Responses Asthma

John M. Armstrong, Deborah Loer-Martin, and Ramona Leibnitz CONTENTS

Introduction 230

Asthma: An Allergic Response 230

Asthma: An Increasingly Common Childhood Disease with an

Unknown Cause 230

Asthma: The Role of Atopy, Risk Factors, and Maternal Exposures 231

Asthma: Toward a Molecular Understanding 231

Sensitization to Allergens and the Development of Asthma 232

Sensitization vs. Triggering 232

Asthmatic Inflammation 234

Mechanisms of Asthmatic Inflammation: Inter- and Intracellular

Mediators 245

Cytokines Involved in Promoting Allergic or Asthmatic

Inflammation 245

Cytokines Involved in Regulating or Inhibiting Allergic or Asthmatic Inflammation 249

Signaling Pathways and Transcription Factors Involved in Asthma Pathogenesis 250

Section Summary 252

The Influence of Maternal-Fetal Interactions on Allergen Sensitization in the Human Fetus and Neonate 253

Fetal Sensitization and Subsequent Immune Responses in Childhood 254

Fetal IgE 255

0-415-28457-0/05/$0.00+$1.50 © 2005 by CRC Press LLC

The TH2-Bias of the Neonatal Immune System 256

Genetics, Epigenetics, and Asthma 257

Section Summary 259

Fetal Exposure to Toxicants and Development of Childhood Asthma 260

Allergens and Maternal Exposure 260

Relationship between Allergens and Development of Asthma 260

Dust Mites and Cockroaches 261

Pet Dander, Fungi/Mold, and Pollen 261

Environmental Toxicants and Maternal Exposure 262

Pesticides 262

Polycyclic Halogenated Hydrocarbons 263

Other Indoor Chemical Contaminants 264

Heavy Metals 264

Environmental Tobacco Smoke (ETS) 267

Effects of ETS on Respiratory Health 267

Effects of Maternal Smoking 268

Section Summary 268

Chapter Summary 269

References 269

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