Centre for Clinical Microbiology, Department of Infection, UCL (University College London), London, United Kingdom.
London School of Hygiene and Tropical Medicine, London, United Kingdom.
J Allergy Clin Immunol. 2021 Jul;148(1):33-39. doi: 10.1016/j.jaci.2021.05.008. Epub 2021 May 24.
It is often suggested that hygiene is not compatible with the microbial exposures that are necessary for establishment of the immune system in early life. However, when we analyze the microbial exposures of modern humans in the context of human evolution and history, it becomes evident that whereas children need exposure to the microbiotas of their mothers, other family members, and the natural environment, exposure to the unnatural microbiota of the modern home is less relevant. In addition, any benefits of exposure to the infections of childhood within their household setting are at least partly replaced by the recently revealed nonspecific effects of vaccines. This article shows how targeting hygiene practices at key risk moments and sites can maximize protection against infection while minimizing any impact on essential microbial exposures. Moreover, this targeting must aim to reduce direct exposure of children to cleaning agents because those agents probably exert T2-adjuvant effects that trigger allergic responses to normally innocuous antigens. Finally, we need to halt the flow of publications in the scientific literature and the media that blame hygiene for the increases in immunoregulatory disorders. Appropriately targeted hygiene behavior is compatible with a healthy lifestyle that promotes exposure to essential microorganisms.
人们常说，讲卫生与儿童早期免疫系统发育所需的微生物暴露是相悖的。然而，当我们从人类进化和历史的角度来分析现代人所接触到的微生物时，就会发现儿童确实需要接触母亲、其他家庭成员和自然环境中的微生物群，但对于现代家庭中不自然的微生物群的接触则不那么重要。此外，在家庭环境中接触儿童时期感染的任何益处，至少部分被最近发现的疫苗的非特异性效应所取代。本文展示了如何针对关键的风险时刻和部位进行卫生实践，从而在最大程度地预防感染的同时，将对必要微生物暴露的任何影响降至最低。此外，这种针对性干预必须旨在减少儿童直接接触清洁剂，因为这些清洁剂可能会产生 T2 佐剂效应，从而引发对正常无害抗原的过敏反应。最后，我们需要阻止科学文献和媒体上的出版物将卫生归咎于免疫调节紊乱增加的这种做法。有针对性的卫生行为与促进接触必需微生物的健康生活方式是兼容的。
