Abstract
The newborn immune system differs quantitatively and functionally from that of adults. Development of the immune system has important implications for childhood diseases. The immaturity of the immune system in the first years of life may contribute to failure of tolerance induction and in the development of allergic disease. T cell function is diminished, especially the capacity to produce cytokines; production of interferon (IFN)-γ, and IL-4 is strongly reduced. IFN-γ has been found to be even lower in cord blood of newborns with a family history of atopy. Differences in other cell types(natural killer cells, antigen-presenting cells, and B cells) could also play a role in the development of allergic disease. Current data suggest that irregularities in IgE synthesis, helper T cell subsets (Th1, Th2, CD45RA, and CD45RO), cytokines (IL-4, IFN-γ), and possibly other cell types may play a role in the development of allergy in childhood. Moreover, the role of cell surface molecules, like co-stimulatory molecules(CD28, CD40L), activation markers (CD25), and adhesion molecules(LFA-1/ICAM-1, VLA-4/VCAM-1) is also discussed. These variables are modulated by genetic (relevant loci are identified on chromosome 5q, 11q, and 14) and environmental forces (allergen exposure, viral infections, and smoke). The low sensitivity of current predictive factors for the development of allergic diseases, such as cord blood IgE levels, improves in combination with family history and by measurement of in vitro responses of lymphocytes and skin reactivity to allergens. New therapeutic approaches are being considered on the basis of our current understanding of the immunopathology of allergic disease, for instance cytokine therapy and vaccination with tolerizing doses of allergen or peptides.
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Abbreviations
- APC:
-
antigen-presenting cell
- CD23:
-
low affinity receptor for IgE (FcεRII)
- CD25:
-
IL-2 receptor
- CD40L:
-
CD40 ligand
- CD45RA:
-
marker of naive T cells CD45RO marker of activated or memory T cells
- ICAM-1:
-
intercellular adhesion molecule-1
- LFA-1:
-
lymphocyte function associated antigen-1
- MHC:
-
major histocompatibility complex
- MNC:
-
mononuclear cell
- NK:
-
natural killer
- PBMC:
-
peripheral blood mononuclear cell
- PGE2:
-
prostaglandin E2
- IFN:
-
interferon
- rIFN-γ:
-
recombinant IFN-γ
- RSV:
-
respiratory syncytial virus
- Th:
-
helper T cell
- TNF-α:
-
tumor necrosis factor-α
- VCAM-1:
-
vascular cell adhesion molecule-1
- VLA-4:
-
very late antigen-4
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Acknowledgements
The authors thank Prof. Dr. R. Benner, Department of Immunology, Erasmus University, and Dr. H. de Groot, Department of Allergology, Dijkzigt Hospital, for critically reading this manuscript.
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Manuscript dedicated to Professor H.K.A. Visser in honor of his retirement.
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Koning, H., Baert, M., Oranje, A. et al. Development of Immune Functions Related to Allergic Mechanisms in Young Children. Pediatr Res 40, 363–375 (1996). https://doi.org/10.1203/00006450-199609000-00001
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DOI: https://doi.org/10.1203/00006450-199609000-00001
