The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study

Georg Loss; Silvia Apprich; Marco Waser; Wolfgang Kneifel; Jon Genuneit; Gisela Bu¨chele; Juliane Weber; Barbara Sozanska; Hanna Danielewicz; Elisabeth Horak; R. J. Joost van Neerven; Dick Heederik; Peter C. Lorenzen; Erika von Mutius; Charlotte Braun-Fahrla¨nder; Andrzej Boznanski; William Cookson; Paul Cullinan; Anna Debin´ska; Martin Depner; Markus Ege; Urs Frey; Oliver Fuchs; Anne Hyva¨rinen; Sabina Illi; Michael Kabesch; Katalin Kovacs; Aleksandra Kosmeda; Philipp Latzin; Roger Lauener; Stephanie MacNeill; Bernhard Morass; Anne Ce´cile Normand; Renaud Piarroux; Helena Rintala; Mascha K. Rochat; Nikolaos Sitaridis; David Strachan; Christine Strunz-Lehner; Bertrand Sudre; Marco Waser; Inge M. Wouters

doi:10.1016/j.jaci.2011.07.048

The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study

Georg Loss^*, Silvia Apprich, Marco Waser, Wolfgang Kneifel, Jon Genuneit, Gisela Bu¨chele, Juliane Weber, Barbara Sozanska, Hanna Danielewicz, Elisabeth Horak, R. J. Joost van Neerven, Dick Heederik, Peter C. Lorenzen, Erika von Mutius, Charlotte Braun-Fahrla¨nder, Andrzej Boznanski, William Cookson, Paul Cullinan, Anna Debin´ska, Martin DepnerMarkus Ege, Urs Frey, Oliver Fuchs, Anne Hyva¨rinen, Sabina Illi, Michael Kabesch, Katalin Kovacs, Aleksandra Kosmeda, Philipp Latzin, Roger Lauener, Stephanie MacNeill, Bernhard Morass, Anne Ce´cile Normand, Renaud Piarroux, Helena Rintala, Mascha K. Rochat, Nikolaos Sitaridis, David Strachan, Christine Strunz-Lehner, Bertrand Sudre, Marco Waser, Inge M. Wouters

^*Korrespondierende/r Autor/-in für diese Arbeit

Klinik für Kinder- und Jugendmedizin

262 Zitate (Scopus)

Abstract

Background: Farm milk consumption has been identified as an exposure that might contribute to the protective effect of farm life on childhood asthma and allergies. The mechanism of action and the role of particular constituents of farm milk, however, are not yet clear. Objective: We sought to investigate the farm milk effect and determine responsible milk constituents. Methods: In rural regions of Germany, Austria, and Switzerland, a comprehensive questionnaire about farm milk consumption and other farm-related exposures was completed by parents of 8334 school-aged children, and 7606 of them provided serum samples to assess specific IgE levels. In 800 cow's milk samples collected at the participants' homes, viable bacterial counts, whey protein levels, and total fat content were analyzed. Asthma, atopy, and hay fever were associated to reported milk consumption and for the first time to objectively measured milk constituents by using multiple regression analyses. Results: Reported raw milk consumption was inversely associated to asthma (adjusted odds ratio [aOR], 0.59; 95% CI, 0.46-0.74), atopy (aOR, 0.74; 95% CI, 0.61-0.90), and hay fever (aOR, 0.51; 95% CI, 0.37-0.69) independent of other farm exposures. Boiled farm milk did not show a protective effect. Total viable bacterial counts and total fat content of milk were not significantly related to asthma or atopy. Increased levels of the whey proteins BSA (aOR for highest vs lowest levels and asthma, 0.53; 95% CI, 0.30-0.97), α-lactalbumin (aOR for interquartile range and asthma, 0.71; 95% CI, 0.52-0.97), and β-lactoglobulin (aOR for interquartile range and asthma, 0.62; 95% CI, 0.39-0.97), however, were inversely associated with asthma but not with atopy. Conclusions: The findings suggest that the protective effect of raw milk consumption on asthma might be associated with the whey protein fraction of milk.

