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Farm living: effects on childhood asthma and allergy

Nature Reviews Immunology volume 10, pages 861–868 (2010)Cite this article

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An Author Correction to this article was published on 17 July 2019

Abstract

Numerous epidemiological studies have shown that children who grow up on traditional farms are protected from asthma, hay fever and allergic sensitization. Early-life contact with livestock and their fodder, and consumption of unprocessed cow's milk have been identified as the most effective protective exposures. Studies of the immunobiology of farm living point to activation and modulation of innate and adaptive immune responses by intense microbial exposures and possibly xenogeneic signals delivered before or soon after birth.

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Figure 1: A working model of the immunobiology of farm exposure.
Figure 2: Mechanisms potentially underlying the impact of farm exposure on the human immune system.

References

  1. Eder, W., Ege, M. J. & von Mutius, E. The asthma epidemic. N. Engl. J. Med. 355, 2226–2235 (2006).

    CAS  PubMed  Google Scholar 

  2. Strachan, D. P., Anderson, H. R., Limb, E. S., O'Neill, A. & Wells, N. A national survey of asthma prevalence, severity, and treatment in Great Britain. Arch. Dis. Child. 70, 174–178 (1994).

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Riedler, J. et al. Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet 358, 1129–1133 (2001).

    CAS  PubMed  Google Scholar 

  4. Ege, M. J. et al. Not all farming environments protect against the development of asthma and wheeze in children. J. Allergy Clin. Immunol. 119, 1140–1147 (2007).

    PubMed  Google Scholar 

  5. Braun-Fahrländer, C. et al. Prevalence of hay fever and allergic sensitization in farmer's children and their peers living in the same rural community. SCARPOL team. Swiss Study on Childhood Allergy and Respiratory Symptoms with Respect to Air Pollution. Clin. Exp. Allergy 29, 28–34 (1999).

    PubMed  Google Scholar 

  6. Riedler, J., Eder, W., Oberfeld, G. & Schreuer, M. Austrian children living on a farm have less hay fever, asthma and allergic sensitization. Clin. Exp. Allergy 30, 194–200 (2000).

    CAS  PubMed  Google Scholar 

  7. Riedler, J. et al. Early life exposure to farming environment is essential for protection against the development of asthma and allergy: a cross-sectional survey. Lancet 358, 1129–1133 (2001).

    CAS  PubMed  Google Scholar 

  8. Von Ehrenstein, O. S. et al. Reduced risk of hay fever and asthma among children of farmers. Clin. Exp. Allergy 30, 187–193 (2000).

    CAS  PubMed  Google Scholar 

  9. Douwes, J. et al. Farm exposure in utero may protect against asthma, hay fever and eczema. Eur. Respir. J. 32, 603–611 (2008).

    CAS  PubMed  Google Scholar 

  10. Ege, M. J. et al. Prenatal farm exposure is related to the expression of receptors of the innate immunity and to atopic sensitization in school-age children. J. Allergy Clin. Immunol. 117, 817–823 (2006).

    PubMed  Google Scholar 

  11. Schaub, B. et al. Maternal farm exposure modulates neonatal immune mechanisms through regulatory T cells. J. Allergy Clin. Immunol. 123, 774–782 e5 (2009).

    CAS  PubMed  Google Scholar 

  12. Pfefferle, P. I. et al. Cord blood cytokines are modulated by maternal farming activities and consumption of farm dairy products during pregnancy: the PASTURE Study. J. Allergy Clin. Immunol. 125, 108–115 e1–3 (2010).

    CAS  PubMed  Google Scholar 

  13. Ege, M. J. et al. Specific IgE to allergens in cord blood is associated with maternal immunity to Toxoplasma gondii and rubella virus. Allergy 63, 1505–1511 (2008).

    CAS  PubMed  Google Scholar 

  14. Perkin, M. R. & Strachan, D. P. Which aspects of the farming lifestyle explain the inverse association with childhood allergy? J. Allergy Clin. Immunol. 117, 1374–1381 (2006).

    PubMed  Google Scholar 

  15. Wickens, K. et al. Farm residence and exposures and the risk of allergic diseases in New Zealand children. Allergy 57, 1171–1179 (2002).

