The European GABRIEL Advanced Studies
project has provided a large body of data and samples for investigating effects
of traditional farm environments on childhood asthma and atopy. Research on the
GABRIELA cohort has demonstrated that traditional farming environments like
those found in Europe have a protective effect on childhood atopy and, less
consistently, childhood asthma. Yet, recent findings show that microbial
diversity in farming environments appears to play a stronger role for asthma
than for atopy. This month’s issue holds another important report on the impact
of farm life on different childhood wheeze phenotypes by Fuchs et al. (J Allergy Clin Immunol 2012;130:382-388.e6).
Fuchs et al note that there are
different wheeze phenotypes that correlate to different clinical outcomes, and
that comorbid atopy complicates the search for wheeze-specific farm effects. To
address this, the authors partition the study population into atopic and non-atopic
children. In addition to analyzing the farm effect on atopy, they further investigate
the effect on different wheeze phenotypes (transient, current, persistent,
late-onset), airway inflammation and lung function for atopic and non-atopic
children, separately.
They report that farm environment has a
significant beneficial effect on all wheeze phenotypes. This protective effect
was independent of atopic sensitization. This was different for lung mechanics
as measured by lung function and on airway inflammation, on which farming had
no appreciable overall effect. However, farm-exposed atopic children had less severe
lung function impairment and lower exhaled nitric oxide (FeNO) than non-exposed
atopic children.
Fuchs et al. speculate that farming’s
protective effects are mediated through antiviral activities of the innate
immune system that minimize respiratory infections. Future steps in their
research to better elucidate underlying mechanisms will be analyses in
prospective setups and studies further including the analysis of innate and
adaptive immune mechanisms related to defense against viral infections and the
role of the microbiome in upper and lower airways herein.
