Allergy and asthma prevention: the cup half full

Lack of an effective approach to atopic disease prevention is implicit in the global rise in asthma and allergy prevalence over the last 10-20 years. Indeed, asthma appears to be the most common chronic disease of childhood, allergies seem more common than not, and recent evidence suggests that this atopic disease burden is influencing adult prevalence of these conditions as well. Thus, the time seems right for prevention. Considering our current understanding of asthma and allergy pathogenesis, numerous strategies of atopic disease prevention can be envisioned. These strategies can be organized as follows: (1) allergen avoidance; (2) anti-inflammatory pharmacotherapy; (3) inhibition of Th2-type immune development by Th1-type cytokine induction; and (4) dietary and environmental approaches to atopic disease prevention.