Zusammenfassung
Allergien manifestieren sich als eine überschießende Reaktion des Immunsystems gegenüber "normalerweise" harmlosen Umweltantigenen. Diese fehlgeleitete Reaktion wird sowohl durch genetische Faktoren als auch durch Umwelteinflüsse im weitesten Sinne determiniert. Den Umweltfaktoren fällt hierbei eine entscheidende Rolle zu. Klinische und epidemiologischen Studien zeigen, dass bestimmte Umweltfaktoren (z. B. Exposition mit bakteriellen Antigenen) mit einem Schutz vor Allergien und Asthma assoziiert sind. Andererseits sind auch eine Reihe von Umweltfaktoren identifiziert, die die Allergieentstehung fördern. Aktuelle Studien deuten zunehmend daraufhin, dass diese Prägung des Immunsystems wie auch die Induktion von Toleranzmechanismen bereits sehr früh in der kindlichen Entwicklung, inklusive der Gestationsperiode, festgelegt wird. Dieser Artikel diskutiert einige der zugrunde liegenden immunologischen Prozesse im Zusammenhang mit der Etablierung allergischer Erkrankungen im frühen Kindesalter.
Abstract
Allergies manifest as an excessive reaction of the immune system to "normally" harmless environmental antigens. This errant reaction is determined be genetic factors as well as environmental effects in the broadest sense. Environmental factors play a decisive role. Clinical and epidemiological studies show that certain environmental factors (e. g., exposure to bacterial antigens) are associated with protection against allergies and asthma. On the other hand, a succession of environmental factors have been identified that induce allergenesis. Current studies increasingly indicate that this imprinting of the immune system and the induction of tolerance mechanisms are already determined very early in childhood development, including the gestational period. This article discusses some of the underlying immunological processes in connection with the establishment of allergic diseases in early childhood.
Literatur
The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee (1998) Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet 351: 1225–1232
National Heart, Lung and Blood Institute (NHLBI) National Institutes of Health, USA (1999) National Asthma Education and Prevention Programme (NAEPP)
Kulig M, Bergmann R, Klettke U, Wahn V, Tacke U, Wahn U (1999) Natural course of sensitization to food and inhalant allergens during the first 6 years of life. J Allergy Clin Immunol 103: 1173–1179
Cookson WO, Young RP, Sandford AJ et al. (1992) Maternal inheritance of atopic IgE responsiveness on chromosome 11q. Lancet 340: 381–384
Marsh DG, Neely JD, Breazeale DR et al. (1994) Linkage analysis of IL4 and other chromosome 5q31.1 markers and total serum immunoglobulin E concentrations. Science 264: 1152–1156
Strachan DP (1989) Hay fever, hygiene, and household size. BMJ 299: 1259–1260
Rook G, Stanford JL (1998) Give us this day our daily germs. Immunol Today 19: 113–116
Riedler J, Eder W, Oberfeld G, Schreuer M (2000) Austrian children living on a farm have less hay fever, asthma and allergic sensitization. Clin Exp Allergy 30: 194–200
Riedler J, Braun-Fahrländer C, Eder W et al. (2001) Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet 358: 1129–1133
Braun-Fahrlander C, Riedler J, Herz U et al. (2002) Environmental exposure to endotoxin and its relation to asthma in school-age children. N Engl J Med 347: 869–877
Mosmann TR, Cherwinski H, Bond MW, Giedlin MA, Coffman RL (1986) Two types of murine helper T cell clone. I. Definition according to profiles of lymphokine activities and secreted proteins. J Immunol 136: 2348–2357
Kim J, Woods A, Becker-Dunn E, Bottomly K (1985) Distinct functional phenotypes of cloned Ia-restricted helper T-cells. J Exp Med 162: 188–201
Strober W, Kelsall B, Fuss I et al. (1997) Reciprocal IFN-gamma and TGF-beta responses regulate the occurrence of mucosal inflammation. Immunol Today 18: 61–64
Rissoan MC, Soumelis V, Kadowaki N et al. (1999) Reciprocal control of T helper cell and dendritic cell differentiation. Science 283: 1183–1186
Kalinski P, Hilkens CM, Wierenga EA, Kapsenberg ML (1999) T-cell priming by type-1 and type-2 polarized dendritic cells: the concept of a third signal. Immunol Today 20: 561–567
Seder RA, Gazzinelli R, Sher A, Paul WE (1993) Interleukin 12 acts directly on CD4+ T cells to enhance priming for interferon gamma production and diminishes interleukin 4 inhibition of such priming. Proc Natl Acad Sci U S A 90: 10188–10192
Lin H, Mosmann TR, Guilbert L, Tuntipopipat S, Wegmann TG (1993) Synthesis of T helper 2-type cytokines at the maternal-fetal interface. J Immunol 151: 4562–4573
Wegmann TG, Lin H, Guilbert L, Mosmann TR (1993) Bidirectional cytokine interactions in the maternal-fetal relationship: is successful pregnancy a TH2 phenomenon? Immunol Today 14: 353–356
Clark DA, Flanders KC, Banwatt D et al. (1990) Murine pregnancy decidua produces a unique immunosuppressive molecule related to transforming growth factor beta-2. J Immunol 144: 3008–3014
Clark DA, Arck PC, Chaouat G (1999) Why did your mother reject you? Immunogenetic determinants of the response to environmental selective pressure expressed at the uterine level. Am J Reprod Immunol 41: 5–22
Tang ML, Kemp AS, Thorburn J, Hill DJ (1994) Reduced interferon-gamma secretion in neonates and subsequent atopy. Lancet 344: 983–985
Warner JO, Warner JA, Miles EA, Jones AC (1994) Reduced interferon-gamma secretion in neonates and subsequent atopy. Lancet 344: 1516
Prescott SL, Macaubas C, Smallacombe T, Holt BJ, Sly PD, Holt PG (1999) Development of allergen-specific T-cell memory in atopic and normal children. Lancet 353: 196–200
Herz U, Ahrens B, Scheffold A, Joachim R, Radbruch A, Renz H (2000) Impact of in utero Th2 immunity on T cell deviation and subsequent immediate-type hypersensitivity in the neonate. Eur J Immunol 30: 714–718
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Herz, U., Renz, H. Die immunologische Basis der frühkindlichen Immundeviation. Monatsschr Kinderheilkd 151 (Suppl 1), S5–S9 (2003). https://doi.org/10.1007/s00112-003-0800-4
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DOI: https://doi.org/10.1007/s00112-003-0800-4