Originalsprache	Englisch
Zeitschrift	Journal of Allergy and Clinical Immunology
Jahrgang	128
Ausgabenummer	4
Seiten (von - bis)	766-773
Seitenumfang	8
ISSN	0091-6749
DOIs	https://doi.org/10.1016/j.jaci.2011.07.048
Publikationsstatus	Veröffentlicht - 01.10.2011

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Supported by a European Union Research grant under the FP6-LifeSCIHEALTH Integrated Program LSH-2004-1.2.5-1 (contract no. 018996 ). Disclosure of potential conflict of interest: J. Weber, B. Sozanska, H. Danielewicz, A Boznanski, A. Dębińska, M. Depner, A. Kosmęda, and C. Strunz-Lehner have received research support from the European Commission . D. Heederik and I. M. Wouters have received research support from the European Union . E. von Mutius is a consultant for Novartis, GlaxoSmithKline, ALK-Abelló, and Protectimmun; has received a speaker's fee from InfectoPharm; has received research support from Airsonett AB ; is a member of the Expert Panel for UK Research Excellence Framework; and is an Associate Editor for the Journal of Allergy and Clinical Immunology. M. Ege has received research support from the European Commission and the Deutsche Forschungsgemeinschaft (DFG) . M. Kabesch has financial interests in Roxall, GlaxoSmithKline, Novartis, Sanofi-Aventis, Allergopharma, and AstraZeneca GmbH and has received research support from DFG, BMBF, and the European Union . The rest of the authors have declared that they have no conflict of interest.

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SDG 3 – Gesundheit und Wohlergehen

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Forschungsschwerpunkt: Gehirn, Hormone, Verhalten - Center for Brain, Behavior and Metabolism (CBBM)

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10.1016/j.jaci.2011.07.048

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Loss, G., Apprich, S., Waser, M., Kneifel, W., Genuneit, J., Bu¨chele, G., Weber, J., Sozanska, B., Danielewicz, H., Horak, E., Joost van Neerven, R. J., Heederik, D., Lorenzen, P. C., von Mutius, E., Braun-Fahrla¨nder, C., Boznanski, A., Cookson, W., Cullinan, P., Debin´ska, A., ... Wouters, I. M. (2011). The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study. Journal of Allergy and Clinical Immunology, 128(4), 766-773. https://doi.org/10.1016/j.jaci.2011.07.048

@article{e331e0d77107480daa7ad695461fc724,

title = "The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study",

abstract = "Background: Farm milk consumption has been identified as an exposure that might contribute to the protective effect of farm life on childhood asthma and allergies. The mechanism of action and the role of particular constituents of farm milk, however, are not yet clear. Objective: We sought to investigate the farm milk effect and determine responsible milk constituents. Methods: In rural regions of Germany, Austria, and Switzerland, a comprehensive questionnaire about farm milk consumption and other farm-related exposures was completed by parents of 8334 school-aged children, and 7606 of them provided serum samples to assess specific IgE levels. In 800 cow's milk samples collected at the participants' homes, viable bacterial counts, whey protein levels, and total fat content were analyzed. Asthma, atopy, and hay fever were associated to reported milk consumption and for the first time to objectively measured milk constituents by using multiple regression analyses. Results: Reported raw milk consumption was inversely associated to asthma (adjusted odds ratio [aOR], 0.59; 95\% CI, 0.46-0.74), atopy (aOR, 0.74; 95\% CI, 0.61-0.90), and hay fever (aOR, 0.51; 95\% CI, 0.37-0.69) independent of other farm exposures. Boiled farm milk did not show a protective effect. Total viable bacterial counts and total fat content of milk were not significantly related to asthma or atopy. Increased levels of the whey proteins BSA (aOR for highest vs lowest levels and asthma, 0.53; 95\% CI, 0.30-0.97), α-lactalbumin (aOR for interquartile range and asthma, 0.71; 95\% CI, 0.52-0.97), and β-lactoglobulin (aOR for interquartile range and asthma, 0.62; 95\% CI, 0.39-0.97), however, were inversely associated with asthma but not with atopy. Conclusions: The findings suggest that the protective effect of raw milk consumption on asthma might be associated with the whey protein fraction of milk.",

author = "Georg Loss and Silvia Apprich and Marco Waser and Wolfgang Kneifel and Jon Genuneit and Gisela Bu¨chele and Juliane Weber and Barbara Sozanska and Hanna Danielewicz and Elisabeth Horak and \{Joost van Neerven\}, \{R. J.\} and Dick Heederik and Lorenzen, \{Peter C.\} and \{von Mutius\}, Erika and Charlotte Braun-Fahrla¨nder and Andrzej Boznanski and William Cookson and Paul Cullinan and Anna Debin´ska and Martin Depner and Markus Ege and Urs Frey and Oliver Fuchs and Anne Hyva¨rinen and Sabina Illi and Michael Kabesch and Katalin Kovacs and Aleksandra Kosmeda and Philipp Latzin and Roger Lauener and Stephanie MacNeill and Bernhard Morass and Normand, \{Anne Ce´cile\} and Renaud Piarroux and Helena Rintala and Rochat, \{Mascha K.\} and Nikolaos Sitaridis and David Strachan and Christine Strunz-Lehner and Bertrand Sudre and Marco Waser and Wouters, \{Inge M.\}",

