with hydrolysed infant formulas has been shown efficacious in preventing eczema in children predisposed to allergy. However, this preventive effect has never been related to the natural course of eczema in children with or without a family history of allergy. The aim of this study therefore was to compare the course of eczema in predisposed children after nutritional intervention to the natural course of eczema.
The prospective German birth cohort study GINIplus includes a total of 5991 children, subdivided into interventional and non-interventional groups. Children with a familial predisposition for allergy whose parents agreed to participate in the prospective, double-blind intervention trial (N=2252) were randomly assigned at birth to one of four formulas: partially or extensively hydrolysed whey, extensively hydrolysed casein (eHF-C) or standard cow's milk formula. Children with or without familial predisposition represented the non-interventional group (N=3739). Follow-up data were taken from yearly self-administered questionnaires from 1 up to 6 years. The outcome was physician-diagnosed eczema and its symptoms. The cumulative incidence of eczema in predisposed children with or without nutritional intervention was compared with that of non-predisposed children who did not receive intervention. Cox regression was used to adjust for confounding.
Predisposed children without nutritional intervention had a 2.1 times higher risk for eczema [95% confidence interval (CI) 1.6-2.7] than children without a familial predisposition. The risk was smaller with nutritional intervention even levelling out to 1.3 (95% CI 0.9-1.9) in children fed eHF-C formula.
Although direct comparability is somewhat restricted, the data demonstrate that early intervention with hydrolysed infant formulas can substantially compensate up until the age of 6 years for an enhanced risk of childhood eczema due to familial predisposition to allergy.
Clinical & Experimental Allergy 04/2010; 40(4):627-36. · 5.03 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: At the time of the German reunification in 1990, manifestations of most allergic diseases were less prevalent in East than in West Germany. It was hypothesized that these East-West differences would diminish with lifestyle and pollution changes in East Germany.
To investigate whether changes in the prevalence of asthma, hayfever, eczema or allergic sensitization in East Germany approached the levels seen in West Germany and to identify possible lifestyle or environmental factors that may influence this.
Between 1991 and 2000, 6-year-old children from four areas in East Germany participated in an annual survey. Every 3rd year, a parallel survey was performed in four areas of West Germany. In total, 31 903 children were included. Parents completed a questionnaire regarding lifestyle factors and diagnoses and symptoms of asthma, hayfever and eczema. In sub-areas, eczema was clinically assessed by a dermatologist. Specific IgE sensitization was determined for 6121 children. Logistic regression was used to analyse differences in time trends and the influence of lifestyle and pollution changes.
Lifestyle and pollution changed significantly differently between East and West Germany. The trends in hayfever and in strong (specific IgE >3.5) sensitization against pollen, and particularly birch pollen, were steeper in East than in West Germany. The trend towards marked pollen sensitization was four times stronger (95% confidence interval 1.2-13.9) in East than in West Germany. Increasing numbers of only children, less single-room heating with fossil fuels and increasing importance of traffic-related pollution in East Germany partly explained these differences in time trends.
Hayfever and sensitization against pollen were the most sensitive allergic manifestations to changes experienced specifically in East Germany. Influences of lifestyle (single-room heating, living as a single child) were important in explaining different trend developments.
Clinical & Experimental Allergy 02/2010; 40(2):289-98. · 5.03 Impact Factor
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E Schnabel,
S Sausenthaler,
B Schaaf,
T Schäfer,
I Lehmann,
H Behrendt,
O Herbarth,
M Borte, U Krämer,
A von Berg,
H-E Wichmann,
J Heinrich
[show abstract]
[hide abstract]
ABSTRACT: Food allergy is common, especially in childhood, where 6-8% of children are affected. Identification of early and efficient markers for later development of food allergy is very important.
We examined the ability of repeated measurements of food sensitization in early childhood to predict doctor-diagnosed food allergy (DDFA) at the age of 6 years.
The analysis was based on data from a prospective birth cohort study. Information was collected by parental questionnaires, and blood samples were obtained at 2 and 6 years of age. Children with repeated determination of sensitization to food allergens at 2 and 6 years of age were categorized into the sensitization phenotypes: no, early onset, late onset and persistent sensitization. The association between sensitization phenotypes and DDFA was prospectively investigated using multiple logistic regression analyses.
