Ontogeny of Allergy

  • Bengt Björkstén


Sensitization, as proven by the demonstration of low levels of immunoglobin E (IgE) antibodies directed against environmental allergens, appears to be part of the normal immune response (1). In most instances these antibodies are only temporary, as the continuing IgE antibody formation is rapidly suppressed. But when genetically predisposed individuals are exposed to an allergen at a time when the regulation of the immune system is immature, then higher levels of IgE antilbodies, lasting for a long time, may appear. The more susceptible to sensitization the individual is, the lower is the allergen dose needed for this to occur. The fact that an individual is sensitized does not, however, necessarily mean that clinical symptoms, i.e., allergic disease, will develop. It is not known which factors decide what allergic manifestations will appear in an atopic individual, e.g., whether he or she will suffer from atopic dermatitis, asthma, hay fever, gastrointestinal allergy, or several of them. It is likely, however, that the selection of a target organ is also at least partially under genetic control.


Allergic Disease Allergy Clin Immunol Atopic Disease Pertussis Vaccine Positive Skin Prick Test 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Björkstén B (1994) Risk factors in early childhood for the development of atopic diseases. Allergy 49: 400–407.PubMedCrossRefGoogle Scholar
  2. 2.
    Holt P (1995) Postnatal maturation of immune competence during infancy and childhood. Pediatr Allergy Immunol 6: 59–70.PubMedCrossRefGoogle Scholar
  3. 3.
    Duchén K, Björkstén B (1991) Sensitization via the breast milk. In: Mestecky J, ed. Immunology of Milk and the Neonate. Plenum, New York, pp. 427–436.CrossRefGoogle Scholar
  4. 4.
    Björkstén B (1983) Does breast feeding prevent the development of allergy? Immunol Today 4: 215–217.CrossRefGoogle Scholar
  5. 5.
    Björkstén F, Suoniemi I, Koski V (1980) Neonatal birch-pollen contact and subsequent allergy to birch pollen. Clin Allergy 10: 585–591.PubMedCrossRefGoogle Scholar
  6. 6.
    Björkstén F, Suoniemi I (1981) Time and intensity of first pollen contacts and risk of subsequent pollen allergies. Acta Med Scand 209: 299–303.PubMedCrossRefGoogle Scholar
  7. 7.
    Morrison Smith J (1973) Skin tests and atopic allergy in children. Clin Allergy 3: 269–275.CrossRefGoogle Scholar
  8. 8.
    Settipane R, Hagy G (1979) Effect of atmospheric pollen on the newborn. Rhode Island Med J 62: 477–482.Google Scholar
  9. 9.
    Morrison-Smith J, Springett VH (1979) Atopic disease and month of birth. Clin Allergy 9: 153–157.CrossRefGoogle Scholar
  10. 10.
    Suoniemi I, Björkstén F, Haahtela T (1981) Dependence of immediate hypersensitivity in the adolescent period on factors encountered in infancy. Allergy 36: 263–268.PubMedCrossRefGoogle Scholar
  11. 11.
    Croner S, Kjellman N-IM (1986) Predictors of atopic disease: cord blood IgE and month of birth. Allergy 41: 68–70.PubMedCrossRefGoogle Scholar
  12. 12.
    Husband A, King M, Brown R (1987) Behaviorally conditioned modification of T cell subset ratios in rats. Immunol Lett 14: 91–94.PubMedCrossRefGoogle Scholar
  13. 13.
    King M, Husband A, Kusnecov A (1987) Behavioral conditioning of the immune system: From laboratory to clinical application. In: Sheppard J, ed. Advances in Behavioral Medicine. Cumberland College of Health Sciences, Sydney, Vol. 4, pp. 110–117.Google Scholar
  14. 14.
    Anonymous. (1987) Depression, stress and immunity. Lancet 1: 1467–1468.Google Scholar
  15. 15.
    Jemmott JI, Borysenko J, Borysenko M, et al. (1983) Academic stress, power motivation, and decrease in secretion rate of salivary secretory immunoglobulin A. Lancet 1: 1400–1412.PubMedCrossRefGoogle Scholar
  16. 16.
    European Community Respiratory Health Survey. (1996) Variations in the prevalence of respiratory symptoms, selfreported asthma attacks, and use of asthma medication in the European Community Respiratory Health Survey (ECRHS). Eur Respir J 9: 687–695.CrossRefGoogle Scholar
  17. 17.
