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Previous Volume 347:869-877 September 19, 2002 Number 12 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Weiss, S. T. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background In early life, the innate immune system can recognize both viable and nonviable parts of microorganisms. Immune activation may direct the immune response, thus conferring tolerance to allergens such as animal dander or tree and grass pollen.

Methods Parents of children who were 6 to 13 years of age and were living in rural areas of Germany, Austria, or Switzerland where there were both farming and nonfarming households completed a standardized questionnaire on asthma and hay fever. Blood samples were obtained from the children and tested for atopic sensitization; peripheral-blood leukocytes were also harvested from the samples for testing. The levels of endotoxin in the bedding used by these children were examined in relation to clinical findings and to the cytokine-production profiles of peripheral-blood leukocytes that had been stimulated with lipopolysaccharide and staphylococcal enterotoxin B. Complete data were available for 812 children.

Results Endotoxin levels in samples of dust from the child's mattress were inversely related to the occurrence of hay fever, atopic asthma, and atopic sensitization. Nonatopic wheeze was not significantly associated with the endotoxin level. Cytokine production by leukocytes (production of tumor necrosis factor , interferon-, interleukin-10, and interleukin-12) was inversely related to the endotoxin level in the bedding, indicating a marked down-regulation of immune responses in exposed children.

Conclusions A subject's environmental exposure to endotoxin may have a crucial role in the development of tolerance to ubiquitous allergens found in natural environments.

Source Information

From the Institute of Social and Preventive Medicine, Basel, Switzerland (C.B.-F., M.W., L.G.); Children's Hospital Salzburg, Salzburg, Austria (J.R., W.E.); the Department of Clinical Chemistry and Molecular Diagnostics, Hospital of the Philipps University, Marburg, Germany (U.H., H.R.); the Dr. von Hauner Children's Hospital, Munich, Germany (S.M., D.C., F.G., E.M.); the Department of Experimental Pneumology, Ruhr University, Bochum, Germany (A.B.); University Children's Hospital, Zurich, Switzerland (R.P.L.); and the Institute of Occupational and Environmental Medicine, University of Munich, Munich, Germany (R.S., D.N.).

Address reprint requests to Dr. Braun-Fahrländer at the Institute of Social and Preventive Medicine, University of Basel, Steinengraben 49, CH-4051 Basel, Switzerland, or at c.braun{at}unibas.ch.

Full Text of this Article

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Endotoxin and Asthma
Maziak W., Perzanowski M. S., Platts-Mills T. A.E., Speiser D. E., Zippelius A., Braun-Fahrländer C., Lauener R. P., von Mutius E., Weiss S. T.
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N Engl J Med 2003; 348:171-174, Jan 9, 2003. Correspondence

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