Foetal airway structure can be affected by the environment
Genes plus environmental factors can affect the developing structure of foetal airways before sensitisation to known allergens. Two basic components contribute to asthma; altered airway wall structure and airway inflammation. This paper argues that genetic polymorphism plus environmental factors can influence foetal airway wall structure independent of allergic sensitisation and that this phenomena can take place simultaneously leading, but not inevitably, to allergy and asthma. The paper is also a review of clinical studies on allergen/antigen exposure in early life including discussion on the gene encoded SPINK5 which protects epithelial cells against the major mite allergen. It also discusses the effect of nutritional influences on lung function, how neutrophiles, as opposed to eosinophiles, can impact on airway remodelling and how postnatal infections and pollutants promote inflammatory immune response not associated with allergy but with transient infant wheeze.
‘Developmental Origins of Asthma and Related Allergic Disorders’, J.O. Warner 2006, Chapter 26, p 349-369; Developmental Origins of Health and Disease, Published by Cambridge University Press. Edited by P Gluckman, M Hanson