    Burney P. (1993) Epidemiology of asthma. Allergy 48: 17–21.PubMedCrossRefGoogle Scholar
  18. 18.
    Pearce N, Weiland S, Keil U, et al. (1993) Self-reported prevalence of asthma symptoms in children in Australia, England, Germany and New Zealand: an international comparison using the ISAAC protocol. Eur Respir J 6: 1455–1461.PubMedGoogle Scholar
  19. 19.
    Aberg N (1989) Asthma and allergic rhinitis in Swedish conscripts. Clin Exp Allergy 19: 59–63.PubMedCrossRefGoogle Scholar
  20. 20.
    Barbee R, Kaltenborn W, Lebowitz M, Burrows B (1987) Longitudinal changes in allergen skin test reactivity in a community population sample. J Allergy Clin Immunol 79: 16–24.PubMedCrossRefGoogle Scholar
  21. 21.
    Burney P, Chinn S, Rona R. (1990) Has the prevalence of asthma increased in children? Evidence from the national study of health and growth 1973–86. Br Med J 300: 1306–1310.CrossRefGoogle Scholar
  22. 22.
    Burr M, Butland B, King S, Vaughan-Williams E (1989) Changes in asthma prevalence: Two surveys fifteen years apart. Arch Dis Child 64: 1452–1456.Google Scholar
  23. 23.
    Wichmann H (1995) Environment, life-style and allergy: the German answer. Allergo J 4: 315–316.Google Scholar
  24. 24.
    van Niekerk C, Weinberg E, Shore S, Heese HdV, van Schalkwyk D (1979) Prevalence of asthma: a comparative study of urban and rural Xhosa children. Clin Allergy 9: 319–324.PubMedCrossRefGoogle Scholar
  25. 25.
    Waite D, Eyles E, Tonkin S, O’Donnell T (1980) Asthma prevalence in Tokelauan children in two environments. Clin Allergy 10: 71–75.PubMedCrossRefGoogle Scholar
  26. 26.
    Bräbäck L, Kälvesten L (1991) Urban living as a risk factor for atopic sensitization in Swedish schoolchildren. Pediatr Allergy Immunol 2: 14–19.CrossRefGoogle Scholar
  27. 27.
    Bräbäck L, Breborowicz A, Dreborg S, Knutsson A, Pieklik H, Björkstén B (1994) Atopic sensitization and respiratory symptoms among Polish and Swedish schoolchildren. Clin Exper Allergy 24: 826–835.CrossRefGoogle Scholar
  28. 28.
    von Mutius E, Sherrill D, Fritzsch C, Martinez F, Lebowitz M (1995) Air pollution and upper respiratory symptoms in children from East Germany. Eur Respir J 8: 723–728.Google Scholar
  29. 29.
    von Mutius E, Martinez FD, Fritzsch C, Nicolai T, Roe11 G, Thiemann HH (1994) Prevalence of asthma and atopy in two areas of West and East Germany. Am J Respir Crit Care Med 149: 358–364.Google Scholar
  30. 30.
    Riikjäry M, Julge K, Vasar M, Bräbäck L, Knutsson A, Björkstén B (1995) The prevalence of atopic sensitization and respiratory symptoms among Estonian school children. Clin Exp Allergy 25: 1198–1204.Google Scholar
  31. 31.
    Bräbäck L, Breborowicz A, Julge K, Knutsson A, Riikjäry M-A, Vasar M, Björkstén B (1995) Risk factors for respiratory symptoms and atopic sensitization in the Baltic area. Arch Dis Child 72: 487–493.PubMedCrossRefGoogle Scholar
  32. 32.
    Jögi R, Jansson C, Björnsson E, Boman G, Björkstén B (1996) The prevalence of athmatic respiratory symptoms among adults in an Estonian and Swedish university town. Allergy 51: 331–336.PubMedCrossRefGoogle Scholar
  33. 33.
    Halvorsen R; Bosnes V, Thorsby E (1986) T cell responses to a Dermatophagoides farinae allergen preparation in allergies and healthy controls. Int Arch Allergy Appl Immunol 80: 62–69.PubMedCrossRefGoogle Scholar
  34. 34.
