Food, drug, insect sting allergy, and anaphylaxis
Urinary levels of triclosan and parabens are associated with aeroallergen and food sensitization

https://doi.org/10.1016/j.jaci.2012.05.006Get rights and content

Background

Endocrine-disrupting compounds (EDCs) have immune-modulating effects. We were interested in determining their association with allergic sensitization.

Objective

We sought to determine the association between EDCs and allergic sensitization and whether this relationship depends on the antimicrobial properties of the EDCs, sex, or both.

Methods

Data were obtained from the 2005-2006 National Health and Nutrition Examination Survey in which urinary bisphenol A; triclosan; benzophenone-3; propyl, methyl, butyl, and ethyl parabens; and specific IgE levels were available for 860 children. Aeroallergen and food sensitizations were defined as having at least 1 positive (≥0.35 kU/L) specific IgE level to an aeroallergen or a food. Logistic regression was used to determine the association of EDCs and sensitization. Analyses were adjusted for urinary creatinine level, age, sex, ethnicity, and poverty index ratio.

Results

The odds of aeroallergen sensitization significantly increased with the level of the antimicrobial EDCs triclosan and propyl and butyl parabens (P ≤ .04). The odds of food sensitization significantly increased with the level of urinary triclosan among male subjects (odds ratio for third vs first tertiles, 3.9; P = .02 for trend). There was a significant interaction between sex and triclosan level, with male subjects being more likely to be food sensitized with exposure (P = .03). Similar associations were not identified for the nonantimicrobial EDCs bisphenol A and benzophenone-3 (P > .2).

Conclusions

As a group, EDCs are not associated with allergen sensitization. However, levels of the antimicrobial EDCs triclosan and parabens were significantly associated with allergic sensitization. The potential role of antimicrobial EDCs in allergic disease warrants further study because they are commonly used in Western society.

Section snippets

Study design

Data were obtained from the 2005-2006 NHANES,40 a US-based survey designed to be representative of the noninstitutionalized US population. Participation in the survey is voluntary. A total of 10,348 subjects participated in NHANES 2005-2006. Children aged 6 to 18 years were included in the analyses because childhood is when most sensitization develops. Sociodemographic data, urinary EDC levels, total and specific IgE levels, respiratory disease questionnaire data, and medical condition

Patients' characteristics

Eight hundred sixty subjects had complete data for the primary analysis of urinary EDC levels on aeroallergen sensitization, and 859 had complete data for analysis of EDC levels on food sensitization. Urinary levels of each EDC by tertile or exposure status are shown in Table E1 in this article's Online Repository at www.jacionline.org, and urinary levels according to race/ethnicity are shown in Table E2, Table E3 in this article's Online Repository at www.jacionline.org. Male subjects were

Discussion

In this large, nationally representative sample, we investigated the relationship between EDCs and atopy. We hypothesized that environmental exposure to EDCs would be associated with allergic disease. We were further interested in determining whether the relationship between EDCs and allergic outcomes was dependent on the antimicrobial properties of EDCs. Of the EDCs examined, only urinary levels of triclosan and propyl and butyl parabens were significantly associated with aeroallergen

References (48)

  • E.J. Routledge et al.

    Some alkyl hydroxy benzoate preservatives (parabens) are estrogenic

    Toxicol Appl Pharmacol

    (1998)
  • S. Watanabe et al.

    Differences in fecal microflora between patients with atopic dermatitis and healthy control subjects

    J Allergy Clin Immunol

    (2003)
  • M. Kalliomaki et al.

    Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial

    Lancet

    (2001)
  • M. Wang et al.

    Reduced diversity in the early fecal microbiota of infants with atopic eczema

    J Allergy Clin Immunol

    (2008)
  • P.J. Gergen et al.

    Total IgE levels and asthma prevalence in the US population: results from the National Health and Nutrition Examination Survey 2005-2006

    J Allergy Clin Immunol

    (2009)
  • M. Allmyr et al.

    Triclosan in plasma and milk from Swedish nursing mothers and their exposure via personal care products

    Sci Total Environ

    (2006)
  • X. Ye et al.

    Quantification of the urinary concentrations of parabens in humans by on-line solid phase extraction-high performance liquid chromatography-isotope dilution tandem mass spectrometry

    J Chromatogr B Analyt Technol Biomed Life Sci

    (2006)
  • E. Diamanti-Kandarakis et al.

    Endocrine-disrupting chemicals: an Endocrine Society scientific statement

    Endocr Rev

    (2009)
  • M. Chalubinski et al.

    Endocrine disrupters–potential modulators of the immune system and allergic response

    Allergy

    (2006)
  • K. Mortimer et al.

    Early-lifetime exposure to air pollution and allergic sensitization in children with asthma

    J Asthma

    (2008)
  • K. Mortimer et al.

    Air pollution and pulmonary function in asthmatic children: effects of prenatal and lifetime exposures

    Epidemiology

    (2008)
  • S.K. Ahluwalia et al.

    The indoor environment and its effects on childhood asthma

    Curr Opin Allergy Clin Immunol

    (2011)
  • B.D. Spycher et al.

    Routine vaccination against pertussis and the risk of childhood asthma: a population-based cohort study

    Pediatrics

    (2009)
  • J. Leonardi-Bee et al.

    Asthma and current intestinal parasite infection: systematic review and meta-analysis

    Am J Respir Crit Care Med

    (2006)
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    Supported by National Institutes of Health grant T32AI007056-31.

    Disclosure of potential conflict of interest: E. C. Matsui has consulted for Merck/UBC, has received grants from the NIH, and has received payment for lectures and travel from Indoor Biotechnologies. R. A. Wood has consulted for the Asthma and Allergy Foundation of America, has provided expert witness testimony for the NIH, and has received royalties from UpToDate. C. A. Keet has received grants from the NIH. J. H. Savage declares that she has no relevant conflicts of interest.

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