You have free access to this content
The ‘hygiene hypothesis’ for autoimmune and allergic diseases: an update
Article first published online: 11 MAR 2010
DOI: 10.1111/j.1365-2249.2010.04139.x
© 2010 British Society for Immunology
Additional Information
How to Cite
Okada, H., Kuhn, C., Feillet, H. and Bach, J.-F. (2010), The ‘hygiene hypothesis’ for autoimmune and allergic diseases: an update. Clinical & Experimental Immunology, 160: 1–9. doi: 10.1111/j.1365-2249.2010.04139.x
Publication History
- Issue published online: 11 MAR 2010
- Article first published online: 11 MAR 2010
- Accepted for publication 21 January 2010
References
- 1. Hay fever, hygiene, and household size. BMJ 1989; 299:1259–60.
- 2. The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 2002; 347:911–20.
- 3ISAAC. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet 1998; 351:1225–32.
- 4, , , . The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy 2004; 59:469–78.
- 5, , . The asthma epidemic. N Engl J Med 2006; 355:2226–35.
- 6. The global burden of asthma. Chest 2006; 130 (1 Suppl.):4S–12S.
- 7. Atopic dermatitis. N Engl J Med 2008; 358:1483–94.
- 8, , . Time trends in the incidence of type 1 diabetes in Finnish children: a cohort study. Lancet 2008; 371:1777–82.
- 9, , et al. Prevalence and incidence of primary biliary cirrhosis are increasing in Finland. Scand J Gastroenterol 2007; 42:1347–53.
- 10. The rise of childhood type 1 diabetes in the 20th century. Diabetes 2002; 51:3353–61.
- 11, , . Nationwide, prospective registration of type 1 diabetes in children aged < 15 years in Norway 1989–1998: no increase but significant regional variation in incidence. Diabetes Care 2004; 27:1618–22.
- 12, , , , , . Incidence and prevalence of multiple sclerosis in Olmsted County, Minnesota, 1985–2000. Neurology 2003; 61:1373–7.
- 13, , , , . Parasitic worms and inflammatory diseases. Parasite Immunol 2006; 28:515–23.
- 14, , . Multiple sclerosis in US veterans of the Vietnam era and later military service: race, sex, and geography. Ann Neurol 2004; 55:65–71.
- 15, , et al. Childhood diabetes in China. Enormous variation by place and ethnic group. Diabetes Care 1998; 21:525–9.
- 16, . Trends in the incidence of childhood-onset diabetes in Europe 1989–1998. Diabetologia 2001; 44 (Suppl. 3):B3–8.
- 17, , et al. A six-fold gradient in the incidence of type 1 diabetes at the eastern border of Finland. Ann Med 2005; 37:67–72.
- 18, , , , . Evidence for an environmental effect in the aetiology of insulin dependent diabetes in a transmigratory population. BMJ 1992; 304:1020–2.
- 19, , . The changing frequency of multiple sclerosis in Israel. Arch Neurol 1973; 29:107–10.
- 20, , . The age-range of risk of developing multiple sclerosis: evidence from a migrant population in Australia. Brain 2000; 123 (Pt 5):968–74.
- 21, , , , , . Incidence of insulin dependent diabetes mellitus in Karachi, Pakistan. Arch Dis Child 1997; 76:121–3.
- 22, , . Multiple sclerosis among American, Japanese and Chinese migrants to California and Washington. J Chronic Dis 1972; 25:3–10.
- 23. Frequency of lupus in people of African origin. Lupus 1995; 4:176–8.
- 24, , . Epidemiology of childhood IDDM in Northern Ireland 1989–1994: low incidence in areas with highest population density and most household crowding. Northern Ireland Diabetes Study Group. Diabetologia 1996; 39:1063–9.
- 25, , , . Small-area variations and sociodemographic correlates for the incidence of Crohn's disease and ulcerative colitis. Am J Epidemiol 2001; 154:328–35.
- 26, , , . The incidence of atopic dermatitis in school entrants is associated with individual life-style factors but not with local environmental factors in Hannover, Germany. Br J Dermatol 2002; 147:95–104.
- 27, , , , , . Epidemiological study of multiple sclerosis in Israel. II. Multiple sclerosis and level of sanitation. J Neurol Neurosurg Psychiatry 1966; 29:60–8.
- 28. Complex interactions of pollutant and allergen exposures and their impact on people with asthma. Pediatrics 2009; 123 (Suppl. 3):S160–7.
- 29, , , , , . Prevalence of asthma and atopy in two areas of West and East Germany. Am J Respir Crit Care Med 1994; 149 (2 Pt 1):358–64.