Of 3097 children recruited at birth, a complete follow-up of IgE measurements and questionnaires at 1.5, 2 and 6 years were available for 1082 children. Early food allergen sensitization (fx5) was a strong risk for DDFA at 6 years [odds ratio (OR)=4.7; 95% confidence intervals (95% CI) 2.0-11.2] and for a new onset of DDFA at 6 years (OR=4.1; 95% CI 1.5-11.3). Additionally, persistent food allergen sensitization increased the risk of DDFA at 6 years (OR=6.1; 95% CI 2.7-13.7). Early sensitized children with a history of parental atopy showed the highest risk for DDFA at 6 years.
Food-sensitized children during the first 2 years of life, especially with a family history of atopy, might be considered as a susceptible subgroup that requires specific attention concerning the development of food allergy-related symptoms.
Clinical & Experimental Allergy 12/2009; 40(3):450-7. · 5.03 Impact Factor
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C.-M. Chen,
S. Sausenthaler,
W. Bischof,
O. Herbarth,
M. Borte,
H. Behrendt, U. Krämer,
H. C. Williams,
H.-E. Wichmann,
J. Heinrich,
the LISA Study Group
[show abstract]
[hide abstract]
ABSTRACT: Background. Previous studies have reported a protective association between high levels of exposure to endotoxin during infancy and the development of subsequent eczema within the first 6 months of life.Aim. To investigate the association between exposure in infancy to endotoxin from mattress dust and the development of eczema up to age of 6 years in 2166 children participating in the German Influences of Lifestyle-Related Factors on the Immune System and the Development of Allergies in Childhood (LISA) study, an ongoing population-based birth-cohort study.Methods. Endotoxin levels in house dust samples collected at 3 months after birth were quantified using the kinetic Limulus amebocyte lysate assay. Specific IgE antibodies to common food and aeroallergens were measured using radioallergosorbent test, fluorenzyme immunoassay (Pharmacia CAP system) when children were 2 and 6 years old. Information on eczema symptoms and physician-diagnosed eczema were collected at each follow-up using a questionnaire.Results. No association was found between endotoxin exposure from mattresses (the mattresses of each child and their parents were examined) during infancy and the development of eczema symptoms or doctor-diagnosed eczema by 6 years of age (OR = 1.1, 95% CI 0.5–2.3, and OR = 1.1, 95% CI 0.4–3.3, respectively). No association was found when children with only atopic eczema.Conclusion. Endotoxin exposure during infancy is unlikely to have a large long-term effect on the development of eczema, especially the atopic form.
Clinical and Experimental Dermatology 10/2009; 35(3):238 - 244. · 1.20 Impact Factor
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ABSTRACT: Previous studies have reported a protective association between high levels of exposure to endotoxin during infancy and the development of subsequent eczema within the first 6 months of life.
To investigate the association between exposure in infancy to endotoxin from mattress dust and the development of eczema up to age of 6 years in 2166 children participating in the German Influences of Lifestyle-Related Factors on the Immune System and the Development of Allergies in Childhood (LISA) study, an ongoing population-based birth-cohort study.
Endotoxin levels in house dust samples collected at 3 months after birth were quantified using the kinetic Limulus amebocyte lysate assay. Specific IgE antibodies to common food and aeroallergens were measured using radioallergosorbent test, fluorenzyme immunoassay (Pharmacia CAP system) when children were 2 and 6 years old. Information on eczema symptoms and physician-diagnosed eczema were collected at each follow-up using a questionnaire.
No association was found between endotoxin exposure from mattresses (the mattresses of each child and their parents were examined) during infancy and the development of eczema symptoms or doctor-diagnosed eczema by 6 years of age (OR = 1.1, 95% CI 0.5-2.3, and OR = 1.1, 95% CI 0.4-3.3, respectively). No association was found when children with only atopic eczema.
Endotoxin exposure during infancy is unlikely to have a large long-term effect on the development of eczema, especially the atopic form.
Clinical and Experimental Dermatology 10/2009; 35(3):238-44. · 1.20 Impact Factor
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I Brockow,
A Zutavern,
U Hoffmann,
A Grübl,
A von Berg,
S Koletzko,
B Filipiak,
C P Bauer,
H E Wichmann,
D Reinhardt,
D Berdel, U Krämer,
J Heinrich
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ABSTRACT: Only a few studies have analyzed the value of early sensitization in predicting the development of atopic disease. The relevance of low immunoglobulin (Ig) E antibody levels in this respect also remains unclear.
To investigate the relevance of sensitization in 12-month-old children in the development of atopic disease by the age of 6 years.
We analyzed data for 1290 children with a positive family history of atopy from the prospective, multicenter German Infant Nutritional Intervention (GINIplus) study and investigated the relationship between the presence of detectable specific IgE antibodies at the age of 12 months and the development of atopic disease by the age of 6 years.
