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Science 19 April 2002: Vol. 296. no. 5567, pp. 490 - 494 DOI: 10.1126/science.296.5567.490
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Review
Allergy, Parasites, and the Hygiene Hypothesis
Maria Yazdanbakhsh,1*
Peter G. Kremsner,23
Ronald van Ree4
The increase of allergic diseases in the
industrialized world has often been explained by a decline in
infections during childhood. The immunological explanation has been put
into the context of the functional T cell subsets known as T helper 1 (TH1) and T helper 2 (TH2) that
display polarized cytokine profiles. It has been argued that bacterial
and viral infections during early life direct the maturing immune
system toward TH1, which counterbalance proallergic
responses of TH2 cells. Thus, a reduction in the overall microbial burden will result in weak TH1 imprinting and
unrestrained TH2 responses that allow an increase in
allergy. This notion is contradicted by observations that the
prevalence of TH1-autoimmune diseases is also increasing
and that TH2-skewed parasitic worm (helminth) infections
are not associated with allergy. More recently, elevations of
anti-inflammatory cytokines, such as interleukin-10, that occur during
long-term helminth infections have been shown to be inversely
correlated with allergy. The induction of a robust anti-inflammatory
regulatory network by persistent immune challenge offers a unifying
explanation for the observed inverse association of many infections
with allergic disorders.
1 Department of Parasitology, Leiden University Medical
Center, Leiden, Netherlands.
2 Department of Parasitology,
Institute for Tropical Medicine, University of Tuebingen, Germany.
3 Research Unit, Albert Schweitzer Hospital, Lambarene,
Gabon.
4 Department of Immunopathology, Sanquin Research at
CLB, Amsterdam, Netherlands.
*
To whom correspondence should be addressed. E-mail:
M.Yazdanbakhsh{at}LUMC.NL
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- Addressing Parents' Concerns: Do Vaccines Cause Allergic or Autoimmune Diseases?.
- P. A. Offit and C. J. Hackett (2003)
Pediatrics
111, 653-659
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- Immunomodulation of experimental autoimmune encephalomyelitis by helminth ova immunization.
- D. Sewell, Z. Qing, E. Reinke, D. Elliot, J. Weinstock, M. Sandor, and Z. Fabry (2003)
Int. Immunol.
15, 59-69
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- A Novel Host-Parasite Lipid Cross-talk. SCHISTOSOMAL LYSO-PHOSPHATIDYLSERINE ACTIVATES TOLL-LIKE RECEPTOR 2 AND AFFECTS IMMUNE POLARIZATION.
- D. van der Kleij, E. Latz, J. F. H. M. Brouwers, Y. C. M. Kruize, M. Schmitz, E. A. Kurt-Jones, T. Espevik, E. C. de Jong, M. L. Kapsenberg, D. T. Golenbock, et al. (2002)
J. Biol. Chem.
277, 48122-48129
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- An Enteric Helminth Infection Protects Against an Allergic Response to Dietary Antigen.
- M. E. H. Bashir, P. Andersen, I. J. Fuss, H. N. Shi, and C. Nagler-Anderson (2002)
J. Immunol.
169, 3284-3292
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- Parasite-activated TH2 cytokine signaling via a T-cell independent pathway
- Ka Bian, et al.
- Science Online, 25 Jun 2002
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