primary prevention of allergic diseases current concepts and mechanisms过敏性疾病的初级预防当前概念和机制.pdfVIP

ORIGINAL ARTICLE Primary Prevention of Allergic Diseases: Current Concepts and Mechanisms Kerstin Gerhold, MD, Yasemin Darcan, MD, and Eckard Hamelmann, MD Atopic diseases, the new ‘‘epidemic of the twenty-first century’’ and a central health problem of industrial nations, call for the development of innovative primary prevention strategies. The present review provides an overview of current experimental and immunomodulatory procedures and their underlying mechanisms. Key words: asthma, Th1/Th2-cytokines, immunomodulation, mouse model s a new ‘‘epidemic of the 21st century’’1 causing allergen avoidance for primary prevention of allergy A growing health problems, particularly in industrialized appeared not to be practical or sufficient,5 and present countries, atopic diseases such as hay fever, bronchial antiphlogistic therapies with antihistamines or steroids just asthma, and atopic dermatitis call for the development of diminish symptoms for a short time but potentially cause innovative primary prevention concepts (Figure 1, Table 1). side effects and are not curative.6 Pathophysiology of allergic diseases is based on extreme New immunomodulatory strategies aim to support T helper (Th)2 immune responses to commonly harmless naturally occurring regulatory mechanisms that may protect environmental antigens. The key cytokines interleukin against predominant Th2 immune responses and maintain (IL)-4 and IL-13 induce immunoglobulin (Ig) class switch the immunologic balance, thus preventing the development in B cells, leading to excessive IgE production with of allergen sensitization as the first step of the atopic march subsequent mast cell activatio