    Wierenga EA, Snoek M, Jansen HM, Bos JD, van LR, Kapsenberg ML (1991) Human atopen-specific types 1 and 2 T helper cell clones. J Immunol 147: 2942–2949.Google Scholar
  35. 35.
    Holt P (1995) Environmental factors and primary t-cell sensitization to inhalant allergens in infancy: reappraisal of the role of infections and air pollution. Pediatr Allergy Immunol 6: 1–10.PubMedCrossRefGoogle Scholar
  36. 36.
    McMenamin C, Holt PG (1993) The natural immune response to inhaled soluble protein antigens involves major histocompatibility complex (MHC) class I-restricted CD8+ T cell-mediated but MHC class II-restricted CD4+ T cell-dependent immune deviation resulting in selective suppression of IgE production. J Exp Med 178: 889–899.PubMedCrossRefGoogle Scholar
  37. 37.
    Sedgwick J, Holt P (1984) Suppression of IgE responses in inbred rats by repeated respiratory tract exposure to antigen: responder phenotype influences isotype specificity of induced tolerance. Eur J Immunol 14: 893–897.PubMedCrossRefGoogle Scholar
  38. 38.
    Rinas U, Horneff G, Wahn V (1993) Interferon-gamma production by cord-blood mononuclear cells is reduced in newborns with a family history of atopic disease and is independent from cord blood IgElevels. Pediatr Allergy Immunol 4: 60–64.PubMedCrossRefGoogle Scholar
  39. 39.
    Warner JA, Miles EA, Jones AC, Quint DJ, Colwell BM, Warner JO (1994) Is deficiency of interferon gamma production by allergen triggered cord blood cells a predictor of atopic eczema? Clin Exp Allergy 24: 423–430.PubMedCrossRefGoogle Scholar
  40. 40.
    Tang M, Kemp A, Thorburn J, Hill D (1994) Reduced interferon-gamma secretion in neonates and subsequent atopy. Lancet 344: 983–985.PubMedCrossRefGoogle Scholar
  41. 41.
    Björkstén B, Borres M, Einarsson R (1995) Interleukin-4, soluble CD23, and interferon-g levels in serum during the first 18 months of life. Int Arch Allergy Immunol 107: 34–36.PubMedCrossRefGoogle Scholar
  42. 42.
    Wu CY, Demeure CE, Gately M, Podlaski F, Yssel H, Kiniwa M, Delespesse G (1994) In vitro maturation of human neonatal CD4 T lymphocytes. I. Induction of IL-4-producing cells after long-term culture in the presence of IL-4 plus either IL-2 or IL-12. J Immunol 152: 1141–1153.PubMedGoogle Scholar
  43. 43.
    Kemeny DM, Urbanek R, Ewan P, McHugh S, Richards D, Patel S, Lessof MH (1989) The subclass of IgG antibody in allergic disease: II. The IgG subclass of antibodies produced following natural exposure to dust mite and grass pollen in atopic and non-atopic individuals. Clin Exp Allergy 19: 545–549.Google Scholar
  44. 44.
    Kemeny DM, Price JF, Richardson V, Richards D, Lessof MH (1991) The IgE and IgG subclass antibody response to foods in babies during the first year of life and their relationship to feeding regimen and the development of food allergy. J Allergy Clin Immunol 87: 920–992.PubMedCrossRefGoogle Scholar
  45. 45.
    Hattevig G, Kjellman B, Johansson SGO, Björkstén B (1984) Clinical symptoms and IgE responses to common food proteins in atopic and healthy children. Clin Allergy 14: 551–559.PubMedCrossRefGoogle Scholar
  46. 46.
    Hattevig G, Kjellman B, Björkstén B (1993) Appearance of IgE antibodies to ingested and inhaled allergens during first 12 years of life in atopic and non-atopic children. Pediatr Allergy Immunol 4: 182–189.PubMedCrossRefGoogle Scholar
  47. 47.
    Duchén K, Einarsson R, Grodzinsky E, Hattevig G, Björkstén B (1997) The development of IgG-1 and IgG-4 antibodies against beta-lactoglobulin and ovalbumin in healthy and atopic girls. Ann Allergy 78: 363–368.CrossRefGoogle Scholar
  48. 48.
