Early origins of XXXX : a review of processes and influences during early immune development.

@entity1 @entity566 @entity56 @entity9539
PURPOSE OF REVIEW: With the disturbing increase in @entity56 , there is a pressing need to determine the causes, pathogenesis and safe avenues for disease prevention. Although events in early life appear important, no causal pathways have been identified. This review examines new developments in the area of foetal and early postnatal immune maturation. It secondly addresses early predisposing influences and protective factors that may have a future role in @entity566 prevention. RECENT FINDINGS: New developments in the understanding of the ontogeny of allergen-specific immune responses in atopic @entity1 are discussed, including the role of early type 1 and 2 immune responses, and how these are influenced by perinatal antigen presenting cell and T-cell immaturity. The controversial role of early dietary exposures including breastfeeding, food allergens, hydrolyzed formulae and other dietary factors including @entity9539 are discussed in the context of the most recent literature. Equally contentious, the role of early house dust and pet allergen exposure is discussed in light of new epidemiological studies and disappointing early results of multicentre allergen avoidance studies. Finally, a number of studies in animals and @entity1 suggest that bacterial products can influence early immune development, providing a new potential therapeutic avenue for disease treatment and prevention. SUMMARY: Complex multifactorial genetic and environmental interactions make research in this area difficult and apparent associations with @entity56 may not be causal in nature. Many current targets for prevention, such as early allergen exposure and @entity1 feeding practices, are proving to be ineffective and may not be directly implicated in rising rates of disease.
