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Levels of Environmental Endotoxin and Prevalence of Atopic Disease
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To the Editor: While the prevalence of asthma and allergic disease is increasing worldwide,1 both diseases appear to be less common in rural settings in developing countries and farming communities in industrialized countries.2 Indeed, some locales seem to be almost free of asthma.3 To explain the low prevalence of asthma in these settings, the "hygiene hypothesis" suggests that early childhood exposure to high levels of bacterial and viral pathogens leads to a lower risk of asthma and atopy.4-5 The immune response to these infections would presumably inhibit helper T cell type 2 (TH2)–type allergic responses.
We recently reported on the potential of environmental endotoxin—a cell-wall component from gram-negative bacteria that is ubiquitous in the environment—to provide an atopy-protective effect.6 Infants sensitized to common allergens had significantly lower levels of house-dust endotoxin in their homes. Furthermore, higher house-dust endotoxin levels correlated with increased proportions of interferon- –producing CD4 TH1 . . . [Full Text of this Article] Methods
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