Influence of life-style factors on the development of the immune system and allergies in East and West Germany

Our website for the participants of the LISA study: (in german).

Study objectives:

  • To determine the influence of life-style factors, environmental exposures, and health-related behaviour on the development of the immune system and the incidence of allergic diseases in children.
  • To determine the influence of traffic emissions and genetics

Study aims:

  • Are regional differences (East/West Germany) in humoral and cellular immune parameters and in the prevalence of allergic diseases detectable in children?
  • Do exposures early in infancy differ between the study regions (e.g. infections, exposure to allergens, health-related behaviour of the parents)?
  • What is the quantitative influence of pollutants, and indoor and outdoor allergens on the development of allergies?
  • What are the genetic influences on allergies and other illnesses of the immune system or respiratory tract? How do genetic factors and environmental factors (nutrition, pollutants) interact?

Study design:
Prospective cohort study in 4 regions of Germany (Munich, Leipzig, Wesel, Bad Honnef)
Recruitment period: 11/97-01/99, Follow-up since birth.

Study population:
3097 healthy, fullterm newborns were included in the study.

Study area:
1467 newborns from Munich, 976 from Leipzig, 348 from Wesel, and 306 from Bad Honnef.

Study methods:

  • Questionnaires: monthly protocols during the first year of life, questionnaires every 6 months until age 2 years and thereafter at age 4, 6, 10, 15, 20 years and during the COVID pandemic.
  • Exposure assessment: measurement of house dust mite, cat allergens, and of endotoxin; in a subpopulation indoor measurement of volatile organic compounds
  • Blood analyses: cord blood IgE, at age 2 years specific IgE, IgG subclasses, antibodies directed against viruses, immunisation antibodies; in a subpopulation measurement of intracellular cytokines in T lymphocytes and surface antigen expression of lymphocytes (at birth and at age 2 years). Blood analysis at age of 6, 10 and 15 years.
  • Medical examination at age 2, 6, 10 and 15 years.

Current status:
The 20-year follow-up will start in 2022.

Marie Standl (Principal Investigator)

Study center Munich: Helmholtz Zentrum München - Institute of Epidemiology, PI: M. Standl; 
Study Center Leipzig: UFZ-Center for Environmental Research Leipzig-Halle; PI: G. Herberth,
Study Region Rhineland: Marien-Hospital Wesel, Department of Pediatrics; PI: A. von Berg. IUF Institute of Environmental Research. PI T. Schikowski. Evangelisches Krankenhaus Düsseldorf, Children‘s Hospital. Clinical PI M. Gappa. Medical Praxis for Children, Bad Honnef, PI: B. Schaaf.

Partly by BMBF (Public Health Forschungsverbund Bayern), IUF, EU, DFG

Helmholtz Zentrum München
Institute of Epidemiology
Dr. Marie Standl
Ingolstädter Landstraße 1
D-85764 Neuherberg
Tel. +49-(0)89-3187-2952
Fax +49-(0)89-3187-3380

Related publications:

Harris C, Buyken A, Koletzko S, von Berg A, Berdel D, Schikowski T, Koletzko B, Heinrich J, Standl M.
Dietary Fatty Acids and Changes in Blood Lipids during Adolescence: The Role of Substituting Nutrient Intakes.
Nutrients. 2017 Feb 11;9(2).

Flexeder C, Thiering E, Koletzko S, Berdel D, Lehmann I, von Berg A, Hoffmann B, Bauer CP, Heinrich J, Schulz H.
Higher serum 25(OH)D concentrations are associated with improved FEV1 and FVC in adolescence.
Eur Respir J. 2017 Apr 26;49(4). pii: 1601804.

Tischer C, Weikl F, Probst AJ, Standl M, Heinrich J, Pritsch K.
Urban Dust Microbiome: Impact on Later Atopy and Wheezing.
Environ Health Perspect. 2016 Dec;124(12):1919-1923.

Thiering E, Markevych I, Brüske I, Fuertes E, Kratzsch J, Sugiri D, Hoffmann B, von Berg A, Bauer CP, Koletzko S, Berdel D, Heinrich J.
Associations of Residential Long-Term Air Pollution Exposures and Satellite-Derived Greenness with Insulin Resistance in German Adolescents.
Environ Health Perspect. 2016 Aug;124(8):1291-8.

