Dataset Information

Impact of Early-Life Exposures to Infections, Antibiotics, and Vaccines on Perinatal and Long-term Health and Disease.

ABSTRACT: Essentially, all neonates are exposed to infections, antibiotics, or vaccines early in their lives. This is especially true for those neonates born underweight or premature. In contrast to septic adults and children who are at an increased risk for subsequent infections, exposure to infection during the neonatal period is not associated with an increased risk of subsequent infection and may be paradoxically associated with reductions in late-onset sepsis (LOS) in the most premature infants. Perinatal inflammation is also associated with a decreased incidence of asthma and atopy later in life. Conversely, septic neonates are at increased risk of impaired long-term neurodevelopment. While the positive effects of antibiotics in the setting of infection are irrefutable, prolonged administration of broad-spectrum, empiric antibiotics in neonates without documented infection is associated with increased risk of LOS, necrotizing enterocolitis, or death. Vaccines provide a unique opportunity to prevent infection-associated disease; unfortunately, vaccinations have been largely unsuccessful when administered in the first month of life with the exception of vaccines against hepatitis B and tuberculosis. Future vaccines will require the use of novel adjuvants to overcome this challenge. This review describes the influence of infections, antibiotics, and vaccines during the first days of life, as well as the influence on future health and disease. We will also discuss potential immunomodulating therapies, which may serve to train the preterm immune system and reduce subsequent infectious burden without subjecting neonates to the risks accompanied by virulent pathogens.

SUBMITTER: Raymond SL

PROVIDER: S-EPMC5481313 | biostudies-other | 2017

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:Rationalepopulation-based studies have demonstrated associations between ambient air pollution exposures and mortality, but few have been able to adjust for occupational exposures. Additionally, two studies have observed higher risks in individuals with occupational dust, gas, or fume exposure.Objectiveswe examined the association of ambient residential exposure to particulate matter less than 10 microm in diameter (PM(10)), particulate matter less than 2.5 microm in diameter (PM(2.5)), NO(2), SO(2), and mortality in 53,814 men in the U.S. trucking industry.Methodsexposures for PM(10), NO(2), and SO(2) at each residential address were assigned using models combining spatial smoothing and geographic covariates. PM(2.5) exposures in 2000 were assigned from the nearest available monitor. Single and multipollutant Cox proportional hazard models were used to examine the association of an interquartile range (IQR) change (6 microg/m(3) for PM(10), 4 microg/m(3) for PM(2.5), 4ppb for SO(2), and 8ppb for NO(2)) and the risk of all-cause and cause-specific mortality.Measurements and main resultsan IQR change in ambient residential exposures to PM(10) was associated with a 4.3% (95% confidence interval [CI], 1.1-7.7%) increased risk of all-cause mortality. The increase for an IQR change in SO(2) was 6.9% (95% CI, 2.3-11.6%), for NO(2) was 8.2% (95% CI, 4.5-12.1%), and for PM(2.5) was 3.9% (95% CI, 1.0-6.9%). Elevated associations with cause-specific mortality (lung cancer, cardiovascular and respiratory disease) were observed for PM(2.5), SO(2), and NO(2), but not PM(10). None of the pollutants were confounded by occupational exposures. In multipollutant models, overall, the associations were attenuated, most strongly for PM(10). In sensitivity analyses excluding long-haul drivers, who spend days away from home, larger hazard ratios were observed.Conclusionsin this population of men, residential ambient air pollution exposures were associated with mortality.

Dataset Information

Impact of Early-Life Exposures to Infections, Antibiotics, and Vaccines on Perinatal and Long-term Health and Disease.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets