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Immunocompetence and allergy.

Stephen J McGeady1

  • 1Division of Allergy and Clinical Immunology, Nemours Children's Clinic-Wilmington, Alfred I. duPont Hospital for Children, Wilmington, Delaware 19899, USA. smcgeady@nemours.org

Pediatrics
|April 3, 2004
PubMed
Summary
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The rise in allergic diseases like asthma in developed nations may be linked to modern lifestyles. The "hygiene hypothesis" suggests reduced exposure to microbes and endotoxin promotes immune responses favoring atopy.

Area of Science:

  • Immunology
  • Epidemiology
  • Environmental Health

Background:

  • Developed nations observe a significant increase in allergic diseases such as asthma, allergic rhinitis, atopic dermatitis, and allergic gastroenteropathy, collectively termed atopic diseases.
  • The underlying causes for this epidemic remain unclear, but modern lifestyle factors are suspected to influence immune system development.

Purpose of the Study:

  • To explore potential explanations for the rising prevalence of atopic diseases.
  • To evaluate two primary hypotheses: changes in nutrition/toxicant exposure and reduced exposure to infectious agents.

Main Methods:

  • Review and analysis of existing evidence supporting two main hypotheses.
  • Comparison of the explanatory power of the "toxicant/nutrition hypothesis" versus the "hygiene hypothesis".

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Main Results:

  • The study discusses two hypotheses: Hypothesis 1 (nutritional changes/toxicants) and Hypothesis 2 (reduced exposure to microbes/endotoxin, known as the "hygiene hypothesis").
  • Evidence supporting the "hygiene hypothesis" (Hypothesis 2) is considered stronger and more convincing than evidence for Hypothesis 1.

Conclusions:

  • The "hygiene hypothesis" provides a more compelling explanation for the current epidemic of atopic diseases in developed nations.
  • Modern lifestyles in affluent societies, characterized by reduced exposure to infectious agents, may predispose individuals to Th2-biased immune responses and subsequent atopy.