    Van Asperen PP, Kemp AS, Mellis CM (1984) Skin test reactivity and clinical allergen sensitivity in infancy. J Allergy Clin Immunol 73: 381–386.PubMedCrossRefGoogle Scholar
  49. 49.
    Jones AC, Miles EA, Warner JO, Colwell BM, Bryant TN, Warner JA (1996) Fetal peripheral blood mononuclear cell proliferative responses to mitogenic and allergenic stimuli during gestation. Pediatr Allergy Immunol 7: 109–116.PubMedCrossRefGoogle Scholar
  50. 50.
    Holt PG, Clough JB, Holt BJ, et al. (1992) Genetic risk for atopy is associated with delayed postnatal maturation of T-cell competence. Clin Exp Allergy 22: 1093–1099.PubMedCrossRefGoogle Scholar
  51. 51.
    Nelson D, McMenamin C, Wilkes L, Holt PG (1991) Postnatal development of respiratory mucosal immune function in the rat: Regulation of IgE responses to inhaled allergen. Pediatr Allergy Immunol 4: 170–177.Google Scholar
  52. 52.
    Nelson DJ, McMenamin C, McWilliam AS, Brenan M, Holt PG (1994) Development of the airway intraepithelial dendritic cell network in the rat from class II MHC (Ia) negative precursors: differential regulation of Ia expression at different levels of the respiratory tract. J Exp Med 179: 203–212.PubMedCrossRefGoogle Scholar
  53. 53.
    Madani G, Heiner DC (1989) Antibody transmission from mother to fetus. Curr Opin Immunol 1: 1157–1164.PubMedCrossRefGoogle Scholar
  54. 54.
    Miller DL, Hirvonen T, Gitlin D (1973) Synthesis of IgE by human conceptus. J Allergy Clin Immunol 52: 182–188.PubMedCrossRefGoogle Scholar
  55. 55.
    Rognum TO, Thrane S, Stoltenberg L, Vege A, Brandtzaeg P (1992) Development of intestinal mucosal immunity in fetal life and the first postnatal months. Pediatr Res 32: 145–149.PubMedCrossRefGoogle Scholar
  56. 56.
    Delespesse G, Sarfati M, Lang G, Sehon A (1983) Prenatal and neonatal synthesis of IgE. Monogr Allergy 18: 83–95.PubMedGoogle Scholar
  57. 57.
    Kjellman N-IM (1994) IgE determinations in neonates is not suitable for general screening. Pediatr Allergy Immunol 5: 1–4.PubMedCrossRefGoogle Scholar
  58. 58.
    Businco L, Marchetti F, Pellegrini G, Perlini R (1983) Predictive value of cord blood IgE levels in ‘at-risk’ newborn babies and influence of type of feeding. Clin Allergy 13: 503–508.PubMedCrossRefGoogle Scholar
  59. 59.
    Host A, Halken S (1990) A prospective study of cow milk allergy in Danish infants during the first 3 years of life. Allergy 45: 587–596.PubMedCrossRefGoogle Scholar
  60. 60.
    H¢st A, Husby S, Gjesing B, Larsen J, L¢wenstein H (1992) Prospective estimation of IgG, IgG subclass and IgE antibodies to dietary proteins in infants with cow milk allergy. Allergy 47: 218–229.Google Scholar
  61. 61.
    Levin S, Altman Y, Sela M (1971) Penicillin and dinitrophenyl antibodies in newborn and mothers detected with chemically modified bacteriophage. Pediatr Res 5: 87–88.CrossRefGoogle Scholar
  62. 62.
    Weil G, Hussain R, Kumaraswami V, Tripathy S, Phillips K, Oliesen E (1983) Prenatal allergic sensitization to helminth antigen in offspring of parasite-infected mothers. J Clin Invest 71: 1124–1129.PubMedCrossRefGoogle Scholar
  63. 63.
    Dahl GMK, Telemo E, Wesström BR, Jacobsson I, Lindberg T, Karlsson BW (1984) The passage of orally fed protein from mother to foetus in the rat. Comp Biochem Physiol 74: 199–201.CrossRefGoogle Scholar
  64. 64.
    Husby S, Schultz Larsen F, Petersen PH (1987) Genetic influence on the serum levels of naturally occurring human IgG antibodies to dietary antigens. Quantitative assessment from a twin study. J Immunogenet 14: 131–142.Google Scholar
  65. 65.