- 30, , . Vitamin effects on the immune system: vitamins A and D take centre stage. Nat Rev Immunol 2008; 8:685–98.
- 31, , , , . Circulating vitamin D concentrations in two neighboring populations with markedly different incidence of type 1 diabetes. Diabetes Care 2006; 29:1458–9.
- 32, , et al. Exposure to infant siblings during early life and risk of multiple sclerosis. JAMA 2005; 293:463–9.
- 33, , , , . Atopy, home environment and the risk of childhood-onset type 1 diabetes: a population-based case–control study. Pediatr Diabetes 2008; 9 (3 Pt 1):191–6.
- 34, , , , , . Siblings, day-care attendance, and the risk of asthma and wheezing during childhood. N Engl J Med 2000; 343:538–43.
- 35, , et al. Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet 2001; 358:1129–33.
- 36, , et al. Prenatal farm exposure is related to the expression of receptors of the innate immunity and to atopic sensitization in school-age children. J Allergy Clin Immunol 2006; 117:817–23.
- 37, , et al. Environmental exposure to endotoxin and its relation to asthma in school-age children. N Engl J Med 2002; 347:869–77.
- 38, , , , , . Endotoxin exposure is a risk factor for asthma: the national survey of endotoxin in United States housing. Am J Respir Crit Care Med 2005; 172:1371–7.
- 39, , et al. IPEADAM study: indoor endotoxin exposure, family status, and some housing characteristics in English children. J Allergy Clin Immunol 2006; 117:656–62.
- 40, , et al. Poor sanitation and helminth infection protect against skin sensitization in Vietnamese children: a cross-sectional study. J Allergy Clin Immunol 2006; 118:1305–11.
- 41, , . Influence of environmental viral agents on frequency and tempo of diabetes mellitus in BB/Wor rats. Diabetes 1991; 40:259–62.
- 42, , , , , . Unresponsiveness to experimental allergic encephalomyelitis in Lewis rats pretreated with complete Freund's adjuvant. Int Arch Allergy Appl Immunol 1985; 76:193–9.
- 43, , , , . Mycobacterial antigens attenuate late phase response, airway hyperresponsiveness, and bronchoalveolar lavage eosinophilia in a mouse model of bronchial asthma. Int Immunopharmacol 2001; 1:1743–51.
- 44, , et al. Transforming growth factor-beta and natural killer T-cells are involved in the protective effect of a bacterial extract on type 1 diabetes. Diabetes 2006; 55:179–85.
- 45, , , , , . Effect of anthelmintic treatment on the allergic reactivity of children in a tropical slum. J Allergy Clin Immunol 1993; 92:404–11.
- 46, , et al. Long-term treatment of intestinal helminths increases mite skin-test reactivity in Gabonese schoolchildren. J Infect Dis 2004; 189:892–900.
- 47, , , . Clinical improvement of asthma after anthelminthic treatment in a tropical situation. Am J Respir Crit Care Med 1997; 156:50–4.
- 48, , et al. Effect of albendazole treatments on the prevalence of atopy in children living in communities endemic for geohelminth parasites: a cluster-randomised trial. Lancet 2006; 367:1598–603.
- 49, , , , , . A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection. N Engl J Med 2003; 349:1341–8.
- 50, . Association between parasite infection and immune responses in multiple sclerosis. Ann Neurol 2007; 61:97–108.
- 51, , , , . Trichuris suis therapy in Crohn's disease. Gut 2005; 54:87–90.
- 52, , , , . Trichuris suis therapy for active ulcerative colitis: a randomized controlled trial. Gastroenterology 2005; 128:825–32.
- 53, , et al. A proof of concept study establishing Necator americanus in Crohn's patients and reservoir donors. Gut 2006; 55:136–7.
- 54, , et al. Probiotics: from myth to reality. Demonstration of functionality in animal models of disease and in human clinical trials. Antonie Van Leeuwenhoek 1999; 76:279–92.
- 55, , , , , . Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet 2001; 357:1076–9.
- 56, , , . Probiotics during the first 7 years of life: a cumulative risk reduction of eczema in a randomized, placebo-controlled trial. J Allergy Clin Immunol 2007; 119:1019–21.
- 57, , et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol 2007; 119:192–8.
- 58, , , . Randomized, double-blind, placebo-controlled trial of probiotics for primary prevention: no clinical effects of Lactobacillus GG supplementation. Pediatrics 2008; 121:e850–6.
- 59, , et al. Probiotics prevent IgE-associated allergy until age 5 years in cesarean-delivered children but not in the total cohort. J Allergy Clin Immunol 2009; 123:335–41.
