Go to JCI Insight
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
  • Clinical Research and Public Health
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Gastroenterology
    • Immunology
    • Metabolism
    • Nephrology
    • Neuroscience
    • Oncology
    • Pulmonology
    • Vascular biology
    • All ...
  • Videos
    • Conversations with Giants in Medicine
    • Video Abstracts
  • Reviews
    • View all reviews ...
    • Complement Biology and Therapeutics (May 2025)
    • Evolving insights into MASLD and MASH pathogenesis and treatment (Apr 2025)
    • Microbiome in Health and Disease (Feb 2025)
    • Substance Use Disorders (Oct 2024)
    • Clonal Hematopoiesis (Oct 2024)
    • Sex Differences in Medicine (Sep 2024)
    • Vascular Malformations (Apr 2024)
    • View all review series ...
  • Viewpoint
  • Collections
    • In-Press Preview
    • Clinical Research and Public Health
    • Research Letters
    • Letters to the Editor
    • Editorials
    • Commentaries
    • Editor's notes
    • Reviews
    • Viewpoints
    • 100th anniversary
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • Reviews
  • Review series
  • Conversations with Giants in Medicine
  • Video Abstracts
  • In-Press Preview
  • Clinical Research and Public Health
  • Research Letters
  • Letters to the Editor
  • Editorials
  • Commentaries
  • Editor's notes
  • Reviews
  • Viewpoints
  • 100th anniversary
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
Environmental exposures and mechanisms in allergy and asthma development
Liza Bronner Murrison, … , Jocelyn Biagini Myers, Gurjit K. Khurana Hershey
Liza Bronner Murrison, … , Jocelyn Biagini Myers, Gurjit K. Khurana Hershey
Published February 11, 2019
Citation Information: J Clin Invest. 2019;129(4):1504-1515. https://doi.org/10.1172/JCI124612.
View: Text | PDF
Review Series Article has an altmetric score of 60

Environmental exposures and mechanisms in allergy and asthma development

  • Text
  • PDF
Abstract

Environmental exposures interplay with human host factors to promote the development and progression of allergic diseases. The worldwide prevalence of allergic disease is rising as a result of complex gene-environment interactions that shape the immune system and host response. Research shows an association between the rise of allergic diseases and increasingly modern Westernized lifestyles, which are characterized by increased urbanization, time spent indoors, and antibiotic usage. These environmental changes result in increased exposure to air and traffic pollution, fungi, infectious agents, tobacco smoke, and other early-life and lifelong risk factors for the development and exacerbation of asthma and allergic diseases. It is increasingly recognized that the timing, load, and route of allergen exposure affect allergic disease phenotypes and development. Still, our ability to prevent allergic diseases is hindered by gaps in understanding of the underlying mechanisms and interaction of environmental, viral, and allergen exposures with immune pathways that impact disease development. This Review highlights epidemiologic and mechanistic evidence linking environmental exposures to the development and exacerbation of allergic airway responses.

Authors

Liza Bronner Murrison, Eric B. Brandt, Jocelyn Biagini Myers, Gurjit K. Khurana Hershey

×

Figure 1

Epithelial pathways impacted by environmental exposures promote asthma pathogenesis.

Options: View larger image (or click on image) Download as PowerPoint
Epithelial pathways impacted by environmental exposures promote asthma p...
Exposure to air pollutants induces oxidative stress. AhR recognizes polycyclic aromatic hydrocarbons on diesel exhaust particles (DEPs), promoting cytochrome P450 family 1 A1–mediated (CYP1A1-mediated) detoxification. Oxidative stress induces Nrf2 translocation to the nucleus, leading to antioxidant transcription. Failure to detoxify results in release of the neutrophil chemokine IL-8, the antigen-presenting cell (APC) chemokine CCL20, and proinflammatory cytokines (including IL-1, IL-6, and TNF-α) that in the absence of allergen promote naive T cell differentiation into IL-17A–producing Th17 cells. Similarly, exposure to mold-derived β-glucans, which signal through dectin-1, induces recruitment of IL-17A–secreting Th17 and γδT cells and neutrophils. Mold and other complex allergens also stimulate epithelial cells through pathogen-associated molecular pattern (PAMP) receptors like TLRs. TLR4 recognizes the house dust mite allergen Derp2 and endotoxins, which can modulate NF-κB activation of proinflammatory cytokines via the ubiquitin-modifying enzyme A20. Notch4-Jagged1 interaction between T cells and APCs, respectively, can induce Th2 cell generation when APCs are exposed to allergens and epithelial cell–derived IL-25, IL-33, and/or TSLP. These cytokines can be released following viral infection of epithelial cells and cellular damage resulting from exposure to pollutants and/or proteolytic allergens. They can induce innate lymphoid cells (ILC2s) to release IL-13, which drives mucus production and AHR, and IL-5, which is central to eosinophil biology. In addition to interacting with APCs and Th2 cells to potentiate allergic responses and IgE generation, ILC2s also release amphiregulin (AREG) to promote tissue repair. HRV and RSV infections in asthmatics can exacerbate Th2 responses and inhibit type 1 IFN responses, enhancing viral replication and promoting more severe disease.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

Sign up for email alerts

Picked up by 7 news outlets
Posted by 7 X users
On 1 Facebook pages
361 readers on Mendeley
See more details