note = "Funding Information: Supported by a European Union Research grant under the FP6-LifeSCIHEALTH Integrated Program LSH-2004-1.2.5-1 (contract no. 018996 ). Funding Information: Disclosure of potential conflict of interest: J. Weber, B. Sozanska, H. Danielewicz, A Boznanski, A. D{\c e}bi{\'n}ska, M. Depner, A. Kosm{\c e}da, and C. Strunz-Lehner have received research support from the European Commission . D. Heederik and I. M. Wouters have received research support from the European Union . E. von Mutius is a consultant for Novartis, GlaxoSmithKline, ALK-Abell{\'o}, and Protectimmun; has received a speaker's fee from InfectoPharm; has received research support from Airsonett AB ; is a member of the Expert Panel for UK Research Excellence Framework; and is an Associate Editor for the Journal of Allergy and Clinical Immunology. M. Ege has received research support from the European Commission and the Deutsche Forschungsgemeinschaft (DFG) . M. Kabesch has financial interests in Roxall, GlaxoSmithKline, Novartis, Sanofi-Aventis, Allergopharma, and AstraZeneca GmbH and has received research support from DFG, BMBF, and the European Union . The rest of the authors have declared that they have no conflict of interest. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2011",

month = oct,

day = "1",

doi = "10.1016/j.jaci.2011.07.048",

language = "English",

volume = "128",

pages = "766--773",

journal = "Journal of Allergy and Clinical Immunology",

issn = "0091-6749",

publisher = "Elsevier Inc.",

number = "4",

}

Loss, G, Apprich, S, Waser, M, Kneifel, W, Genuneit, J, Bu¨chele, G, Weber, J, Sozanska, B, Danielewicz, H, Horak, E, Joost van Neerven, RJ, Heederik, D, Lorenzen, PC, von Mutius, E, Braun-Fahrla¨nder, C, Boznanski, A, Cookson, W, Cullinan, P, Debin´ska, A, Depner, M, Ege, M, Frey, U, Fuchs, O, Hyva¨rinen, A, Illi, S, Kabesch, M, Kovacs, K, Kosmeda, A, Latzin, P, Lauener, R, MacNeill, S, Morass, B, Normand, AC, Piarroux, R, Rintala, H, Rochat, MK, Sitaridis, N, Strachan, D, Strunz-Lehner, C, Sudre, B, Waser, M & Wouters, IM 2011, 'The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study', Journal of Allergy and Clinical Immunology, Jg. 128, Nr. 4, S. 766-773. https://doi.org/10.1016/j.jaci.2011.07.048

TY - JOUR

T1 - The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study

AU - Loss, Georg

AU - Apprich, Silvia

AU - Waser, Marco

AU - Kneifel, Wolfgang

AU - Genuneit, Jon

AU - Bu¨chele, Gisela

AU - Weber, Juliane

AU - Sozanska, Barbara

AU - Danielewicz, Hanna

AU - Horak, Elisabeth

AU - Joost van Neerven, R. J.

AU - Heederik, Dick

AU - Lorenzen, Peter C.

AU - von Mutius, Erika

AU - Braun-Fahrla¨nder, Charlotte

AU - Boznanski, Andrzej

AU - Cookson, William

AU - Cullinan, Paul

AU - Debin´ska, Anna

AU - Depner, Martin

AU - Ege, Markus

AU - Frey, Urs

AU - Fuchs, Oliver

AU - Hyva¨rinen, Anne

AU - Illi, Sabina

AU - Kabesch, Michael

AU - Kovacs, Katalin

AU - Kosmeda, Aleksandra

AU - Latzin, Philipp

AU - Lauener, Roger

AU - MacNeill, Stephanie

AU - Morass, Bernhard

AU - Normand, Anne Ce´cile

AU - Piarroux, Renaud

AU - Rintala, Helena

AU - Rochat, Mascha K.

AU - Sitaridis, Nikolaos

AU - Strachan, David

AU - Strunz-Lehner, Christine

AU - Sudre, Bertrand

AU - Waser, Marco

AU - Wouters, Inge M.

