Department of Neurology, Institute for Neurological Research Dr Raúl Carrea, FLENI, Argentina.
Mult Scler. 2011 Oct;17(10):1162-9. doi: 10.1177/1352458511418027.
MS incidence has significantly increased during the second half of the 20th century, generating considerable interest in analyzing the basis for this rise in the developed world. Particular emphasis is being placed on the role infections might play in exacerbating or preventing disease onset. Epidemiological data suggest that improvement in sanitation conditions and reduced exposure to infection might explain, at least in part, these changes. The hygiene hypothesis is not new and is currently used to explain the increasing incidence of allergies and other autoimmune diseases. Because helminths are powerful modulators of host immunity, some authors hypothesize that reduced parasite exposure due to improved hygiene conditions may favor MS development. We discuss epidemiological, experimental, clinical and molecular data supporting the protective role of helminthes against MS. Better understanding of host-parasite interactions caused by specific parasite molecules with immunomodulatory effects will help combat allergies and autoimmune disease without the price of untoward infection as a side-effect.
多发性硬化症(MS)的发病率在 20 世纪下半叶显著增加,这引起了人们对分析发达国家发病率上升原因的极大兴趣。人们特别关注感染在加剧或预防疾病发作方面可能发挥的作用。流行病学数据表明,卫生条件的改善和感染暴露的减少至少可以部分解释这些变化。卫生假说并不是一个新的概念,目前它被用来解释过敏和其他自身免疫性疾病发病率的上升。由于寄生虫是宿主免疫的强有力调节剂,一些作者假设,由于卫生条件的改善而导致寄生虫暴露减少,可能有利于 MS 的发展。我们讨论了支持寄生虫对 MS 具有保护作用的流行病学、实验、临床和分子数据。更好地了解具有免疫调节作用的特定寄生虫分子引起的宿主-寄生虫相互作用,将有助于在不产生不良感染副作用的情况下对抗过敏和自身免疫性疾病。