Development of childhood asthma is complex with a strong interaction of genetic, epigenetic, and environmental factors. Ultimately, it is critical how the immune system of a child responds to these influences and whether effective strategies for a balanced and healthy immune maturation can be assured. Pregnancy and early childhood are particularly susceptible for exogenous influences due to the developing nature of a child’s immune system. While endogenous influences such as family history and the genetic background are immutable, epigenetic regulations can be modulated by both heredity and environmental exposures. Prenatal influences such as a mother’s nutrition, smoking, or infections influence the complex interplay of innate and adaptive immune regulation as well as peri- and postnatal influences including mode of delivery. Early in life, induction and continuous training of healthy maturation include balanced innate immunity (e.g., via innate lymphoid cells) and an equilibrium of T-cell subpopulations (e.g., via regulatory T cells) to counter-regulate potential pro-inflammatory or exuberant immune reactions. Later in childhood, rather compensatory immune mechanisms are required to modulate deviant regulation of a child’s already primed immune trajectory. The specific effects of exogenous and endogenous influences on a child’s maturing immune system are summarized in this review, and its importance and potential intervention for early prevention and treatment strategies are delineated.

中文翻译：

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早期免疫调节在哮喘发展中的作用。

儿童哮喘的发展是复杂的，具有遗传，表观遗传和环境因素的强烈相互作用。最终，至关重要的是儿童的免疫系统如何应对这些影响，以及能否确保平衡，健康的免疫成熟的有效策略。由于儿童免疫系统的发育性，怀孕和幼儿期特别容易受到外源性影响。尽管诸如家族史和遗传背景之类的内源性影响是不可变的，但遗传和环境暴露均可调节表观遗传规则。母亲的营养，吸烟或感染等产前影响会影响先天和适应性免疫调节以及产后和产后影响（包括分娩方式）的复杂相互作用。早年 健康成熟的诱导和持续训练包括平衡的先天免疫力（例如，通过先天淋巴样细胞）和平衡的T细胞亚群（例如，通过调节性T细胞）以反调节潜在的促炎性或旺盛的免疫反应。在童年后期，需要相当的代偿性免疫机制来调节对儿童已经准备好的免疫轨迹的异常调节。这篇综述总结了外源性和内源性影响对儿童成熟的免疫系统的特定影响，并阐述了其对早期预防和治疗策略的重要性和潜在的干预措施。通过调节性T细胞）来反调节潜在的促炎性或旺盛的免疫反应。在童年后期，需要相当的代偿性免疫机制来调节对儿童已经准备好的免疫轨迹的异常调节。这篇综述总结了外源性和内源性影响对儿童成熟的免疫系统的特定影响，并阐述了其对早期预防和治疗策略的重要性和潜在的干预措施。通过调节性T细胞）来反调节潜在的促炎性或旺盛的免疫反应。在童年后期，需要相当的代偿性免疫机制来调节对儿童已经准备好的免疫轨迹的异常调节。这篇综述总结了外源性和内源性影响对儿童成熟的免疫系统的特定影响，并阐述了其对早期预防和治疗策略的重要性和潜在的干预措施。