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Author Bisgaard, H.; Bonnelykke, K.; Stokholm, J. url  doi
openurl 
  Title Immune-mediated diseases and microbial exposure in early life Type Journal Article
  Year (down) 2014 Publication Clinical and Experimental Allergy Abbreviated Journal Clin Exp Allergy  
  Volume 44 Issue 4 Pages 475-481  
  Keywords Age Factors; *Host-Pathogen Interactions; Humans; Immune System Diseases/*etiology/microbiology/virology  
  Abstract The non-communicable disease pandemic includes immune-mediated diseases such as asthma and allergy, which are likely originating in early life where the immature immune system is prone to alterations caused by the exposome. The timing of exposure seems critical for the developing immune system, and certain exposures may have detrimental effects in the earliest life, but no or even beneficial effects later. The human microbiome and infections are candidates as intermediary in the interaction between the host and the environment. The evidence seems inconsistent as infections as well as particular colonization patterns in neonates drive both short-term and long-term asthma symptoms, while, on the other hand, the composition of the microbiome in early life may protect against asthma and allergy in later life. This apparent contradiction may be explained by a deeper disease heterogeneity than we are currently able to discriminate, and in particular, the indiscriminate lumping together of different diseases into one atopic disease category. Also, the microbiome needs a differentiated understanding, considering balance between microbial groups, diversity and microbial genetic capability. Furthermore, the effects of the microbial exposure may only affect individuals with certain susceptibility genes. Few of the observations have been replicated, and publication bias is likely. Therefore, we are still far from understanding, or having proved, causal effects of the human microbiome. Still, the microbiome-gene interaction is a fascinating paradigm that fosters exiting research and promises a breakthrough in the understanding of the mechanisms driving asthma, allergy and eczema, and potentially also other immune-mediated non-communicable diseases.  
  Address Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Gentofte, Copenhagen, Denmark; The Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark  
  Corporate Author Thesis  
  Impact Factor 04,769 First Author Bisgaard, H. Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Senior Author Stokholm, J.  
  ISSN 0954-7894 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:24533884 Approved no  
  Call Number Serial 39  
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