The immune system matures according to developmental pathways but also in response to the environment. Four manipulators impact many facets of the immune system and deserve attention. First and foremost, nutrition plays a vital role in the ability of the body to defend against pathogens (Bardare et al. 1993; Devereux et al. 2002). The majority of immunocompromised individuals in the world simply lack nourishment (Janeway Jr. et al. 1997a). Studies implicate maternal diet in development of atopic disease (Bardare et al. 1993; Devereux et al. 2002). Other maternal behaviors such as breastfeeding can decrease risk of allergy, asthma, and autoimmune disease (Bjorksten 1999a; Hanson 1998). The benefits of breastfeeding indicate that the neonate's diet plays a significant role in maturation of immune system function.
Second, maternal disease and vaccination can impact immune development in the fetus. This maternal influence can be harmful to the fetus (for example, the association of fetal and perinatal loss with malaria infection during pregnancy [Shulman and Dorman 2003]), but can also provide an important avenue for positive clinical manipulation (Gruber 2003). This area of research has much to offer as a critical window into the developing immune system.
Likewise, the third area, exposure to toxins, offers insight into vulnerable periods during development. Much work needs to be done on assessment of toxicant exposure in early life and the development of disease—particularly autoimmune disease—in later life. Popular opinion generates diffuse anxiety about scientific advances (such as offered through genetically modified foods) because of the unknown effect on people's immune systems and the subsequent ability to defend against diseases such as cancer.
Finally, medical advances have resulted in modern pharmacologic manipulation of the immune system. Effective immunosuppressive drugs allow transplantation to be a viable treatment for numerous abnormalities, but often at a cost of the body's effective inherent defense system. Likewise, medical treatments for cancers and other diseases manipulate the immune response, forfeiting future health in the interest of immediate survival. How these manipulators affect the developing immune system will be revealed with future research.
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