Hygiene hypothesis and prevalence of glomerulonephritis
Hygiene hypothesis and prevalence of glomerulonephritis
复制标题
DOI：
10.1111/j.1523-1755.2005.09711.x
复制
发表时间：
2005-08-01
影响因子：
19.6
通讯作者：
Johnson, RJ
中科院分区：
文献类型：
--
作者：
Hurtado, A;Johnson, RJ
卫生假说的提出是为了解释在工业化（西方化）社会中观察到的过敏症的显著增加。这一假说提出，早期和频繁暴露于细菌和其他抗原，如在发展中国家常见的，导致正常的Th 1应答，但在工业化国家观察到的更好的公共卫生和更少的感染可能导致Th 2表型的持续存在，从而增加我们患过敏症的风险。在生命早期感染麻疹或甲型肝炎病毒，接种卡介苗，某些胃肠道细菌，以及环境内毒素暴露可能会保护个体在成年后不会发生过敏。奇怪的是，寄生虫感染刺激Th 2细胞反应;然而，过敏性疾病的发生率非常低，可能是由于T调节淋巴细胞的刺激，可以下调Th 1。某些类型的人肾小球肾炎（GN）具有Th 1-优势免疫应答，包括新月体和膜增殖性GN，而其它类型的GN具有优势Th 2免疫应答，包括膜性肾病、微小病变病和免疫球蛋白A肾病。对特定GN患病率的回顾表明，发展中国家膜增生性GN的患病率较高，工业化国家免疫球蛋白A肾病和微小病变疾病的发生率较高，这可以用卫生假说来解释。我们建议研究Th 1/Th 2平衡，特别是在儿童时期的发展，应该进行，以确定是否早期极化的免疫反应是负责特定形式的GN的后期发展。
The hygiene hypothesis was proposed to explain the marked increase in allergies that has been observed in industrialized (Westernized) societies. This hypothesis proposes that early and frequent exposure to bacterial and other antigens, such as is common in developing nations, leads to a normal Th1 response, but that better public hygiene and less infections observed in industrialized nations may lead to persistence of the Th2 phenotype and thereby increase our risk for developing allergies. Infection early in life with measles or hepatitis A virus, immunization with bacille Calmette-Guerin, certain gastrointestinal bacteria (lactobacillus), and environmental endotoxin exposure may protect individuals from developing allergy in adulthood. Paradoxically, infestation by parasites stimulates a Th2-cell response; however, the incidence of allergic disease is very low, perhaps due to the stimulation of T-regulatory lymphocytes that can downregulate Th1. and Th2 responses.Some types of human glomerulonephritis (GN) have Th1-predominant immune responses, including crescentic and membranoproliferative GN, whereas other types of GN have a predominant Th2 immune response, including membranous nephropathy, minimal change disease, and immunoglobulin A nephropathy. A review of the prevalence of specific GN shows that the higher prevalence of membranoproliferative GN in developing countries and the higher frequency of immunoglobulin A nephropathy and minimal change disease in industrialized countries could be explained by the hygiene hypothesis. We suggest that studies examining Th1/Th2 balance, particularly as it develops in childhood, should be performed to determine if early polarization of the immune response is responsible for the later development of specific forms of GN.