Kıykım Ayça, Öğülür İsmail, Yazıcı Duygu, Çokuğraş Haluk, Akdiş Mübeccel, Akdiş Cezmi A
Department of Pediatric Allergy and Immunology, İstanbul University- Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey.
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
Turk Arch Pediatr. 2023 Mar;58(2):122-128. doi: 10.5152/TurkArchPediatr.2023.23006.
Chronic inflammatory conditions including allergic, autoimmune, metabolic, and neuropsychiatric disorders are constantly increasing and leading to a high burden, especially in more industrialized countries. The prevalence is still on the rise in developing countries. The start of the steep increase in asthma, atopic dermatitis, and allergic rhinitis dates to the 1960s, whereas a second wave with an increase in eosinophilic gastrointestinal disease, food allergy, and drug hypersensitivity started after the 2000s. These diseases also started to appear more with neuropsychiatric and autoimmune conditions during the last few decades. Many theories have been proposed to explain this outbreak. The hygiene hypothesis was consolidated by "old friends" and biodiversity, although some gaps remained unresolved. The introduction of the epithelial barrier hypothesis gave us a new perspective to explain the effects of industrialization without environment control and health concerns creeping into our daily lives. The present review touches on the possible explanations of why epithelial barrier hypothesis covers all previous ones, which are not contradictory but mostly complementary.
包括过敏性、自身免疫性、代谢性和神经精神性疾病在内的慢性炎症性疾病正在不断增加，并导致沉重负担，尤其是在工业化程度较高的国家。在发展中国家，其患病率仍在上升。哮喘、特应性皮炎和过敏性鼻炎的急剧增加始于20世纪60年代，而嗜酸性胃肠道疾病、食物过敏和药物超敏反应增加的第二波高峰始于21世纪初。在过去几十年中，这些疾病也开始更多地与神经精神性和自身免疫性疾病同时出现。人们提出了许多理论来解释这种爆发。“老朋友”和生物多样性巩固了卫生假说，尽管一些空白仍未得到解决。上皮屏障假说的提出为我们提供了一个新的视角，以解释工业化的影响，同时环境控制和健康问题也悄然进入我们的日常生活。本综述探讨了上皮屏障假说涵盖所有先前假说的可能解释，这些解释并非相互矛盾，而是大多相互补充。