    CAS  PubMed  Google Scholar 

  16. Waser, M. et al. Inverse association of farm milk consumption with asthma and allergy in rural and suburban populations across Europe. Clin. Exp. Allergy 37, 661–670 (2007).

    CAS  PubMed  Google Scholar 

  17. Perkin, M. R. Unpasteurized milk: health or hazard? Clin. Exp. Allergy 37, 627–630 (2007).

    CAS  PubMed  Google Scholar 

  18. Seedorf, J. et al. Concentrations and emissions of airborne endotoxins and microorganisms in livestock buildings in Northern Europe. J. Agr. Eng. Res. 70, 97–109 (1998).

    Google Scholar 

  19. Peters, M. et al. Arabinogalactan isolated from cowshed dust extract protects mice from allergic airway inflammation and sensitization. J. Allergy Clin. Immunol. 126, 648–656 (2010).

    CAS  PubMed  Google Scholar 

  20. Sudre, B. et al. High levels of grass pollen inside European dairy farms: a role for the allergy-protective effects of environment? Allergy 64, 1068–1073 (2009).

    CAS  PubMed  Google Scholar 

  21. Vogel, K. et al. Animal shed Bacillus licheniformis spores possess allergy-protective as well as inflammatory properties. J. Allergy Clin. Immunol. 122, 307–312 (2008).

    PubMed  Google Scholar 

  22. Braun-Fahrländer, C. et al. Environmental exposure to endotoxin and its relation to asthma in school-age children. N. Engl. J. Med. 347, 869–877 (2002).

    PubMed  Google Scholar 

  23. van Strien, R. T. et al. Microbial exposure of rural school children, as assessed by levels of N-acetyl-muramic acid in mattress dust, and its association with respiratory health. J. Allergy Clin. Immunol. 113, 860–867 (2004).

    CAS  PubMed  Google Scholar 

  24. Douwes, J. et al. Lifelong farm exposure may strongly reduce the risk of asthma in adults. Allergy 62, 1158–1165 (2007).

    CAS  PubMed  Google Scholar 

  25. Lauener, R. P. et al. Expression of CD14 and Toll-like receptor 2 in farmers' and non-farmers' children. Lancet 360, 465–466 (2002).

    CAS  PubMed  Google Scholar 

  26. Ege, M. J. et al. Prenatal farm exposure is related to the expression of receptors of the innate immunity and to atopic sensitization in school-age children. J. Allergy Clin. Immunol. 117, 817–823 (2006).

    PubMed  Google Scholar 

  27. Stern, D. A. et al. Exposure to a farming environment has profound, allergen-specific effects on in vivo isotype switching in response to common inhalants. J. Allergy Clin. Immunol. 119, 351–358 (2007).

    CAS  PubMed  Google Scholar 

  28. von Mutius, E. & Schmid, S. The PASTURE project: EU support for the improvement of knowledge about risk factors and preventive factors for atopy in Europe. Allergy 61, 407–413 (2006).

    CAS  PubMed  Google Scholar 

  29. Pfefferle, P. I. et al. Cord blood allergen-specific IgE is associated with reduced IFN-γ production by cord blood cells: the Protection against Allergy-Study in Rural Environments (PASTURE) study. J. Allergy Clin. Immunol. 122, 711–716 (2008).

    CAS  PubMed  Google Scholar 

  30. Chen, X., Baumel, M., Mannel, D. N., Howard, O. M. & Oppenheim, J. J. Interaction of TNF with TNF receptor type 2 promotes expansion and function of mouse CD4+CD25+ T regulatory cells. J. Immunol. 179, 154–161 (2007).

    CAS  PubMed  Google Scholar 

  31. Lauener, R. P. L., Goyert, S. M., Geha, R. S. & Vercelli, D. Interleukin 4 down-regulates the expression of CD14 in normal human monocytes. Eur. J. Immunol. 20, 2375–2381 (1990).

    CAS  PubMed  Google Scholar 

  32. Cosentino, G. et al. IL-13 downregulates CD14 expression and TNF-α secretion in human monocytes. J. Immunol. 155, 3145–3151 (1995).

