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Environmental determinants of allergy and asthma in early life
Open accessAbstract
Allergic disease prevalence has increased significantly in recent decades. Primary prevention efforts are being guided by study of the exposome (or collective environmental exposures beginning during the prenatal period) to identify modifiable factors that affect allergic disease risk. In this review we explore the evidence supporting a relationship between key components of the external exposome in the prenatal and early-life periods and their effect on atopy development focused on microbial, allergen, and air pollution exposures. The abundance and diversity of microbial exposures during the first months and years of life have been linked with risk of allergic sensitization and disease. Indoor environmental allergen exposure during early life can also affect disease development, depending on the allergen type, dose, and timing of exposure. Recent evidence supports the role of ambient air pollution in allergic disease inception. The lack of clarity in the literature surrounding the relationship between environment and atopy reflects the complex interplay between cumulative environmental factors and genetic susceptibility, such that no one factor dictates disease development in all subjects. Understanding the effect of the summation of environmental exposures throughout a child's development is needed to identify cost-effective interventions that reduce atopy risk in children.
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“Allergic diseases, including asthma, are increasingly understood as multifactorial complex outcomes of genetic predisposition, environmental exposures, shaped by inflammatory and metabolic processes, host-microbiota interactions, and even epigenetic modifications (67–73).”
From Indoor Allergen Interventions in Homes and Schools for Managing Asthma (2025) · cites this paper as [67]
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Metadata
- Authors
- Burbank, A. J., Sood, A. K., Kesic, M. J., Peden, D. B., & Hernandez, M. L.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Hernandez, Michelle L.
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2017-07
- Volume
- 140
- Issue
- 1
- Pages
- 1-12
- ISSN
- 0091-6749 (ISSN-L)
- PMC
- PMC5675123
- OpenAlex
- W2733928499
- Cited by
- 299
- References
- 155
- Citations by year
- 2026: 19 · 2025: 21 · 2024: 28 · 2023: 31 · 2022: 39 · 2021: 48 · 2020: 51 · 2019: 30 · 2018: 26 · 2017: 4
- FWCI
- 3.72
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- American Academy of Allergy Asthma and Immunology
- National Institute of General Medical Sciences (T32GM086330)
- National Institute of Environmental Health Sciences (R01ES023349, K23ES021745, P30ES010126)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Keywords
- allergic diseases, asthma, exposome, prenatal exposure, early life exposure, atopy, allergen sensitization, microbial exposure, indoor allergens, ambient air pollution, environmental risk factors, genetic susceptibility, primary prevention
- MeSH terms
- Air Pollution, Allergens, Animals, Environmental Exposure, Humans, Hypersensitivity, Risk Factors, Microbiota
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