期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 137, 期 3, 页码 690-697出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2016.01.004
关键词
Hygiene hypothesis; asthma; sensitization; microbes; microbiome; helminths; viruses; immune regulation
资金
- Dutch Lung Foundation
- Boehringer Ingelheim
- Galapagos
- German Federal Ministry of Research (BMBF)
- German Research Foundation (DFG)
- European Commission
- European Research Council
- Friesland Campina
- GlaxoSmithKline
- Chiesi
- Merck
- Pfizer
- German Research Foundation (DFG) [SFB/TR22]
- Academy of Finland
- Wellcome Trust
- Rainin Foundation
- Asthma UK
- Medical Research Council
- Abbvie
- Thermo Fisher
- Thermo Fisher Scientific
- MEDA Pharmaceuticals
- Nutritia
- Mead Johnson Nutrition
- Abbott
- IMed-Emerade
- Allergy Therapeutics
- Stallergenes
- German Research Foundation
- Friesland-Campina
- Novartis
- Mundipharma
- DOC Congress SRL
- Oekosoziales Forum Oberoesterreich
- MRC [G0901697] Funding Source: UKRI
- Asthma UK [SPD-2012-172] Funding Source: researchfish
- Medical Research Council [G0901697, G0800649] Funding Source: researchfish
The worldwide incidence and prevalence of asthma continues to increase. Asthma is now understood as an umbrella term for different phenotypes or endotypes, which arise through different pathophysiologic pathways. Understanding the many factors contributing to development of the disease is important for the identification of novel therapeutic targets for the treatment of certain asthma phenotypes. The hygiene hypothesis has been formulated to explain the increasing prevalence of allergic disease, including asthma. This hypothesis postulates that decreased exposure at a young age to certain infectious agents as a result of improved hygiene, increased antibiotic use and vaccination, and changes in lifestyle and dietary habits is associated with changes in the immune system, which predispose subjects to allergy. Many microbes, during their coevolution with human subjects, developed mechanisms to manipulate the human immune system and to increase their chances of survival. Improving models of asthma, as well as choosing adequate end points in clinical trials, will lead to a more complete understanding of the underlying mechanisms, thus providing an opportunity to devise primary and secondary interventions at the same time as identifying new molecular targets for treatment. This article reports the discussion and conclusion of a workshop under the auspices of the Netherlands Lung Foundation to extend our understanding of how modulation of the immune system by bacterial, parasitic, and viral infections might affect the development of asthma and to map out future lines of investigation.
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