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Risk Factors in Allergy/Asthma

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The incidence of allergic rhinitis and asthma is increasing. Nobody knows why with certainty, but there are many theories including better diagnosis, urban living, higher exposure to dust mites, atmospheric pollution, nutrition, lifestyle changes, maternal smoking, diesel fumes, geography, the "hygiene hypothesis," and several others. It has been known that atopic disease runs in families and a family history is the strongest risk factor for the development of allergies/asthma. Molecular studies also have identified some specific atopic entities that are determined genetically (eosinophils, interleukin-5, etc.). Environmental issues and lifestyle changes are becoming increasingly more important as significant risk factors but the evidence can be confusing, controversial, and even contradictory. There is overwhelming evidence that sensitization to indoor allergens is a major risk factor for the development of clinical atopic disease in genetically susceptible individuals. Not everyone agrees and there are newer data to suggest that early exposure to endotoxin and/or living on a farm and even early exposure to cats and dogs protects against sensitization by driving the immune system to a TH1 lymphocyte response. To this point, the new data are impressive if not compelling. The "hygiene hypothesis" suggests that lack of exposure to a childhood infection, endotoxin, and bacterial products is an important determinant regarding development of atopic disease. It is clear that a family history (genetics) is the strongest risk factor for the development of clinic atopic disease but it is also clear that environmental issues play a significant role and that there is a lot we still do not know.
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Document Type: Regular Paper

Publication date: 2004-01-01

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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