In all, 10.9% of children analyzed developed sensitization. At the age of 6 years, 20.6% of children with early sensitization had eczema compared to 9.4% of those without (odds ratio [OR], 2.31; 95% confidence interval [CI], 1.42-3.74). The corresponding figures were 15.4% vs 7.3% for allergic rhinitis (OR, 2.22; CI, 1.31-3.78) and 10.2% vs 2.6% (OR, 3.93; 95% CI, 1.98-7.76) for asthma. Children with early sensitization to aeroallergens had the greatest risk of subsequent atopic disease. Early sensitization did not increase risk in children without eczema within the first year of life. Very low specific IgE levels (0.18-0.34 kU/L) were not significantly associated with any of the outcomes analyzed.
Sensitization to common food allergens and to aeroallergens in particular during the first year of life was found to be a strong predictor for the development of atopic disease by the age of 6 years in children with a positive family history of atopy.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 02/2009; 19(3):180-7. · 2.27 Impact Factor
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C-M Chen,
S Weidinger,
N Klopp,
S Sausenthaler,
W Bischof,
O Herbarth,
M Bauer,
M Borte,
B Schaaf,
I Lehmann,
H Behrendt, U Krämer,
D Berdel,
A von Berg,
C P Bauer,
S Koletzko,
T Illig,
H-E Wichmann,
J Heinrich
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ABSTRACT: In a recent genome wide scan, a functional promoter variant (rs2251746) in the gene encoding the alpha chain of the high affinity receptor for immunoglobulin E (IgE) (FCER1A) was identified as major determinant of serum IgE levels.
The aim of this study was to investigate the role of rs2251746 on total IgE levels measured at different stages of life from birth (cord blood) up to the age of 6 and to evaluate its interaction with the environmental influences in two German birth cohorts.
Data from two German birth cohorts were analysed (n = 1043 for the LISA cohort and n = 1842 for the GINI cohort). In the studies, total serum IgE was measured from cord blood, and blood samples taken at the age of 2/3 and 6 years. In a subgroup of the LISA study, house dust samples were collected at age of 3 months and the amount of endotoxin was determined. Random effect models were used to analyse the longitudinal health outcomes.
In the two cohorts, the heterozygote and the rare homozygote of rs2251746 was consistently associated with lower total IgE levels from birth up to the age of 6 years with an allele-dose effect (P < 0.02 for blood samples taken at each time point in both cohorts). No interaction between the two FCER1A encoding gene and environmental exposures including endotoxin, worm infestation and day care centre attendance during early childhood were observed.
Common variants in FCER1A strongly influence basal IgE production independently from environmental stimuli. These effects can be observed already in cord blood pointing to altered gene expression in foetus.
Allergy 02/2009; 64(9):1327-32. · 6.27 Impact Factor
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S Sausenthaler,
P Rzehak,
C M Chen,
P Arck,
A Bockelbrink,
T Schäfer,
B Schaaf,
M Borte,
O Herbarth, U Krämer,
A von Berg,
H E Wichmann,
J Heinrich
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ABSTRACT: Stress has been suggested to impact the onset and exacerbation of eczema and other atopic disorders. Whether early exposure to stress-related factors might exert long-term effects remains to be clarified.
The objective of this study was to investigate whether stress-related maternal factors during pregnancy are associated with childhood eczema during the first 6 years of life.
Data from 3004 children from a prospective German birth cohort study (LISA) were analyzed. Information from maternity certificates and questionnaire information on unwanted pregnancy were used to evaluate stress-related maternal factors during pregnancy. Prevalence data for physician-diagnosed eczema were available up to the age of 6 years.
Maternal factors during pregnancy were positively associated with childhood eczema in terms of cumulative prevalence up to the age of 2 years (adjusted odds ratio, 1.48; 95% confidence interval, 0.95-2.30) after adjusting for potential confounders. Beyond the second year no increased risk was observed.
The results of this study suggest that stress-related maternal factors during pregnancy are associated with an increased risk of childhood eczema during the first 2 years of life. The impact of postnatal stress such as parental divorce or separation on this association could not be clarified. Future studies should therefore further elucidate how prenatal and postnatal stress interact and whether prenatal stress might have a programming effect. If future studies confirm the findings of this study, reducing maternal stress during pregnancy might be a possible target in the primary prevention of eczema during childhood.
Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2009; 19(6):481-7. · 2.27 Impact Factor