    Zeiger R, Heller S, Mellon M, Helsey J, Hamburger R, Sampson H (1992) Genetic and environmental factors affecting the development of atopy through age 4 in children of atopic parents: A prospective randomized study of food allergen avoidance. Pediatr Allergy Immunol 3: 110–127.Google Scholar
  66. 66.
    Fälth-Magnusson K, Kjellman N-IM (1992) Allergy prevention by maternal elimination diet during late pregnancy-a 5-year follow-up of a randomized study. J Allergy Clin Immunol 89: 709–713.PubMedCrossRefGoogle Scholar
  67. 67.
    Mellander L, Carlsson B, Hanson L-A (1986) Secretory IgA and IgM antibodies to E. coli and poliovirus type I antigens occur in amniotic fluid, meconium and saliva from newborns. Clin Exp Immunol 63: 555–561.Google Scholar
  68. 68.
    Hahn ZM, Carlsson B, Björkander J, Osterhaus AD, Mellander L, Hanson LA (1992) Presence of non-maternal antibodies in newborns of mothers with antibody deficiencies. Pediatr Res 32: 150–154.CrossRefGoogle Scholar
  69. 69.
    Kimpen J, Callaert H, Embrechts P, Bosmans E (1989) Influence of sex and gestational age on cord blood IgE. Acta Paediatr Scand 78: 233–238.PubMedCrossRefGoogle Scholar
  70. 70.
    Piccinni MP, Mecacci F, Sampognaro S, Manetti R, Parronchi P, Maggi E, Romagnini S (1993) Aeroallergen sensitization can occur during fetal life. Int Arch Allergy Immunol 102: 301–303.PubMedCrossRefGoogle Scholar
  71. 71.
    Bramwell F (1970) The transmission of antibodies. In: Bramwell F, ed. The transmission of immunity from the mother to the young. North-Holland, Amsterdam, pp. 242–250.Google Scholar
  72. 72.
    Amstey MS (1991) The potential for maternal immunization to protect against neonatal infections. Semin Perinatol 15: 206–209.PubMedGoogle Scholar
  73. 73.
    Lilja G, Dannaeus A, Fälth-Magnusson K, Graff Lonnevig V, Johansson SGO, Kjellman N-IM, Öman H (1988) Immune response of the atopic woman and foetus: effects of high-and low-dose food allergen intake during late pregnancy. Clin Allergy 18: 131–142.PubMedCrossRefGoogle Scholar
  74. a. Jenmalm M, Björkstén B (1998) Maternal influence on IgG subclass antibodies to Beta 1 during the first 18 months of life detected with a sensitive ELISA, in press.Google Scholar
  75. 74.
    Fälth-Magnusson K, Oman H, Kjellman N-IM (1987) Maternal abstention from cow milk and egg in allergy risk pregnancies. Effect on antibody production in the mother and the newborn. Allergy 42: 64–73.Google Scholar
  76. 75.
    Dannaeus A, Johansson S, Foucard T (1978) Clinical and immunological aspects of food allergy in childhood H. Development of allergic symptoms and humoral immune response to foods in infants of atopic mothers during the first 24 months of life. Acta Paediatr Scand 67: 497–504.PubMedCrossRefGoogle Scholar
  77. 76.
    Vassella C, Odelram H, Kjellman N-I, Borres M, Vanto T, Björkstén B (1994) High anti-IgE levels at birth are associated with a reduced allergy incidence in early childhood. Clin Exp Allergy 24: 771–777.PubMedCrossRefGoogle Scholar
  78. 77.
    Cookson W, Young R, Sanford A, Moffatt MF, Shirakawa T, Sharp PA, Faux JA, Julier C, Le Souef P, Nakamura V (1992) Maternal inheritance of atopic IgE responsiveness on chromosome 1 lq. Lancet 340: 381–384.PubMedCrossRefGoogle Scholar
  79. 78.
    Wegmann T, Lin H, Guilbert L, Mosmann TR (1993) Bidirectional cytokine interactions in the maternal-fetal relationship: is successful pregnancy a Th2 phenomenon? Immunol Today 14: 353–356.PubMedCrossRefGoogle Scholar
  80. 79.
    Chen N, Field EH (1995) Enhanced type 2 and diminished type 1 cytokines in neonatal tolerance. Transplantation 60: 1187–1193.PubMedGoogle Scholar
  81. 80.
