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The 22 annual Transatlantic Airway Conference (TAC) was convened in January of 2007 to review and discuss the latest developments in airway biology and the impact of innate immune responses on environmental airway disease. This topic was approached from several different directions, including epidemiologic, genetic, pathogenic, and therapeutic studies. The goal of this conference was to identify common themes emerging from various methodological approaches, and at the same time, promote cross-fertilization of ideas. Although this goal is frequently stated, it is not always achieved, perhaps because the investigative approaches are either too divergent or too similar. The 2007 TAC was an exception, and revealed unifying themes from presentations based on fundamentally different investigative approaches. A major theme that emerged from this conference was the interdependence of factors that predispose to airway disease. Epidemiologic studies were presented by Erica von Mutius of the University Children’s Hospital in Munich, Germany. Dr. von Mutius described several studies showing that exposure to a farming environment protects against developing allergic asthma. However, the impact of this effect depends on multiple factors, including the geographical location of the farm, and the types of animals and agriculture that are present on it. In addition, she showed that individuals living on farms have increased levels of innate immune genes, such as the Toll-like receptor 4 (TLR4). Because TLR4 is required for signaling responses to endotoxin or lipopolysaccharide (LPS), this finding strengthens the notion that the LPS associated with farm animals and fodder influences the development of airway disease. LPS is not the only environmental agent affecting levels of TLR4; John Hollingsworth of Duke University showed that the biologic response to ozone is dependent on intact TLR4 and that exposure to ozone can modify subsequent response to inhaled LPS. Such relationships between environmental exposures and innate immune genes are likely to be the focus of much investigation over the next several years. The theme of gene–environment interrelationships was echoed and extended in a presentation by Fernando Martinez of the University of Arizona. Using the CD14 gene as an example, Dr. Martinez showed that the impact of specific genetic polymorphisms on disease susceptibility can vary, depending on the environmental conditions to which these individuals are exposed. CD14, which is part of a protein complex that includes TLR4 |
