JO Warner, JA Warner, EA Miles, AC Jones

Abstract

The prevalence of asthma and related allergic disorders has increased considerably over the last 20-30 years. As genetic stock has not changed, environmental factors must have influenced the phenotype. Studies have shown that the key events leading to sensitization and the development of allergic disease are operative early in life. Indeed, our own studies would suggest that primary sensitization frequently occurs in utero. Postnatal allergen exposure then localises the cells to target organs where inflammation develops and disease manifests. The characteristics of the allergic immune response are now clearly elaborated with distinct subclasses of lymphocyte generating a particular set of peptide regulatory factors (cytokines) being pivotal in controlling both the production of immunoglobulin E and the activation of eosinophils and mast cells. Insights into the mechanisms leading to sensitization are beginning to identify therapeutic targets which may in the future reduce the prevalence of allergic disease in a highly cost effective manner. The interventions will include modification of the environment, immune modulation and targeted pharmacotherapy.

近20-30年哮喘及其有關的過敏性疾病的患病率有明顯的增長。由於遺傳物質並未發生改變，所以環境的變化則引起表現型的變化。研究發現導致敏感狀態和出現過敏性疾病的關鍵因素發生於生後的早期階段。的確，我們的研究提示原發性致敏狀態常起源於宮內。生後接觸過敏原則將細胞定位於靶器官，並形成炎症、病灶。過敏性免疫反應的特點已經闡明，淋巴細胞中的一個特殊亞類產生一種特異性的多肽調節因子（細胞因子）以控制IgE、嗜酸性細胞和肥大細胞的分泌。對致敏狀態的深入認識已開始應用於臨床治療之中，這可能成為行之有效的降低過敏性疾病患病率的方法。干預將包括改變環境、免疫調理和針對靶器官的藥物治療。