Environmental exposures interplay with human host factors to promote the development and progression of allergic diseases. The worldwide prevalence of allergic disease is rising as a result of complex gene-environment interactions that shape the immune system and host response. Research shows an association between the rise of allergic diseases and increasingly modern Westernized lifestyles, which are characterized by increased urbanization, time spent indoors, and antibiotic usage. These environmental changes result in increased exposure to air and traffic pollution, fungi, infectious agents, tobacco smoke, and other early-life and lifelong risk factors for the development and exacerbation of asthma and allergic diseases. It is increasingly recognized that the timing, load, and route of allergen exposure affect allergic disease phenotypes and development. Still, our ability to prevent allergic diseases is hindered by gaps in understanding of the underlying mechanisms and interaction of environmental, viral, and allergen exposures with immune pathways that impact disease development. This Review highlights epidemiologic and mechanistic evidence linking environmental exposures to the development and exacerbation of allergic airway responses.

/pdf/environmental-exposures-and-mechanisms-in-allergy-and-asthma-24s258bfee.pdf

Environmental exposures and mechanisms in allergy and asthma development

https://link.springer.com/content/pdf/10.1186%2Fs40413-016-0110-7.pdf

Particularities of allergy in the Tropics.

Allergic rhinitis (AR) represents a global health concern where it affects approximately 400 million people worldwide. The prevalence of AR has increased over the years along with increased urbanization and environmental pollutants thought to be some of the leading causes of the disease. Understanding the pathophysiology of AR is crucial in the development of novel therapies to treat this incurable disease that often comorbids with other airway diseases. Hence in this mini review, we summarize the well-established yet vital aspects of AR. These include the epidemiology, clinical and laboratory diagnostic criteria, AR in pediatrics, pathophysiology of AR, Th2 responses in the disease, as well as pharmacological and immunomodulating therapies for AR patients.

/pdf/allergic-rhinitis-a-clinical-and-pathophysiological-overview-361uplvl.pdf

Allergic Rhinitis: A Clinical and Pathophysiological Overview

Environmental variations induced by industrialization and climate change partially explain the increase in prevalence and severity of allergic disease. One possible mechanism is the increase in allergen production leading to more exposure and sensitization in susceptible individuals. House dust mites (HDMs) are important sources of allergens inducing asthma and rhinitis, and experimentally they have been demonstrated to be very sensitive to microenvironment modifications; therefore, global or regional changes in temperature, humidity, air pollution or other environmental conditions could modify natural HDM growth, survival and allergen production. There is evidence that sensitization to HDMs has increased in some regions of the world, especially in the subtropical and tropical areas; however, the relationship of this increase with environmental changes is not so clear as has reported for pollen allergens. In this review, we address this point and explore the effects of current and predicted environmental changes on HDM growth, survival and allergen production, which could lead to immunoglobulin E (IgE) sensitization and allergic disease prevalence. We also assess the role of adjuvants of IgE responses, such as air pollution and helminth infections, and discuss the genetic and epigenetic aspects that could influence the adaptive process of humans to drastic and relatively recent environmental changes we are experiencing.

/pdf/house-dust-mite-allergy-under-changing-environments-1xims1x9eh.pdf

House Dust Mite Allergy Under Changing Environments

Background The prevalence of allergic diseases differs in urban and rural populations. Objective We sought to assess associations between environmental and dietary factors with allergic diseases in urban and rural South African children. Methods Toddlers aged 12 to 36 months were assessed for food allergen and aeroallergen sensitization, atopic dermatitis, allergic rhinitis, asthma, and challenge-proved food allergy. Information was collected on family history of allergic diseases, household size, socioeconomic status, delivery mode, antibiotic and probiotic use, exposure to fermented and unpasteurized milk, antihelminth treatment, sunlight exposure, pet and farm animal exposure, cigarette smoke, and household cooking and heating fuels. Antenatal exposures to pets, livestock, and cigarette smoke were assessed. A subsection completed questions on consumption of fruits and vegetables, fast foods, soft drinks/fruit juices, and fried/microwaved meat. Results Risk and protective factors differed between urban and rural settings. Exposure to farm animals in infants and their mothers during pregnancy was protective against allergic outcomes in the rural population. Consumption of unpasteurized milk is uncommon in this group of rural children and is unlikely to be an important factor in rural protection. In urban children birth by cesarean section is associated with food allergy, and consumption of fermented milk products is associated with reduced asthma and atopic dermatitis. In both cohorts antenatal maternal smoking and environmental smoking exposure were predominantly associated with asthma, and consumption of fast foods and fried meats were associated with allergy. Conclusion In this rural environment exposure to livestock is the strongest protective factor. In urban communities, where animal contact is rare, risk factors include cesarian section, and protective factors include consumption of fermented milk products. Modifiable risk factors urgently require interventions to prevent increasing allergy rates in countries undergoing rapid urbanization.

Environmental factors associated with allergy in urban and rural children from the South African Food Allergy (SAFFA) cohort

SummaryBackground
Little is known about time trend of prevalence of asthma and the association between the changing prevalence and allergen sensitization in Chinese children.

Objective
To determine the changes in prevalence of asthma and allergen sensitization in schoolchildren over a period of 15 years.

Methods
A total of 6928 schoolchildren aged 13–14 years in 2009 were recruited for the study using the Phase III Protocol of the International Study of Asthma and Allergic disease in Childhood (ISAAC) and 2531 of them underwent skin prick test for seven common aeroallergens. The results were compared with those obtained in the Phase I (1994/95) and III (2001/02) ISAAC studies.

Results
The prevalence of asthma ever and current wheeze increased from 3.9% and 3.4% in 1994, to 4.6% and 4.8% in 2001 (P  0.05). Sensitization to HDMs, especially Dermatophagoides Pteronyssinus was associated with increase in prevalence of wheeze.

Conclusion
The prevalence of wheeze and sensitization to common aeroallergens in secondary schoolchildren in Guangzhou China has increased significantly since 1994. Sensitization to HDMs is an important risk factor associated with the increase in prevalence of wheeze in this group of population in Guangzhou city.

House dust mite sensitization is the main risk factor for the increase in prevalence of wheeze in 13‐ to 14‐year‐old schoolchildren in Guangzhou city, China

Associations of Early Life Exposures and Environmental Factors With Asthma Among Children in Rural and Urban Areas of Guangdong, China.

House Dust Mite Sensitization Is the Main Risk Factor for the Increase in Prevalence of Wheeze in 13-14 Year Old Schoolchildren in Guangzhou City, China

Comparative Study Of Food Allergy In Urban And Rural Schoolchildren: The Europrevall-INCO Survey In China

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House dust mite sensitization is the main risk factor for the increase in prevalence of wheeze in 13‐ to 14‐year‐old schoolchildren in Guangzhou city, China

Associations of Early Life Exposures and Environmental Factors With Asthma Among Children in Rural and Urban Areas of Guangdong, China.

House Dust Mite Sensitization Is the Main Risk Factor for the Increase in Prevalence of Wheeze in 13-14 Year Old Schoolchildren in Guangzhou City, China

Comparative Study Of Food Allergy In Urban And Rural Schoolchildren: The Europrevall-INCO Survey In China