Infectious agents can induce autoimmune diseases in severalexperimental settings, some of which have clinical counterparts.A variety of mechanisms have been invoked to explain these observations,including molecular mimicry and an increase in the immunogenicityof autoantigens caused by inflammation in the target organ.1Paradoxically, infectious agents can also suppress allergicand autoimmune disorders. In this review, I will summarize theevidence that the main factor in the increased prevalence ofthese diseases in industrialized countries is the reductionin the incidence of infectious diseases in those countries overthe past three decades. This concept is not new. In . . . [Full Text of this Article]
Contrasting Epidemiologic Trends in Developed Countries
The Geographic Distribution of Allergic and Autoimmune Diseases
The North–South Gradient
Genetic Factors
Environmental Factors
Interactions between Genetic and Environmental Factors
Socioeconomic Status
Childhood Infection
Other Factors
Is the Decreased Incidence of Infectious Diseases Causally Related to the Increased Incidence of Immunologic Diseases?
Animal Models
Underlying Mechanisms
Type 1 and Type 2 Helper T Cells
Regulatory T Cells and Cytokines
Other Mechanisms
Clinical Implications
Source Information
From INSERM Unité 25, Institut de Recherches Necker–Enfants Malades, Hôpital Necker, Paris.
Address reprint requests to Dr. Bach at INSERM Unité 25, Hôpital Necker, 161 rue de Sèvres, 75743 Paris CEDEX 15, France, or at bach@necker.fr.
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