    Lilja G, Dannaeus A, Foucard T, Graff-Lonnevig V, Johansson S, Oman H (1989) Effects of maternal diet during late pregnancy and lactation on the development of atopic diseases in infants up to eighteen months of age-in vivo results. Clin Exp Allergy 19: 473–479.PubMedCrossRefGoogle Scholar
  82. 81.
    Halken S, Host A, Nilsson L, Taudorf E (1995) Passive smoking as a risk factor for development of obstructive respiratory disease and allergic sensitization. Allergy 50: 97–105.PubMedCrossRefGoogle Scholar
  83. 82.
    Björkstén B, Finnström O, Wichman K (1988) Intrauterine exposure to the beta-adrenergic receptor-blocking agent metoprolol and allergy. Int Arch Allergy Appl Immunol 87: 59–62.PubMedCrossRefGoogle Scholar
  84. 83.
    Rylander E, Pershagen G, Eriksson M, Nordvall L (1993) Parental smoking and other risk factors for wheezing bronchitis in children. Eur J Epidemiol 9: 517–526.PubMedCrossRefGoogle Scholar
  85. 84.
    Kajosaari M, Saarinen UM (1983) Prophylaxis of atopic disease by six months total solid food elimination. Acta Pædiatr Scand 72: 411–441.PubMedCrossRefGoogle Scholar
  86. 85.
    Saarinen U (1995) Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet 346: 1065–1069.PubMedCrossRefGoogle Scholar
  87. 86.
    Koutras AK, Vigorita VJ (1989) Fecal secretory immunoglobulin A in breast milk versus formula feeding in early infancy. J Pediatr Gastroenterol Nutr 9 (1): 58–61.PubMedGoogle Scholar
  88. 87.
    Goldman A (1986) Immunologic system in human milk. J Pediatric Gastroenterol Nutr 5: 343–345.CrossRefGoogle Scholar
  89. 88.
    Machtinger S, Moss R (1986) Cow’s milk allergy in breast-fed infants: The role of allergen and maternal secretory IgA antibody. J Allergy Clin Immunol 77: 341–347.Google Scholar
  90. 89.
    Prentice A (1987) Breast feeding increases concentrations of IgA in infants’ urine. Archives Disease Childhood 62: 792–795.CrossRefGoogle Scholar
  91. 90.
    Robinson G (1991) Identification of a secretory IgA receptor on breast-milk macrophages: Evidence for specific activation via these receptors. Pediatric Res 29: 429–434.CrossRefGoogle Scholar
  92. 91.
    Pittard W, Bill K (1979) Immunoregulation by breast milk cells. Cell Immunol 42: 437–414.PubMedCrossRefGoogle Scholar
  93. 92.
    Schlesinger J, Covelli HD (1977) Evidence for transmission of lymphocyte responses to tuberculin by breast-feeding. Lancet 529–532.Google Scholar
  94. 93.
    Shiba T, Minagawa T, Mito K, Nakane A, Suga K, Hanjo T, Nakao T (1987) Effect of breast feeding on responses of systemic interferon and virus-specific lymphocyte transformation in infants with respiratory syncytial virus infection. J Med Virol 21: 7–14.CrossRefGoogle Scholar
  95. 94.
    Delespesse G (1986) Presence of IgE suppressive factors in human colostrum. Eur J Immunol 16: 1005–1008.PubMedCrossRefGoogle Scholar
  96. 95.
    Osebold J, Chung Zee Y, Gershwin L (1988) Enhancement of allergic lung sensitization in mice by ozone inhalation. Proc Soc Exp Biol Med 188: 259–264.PubMedGoogle Scholar
  97. 96.
    Holt P, McMenamin C, Nelson D (1990) Primary sensitization to inhalant allergens during infancy. Pediatr Allergy Immunol 1: 3–13.CrossRefGoogle Scholar
  98. 97.
    Holt P, McMenamin C (1989) Defense against allergic sensitization in the healthy lung: the role of inhalation tolerance. Clin Exp Allergy 19: 255–262.PubMedCrossRefGoogle Scholar
  99. 98.
    Holt P (1987) Immune and inflammatory function in cigarette smokers. Thorax 42: 241–249.PubMedCrossRefGoogle Scholar
  100. 99.
