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Jaarboek no. 87. 2008/2009 - Koninklijke Maatschappij voor ...

Jaarboek no. 87. 2008/2009 - Koninklijke Maatschappij voor ...

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132 Diligentia<br />

infections are able to suppress allergic disorders. In terms of mechanisms involved in suppression<br />

of airway inflammation by helminth infections, there is evidence that regulatory<br />

cells such as Tregs and regulatory B cells are involved. The transfer of T and B cells from<br />

chronically infected mice into allergen sensitized mice protected the development of airway<br />

inflammation following allergen challenge of sensitized mice.<br />

Concluding remarks<br />

The epidemiologic studies as well as studies in experimental models of asthma, support<br />

the <strong>no</strong>tion that certain infections reduce the risk of developing an allergic disease. The<br />

mechanisms so far point towards an important role for regulatory cells of the immune system.<br />

Therefore it is proposed that in areas where infections are highly endemic, exposure<br />

to microbial compounds can lead to the development of a robust regulatory response,<br />

which in turn can ensure that inflammatory immune activation is kept under control and<br />

thus prevents the development of overt inflammation in tissues such as in the lung.<br />

Key references<br />

Asher M.I., Montefort S., Björkstén B., Lai C.K., Strachan D.P., Weiland S.K., Williams H.; ISAAC Phase Three Study<br />

Group. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhi<strong>no</strong>conjunctivitis, and eczema<br />

in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368:733-43<br />

Bousquet J., Burney P.G., Zuberbier T., Cauwenberge P.V., Akdis C.A., Bindslev-Jensen C., Bonini S., Fokkens W.J.,<br />

Kauffmann F., Kowalski M.L., Lodrup-Carlsen K., Mullol J., Nizankowska-Mogilnicka E., Papadopoulos N., Toskala<br />

E., Wickman M., Anto J., Auvergne N., Bachert C., Bousquet P.J., Brunekreef B., Ca<strong>no</strong>nica G.W., Carlsen K.H.,<br />

Gjomarkaj M., Haahtela T., Howarth P., Lenzen G., Lotvall J., Radon K., Ring J., Salapatas M., Schünemann H.J.,<br />

Szczecklik A., Todo-Bom A., Valovirta E., von Mutius E., Zock J.P. GA(2)LEN (Global Allergy and Asthma European<br />

Network) addresses the allergy and asthma ‘epidemic’ Allergy. <strong>2009</strong> Apr 7 (epublication ahead)<br />

Cookson W.O., Moffatt M.F. Asthma: an epidemic in the absence of infection? Science. 1997; 275:41-2<br />

Van den Biggelaar A.H., Rodrigues L.C., van Ree R., et al. Long-term treatment of intestinal helminths increases mite<br />

skin-test reactivity in Gabonese schoolchildren. J Infect Dis. 2004; 189:892-900.<br />

Yazdanbakhsh M., Kremsner P.G., van Ree R. Allergy, parasites, and the hygiene hypothesis. Science 2002, 296:490-4<br />

Immu<strong>no</strong>logie van de hygiëne-hypothese

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