    CAS  PubMed  Google Scholar 

  33. Wright, A. L. The epidemiology of the atopic child: who is at risk for what? J. Allergy Clin. Immunol. 113, S2–S7 (2004).

    PubMed  Google Scholar 

  34. Vuillermin, P. J. et al. Microbial exposure, interferon gamma gene demethylation in naïve T-cells, and the risk of allergic disease. Allergy 64, 348–353 (2009).

    CAS  PubMed  Google Scholar 

  35. Stern, D. A., Guerra, S., Halonen, M., Wright, A. L. & Martinez, F. D. Low IFN-γ production in the first year of life as a predictor of wheeze during childhood. J. Allergy Clin. Immunol. 120, 835–841 (2007).

    CAS  PubMed  Google Scholar 

  36. Romagnani, S. Coming back to a missing immune deviation as the main explanatory mechanism for the hygiene hypothesis. J. Allergy Clin. Immunol. 119, 1511–1513 (2007).

    PubMed  Google Scholar 

  37. Amsen, D. et al. Instruction of distinct CD4 T helper cell fates by different notch ligands on antigen-presenting cells. Cell 117, 515–526 (2004).

    CAS  PubMed  Google Scholar 

  38. Debarry, J. et al. Acinetobacter lwoffii and Lactococcus lactis strains isolated from farm cowsheds possess strong allergy-protective properties. J. Allergy Clin. Immunol. 119, 1514–1521 (2007).

    PubMed  Google Scholar 

  39. Levy, O. Innate immunity of the newborn: basic mechanisms and clinical correlates. Nature Rev. Immunol. 7, 379–390 (2007).

    CAS  Google Scholar 

  40. Halonen, M. et al. Th1/Th2 patterns and balance in cytokine production in the parents and infants of a large birth cohort. J. Immunol. 182, 3285–3293 (2009).

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Muzio, M. et al. Differential expression and regulation of toll-like receptors (TLR) in human leukocytes: selective expression of TLR3 in dendritic cells. J. Immunol. 164, 5998–6004 (2000).

    CAS  PubMed  Google Scholar 

  42. Bach, F. H. et al. Barriers to xenotransplantation. Nature Med. 1, 869–873 (1995).

    CAS  PubMed  Google Scholar 

  43. Forte, P., Lilienfeld, B. G., Baumann, B. C. & Seebach, J. D. Human NK cytotoxicity against porcine cells is triggered by NKp44 and NKG2D. J. Immunol. 175, 5463–5470 (2005).

    CAS  PubMed  Google Scholar 

  44. Snijders, A., Kalinski, P., Hilkens, C. M. & Kapsenberg, M. L. High-level IL-12 production by human dendritic cells requires two signals. Int. Immunol. 10, 1593–1598 (1998).

    CAS  PubMed  Google Scholar 

  45. Friedlander, S. L. et al. Viral infections, cytokine dysregulation and the origins of childhood asthma and allergic diseases. Pediatr. Infect. Dis. J. 24, S170–S176 (2005).

    PubMed  Google Scholar 

  46. Martinez, F. D. The origins of asthma and chronic obstructive pulmonary disease in early life. Proc. Am. Thorac. Soc. 6, 272–277 (2009).

    PubMed  PubMed Central  Google Scholar 

  47. Peters, M. et al. Inhalation of stable dust extract prevents allergen induced airway inflammation and hyperresponsiveness. Thorax 61, 134–139 (2006).

    CAS  PubMed  Google Scholar 

  48. Conrad, M. L. et al. Maternal TLR signaling is required for prenatal asthma protection by the nonpathogenic microbe Acinetobacter lwoffii F78. J. Exp. Med. 206, 2869–2877 (2009).

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Gorelik, L. et al. Modulation of dendritic cell function by cowshed dust extract. Innate Immun. 14, 345–355 (2008).

    CAS  PubMed  Google Scholar 

  50. Holt, P. G. & Strickland, D. H. Soothing signals: transplacental transmission of resistance to asthma and allergy. J. Exp. Med. 206, 2861–2864 (2009).

