Versini Mathilde, Jeandel Pierre-Yves, Bashi Tomer, Bizzaro Giorgia, Blank Miri, Shoenfeld Yehuda
The Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Israel.
Department of Internal Medicine, Archet-1 Hospital, University of Nice-Sophia-Antipolis, 151 Route de Saint Antoine de Ginestière, 06202, Nice, France.
BMC Med. 2015 Apr 13;13:81. doi: 10.1186/s12916-015-0306-7.
The Hygiene Hypothesis (HH) attributes the dramatic increase in autoimmune and allergic diseases observed in recent decades in Western countries to the reduced exposure to diverse immunoregulatory infectious agents. This theory has since largely been supported by strong epidemiological and experimental evidence.
The analysis of these data along with the evolution of the Western world's microbiome enable us to obtain greater insight into microorganisms involved in the HH, as well as their regulatory mechanisms on the immune system. Helminthes and their derivatives were shown to have a protective role. Helminthes' broad immunomodulatory properties have already begun to be exploited in clinical trials of autoimmune diseases, including inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, and type-1 diabetes.
In this review, we will dissect the microbial actors thought to be involved in the HH as well as their immunomodulatory mechanisms as emphasized by experimental studies, with a particular attention on parasites. Thereafter, we will review the early clinical trials using helminthes' derivatives focusing on autoimmune diseases.
卫生假说（HH）将西方国家近几十年来观察到的自身免疫性疾病和过敏性疾病的急剧增加归因于接触多种免疫调节性感染因子的减少。此后，这一理论在很大程度上得到了强有力的流行病学和实验证据的支持。
对这些数据的分析以及西方世界微生物群的演变使我们能够更深入地了解参与卫生假说的微生物及其对免疫系统的调节机制。已证明蠕虫及其衍生物具有保护作用。蠕虫广泛的免疫调节特性已开始在自身免疫性疾病的临床试验中得到应用，包括炎症性肠病、多发性硬化症、类风湿性关节炎和1型糖尿病。
在本综述中，我们将剖析被认为参与卫生假说的微生物因素及其在实验研究中强调的免疫调节机制，尤其关注寄生虫。此后，我们将回顾使用蠕虫衍生物针对自身免疫性疾病的早期临床试验。
