Role of Antibiotics and Infection-Host Interactions in the Prevalence of Respiratory Atopy: Experience and Perspective

Alketa H Bakiri,Ervin Ç Mingomataj,Alkerta Ibranji

doi:10.2174/1874838401508010001

Abstract

We have witnessed a dramatic increase in the prevalence of respiratory allergies during the last decades. The role of infections in the prevalence of respiratory allergic diseases is attributed to the antagonism between: a) induction of T helper (Th) 1 immune response by human organism; and b) manipulation of the human immune response toward Th2 profile by common infective agents in order to increase their surviving opportunity. This review proposes an important role of massive antibiotics exposure during neonatal and early childhood on the increasing epidemiological trend. It is believed that the antibiotics exposure during early childhood has also provided better surviving opportunity for atopic individuals with an inadequate immune defense against common infections, deviating therefore the genetic background of general population toward Th2 profile. Taking this into account, we suggest that Th2 profile frequency (and consequently atopic phenotype prevalence) can be increased along an individual lifespan after initial massive antibiotic introduction, until the entire population is exposed to them during childhood. This hypothesis may explain findings on epidemiological surveys, which report a prevalent increase among adults in industrialized countries between 1970s and 2000s, while in recently- developed countries this trend begun only at the end of 1980s. These arguments may lead to the conclusion that infections will manipulate the human immunity along generations, whereas actual antibiotics can increase the prevalence of respiratory allergies among a population only along an individual longevity. These findings may be beneficial in the development of future strategies for management of respiratory allergic or infective pathologies.

Highlights

At the beginning of the 20th century, allergies were rare diseases, while the last decades have witnessed a dramatic increase in disease burden and prevalence [1,2,3]
The role of infections in the prevalence of respiratory allergies consists in the antagonism between: a) induction of human T helper (Th) 1 immune response as consequence of infection; and b) manipulation of this immune response toward Th2 profile by common infective agents in order to increase the invaders’ surviving opportunity [2, 15]
Antibiotics, Infections and Respiratory Atopy that a vast proportion of infections cannot be eradicated by traditional antibiotics and that actual human populations show more frequently Th2/IgE profile in association with antibiotics’ use, it could be concluded once more that the development of bronchial and nasal hyperreactivity after early respiratory infections could be considered a predictor for a future allergic “career” as well as a consequence of the invaders’ manipulatory abilities in order to reassure their own reproduction/survivorship [34,35,36]

Summary

Introduction

At the beginning of the 20th century, allergies were rare diseases, while the last decades have witnessed a dramatic increase in disease burden and prevalence [1,2,3]. The identified risk factors for the respiratory atopic pathologies cannot account for the global increasing prevalence, international patterns, or recent declines in some western countries [14].

Results

Conclusion