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[Prevention of asthma and allergic diseases in children]
F Rancé1, J de Blic, P Scheinmann
1Hôpital des enfants, pneumologie-allergologie, 330, avenue de Grande-Bretagne, 31026 cedex, Toulouse, France. rance.f@chu-toulouse.fr <rance.f@chu-toulouse.fr>
Insights
Preventing allergic diseases is challenging, as primary prevention seems unlikely due to "clean" lifestyles. Secondary and tertiary prevention, like immunotherapy and avoiding passive smoking, are crucial for managing asthma and allergies.
Area of Science:
- Immunology
- Public Health
- Pediatrics
Context:
- Allergic diseases represent a significant public health concern in industrialized nations.
- Increasing prevalence of allergic and autoimmune diseases suggests underlying immune dysregulation.
- Early childhood events may influence the development of adult-onset asthma and allergies.
Purpose:
- To review current literature on allergens, atopic symptoms, and sensitization factors.
- To discuss primary, secondary, and tertiary prevention strategies for allergic diseases.
- To highlight the need for evidence-based preventive measures through rigorous studies.
Summary:
- Modern "clean" lifestyles may paradoxically increase allergy risk, challenging primary prevention.
- Immune dysregulation, rather than a simple Th1/Th2 imbalance, is implicated in allergic disease development.
- Passive smoking is a key factor to prevent due to its adverse effects on respiratory development and sensitization.
Impact:
- Findings suggest a shift in prevention strategies from primary to secondary and tertiary interventions.
- Highlights the need for further research into the complex interplay of genetics, environment, and immune response.
- Emphasizes the importance of public health initiatives targeting modifiable risk factors like passive smoking.
Abstract:
Allergic diseases have become a major public health problem in industrialized countries, justifying the development of prevention programs. A review of the literature on allergens and atopic symptoms, age of primary sensitization and other factors associated with allergic diseases development is presented and is followed by a discussion on prevention measures. The most recent physiopathological and immunological data indicate that persistent asthma and allergic diseases in adults may be associated with events in early childhood. The parallel increase in autoimmune and allergic diseases has been correlated with regulatory mechanism defects, contradicting the previous theory that involved a predominantly Th1 or Th2 pathway. The primary prevention of asthma and allergic diseases thus appear to be somewhat utopian. Indeed based on recent results, the risk of developing allergies appears to be related to modern "clean" lyfestyles. Secondary prevention is probably necessary, possibly through specific immunotherapy. Tertiary prevention must also be considered. Passive smoking must be prevented as it can alter the development of the respiratory system and promote allergen sensitization. Randomized, controlled, prospective studies are needed to evaluate the efficacy of the preventive measures.