Markevych I, Smith MP, Jochner S, Standl M, Brüske I, von Berg A, Bauer CP, Fuks K, Koletzko S, Berdel D, Heinrich J, Schulz H.
Neighbourhood and physical activity in German adolescents: GINIplus and LISAplus.
Environ Res. 2016 May;147:284-93.

Fuertes E, Standl M, Forns J, Berdel D, Garcia-Aymerich J, Markevych I, Schulte-Koerne G, Sugiri D, Schikowski T, Tiesler CM10, Heinrich J11.
Traffic-related air pollution and hyperactivity/inattention, dyslexia and dyscalculia in adolescents of the German GINIplus and LISAplus birth cohorts.
Environ Int. 2016 Dec;97:85-92.

Tischer C, Casas L, Wouters IM, Doekes G, Garcia-Esteban R, Gehring U, Hyvärinen A, Oldenwening M, Kerkhof M, Sunyer J, Standl M, Thiering E, Torrent M10, Heinrich J8; HITEA study group.
Early exposure to bio-contaminants and asthma up to 10 years of age: results of the HITEA study.
Eur Respir J. 2015 Feb;45(2):328-37.

Tiesler CM, Birk M, Thiering E, Kohlböck G, Koletzko S, Bauer CP, Berdel D, von Berg A, Babisch W, Heinrich J; GINIplus and LISAplus Study Groups.
Exposure to road traffic noise and children's behavioural problems and sleep disturbance: results from the GINIplus and LISAplus studies.
Environ Res. 2013 May;123:1-8.

Tischer, C.G., Hohmann, C., Thiering, E., Herbarth, O., Müller, A., Henderson, J., Granell, R., Fantini, M.P., Luciano, L., Bergström, A., Kull, I., Link, E., von Berg, A., Kuehni, C.E., Strippoli, M.P., Gehring, U., Wijga, A., Eller, E., Bindslev-Jensen, C., Keil, T., Heinrich, J., ENRIECO consortium:
Meta-analysis of mould and dampness exposure on asthma and allergy in eight European birth cohorts: an ENRIECO initiative.
Allergy. 2011 Dec;66(12):1570-9

Flexeder, C., Thiering, E., Brüske, I., Koletzko, S., Bauer, C.-P., Wichmann, H.-E., Mansmann, U., von Berg, A., Berdel, D., Krämer, U., Schaaf, B., Lehmann, I., Herbarth, O., Heinrich, J.:
Growth velocity during infancy and onset of asthma in school-aged children.
Allergy 2011; DOI: 10.1111/j.1398-9995.2011.02748.x

Tiesler, C.M., Chen, C.M., Sausenthaler, S., Herbarth, O., Lehmann, I., Schaaf, B., Krämer, U., von Berg, A., von Kries, R., Wichmann, H.E., Heinrich, J.; The LISA Study Group:
Passive smoking and behavioural problems in children: Results from the LISAplus prospective birth cohort study.
Environ Res. 2011 Nov;111(8):1173-1179. Epub 2011 Jul 20

Rzehak P, Thijs C, Standl M, Mommers M, Glaser C, Jansen E, Klopp N, Koppelman GH, Singmann P, Postma DS, Sausenthaler S, Dagnelie PC, van den Brandt PA, Koletzko B, Heinrich J, and the KOALA and the LISA study group:
Variants of the FADS1 FADS2 gene cluster, blood levels of polyunsaturated fatty acids and eczema in children within the first 2 years of life.
PLoS One 2010 Oct 11;5(10):e13261.

Chen CM, Weidinger S, Klopp N, Sausenthaler S, Bischof W, Herbarth O, Bauer M, Borte M, Schaaf B, Lehmann I, Behrendt H, Krämer U, Berdel D, von Berg A, Bauer CP, Koletzko S, Illig T, Wichmann HE, Heinrich J; LISA and GINI Study Group:
Common variants in FCER1A influence total serum IgE levels from cord blood up to six years of life.
Allergy. 2009 Sep;64(9):1327-32. Epub 2009 Feb 24.

