asthma severity and prevalence an ongoing interaction between exposure, hygiene, and lifestyle哮喘严重程度和流行之间的互动接触,卫生,和生活方式.pdfVIP

Open access, freely available online Research in Translation Asthma Severity and Prevalence: An Ongoing Interaction between Exposure, Hygiene, and Lifestyle Thomas A. E. Platts-Mills ver the last hundred years, Box 1. Hypotheses about the Cause of the Increase in Asthma: there have been major Arguments For and Against triumphs in medicine related O to public health, vaccination, and Hypothesis 1: Increased exposure to perennial allergens, e.g., dust mites the introduction of new medicines. For: However, over the same period, (A) Housing changes: houses are built more tightly and are more well insulated; more several diseases have increased in furnishings; fi tted carpets, and (B) more time spent indoors. Increased exposure leads to prevalence and/or severity. In some increased sensitization. cases, the causes of the increase have Against: Increases in asthma have been seen in countries where dust mites are not become obvious—the increases in lung present in homes, and in the Netherlands the concentration of mite allergens has cancer, coronary artery disease and actually decreased by as much as tenfold over the past 15 years type 2 diabetes, for example, are not considered to be a mystery. On the Hypothesis 2: Changed immune responsiveness is due to cleanliness other hand, a large group of diseases For: related broadly to “infl ammation” (A) Bacterial and other infections have decreased due to improved hygiene, have also increased. For these, a wide immuni