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Early-life environment, developmental immunotoxicology, and the risk of pediatric allergic disease including asthma


  • Rodney R. Dietert,

    Corresponding author
    1. Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853
    • Department of Microbiology and Immunology, College of Veterinary Medicine, C5-135 VMC, Cornell University, Ithaca, NY 14853, Phone: 607 253-4015
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  • Judith T. Zelikoff

    1. Nelson Institute of Environmental Medicine, New York University School of Medicine, Tuxedo, NY 10987
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  • The authors declare that they received no compensation related to the preparation, submission or publication of this manuscript. Rodney R. Dietert serves as a consultant in developmental immunotoxicology for Burleson Research Technologies, Morrisville, NC and is currently a member of the World Health Organization Harmonization Committee for Risk Assessment in Immunotoxicology (Geneva, Switzerland).


Incidence of childhood allergic disease including asthma (AD-A) has risen since the mid-20th century with much of the increase linked to changes in environment affecting the immune system. Childhood allergy is an early life disease where predisposing environmental exposures, sensitization, and onset of symptoms all occur before adulthood. Predisposition toward allergic disease (AD) is among the constellation of adverse outcomes following developmental immunotoxicity (DIT; problematic exposure of the developing immune system to xenobiotics and physical environmental factors). Because novel immune maturation events occur in early life, and the pregnancy state itself imposes certain restrictions on immune functional development, the period from mid-gestation until 2 years after birth is one of particular concern relative to DIT and AD-A. Several prenatal-perinatal risk factors have been identified as contributing to a DIT-mediated immune dysfunction and increased risk of AD. These include maternal smoking, environmental tobacco smoke, diesel exhaust and traffic-related particles, heavy metals, antibiotics, environmental estrogens and other endocrine disruptors, and alcohol. Diet and microbial exposure also significantly influence immune maturation and risk of allergy. This review considers (1) the critical developmental windows of vulnerability for the immune system that appear to be targets for risk of AD, (2) a model in which the immune system of the DIT-affected infant exhibits immune dysfunction skewed toward AD, and (3) the lack of allergy-relevant safety testing of drugs and chemicals that could identify DIT hazards and minimize problematic exposure of pregnant women and children. Birth Defects Res (Part B) 2008. © 2008 Wiley-Liss, Inc.