- 60, , et al. Oral probiotic administration induces interleukin-10 production and prevents spontaneous autoimmune diabetes in the non-obese diabetic mouse. Diabetologia 2005; 48:1565–75.
- 61, , , , . Probiotics for the prevention of beta cell autoimmunity in children at genetic risk of type 1 diabetes – the PRODIA study. Ann NY Acad Sci 2006; 1079:360–4.
- 62, , , , , . Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol 2009; 104:437–43.
- 63, , et al. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet 2008; 371:651–9.
- 64, , et al. Metagenomic analysis of the human distal gut microbiome. Science 2006; 312:1355–9.
- 65, , , , , . Molecular analysis of commensal host–microbial relationships in the intestine. Science 2001; 291:881–4.
- 66, , , , . Recognition of commensal microflora by toll-like receptors is required for intestinal homeostasis. Cell 2004; 118:229–41.
- 67, , , . The intestinal microflora in allergic Estonian and Swedish 2-year-old children. Clin Exp Allergy 1999; 29:342–6.
- 68, , , , , . Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. J Allergy Clin Immunol 2001; 107:129–34.
- 69, , et al. Gut microbiota and development of atopic eczema in 3 European birth cohorts. J Allergy Clin Immunol 2007; 120:343–50.
- 70, , et al. Innate immunity and intestinal microbiota in the development of Type 1 diabetes. Nature 2008; 455:1109–13.
- 71, , et al. Reduced diversity of faecal microbiota in Crohn's disease revealed by a metagenomic approach. Gut 2006; 55:205–11.
- 72, , , , , . Molecular–phylogenetic characterization of microbial community imbalances in human inflammatory bowel diseases. Proc Natl Acad Sci USA 2007; 104:13780–5.
- 73, , et al. Faecalibacterium prausnitzii is an anti-inflammatory commensal bacterium identified by gut microbiota analysis of Crohn disease patients. Proc Natl Acad Sci USA 2008; 105:16731–6.
- 74, , . A microbial symbiosis factor prevents intestinal inflammatory disease. Nature 2008; 453:620–5.
- 75, , et al. Parasites represent a major selective force for interleukin genes and shape the genetic predisposition to autoimmune conditions. J Exp Med 2009; 206:1395–408.
- 76, , , , . CD4+CD25+ regulatory T cells control Leishmania major persistence and immunity. Nature 2002; 420:502–7.
- 77
- 78, , , , . B cells regulate autoimmunity by provision of IL-10. Nat Immunol 2002; 3:944–50.
- 79, . Natural killer T cells and autoimmune disease. Curr Mol Med 2009; 9:4–14.
- 80, , , . Interleukin-10 and the interleukin-10 receptor. Annu Rev Immunol 2001; 19:683–765.
- 81, . Transforming growth factor-beta in T-cell biology. Nat Rev Immunol 2002; 2:46–53.
- 82, , et al. Toll-like receptor engagement converts T-cell autoreactivity into overt autoimmune disease. Nat Med 2005; 11:138–45.
- 83, , et al. TLR9-signaling pathways are involved in Kilham rat virus-induced autoimmune diabetes in the biobreeding diabetes-resistant rat. J Immunol 2007; 178:693–701.
- 84, . Toll-like receptors and diabetes. Ann NY Acad Sci 2008; 1150:123–32.
- 85, , , , , . Imiquimod, a toll-like receptor 7 ligand, inhibits airway remodelling in a murine model of chronic asthma. Clin Exp Pharmacol Physiol 2009; 36:43–8.
- 86, , et al. Cross sectional retrospective study of prevalence of atopy among Italian military students with antibodies against hepatitis A virus. BMJ 1997; 314:999–1003.
- 87, , et al. Identification of Tapr (an airway hyperreactivity regulatory locus) and the linked Tim gene family. Nat Immunol 2001; 2:1109–16.
- 88, . Asthma genetics 2006: the long and winding road to gene discovery. Genes Immun 2006; 7:95–100.
- 89. Discovering susceptibility genes for asthma and allergy. Nat Rev Immunol 2008; 8:169–82.
- 90, , , , , . A Polymorphism* in the 5′ flanking region of the CD14 gene is associated with circulating soluble CD14 levels and with total serum immunoglobulin E. Am J Respir Cell Mol Biol 1999; 20:976–83.
- 91, , , , , . Schistosoma mansoni egg antigens induce Treg that participate in diabetes prevention in NOD mice. Eur J Immunol 2009; 39:1098–107.

1365-2249/asset/cei_left.gif?v=1&s=ffee144c532fe5e73bbb89290ba14e154b0d400b)
1365-2249/asset/cei_right.gif?v=1&s=c14d545a5215173707c8202758d5b25fd0bede44)