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Radon, K. et al. Contact with farm animals in early life and juvenile inflammatory bowel disease: a case-control study. Pediatrics 120, 354–361 (2007).

    PubMed  Google Scholar 

  52. Radon, K. et al. Exposure to animals and risk of oligoarticular juvenile idiopathic arthritis: a multicenter case-control study. BMC Musculoskelet. Disord. 11, 73 (2010).

    PubMed  PubMed Central  Google Scholar 

  53. Radon, K. et al. Exposure to farming environments in early life and type 1 diabetes: a case-control study. Diabetes 54, 3212–3216 (2005).

    CAS  PubMed  Google Scholar 

  54. Viinanen, A. et al. Prevalence of asthma, allergic rhinoconjunctivitis and allergic sensitization in Mongolia. Allergy 60, 1370–1377 (2005).

    CAS  PubMed  Google Scholar 

  55. Viinanen, A. et al. The protective effect of rural living against atopy in Mongolia. Allergy 62, 272–280 (2007).

    CAS  PubMed  Google Scholar 

  56. Ma, Y. et al. Very low prevalence of asthma and allergies in schoolchildren from rural Beijing, China. Pediatr. Pulmonol. 44, 793–799 (2009).

    PubMed  Google Scholar 

  57. Wong, G. W. Developing world: asthma in a rural setting. Paediatr. Respir. Rev. 7, S119–S120 (2006).

    PubMed  Google Scholar 

  58. Pearce, N. et al. Worldwide trends in the prevalence of asthma symptoms: phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax 62, 758–766 (2007).

    PubMed  PubMed Central  Google Scholar 

  59. Kilpelainen, M., Terho, E. O., Helenius, H. & Koskenvuo, M. Farm environment in childhood prevents the development of allergies. Clin. Exp. Allergy 30, 201–208 (2000).

    CAS  PubMed  Google Scholar 

  60. Alfven, T. et al. Allergic diseases and atopic sensitization in children related to farming and anthroposophic lifestyle – the PARSIFAL study. Allergy 61, 414–421 (2006).

    CAS  Google Scholar 

  61. Klintberg, B., Berglund, N., Lilja, G., Wickman, M. & van Hage-Hamsten, M. Fewer allergic respiratory disorders among farmers' children in a closed birth cohort from Sweden. Eur. Respir. J. 17, 1151–1157 (2001).

    CAS  PubMed  Google Scholar 

  62. Horak, F. Jr et al. Parental farming protects children against atopy: longitudinal evidence involving skin prick tests. Clin. Exp. Allergy 32, 1155–1159 (2002).

    PubMed  Google Scholar 

  63. Portengen, L. et al. Low prevalence of atopy in young Danish farmers and farming students born and raised on a farm. Clin. Exp. Allergy 32, 247–253 (2002).

    CAS  PubMed  Google Scholar 

  64. Smit, L. A. et al. Hay fever and asthma symptoms in conventional and organic farmers in The Netherlands. Occup. Environ. Med. 64, 101–107 (2007).

    PubMed  Google Scholar 

  65. Schulze, A., van Strien, R. T., Praml, G., Nowak, D. & Radon, K. Characterisation of asthma among adults with and without childhood farm contact. Eur. Respir. J. 29, 1169–1173 (2007).

    CAS  PubMed  Google Scholar 

  66. Koskela, H. O., Happonen, K. K., Remes, S. T. & Pekkanen, J. Effect of farming environment on sensitisation to allergens continues after childhood. Occup. Environ. Med. 62, 607–611 (2005).

    CAS  PubMed  PubMed Central  Google Scholar 

  67. Radon, K., Ehrenstein, V., Praml, G. & Nowak, D. Childhood visits to animal buildings and atopic diseases in adulthood: an age-dependent relationship. Am. J. Ind. Med. 46, 349–356 (2004).

    PubMed  Google Scholar 

  68. Remes, S. T., Iivanainen, K., Koskela, H. & Pekkanen, J. Which factors explain the lower prevalence of atopy amongst farmers' children? Clin. Exp. Allergy 33, 427–434 (2003).

