Obihara Charles C, Kimpen Jan L L, Beyers Nulda
Department of Pediatrics, St. Elisabeth Hospital, P.O. Box 90151, 5000 LC Tilburg, The Netherlands.
Curr Allergy Asthma Rep. 2007 Jun;7(3):223-30. doi: 10.1007/s11882-007-0076-1.
The increase in the global incidence of atopic disease and asthma during the past few decades has been ascribed to environmental factors, including the reduction in exposure to serious infections. The hypothetical framework to explain the inverse relationship between infections and atopic disease and asthma has been called the "hygiene hypothesis." Animal and experimental models have identified Mycobacteria as important potential candidates in the hygiene hypothesis by demonstrating that exposure to Mycobacteria or mycobacterial proteins led to subsequent reduction in different atopic manifestations. Although there are epidemiological studies in support, they have not always been consistent. In this review we appraise epidemiologic evidence on the inverse relationship between mycobacterial exposure and atopic disease, explore the immunological mechanisms involved and evidence that this effect may be dose-dependent, and discuss the challenges facing the use of Mycobacteria as vaccine for prevention of atopic disease.
在过去几十年中，全球特应性疾病和哮喘的发病率上升被归因于环境因素，包括接触严重感染的减少。用于解释感染与特应性疾病和哮喘之间反比关系的假设框架被称为“卫生假说”。动物和实验模型已将分枝杆菌确定为卫生假说中的重要潜在候选因素，因为它们表明接触分枝杆菌或分枝杆菌蛋白会导致随后不同特应性表现的减少。尽管有支持性的流行病学研究，但结果并不总是一致。在这篇综述中，我们评估了关于分枝杆菌接触与特应性疾病之间反比关系的流行病学证据，探讨了其中涉及的免疫机制以及这种效应可能呈剂量依赖性的证据，并讨论了将分枝杆菌用作预防特应性疾病疫苗所面临的挑战。
