Atopic eczema, hygiene and hapten hypothesis: immune reaction in the skin predisposes to systemic sensitization.
Abstract
Atopic march is a process, when atopic eczema patients are getting sensitized to aeroallergens and develop further atopic diseases- rhinoconjunctivitis, bronchial asthma and others. Skin barier disturbances in patiens with atopy are considered to be the initial mechanisms.
Several hypotheses have been proposed to explain the increasing prevalence of atopic march in Europe. The hygiene hypothesis was based on the assumption that improved hygiene in population with higher living standards results in insufficient exposure of immune system to microbes, allergens, foods and other influences in early childhood that are important for proper stimmulatory and regulatory function of the immune system.
The consequence is the permanent shift towards Th2 response. The hapten hypothesis explains the increase of atopy in population by the mechanisms of innate imunity as the sub-threshold exposure of the organism to new molecules in critical age (breast feeded infants and toddlers) for the induction of immune tolerance.