Unraveling the Hygiene Hypothesis of helminthes and autoimmunity: origins, pathophysiology, and clinical applications

BMC Medicine

Yehuda Shoenfeld²  Miri Blank³  Giorgia Bizzaro³  Tomer Bashi³  Pierre-Yves Jeandel¹  Mathilde Versini¹ 

[1]Department of Internal Medicine, Archet-1 Hospital, University of Nice-Sophia-Antipolis, 151 Route de Saint Antoine de Ginestière, Nice, 06202, France

[2]The Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

[3]The Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel

关键词: Th1;    T-regulatory cells;    Parasite;    Infection;    Hygiene hypothesis;    Helminthes;    Autoimmune disease;    Autoimmunity;    Autoantibodies;    Allergy;   

Others  :  1171053
DOI  :  10.1186/s12916-015-0306-7

 received in 2014-09-25, accepted in 2015-03-02,  发布年份 2015

【 摘 要 】

Background

The Hygiene Hypothesis (HH) attributes the dramatic increase in autoimmune and allergic diseases observed in recent decades in Western countries to the reduced exposure to diverse immunoregulatory infectious agents. This theory has since largely been supported by strong epidemiological and experimental evidence.

Discussion

The analysis of these data along with the evolution of the Western world’s microbiome enable us to obtain greater insight into microorganisms involved in the HH, as well as their regulatory mechanisms on the immune system. Helminthes and their derivatives were shown to have a protective role. Helminthes’ broad immunomodulatory properties have already begun to be exploited in clinical trials of autoimmune diseases, including inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, and type-1 diabetes.

Summary

In this review, we will dissect the microbial actors thought to be involved in the HH as well as their immunomodulatory mechanisms as emphasized by experimental studies, with a particular attention on parasites. Thereafter, we will review the early clinical trials using helminthes’ derivatives focusing on autoimmune diseases.

【 授权许可】

   
2015 Versini et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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