    Nilsson L, Björkstén B (1993) Factors which promote or prevent allergy. In: Dukor P, Hanson L, eds. Monographs in Allergy. S. Karger AG, Basel, Vol. 31, pp. 190–210.Google Scholar
  101. 100.
    Andrae S, Axelson O, Björkstén B, Fredriksson M, Kjellman N-IM (1988) Symptoms of bronchial hyperreactivity and asthma in relation to environmental factors. Arch Dis Child 63: 473–478.PubMedCrossRefGoogle Scholar
  102. 101.
    Ishizaki T, Koizumi K, Ikemori R, Ishyama Y, Kushibiki E (1987) Studies of prevalence of Japanese cedar pollinosis among the residents in a densely cultivated area. Ann Allergy 58: 265–270.PubMedGoogle Scholar
  103. 102.
    Zetterström O, Osterman K, Machado L, Johansson SGO (1981) Another smoking hazard: raised serum IgE concentration and increased risk of occupational allergy. Brit Med J 283: 1215–1217.CrossRefGoogle Scholar
  104. 103.
    Zetterström O, Nordvall SL, Björkstén B, Ahlstedt S, Stelander M (1985) Increased IgE antibody responses in rats exposed to tobacco smoke. J Allergy Clin Immunol 75: 594–598.PubMedCrossRefGoogle Scholar
  105. 104.
    Munir A, Björkstén B (1992) Indoor air pollution and allergic sensitization. In: Knöppel H, Wolkoff P, eds. Chemical Microbiological Health and Comfort. ECSC, EEC, Brussels, pp. 181–199.Google Scholar
  106. 105.
    Dekker C, Dales R, Bartlett S, Brunekreef B, Zwanenburg H (1991) Childhood asthma and the indoor environment. Chest 100 (4): 922–926.PubMedCrossRefGoogle Scholar
  107. 106.
    Munir AKM, Björkstén B, Einarsson R, Ekstrand-Tobin A, Warner A, Kjellman N-IM (1995) Mite allergens in relation to home conditions of asthmatic children from three climatic regions. Allergy 50: 55–64.PubMedCrossRefGoogle Scholar
  108. 107.
    Wickman M, Nordvall SL, Pershagen G (1992) Risk factors in early childhood for sensitization to airborne allergens. Pediatr Allergy Immunol 3: 128–133.CrossRefGoogle Scholar
  109. 108.
    Wickman M (1993) Residential characteristics and allergic sensitization in children especially to mites [Dissertation]. Karolinska Institutet, Stockholm.Google Scholar
  110. 109.
    Frick OL, Brooks DL (1983) Immunoglobulin E antibodies to pollens augmented in dogs by virus vaccines. Am J Vet Res 44: 440–445.Google Scholar
  111. 110.
    Alwan WH, Kozlowska K, Openshaw PJ (1994) Distinct types of lung disease caused by functional subsets of antiviral T cells. J Exp Med 179: 81–89.PubMedCrossRefGoogle Scholar
  112. 111.
    Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B, Björkstén B (1995) Asthma and IgE antibodies after respiratory syncytial virus bronchiolitis: a prospective cohort study with matched controls. Pediatrics 95: 500–550.PubMedGoogle Scholar
  113. 112.
    Pauwels R, van der Straeten M, Platteu B, Bazin H (1983) The non-specific enhancement of allergy In vitro effects of Bordetella pertussis vaccine on IgE synthesis. Allergy 38: 239–246.PubMedCrossRefGoogle Scholar
  114. 113.
    Sen D, Arora S, Gupta S, Sanyal R (1974) Studies of adrenergic mechanisms in relation to histamine sensitivity in children immunized with Bordetella pertussis vaccine. J Allergy Clin Immunol 54: 25–31.PubMedCrossRefGoogle Scholar
  115. 114.
    Hedenskog S, Björkstén B, Blennow M, Granström G, Granström M (1989) Immunoglobulin E response to pertussis toxin in whooping cough and after immunization with a whole-cell and an acellular pertussis vaccine. Int Arch Allergy Appl Immunol 89: 156–161.Google Scholar
  116. 115.
