Immune deviation and the hygiene hypothesis: a review of the epidemiological evidence

A Kemp, B Björkstén - Pediatric allergy and immunology, 2003 - Wiley Online Library
A Kemp, B Björkstén
Pediatric allergy and immunology, 2003Wiley Online Library
The epidemiological evidence for the proposal that early life immune deviation is the
principal mechanism by which microbial agents prevent the development of atopy has been
reviewed. Seven criteria are proposed which should ideally be fulfilled. The majority of
studies only fulfill two or three criteria. For mycobacteria, measles and respiratory viruses
there are studies that demonstrate a significant increase in atopy or allergic disease.
Parasite infections, which provide a strong TH2 stimulus, are associated with reduced rather …
The epidemiological evidence for the proposal that early life immune deviation is the principal mechanism by which microbial agents prevent the development of atopy has been reviewed. Seven criteria are proposed which should ideally be fulfilled. The majority of studies only fulfill two or three criteria. For mycobacteria, measles and respiratory viruses there are studies that demonstrate a significant increase in atopy or allergic disease. Parasite infections, which provide a strong TH2 stimulus, are associated with reduced rather than enhanced allergen sensitization. The available epidemiological evidence does not provide support for a mechanism of early life immune deviation. The principal environmental influences on atopic disease are likely to occur throughout life and involve interactions between microbes and other non‐infective and lifestyle factors.
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