    CAS  PubMed  Google Scholar 

  69. Braback, L., Hjern, A. & Rasmussen, F. Trends in asthma, allergic rhinitis and eczema among Swedish conscripts from farming and non-farming environments. A nationwide study over three decades. Clin. Exp. Allergy 34, 38–43 (2004).

    CAS  PubMed  Google Scholar 

  70. Kiechl-Kohlendorfer, U. et al. Neonatal characteristics and risk of atopic asthma in schoolchildren: results from a large prospective birth-cohort study. Acta Paediatr. 96, 1606–1610 (2007).

    PubMed  Google Scholar 

  71. Wennergren, G. et al. Asthma in late adolescence – farm childhood is protective and the prevalence increase has levelled off. Pediatr. Allergy Immunol. 21, 806–813 (2010).

    PubMed  Google Scholar 

  72. Eriksson, J. et al. Growing up on a farm leads to lifelong protection against allergic rhinitis. Allergy 65, 1397–1403 (2010).

    CAS  PubMed  Google Scholar 

  73. Kilpelainen, M., Terho, E. O., Helenius, H. & Koskenvuo, M. Childhood farm environment and asthma and sensitization in young adulthood. Allergy 57, 1130–1135 (2002).

    CAS  PubMed  Google Scholar 

  74. Leynaert, B. et al. Does living on a farm during childhood protect against asthma, allergic rhinitis, and atopy in adulthood? Am. J. Respir. Crit. Care Med. 164, 1829–1834 (2001).

    CAS  PubMed  Google Scholar 

  75. Downs, S. H. et al. Having lived on a farm and protection against allergic diseases in Australia. Clin. Exp. Allergy 31, 570–575 (2001).

    CAS  PubMed  Google Scholar 

  76. Midodzi, W. K., Rowe, B. H., Majaesic, C. M. & Senthilselvan, A. Reduced risk of physician-diagnosed asthma among children dwelling in a farming environment. Respirology 12, 692–699 (2007).

    PubMed  Google Scholar 

  77. Dimich-Ward, H., Chow, Y., Chung, J. & Trask, C. Contact with livestock – a protective effect against allergies and asthma? Clin. Exp. Allergy 36, 1122–1129 (2006).

    CAS  PubMed  Google Scholar 

  78. Hoppin, J. A. et al. Pesticides and atopic and nonatopic asthma among farm women in the Agricultural Health Study. Am. J. Respir. Crit. Care Med. 177, 11–18 (2008).

    PubMed  Google Scholar 

  79. Ernst, P. & Cormier, Y. Relative scarcity of asthma and atopy among rural adolescents raised on a farm. Am. J. Respir. Crit. Care Med. 161, 1563–1566 (2000).

    CAS  PubMed  Google Scholar 

  80. Adler, A., Tager, I. & Quintero, D. R. Decreased prevalence of asthma among farm-reared children compared with those who are rural but not farm-reared. J. Allergy Clin. Immunol. 115, 67–73 (2005).

    PubMed  Google Scholar 

  81. Merchant, J. A. et al. Asthma and farm exposures in a cohort of rural Iowa children. Environ. Health Perspect. 113, 350–356 (2005).

    PubMed  Google Scholar 

  82. Chrischilles, E. et al. Asthma prevalence and morbidity among rural Iowa schoolchildren. J. Allergy Clin. Immunol. 113, 66–71 (2004).

    PubMed  Google Scholar 

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  1. Erika von Mutius is at the Dr. von Haunersche Kinderklinik Ludwig Maximilians Universität, 80337 Munich, Germany. erika.von.mutius@med.lmu.de,

    Erika von Mutius

  2. Arizona Center for the Biology of Complex Diseases and Department of Cell Biology, Donata Vercelli is at the Arizona Respiratory Center, University of Arizona, Tucson, Arizona 85719, USA. donata@arc.arizona.edu,

    Donata Vercelli

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von Mutius, E., Vercelli, D. Farm living: effects on childhood asthma and allergy. Nat Rev Immunol 10, 861–868 (2010). https://doi.org/10.1038/nri2871

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