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首页> 外文期刊>Allergy >Scientific rationale for the Finnish Allergy Programme 2008-2018: emphasis on prevention and endorsing tolerance.
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Scientific rationale for the Finnish Allergy Programme 2008-2018: emphasis on prevention and endorsing tolerance.

机译：2008-2018年芬兰过敏项目的科学原理：强调预防和认可耐受性。

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In similarity to many other western countries, the burden of allergic diseases in Finland is high. Studies worldwide have shown that an environment rich in microbes in early life reduces the subsequent risk of developing allergic diseases. Along with urbanization, such exposure has dramatically reduced, both in terms of diversity and quantity. Continuous stimulation of the immune system by environmental saprophytes via the skin, respiratory tract and gut appears to be necessary for activation of the regulatory network including regulatory T-cells and dendritic cells. Substantial evidence now shows that the balance between allergy and tolerance is dependent on regulatory T-cells. Tolerance induced by allergen-specific regulatory T-cells appears to be the normal immunological response to allergens in non atopic healthy individuals. Healthy subjects have an intact functional allergen-specific regulatory T-cell response, which in allergic subjects is impaired. Evidence on this exists with respect to atopicdermatitis, contact dermatitis, allergic rhinitis and asthma. Restoration of impaired allergen-specific regulatory T-cell response and tolerance induction has furthermore been demonstrated during allergen-specific subcutaneous and sublingual immunotherapy and is crucial for good therapeutic outcome. However, tolerance can also be strengthened unspecifically by simple means, e.g. by consuming farm milk and spending time in nature. Results so far obtained from animal models indicate that it is possible to restore tolerance by administering the allergen in certain circumstances both locally and systemically. It has become increasingly clear that continuous exposure to microbial antigens as well as allergens in foodstuffs and the environment is decisive, and excessive antigen avoidance can be harmful and weaken or even prevent the development of regulatory mechanisms. Success in the Finnish Asthma Programme was an encouraging example of how it is possible to reduce both the costs and morbidity of asthma. The time, in the wake of the Asthma Programme, is now opportune for a national allergy programme, particularly as in the past few years, fundamentally more essential data on tolerance and its mechanisms have been published. In this review, the scientific rationale for the Finnish Allergy Programme 2008-2018 is outlined. The focus is on tolerance and how to endorse tolerance at the population level.
机译：与许多其他西方国家相似，芬兰的过敏性疾病负担很高。全世界的研究表明，早年生活在富含微生物的环境下，可以减少随后发生过敏性疾病的风险。随着城市化的发展，无论是在多样性还是数量上，这种接触都大大减少了。环境腐生菌通过皮肤，呼吸道和肠道对免疫系统的持续刺激似乎对于激活包括调节性T细胞和树突状细胞在内的调节网络是必要的。现在有大量证据表明，过敏和耐受性之间的平衡取决于调节性T细胞。由变应原特异性调节性T细胞诱导的耐受性似乎是非特应性健康个体对变应原的正常免疫应答。健康的受试者具有完整的功能性变应原特异性调节性T细胞反应，在过敏性受试者中受损。关于特应性皮炎，接触性皮炎，过敏性鼻炎和哮喘的证据存在。在变应原特异性皮下和舌下免疫治疗期间，已证实受损的变应原特异性调节性T细胞反应和耐受诱导的恢复，对于良好的治疗效果至关重要。但是，也可以通过简单的方法例如通过非限制性地增强耐受性。通过食用农场牛奶并在大自然中消磨时间。到目前为止，从动物模型获得的结果表明，在某些情况下，局部和全身施用过敏原可以恢复耐受性。越来越清楚的是，持续暴露于食品和环境中的微生物抗原以及过敏原具有决定性，而避免避免过多的抗原可能有害并削弱甚至阻止调节机制的发展。芬兰哮喘计划的成功是一个令人鼓舞的例子，说明如何可以降低哮喘的成本和发病率。哮喘计划之后，现在是制定国家过敏计划的合适时机，尤其是在过去几年中，从根本上发布了有关耐受性及其机制的更重要的数据。在这篇综述中，概述了2008-2018年芬兰过敏项目的科学原理。重点是宽容以及如何在人群水平上认可宽容。

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