    Blennow M, Granström M, Björkstén B (1990) Immunoglobulin E response to pertussis toxin after vac cination with acellular pertussis vaccine. In: Manclark CR, ed. Proceedings of the Sixth International Symposium on Pertussis. Department of Health and Human Services, United States Public Health Service, Bethesda, Maryland, pp. 184–188.Google Scholar
  117. 116.
    Duchén K, Granström M, Hedenskog S, Blennow M, Björkstén B (1996) Immunoglobulin E and G responses to pertusis toxin in children immunised with adsorbed and non-adsorbed whole-cell pertussis vaccines. Pediatr Allergy Imunol 7:in press.Google Scholar
  118. 117.
    Nilson L, Kjellman N-IM, Storsaeter J, Gustafsson L, Olin P (1996) Lack of association between pertussis vaccination and symptoms of asthma and allergy. JAMA 275: 760.CrossRefGoogle Scholar
  119. 118.
    Mark A, Björkstén B, Granström M (1995) Immunoglobulin E responses to diphteria and tetanus toxoids after booster with aluminium-adsorbed and fluid DT vaccines. Vaccine 13: 669–673.Google Scholar
  120. 119.
    Mark A, Björkstén B, Granström M (1997) Immunoglobulin E and G antibodies two years after a booster dose of an aluminium-adsorbed and a fluid DT vaccine in relation to atopy. Vaccine in press.Google Scholar
  121. 120.
    Strannegârd I-L, Strannegârd O (1981) Epstein-Barr virus antibody in children with atopic disease. Int Arch Allergy Appl Immunol 64: 314–319.PubMedCrossRefGoogle Scholar
  122. 121.
    Strachan D (1989) Hay fever, hygiene and household size. Br Med J 289: 1259–1260.CrossRefGoogle Scholar
  123. 122.
    Strachan D (1995) Epidemiology of hay fever: towards a community diagnosis. Clin Exp Allergy 25: 296–303.PubMedCrossRefGoogle Scholar
  124. 122a.
    Shirakawa T, Eramoto T, Shimagu S, Hopkins J (1997) The inverse association between tuberculin responses and atopic disorders. Science 275: 77–79.PubMedCrossRefGoogle Scholar
  125. 123.
    von Mutius E, Fritzsch C, Weiland SK, Röll G, Magnussen H (1992) Prevalence of asthma and allergic disorders among schoolchildren in united Germany: a descriptive comparison. Br Med J 305: 1395–1399.CrossRefGoogle Scholar
  126. 124.
    Vasar M, Bräbäck L, Julge K, Knutsson A, Riikjäry M-A, Björkstén B (1996) Pediatr Allergy Immunol 7:in press.Google Scholar
  127. 125.
    Holt PG (1994) A potential vaccine strategy for asthma and allied atopic diseases during early child hood. Lancet 344: 456–458.PubMedCrossRefGoogle Scholar
  128. 126.
    Gustafsson PA, Kjellman N-IM, Cederblad M (1986) Family therapy in the treatment of severe child hood asthma. J Psychosom Res 30: 369–374.PubMedCrossRefGoogle Scholar
  129. 127.
    Gustafsson PA, Kjellman N-IM, Ludvigsson J, Cederblad M (1987) Asthma and family interaction. Arch Dis Child 62: 258–263.PubMedCrossRefGoogle Scholar
  130. 128.
    Gustafsson PA, Björkstén B, Kjellman N-IM (1994) Family dysfunction in asthma-A prospective study of illness development. J Pediatrics 125: 493–498.CrossRefGoogle Scholar
  131. 129.
    Hattevig G, Kjellman B, Sigurs N, Björkstén B, Kjellman N-IM (1989) Effect of maternal avoidance of eggs, cow’s milk and fish during lactation upon allergic manifestations in infants. Clin Exp Allergy 19: 27–32.PubMedCrossRefGoogle Scholar
  132. 130.
    Zeiger RS, Heller S, Mellon MH, Helsey JF, Hamburger RN, Sampson HA (1992) Genetic and environmental factors affecting the development of atopy through age 4 in children of atopic parents: a prospective randomized study of food allergen avoidance. Pediatr Allergy Immunol 3: 110–127.CrossRefGoogle Scholar
  133. 131.
    Arshad SH, Matthews S, Gant C, Hide DW (1992) Effect of allergen avoidance on development of allergic disorders in infancy. Lancet 339: 1493–1497.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Bengt Björkstén

There are no affiliations available

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