N1 - Funding Information: Supported by a European Union Research grant under the FP6-LifeSCIHEALTH Integrated Program LSH-2004-1.2.5-1 (contract no. 018996 ). Funding Information: Disclosure of potential conflict of interest: J. Weber, B. Sozanska, H. Danielewicz, A Boznanski, A. Dębińska, M. Depner, A. Kosmęda, and C. Strunz-Lehner have received research support from the European Commission . D. Heederik and I. M. Wouters have received research support from the European Union . E. von Mutius is a consultant for Novartis, GlaxoSmithKline, ALK-Abelló, and Protectimmun; has received a speaker's fee from InfectoPharm; has received research support from Airsonett AB ; is a member of the Expert Panel for UK Research Excellence Framework; and is an Associate Editor for the Journal of Allergy and Clinical Immunology. M. Ege has received research support from the European Commission and the Deutsche Forschungsgemeinschaft (DFG) . M. Kabesch has financial interests in Roxall, GlaxoSmithKline, Novartis, Sanofi-Aventis, Allergopharma, and AstraZeneca GmbH and has received research support from DFG, BMBF, and the European Union . The rest of the authors have declared that they have no conflict of interest. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2011/10/1

Y1 - 2011/10/1

N2 - Background: Farm milk consumption has been identified as an exposure that might contribute to the protective effect of farm life on childhood asthma and allergies. The mechanism of action and the role of particular constituents of farm milk, however, are not yet clear. Objective: We sought to investigate the farm milk effect and determine responsible milk constituents. Methods: In rural regions of Germany, Austria, and Switzerland, a comprehensive questionnaire about farm milk consumption and other farm-related exposures was completed by parents of 8334 school-aged children, and 7606 of them provided serum samples to assess specific IgE levels. In 800 cow's milk samples collected at the participants' homes, viable bacterial counts, whey protein levels, and total fat content were analyzed. Asthma, atopy, and hay fever were associated to reported milk consumption and for the first time to objectively measured milk constituents by using multiple regression analyses. Results: Reported raw milk consumption was inversely associated to asthma (adjusted odds ratio [aOR], 0.59; 95% CI, 0.46-0.74), atopy (aOR, 0.74; 95% CI, 0.61-0.90), and hay fever (aOR, 0.51; 95% CI, 0.37-0.69) independent of other farm exposures. Boiled farm milk did not show a protective effect. Total viable bacterial counts and total fat content of milk were not significantly related to asthma or atopy. Increased levels of the whey proteins BSA (aOR for highest vs lowest levels and asthma, 0.53; 95% CI, 0.30-0.97), α-lactalbumin (aOR for interquartile range and asthma, 0.71; 95% CI, 0.52-0.97), and β-lactoglobulin (aOR for interquartile range and asthma, 0.62; 95% CI, 0.39-0.97), however, were inversely associated with asthma but not with atopy. Conclusions: The findings suggest that the protective effect of raw milk consumption on asthma might be associated with the whey protein fraction of milk.

AB - Background: Farm milk consumption has been identified as an exposure that might contribute to the protective effect of farm life on childhood asthma and allergies. The mechanism of action and the role of particular constituents of farm milk, however, are not yet clear. Objective: We sought to investigate the farm milk effect and determine responsible milk constituents. Methods: In rural regions of Germany, Austria, and Switzerland, a comprehensive questionnaire about farm milk consumption and other farm-related exposures was completed by parents of 8334 school-aged children, and 7606 of them provided serum samples to assess specific IgE levels. In 800 cow's milk samples collected at the participants' homes, viable bacterial counts, whey protein levels, and total fat content were analyzed. Asthma, atopy, and hay fever were associated to reported milk consumption and for the first time to objectively measured milk constituents by using multiple regression analyses. Results: Reported raw milk consumption was inversely associated to asthma (adjusted odds ratio [aOR], 0.59; 95% CI, 0.46-0.74), atopy (aOR, 0.74; 95% CI, 0.61-0.90), and hay fever (aOR, 0.51; 95% CI, 0.37-0.69) independent of other farm exposures. Boiled farm milk did not show a protective effect. Total viable bacterial counts and total fat content of milk were not significantly related to asthma or atopy. Increased levels of the whey proteins BSA (aOR for highest vs lowest levels and asthma, 0.53; 95% CI, 0.30-0.97), α-lactalbumin (aOR for interquartile range and asthma, 0.71; 95% CI, 0.52-0.97), and β-lactoglobulin (aOR for interquartile range and asthma, 0.62; 95% CI, 0.39-0.97), however, were inversely associated with asthma but not with atopy. Conclusions: The findings suggest that the protective effect of raw milk consumption on asthma might be associated with the whey protein fraction of milk.

UR - https://www.scopus.com/pages/publications/80053575852

U2 - 10.1016/j.jaci.2011.07.048

DO - 10.1016/j.jaci.2011.07.048

M3 - Journal articles

C2 - 21875744

AN - SCOPUS:80053575852

SN - 0091-6749

VL - 128

SP - 766

EP - 773

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

IS - 4

ER -

The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study

Abstract

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