Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Allergy. 2019 Aug;74(8):1445-1456. doi: 10.1111/all.13763. Epub 2019 Apr 4.
Biodiversity hypothesis states that contact with natural environments enriches the human microbiome, promotes immune balance and protects from allergy and inflammatory disorders. We are protected by two nested layers of biodiversity, microbiota of the outer layer (soil, natural waters, plants, animals) and inner layer (gut, skin, airways). The latter inhabits our body and is colonized from the outer layer. Explosion of human populations along with cultural evolution is profoundly changing our environment and lifestyle. Adaptive immunoregulatory circuits and dynamic homeostasis are at stake in the newly emerged urban surroundings. In allergy, and chronic inflammatory disorders in general, exploring the determinants of immunotolerance is the key for prevention and more effective treatment. Loss of immunoprotective factors, derived from nature, is a new kind of health risk poorly acknowledged until recently. The paradigm change has been implemented in the Finnish allergy programme (2008-2018), which emphasized tolerance instead of avoidance. The first results are promising, as allergy burden has started to reduce. The rapidly urbanizing world is facing serious biodiversity loss with global warming, which are interconnected. Biodiversity hypothesis of health and disease has societal impact, for example, on city planning, food and energy production and nature conservation. It has also a message for individuals for health and well-being: take nature close, to touch, eat, breathe, experience and enjoy. Biodiverse natural environments are dependent on planetary health, which should be a priority also among health professionals.
生物多样性假说认为,接触自然环境可以丰富人类微生物组,促进免疫平衡,预防过敏和炎症性疾病。我们受到两层嵌套的生物多样性的保护,外层(土壤、自然水域、植物、动物)和内层(肠道、皮肤、呼吸道)的微生物群。后者栖息在我们的身体中,并从外层殖民。随着人类人口的爆炸式增长和文化的演变,我们的环境和生活方式正在发生深刻的变化。适应性免疫调节回路和动态的体内平衡在新出现的城市环境中受到威胁。在过敏和一般的慢性炎症性疾病中,探索免疫耐受的决定因素是预防和更有效治疗的关键。失去源自自然的免疫保护因素是一种新的健康风险,直到最近才得到认识。这种范式的转变已经在芬兰过敏计划(2008-2018 年)中实施,该计划强调了耐受而不是回避。初步结果令人鼓舞,因为过敏负担开始减轻。快速城市化的世界正面临着全球变暖导致的严重生物多样性丧失,这两者是相互关联的。健康与疾病的生物多样性假说具有社会影响,例如对城市规划、食品和能源生产以及自然保护的影响。它也为个人的健康和幸福带来了一个信息:亲近自然,触摸、食用、呼吸、体验和享受自然。生物多样性的自然环境依赖于行星健康,这也应该是卫生专业人员的优先事项。