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Asthma/Allergic Airways Disease: Does Postnatal Exposure to Environmental Toxicants Promote Airway Pathobiology?

¹ Department of Anatomy, Physiology, and Cell Biology;
² Molecular Biosciences and
³ Pathology Microbiology and Immunology, School of Veterinary Medicine;
⁴ Departments of Pediatrics and
⁵ Medicine, School of Medicine and
⁶ California National Primate Research Center, University of California, Davis, CA 95616, USA

Correspondence: Address correspondence to: Charles G. Plopper, California National Primate Research Center, 1 Shields Avenue, University of California, Davis, CA, 95616 USA; e-mail:cgplopper{at}ucdavis.edu orsmsmiley{at}ucdavis.edu

The recent, dramatic increase in the incidence of childhood asthma suggests a role for environmental contaminants in the promotion of interactions between allergens and the respiratory system of young children. To establish whether exposure to an environmental stressor, ozone (O₃), and an allergen, house dust mite (HDMA), during early childhood promotes remodeling of the epithelial-mesenchymal trophic unit (EMTU) of the tracheobronchial airway wall by altering postnatal development, infant rhesus monkeys were exposed to cyclic episodes of filtered air (FA), HDMA, O₃, or HDMA plus O₃. The following alterations in the EMTU were found after exposure to HDMA, O₃, or HDMA plus O₃: (1) reduced airway number; (2) hyperplasia of bronchial epithelium; (3) increased mucous cells; (4) shifts in distal airway smooth muscle bundle orientation and abundance to favor hyperreactivity; (5) interrupted postnatal basement membrane zone differentiation; (6) modified epithelial nerve fiber distribution; and (7) reorganization of the airway vascular and immune system. Conclusions: cyclic challenge of infants to toxic stress during postnatal lung development modifies the EMTU. This exacerbates the allergen response to favor development of intermittent airway obstruction associated with wheeze. And, exposure of infants during early postnatal lung development initiates compromises in airway growth and development that persist or worsen as growth continues, even with cessation of exposure.

Key Words: Asthma • children • environment • ozone • allergen • Macaca

Abbreviations: HDMA, house dust mite allergen • EMTU, epithelial-mesenchymal trophic unit • BMZ, basement membrane zone • VEGF, vascular endothelial growth factor • O₃, ozone • FA, filtered air

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