The 'hygiene hypothesis' for autoimmune and allergic diseases: an update
The 'hygiene hypothesis' for autoimmune and allergic diseases: an update
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DOI：
10.1111/j.1365-2249.2010.04139.x
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发表时间：
2010-04-01
影响因子：
4.6
通讯作者：
Bach, J. -F.
中科院分区：
文献类型：
--
作者：
Okada, H.;Kuhn, C.;Bach, J. -F.
根据“卫生假说”，西方国家和最近发展中国家感染发病率的下降是自身免疫性和过敏性疾病发病率增加的根源。卫生假说的依据是流行病学数据，特别是移民研究，这些数据表明，从低发病率国家移民到高发病率国家的受试者在第一代时获得高发病率的免疫系统疾病。然而，这些数据和其他数据表明高发病率与高社会经济水平之间的相关性，并不能证明感染与免疫紊乱之间存在因果关系。卫生假说的原理证据来自动物模型，在较小程度上来自人类的干预试验。潜在的机制是多重和复杂的。它们包括减少稳态因子的消耗和免疫调节，涉及各种调节性T细胞亚群和Toll样受体刺激。这些机制在某种程度上可能源于生活方式的改变引起的微生物群的变化，特别是在炎症性肠病中。总之，这些数据为预防自身免疫性和过敏性疾病开辟了新的治疗前景。
P>According to the 'hygiene hypothesis', the decreasing incidence of infections in western countries and more recently in developing countries is at the origin of the increasing incidence of both autoimmune and allergic diseases. The hygiene hypothesis is based upon epidemiological data, particularly migration studies, showing that subjects migrating from a low-incidence to a high-incidence country acquire the immune disorders with a high incidence at the first generation. However, these data and others showing a correlation between high disease incidence and high socio-economic level do not prove a causal link between infections and immune disorders. Proof of principle of the hygiene hypothesis is brought by animal models and to a lesser degree by intervention trials in humans. Underlying mechanisms are multiple and complex. They include decreased consumption of homeostatic factors and immunoregulation, involving various regulatory T cell subsets and Toll-like receptor stimulation. These mechanisms could originate, to some extent, from changes in microbiota caused by changes in lifestyle, particularly in inflammatory bowel diseases. Taken together, these data open new therapeutic perspectives in the prevention of autoimmune and allergic diseases.