Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Environ Health Perspect. 2010 Aug;118(8):1091-9. doi: 10.1289/ehp.1001971. Epub 2010 May 18.
Diseases rarely, if ever, occur in isolation. Instead, most represent part of a more complex web or "pattern" of conditions that are connected via underlying biological mechanisms and processes, emerge across a lifetime, and have been identified with the aid of large medical databases.
We have described how an understanding of patterns of disease may be used to develop new strategies for reducing the prevalence and risk of major immune-based illnesses and diseases influenced by environmental stimuli.
Examples of recently defined patterns of diseases that begin in childhood include not only metabolic syndrome, with its characteristics of inflammatory dysregulation, but also allergic, autoimmune, recurrent infection, and other inflammatory patterns of disease. The recent identification of major immune-based disease patterns beginning in childhood suggests that the immune system may play an even more important role in determining health status and health care needs across a lifetime than was previously understood.
Focusing on patterns of disease, as opposed to individual conditions, offers two important venues for environmental health risk reduction. First, prevention of developmental immunotoxicity and pediatric immune dysfunction can be used to act against multiple diseases. Second, pattern-based treatment of entryway diseases can be tailored with the aim of disrupting the entire disease pattern and reducing the risk of later-life illnesses connected to underlying immune dysfunction. Disease-pattern-based evaluation, prevention, and treatment will require a change from the current approach for both immune safety testing and pediatric disease management.
疾病很少是孤立发生的。相反，大多数疾病代表了更复杂的“模式”的一部分，这些模式通过潜在的生物学机制和过程相互关联，在一生中出现，并借助大型医学数据库得以识别。
我们描述了如何利用对疾病模式的理解来制定新策略，以降低主要基于免疫的疾病和受环境刺激影响的疾病的患病率和风险。
最近定义的一些始于儿童期的疾病模式的例子不仅包括代谢综合征，其特征是炎症失调，还包括过敏、自身免疫、反复感染和其他炎症性疾病模式。最近发现始于儿童期的主要基于免疫的疾病模式表明，免疫系统在决定一生中的健康状况和医疗需求方面可能比以前理解的更为重要。
关注疾病模式而不是个别病症为减少环境健康风险提供了两个重要途径。首先，预防发育性免疫毒性和儿科免疫功能障碍可以用于对抗多种疾病。其次，基于模式的入口疾病治疗可以定制，目的是破坏整个疾病模式并降低与潜在免疫功能障碍相关的晚年疾病风险。基于疾病模式的评估、预防和治疗将需要改变当前的免疫安全性测试和儿科疾病管理方法。
