Role of Antibiotics and Infection-Host Interactions in the Prevalence ofRespiratory Atopy: Experience and Perspective

摘要

We have witnessed a dramatic increase in the prevalence of respiratory allergies during the last decades. Therole of infections in the prevalence of respiratory allergic diseases is attributed to the antagonism between: a) induction ofT helper (Th) 1 immune response by human organism; and b) manipulation of the human immune response toward Th2profile by common infective agents in order to increase their surviving opportunity. This review proposes an importantrole of massive antibiotics exposure during neonatal and early childhood on the increasing epidemiological trend. It is believedthat the antibiotics exposure during early childhood has also provided better surviving opportunity for atopic individualswith an inadequate immune defense against common infections, deviating therefore the genetic background ofgeneral population toward Th2 profile. Taking this into account, we suggest that Th2 profile frequency (and consequentlyatopic phenotype prevalence) can be increased along an individual lifespan after initial massive antibiotic introduction,until the entire population is exposed to them during childhood. This hypothesis may explain findings on epidemiologicalsurveys, which report a prevalent increase among adults in industrialized countries between 1970s and 2000s, while in recently-developed countries this trend begun only at the end of 1980s. These arguments may lead to the conclusion that infectionswill manipulate the human immunity along generations, whereas actual antibiotics can increase the prevalence ofrespiratory allergies among a population only along an individual longevity. These findings may be beneficial in the developmentof future strategies for management of respiratory allergic or infective pathologies.