Morgenstern V, Zutavern A, Cyrys J, Brockow I, Koletzko S, Kramer U, Behrendt H, Herbarth O, von Berg A, Bauer CP, Wichmann HE, Heinrich J, Gini And Lisa Study Group:
Atopic Diseases, Allergic Sensitisation and Exposure to Traffic-Related Air Pollution in Children.
Am J Respir Crit Care Med. 2008 Jun 15;177(12):1331-7.

Brockow I, Zutavern A, Franke K, Schaaf B., von Berg A, Krämer U, Lehmann I, Herbarth O, Borte M, Grübl A, Bauer CP, Wichmann HE and Heinrich J.:
Einfluss von Lebensbedingungen und Verhaltensweisen auf die Entwicklung von Immunsystem und Allergien im Ost-West-Vergleich (LISA).
Monatsschrift Kinderheilkunde 2008, Volume 156/3, 249-255.

Chen CH, Rzehak P, Zutavern A, Fahlbusch B, Bischof W, Herbarth O, Borte M, Lehmann I, Behrendt H, Krämer U, Wichmann HE, Heinrich J, and the LISA Study Group:
Longitudinal Study on Cat Allergen Exposure and the Development of Allergy in Young Children.
J Allergy Clin Immunol. 2007 May;119(5):1148-55.

Slama R, Morgenstern V, Cyrys J, Zutavern A, Herbarth O, Wichmann HE, Heinrich J; LISA Study Group.
Traffic-related atmospheric pollutants levels during pregnancy and offspring's term birth weight: a study relying on a land-use regression exposure model.
Environ Health Perspect. 2007 Sep;115(9):1283-92.

Sausenthaler S, Koletzko S, Schaaf B, Lehmann I, Borte M, Herbarth O, von Berg A, Wichmann HE, Heinrich J for the LISA Study Group:
Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 years of age.
Am J Clin Nutr. 2007 Feb;85(2):530-7.

Zutavern A, Brockow I, Schaaf B, Bolte G, von Berg A, Diez U, Borte M, Herbarth O, Wichmann HE, Heinrich J, LISA Study Group:
Timing of Solid Food Introduction in Relation to Atopic Dermatitis and Atopic Sensitization: Results From a Prospective Birth Cohort Study.
Pediatrics 2006; 117/2:401-411.

Gehring U, Bischof W, Borte M, Herbarth O, Wichmann HE, Heinrich J for the LISA study group:
Levels and predictors of endotoxin in mattress dust samples from East and West German homes.
Indoor Air 2004; 14: 284-292.

Negele K, Heinrich J, Borte M, von Berg A, Schaaf B, Lehmann I, Wichmann H-E, Bolte G for the LISA Study Group:
Mode of delivery and the development of atopic disease during the first 2 years of life.
Pediatr Allergy Immunol 2004: 15:48-54.

Heissenhuber A, Heinrich J, Fahlbusch B, Borte M, Wichmann HE, Bolte G for the LISA Study Group:
Health impacts of second-hand exposure to cat allergen Fel d 1 in infants.
Allergy 2003; 58:154-157.

Lehmann I, Thoelke A, Weiss M, Schlink U, Schulz R, Diez U, Sierig G, Emmrich F, Jacob B, Belcredi P, Bolte G, Heinrich J, Herbarth O, Wichmann HE, Borte M:
T cell reactivity in neonates from an East and a West German city – results of the LISA study.
Allergy 2002; 57:129-136.

Gehring U, Cyrys J, Sedlmeir G, Brunekreef B, Bellander T, Fischer P, Bauer CP, Reinhardt D, Wichmann HE, Heinrich J:
Traffic-related air pollution and respiratory health during the first 3 yrs of life.
Eur Respir J 2002; 19:690-698.

Heinrich J, Bolte G, Hölscher B, Douwes J, Lehmann I, Fahlbusch B, Bischof W, Weiss M, Borte M, Wichmann HE, on behalf of the LISA study group:
Allergens and endotoxin on mothers’ mattresses and total immunoglobulin E in cord blood of neonates.
Eur Respir J 2002; 20: 617-623.


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