| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ludwig Maximilian Universität München, München, Germany
CORRESPONDENCE: E. von Mutius, Dr. von Haunersche Kinderklinik, Ludwig Maximilian Universität München, Lindwurmstr.4, D-;80337, München, Germany. Fax: 49 8951604452
Keywords: asthma, atopy, epidemiology, hygiene, infections
Received: November 2, 2000
Accepted July 27, 2001
Abstract
There is increasing evidence from epidemiological studies to support the "hygiene hypothesis" with regard to the development of allergic diseases. This review will discuss the epidemiological findings relating to atopy and asthma, separately.
The strongest arguments in favour of the "hygiene hypothesis" are the findings relating early life day care attendance to a significantly reduced risk of atopy and asthma, and the strong link between sibship size and the occurrence of atopy as confirmed by numerous studies.
Furthermore, data relating serological immune responses to certain infections such as hepatitis A and Toxoplasma gondii suggest a role for such infections, or alternatively the lack of hygiene, to be operative in the inhibition of the development of allergic immune responses. The effects described seem to be stronger for atopy than for asthma.
Furthermore, biological plausibility for such a hypothesis can be found from findings of recent in vitro studies and from animal experiments. Epidemiological studies attempting to identify single infections as being harmful or beneficial could fail, because it may be the total burden of microbial stimuli rather than a certain infection that directs the maturing immune system into a Th1-type T-;helper cell polarized response. The timing of the exposure seems to be essential for promoting beneficial or harmful effects, and may provide a "window of opportunity".
This article has been cited by other articles:
|
|
 |
|
  S Cherian, N M Smith, and D A Forbes Rapidly increasing prevalence of eosinophilic oesophagitis in Western Australia Arch. Dis. Child., December 1, 2006; 91(12): 1000 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Eder, M. J. Ege, and E. von Mutius The asthma epidemic. N. Engl. J. Med., November 23, 2006; 355(21): 2226 - 2235. [Full Text] [PDF]
|
|
|
|
|
|
P J Helms Exercise induced asthma: real or imagined? Arch. Dis. Child., September 1, 2005; 90(9): 886 - 887. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Bailey, K. Haverson, B. Miller, P. Jones, I. Sola, L. Enjuanes, and C. R. Stokes Effects of Infection with Transmissible Gastroenteritis Virus on Concomitant Immune Responses to Dietary and Injected Antigens Clin. Vaccine Immunol., March 1, 2004; 11(2): 337 - 343. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Adams, N. Nagy, F. Paulart, M.-L. Vanderhaeghen, M. Goldman, and V. Flamand CD8+ T Lymphocytes Regulating Th2 Pathology Escape Neonatal Tolerization J. Immunol., November 15, 2003; 171(10): 5071 - 5076. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T Hazir, C Das, F Piracha, B Waheed, M Azam, and A Tam Carers' perception of childhood asthma and its management in a selected Pakistani community Arch. Dis. Child., October 1, 2002; 87(4): 287 - 290. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K-;H. Carlsen and P.J. Sterk Infection: friend or foe to the development of asthma? Eur. Respir. J., November 1, 2001; 18(5): 744 - 747. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
