Too clean, or not too clean: the hygiene hypothesis and home hygiene.
Too clean, or not too clean: the hygiene hypothesis and home hygiene.
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DOI：
10.1111/j.1365-2222.2006.02463.x
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发表时间：
2006-04
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Strachan最初提出的“卫生假说”提出，最近特应性疾病迅速增加的一个原因可能是儿童早期感染的发生率较低，通过与年长的兄弟姐妹不卫生的接触传播。“卫生假说”一词的使用导致了几种解释，其中一些没有得到更广泛的证据调查的支持。过敏性疾病的增加与致病菌感染的减少无关，也不能用家庭卫生的改变来解释。人们开始形成一种共识，认为生活方式的更根本的改变导致了与某些微生物或其他物种（如蠕虫）的接触减少，而这些微生物或物种对免疫调节机制的发展至关重要。尽管这篇综述的结论是，假设与卫生实践的关系尚未得到证实，但它为寻求改善卫生实践的举措提供了强有力的支持。然而，如果这个假设被重新命名，比如Bjorksten提出的“微生物暴露”假设或“微生物剥夺”假设，将会有所帮助。避免使用“卫生”一词将有助于将注意力集中在确定微生物对特应性疾病的真正影响上，同时最大限度地减少阻碍良好卫生习惯的风险。
The ‘hygiene hypothesis’ as originally formulated by Strachan, proposes that a cause of the recent rapid rise in atopic disorders could be a lower incidence of infection in early childhood, transmitted by unhygienic contact with older siblings. Use of the term ‘hygiene hypothesis’ has led to several interpretations, some of which are not supported by a broader survey of the evidence. The increase in allergic disorders does not correlate with the decrease in infection with pathogenic organisms, nor can it be explained by changes in domestic hygiene. A consensus is beginning to develop round the view that more fundamental changes in lifestyle have led to decreased exposure to certain microbial or other species, such as helminths, that are important for the development of immunoregulatory mechanisms. Although this review concludes that the relationship of the hypothesis to hygiene practice is not proven, it lends strong support to initiatives seeking to improve hygiene practice. It would however be helpful if the hypothesis were renamed, e.g. as the ‘microbial exposure’ hypothesis, or ‘microbial deprivation’ hypothesis, as proposed for instance by Bjorksten. Avoiding the term ‘hygiene’ would help focus attention on determining the true impact of microbes on atopic diseases, while minimizing risks of discouraging good hygiene practice.