Casset Anne, Donnay Carole, de Blay Frédéric
Service de Pneumologie, Hôpital Lyautey, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg.
Rev Prat. 2005 Jun 30;55(12):1299-304.
Three hypotheses are described to explain the relation between allergens and environmental co-factors and the onset of atopy: the hygiene hypothesis, the allergenic hypothesis, and the high exposure tolerance inducing a Th2 derived response with blocking IgG4 synthesis. None of these hypotheses have been confirmed. It seems thus difficult to give recommendations for primary prevention of allergic diseases until results of prospective studies allow to consider a more precise behaviour. In contrast, subjects sensitized and exposed to allergens present an increased risk to develop asthma or non specific bronchial hyperreactivity. Therefore, secondary prevention appears as an essential method for treatment of allergic disease, with clinical benefits on symptoms which have recently been demonstrated in a clinical study.
卫生假说、变应原假说以及高暴露耐受性诱导产生Th2衍生反应并伴有阻断性IgG4合成。这些假说均未得到证实。因此，在前瞻性研究结果允许考虑更精确的行为之前，似乎很难就过敏性疾病的一级预防给出建议。相比之下，已致敏并接触过敏原的个体患哮喘或非特异性支气管高反应性的风险增加。因此，二级预防似乎是治疗过敏性疾病的重要方法，一项临床研究最近已证实其对症状具有临床益处。
