Schaub Bianca, Lauener Roger, von Mutius Erika
University Children's Hospital Munich, Dr von Haunersches Kinderspital, Pediatric Pulmonary Division, LMU Munich, Germany.
J Allergy Clin Immunol. 2006 May;117(5):969-77; quiz 978. doi: 10.1016/j.jaci.2006.03.003.
About 15 years have gone by since Strachan first proposed the idea that infections and unhygienic contact might confer protection against the development of allergic illnesses. The so-called hygiene hypothesis has ever since undergone numerous more or less subtle modifications by various researchers in the fields of epidemiology, clinical science, and immunology. Three major tracts have developed exploring the role of overt viral and bacterial infections, the significance of environmental exposure to microbial compounds, and the effect of both on underlying responses of the innate and adaptive immunity. To date, a truly unifying concept has not yet emerged, but various pieces of a complex interplay between immune responses of the host, characteristics of the invading microorganism, the level and variety of the environmental exposure, and the interactions between a genetic background and a range of exposures becomes apparent. These influences are discussed as determinants for a number of complex allergic illnesses in this review, while we attempt to pay attention to the importance of different phenotypes, namely of the asthma syndrome. Even if today practical implications cannot directly be deduced from these findings, there is great potential for the development of novel preventive and therapeutic strategies in the future.
自斯特拉坎首次提出感染和不卫生接触可能对过敏性疾病的发展具有保护作用这一观点以来，大约已经过去了15年。从那时起，所谓的卫生假说在流行病学、临床科学和免疫学领域经历了众多或大或小的微妙修正。已经形成了三条主要的研究方向，分别探索显性病毒和细菌感染的作用、环境暴露于微生物化合物的意义，以及二者对固有免疫和适应性免疫潜在反应的影响。迄今为止，尚未出现一个真正统一的概念，但宿主免疫反应、入侵微生物的特征、环境暴露的水平和种类以及遗传背景与一系列暴露之间的相互作用等复杂相互作用的各个部分已变得清晰可见。在本综述中，这些影响被作为多种复杂过敏性疾病的决定因素进行讨论，同时我们试图关注不同表型的重要性，即哮喘综合征的表型。即使如今无法直接从这些发现中推断出实际应用，但未来开发新的预防和治疗策略仍具有巨大潜力。
