Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany.
Nat Rev Immunol. 2021 Mar;21(3):177-191. doi: 10.1038/s41577-020-00420-y. Epub 2020 Sep 11.
Allergies, including asthma, food allergy and atopic dermatitis, are increasing in prevalence, particularly in westernized countries. Although a detailed mechanistic explanation for this increase is lacking, recent evidence indicates that, in addition to genetic predisposition, lifestyle changes owing to modernization have an important role. Such changes include increased rates of birth by caesarean delivery, increased early use of antibiotics, a westernized diet and the associated development of obesity, and changes in indoor and outdoor lifestyle and activity patterns. Most of these factors directly and indirectly impact the formation of a diverse microbiota, which includes bacterial, viral and fungal components; the microbiota has a leading role in shaping (early) immune responses. This default programme is markedly disturbed under the influence of environmental and lifestyle risk factors. Here, we review the most important allergy risk factors associated with changes in our exposure to the microbial world and the application of this knowledge to allergy prevention strategies.
过敏反应（包括哮喘、食物过敏和特应性皮炎）的发病率正在上升，尤其是在西方国家。尽管缺乏对这种增加的详细机制解释，但最近的证据表明，除了遗传易感性外，由于现代化而导致的生活方式改变也起着重要作用。这些变化包括剖宫产率的增加、抗生素的早期使用、西方化的饮食以及由此导致的肥胖的发展，以及室内外生活方式和活动模式的变化。这些因素大多数直接或间接影响了多样化微生物群的形成，其中包括细菌、病毒和真菌成分；微生物群在塑造（早期）免疫反应方面起着主导作用。在环境和生活方式危险因素的影响下，这种默认程序明显受到干扰。在这里，我们回顾了与我们接触微生物世界的变化相关的最重要的过敏危险因素，并将这些知识应用于过敏预防策略。
