Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA.
Curr Opin Allergy Clin Immunol. 2013 Apr;13(2):187-92. doi: 10.1097/ACI.0b013e32835e82d3.
There is increasing evidence that the prenatal window represents a critical period in which the developing immune system may be primed toward an allergic phenotype. Studies have investigated the role of a number of maternal environmental exposures on subsequent allergic disorders in the offspring. We summarize findings from recent studies on prenatal environmental factors influencing IgE levels, atopy, and early asthma.
A building literature supports the influence of maternal exposure to environmental pollutants, such as allergens, traffic-related air pollution, tobacco smoke, and organochlorine compounds and social factors on allergic outcomes. More novel associations have been investigated, such as the effect of prenatal exposures to phthalates, bisphenol A, and magnetic fields. There is also rising interest in epigenetics as a pathway of action by which maternal exposure affect immune health.
Emerging research highlights the challenges of investigating in-utero exposures and of relating exposures to such a heterogeneous and complex outcome as allergic disease. Further research is needed on the mechanisms by which prenatal exposure influences allergic response in childhood and how postnatal, familial and social factors, and sex can modify disease outcomes. Epigenetics is a promising new frontier, and likely one of several explanatory factors.
越来越多的证据表明，产前窗口期是一个关键时期，在此期间，发育中的免疫系统可能会朝着过敏表型发展。研究已经调查了许多母体环境暴露对后代后续过敏疾病的作用。我们总结了最近关于影响 IgE 水平、特应性和早期哮喘的产前环境因素的研究结果。
越来越多的文献支持母体暴露于环境污染物（如过敏原、与交通有关的空气污染、烟草烟雾和有机氯化合物）和社会因素对过敏结果的影响。还研究了一些新的关联，如产前暴露于邻苯二甲酸酯、双酚 A 和磁场的影响。人们对表观遗传学作为母体暴露影响免疫健康的作用途径也越来越感兴趣。
新出现的研究强调了研究宫内暴露以及将暴露与过敏等异质和复杂疾病结果相关联的挑战。需要进一步研究产前暴露如何影响儿童期的过敏反应，以及如何通过后天、家庭和社会因素以及性别来改变疾病结果。表观遗传学是一个很有前途的新领域，可能是几个解释因素之一。
