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THE CHANGING WORLD AS PRINCIPAL REASON FOR ATOPY RISING TREND
Abstract
Allergic respiratory diseases were quite rare at the beginning of last century but their prevalence in industrialized countries has now risen to true epidemic proportions. Much of the increase in asthma prevalence is occurring in subjects without a significant genetic predisposition.
As risk factors are described urban environment, industrialization, air pollution, westernalization of life, high hygienic standard, etc.
Therefore, it could be assumed that the above mentioned risk factors act on the human beings or other biologic species relatively for a short time. In this context, such factors might act in this way because of being new environmental constituents and therefore human adaptive mechanisms to them are inadequate yet. However, certain environmental factors may influence genetically some subpopulations even after exposure cessation without directly altering the genome or providing additional survival possibilities, which might induce the deviation of genetic thesaurus for populations into a more frequent allergy-predisposing genotype.
... At the beginning of the 20th century, allergies were rare diseases, while the last decades have witnessed a dramatic increase in disease burden and prevalence [3][4][5]. They represent the most frequent European chronic diseases, affecting more than 60 million people [3]. ...
... They represent the most frequent European chronic diseases, affecting more than 60 million people [3]. Data from several sources indicate worldwide increases in bronchial asthma or allergic rhinitis, especially in English-speaking countries [3,4,6]. Thus, during the 1990s, the prevalence of wheezing or bronchial hyperreactivity among European children aged 13-14 years varied from 32.2% in the United Kingdom to only 2.6% in Albania ( Fig. 1) [3][4][5][7][8][9]. ...
... Data from several sources indicate worldwide increases in bronchial asthma or allergic rhinitis, especially in English-speaking countries [3,4,6]. Thus, during the 1990s, the prevalence of wheezing or bronchial hyperreactivity among European children aged 13-14 years varied from 32.2% in the United Kingdom to only 2.6% in Albania ( Fig. 1) [3][4][5][7][8][9]. Similar variations within these states are evidenced among adults aged 20-44 [4,10]. ...
Antibiotics are one of the most frequently prescribed medications and their rational use has become an essential topic in clinical care. In this context, we have witnessed a dramatic increase in the prevalence of respiratory allergies during the last decades. The infections' role in the prevalence of respiratory allergic diseases is attributed to the antagonism between: a) induction of T helper (Th) 1 immune response by human organisms; and b) manipulation of the human immune response toward Th2 profile by common infective agents to increase their surviving opportunity. This work proposes that extensive antibiotic exposure during neonatal and early childhood plays an important role in the increasing epidemiological trend.
... The development of BA could be also associated with environmental conditions of modern life, especially the increased life's rhythm and expectations. The allergic respiratory diseases were quite rare at the beginning of last century but their prevalence in industrialized countries has now risen to true epidemic proportions [99][100][101]. Thus, data from several sources indicate worldwide prevalence increases of BA or allergic rhinitis over the last 30-40 years, especially in English-speaking countries [102,103]. Although the presence of affected relatives is associated with an increased risk of atopic diseases, recent data suggest that much of the increase in the BA-prevalence is occurring in subjects without a significant genetic predisposition [99,104]. ...
... Thus, data from several sources indicate worldwide prevalence increases of BA or allergic rhinitis over the last 30-40 years, especially in English-speaking countries [102,103]. Although the presence of affected relatives is associated with an increased risk of atopic diseases, recent data suggest that much of the increase in the BA-prevalence is occurring in subjects without a significant genetic predisposition [99,104]. Thus, described data from MAS cohort study conducted in German children at 5 years of age have shown in a majority of cases that asthmatic subpopulation has originated from non-atopic parents, indicating for the environmental impact on the atopy rising trend [99,105,106]. ...
... Although the presence of affected relatives is associated with an increased risk of atopic diseases, recent data suggest that much of the increase in the BA-prevalence is occurring in subjects without a significant genetic predisposition [99,104]. Thus, described data from MAS cohort study conducted in German children at 5 years of age have shown in a majority of cases that asthmatic subpopulation has originated from non-atopic parents, indicating for the environmental impact on the atopy rising trend [99,105,106]. Because this prevalence increase happened relatively in a short period of time, the role of populations' genomic transformation is assumed to be quite limited [101,103]. ...
Asthma is a complex disorder characterized by variable and recurring symptoms, airflow obstruction, bronchial hyper-responsiveness, and underlying inflammation. Although asthma is commonly thought of as a disease of children and young adults, a significant percentage of the older adult population is affected and carry a higher rate of morbidity and mortality from the disease. This book examines the causes, complications and treatment of asthma with topics including mathematical modeling in aspirin-induced asthma; the role of neuroimmune and psychological systems in the pathophysiology of bronchial asthma; special considerations of asthma in older adults; changes in the respiratory epithelium in bronchial asthma; and epidemiology of asthma during pregnancy. (Imprint: Nova Biomedical)
... At the beginning of the 20th century, allergies were rare diseases, while the last decades have witnessed a dramatic increase in disease burden and prevalence [1][2][3]. Allergies represent the most frequent chronic diseases in Europe, affecting more than 60 million people [1]. Data from several sources indicate worldwide increases in bronchial asthma or allergic rhinitis', especially in English-speaking countries [1,2,4]. ...
... Allergies represent the most frequent chronic diseases in Europe, affecting more than 60 million people [1]. Data from several sources indicate worldwide increases in bronchial asthma or allergic rhinitis', especially in English-speaking countries [1,2,4]. Thus, during the 1990s, the 'prevalence of wheezing or bronchial hyperreactivity in European children aged 13-14 years varied from 32.2% in United Kingdom to only 2.6% in Albania' (Fig. 1) [1][2][3][5][6][7]. ...
... Data from several sources indicate worldwide increases in bronchial asthma or allergic rhinitis', especially in English-speaking countries [1,2,4]. Thus, during the 1990s, the 'prevalence of wheezing or bronchial hyperreactivity in European children aged 13-14 years varied from 32.2% in United Kingdom to only 2.6% in Albania' (Fig. 1) [1][2][3][5][6][7]. 'Similar variations between European countries are evidenced among adults aged 20-44 years' [2,8]. ...
We have witnessed a dramatic increase in the prevalence of respiratory allergies during the last decades. The role of infections in the prevalence of respiratory allergic diseases is attributed to the antagonism between: a) induction of T helper (Th) 1 immune response by human organism; and b) manipulation of the human immune response toward Th2 profile by common infective agents in order to increase their surviving opportunity. This review proposes an important role of massive antibiotics exposure during neonatal and early childhood on the increasing epidemiological trend. It is believed that the antibiotics exposure during early childhood has also provided better surviving opportunity for atopic individuals with an inadequate immune defense against common infections, deviating therefore the genetic background of general population toward Th2 profile. Taking this into account, we suggest that Th2 profile frequency (and consequently atopic phenotype prevalence) can be increased along an individual lifespan after initial massive antibiotic introduction, until the entire population is exposed to them during childhood. This hypothesis may explain findings on epidemiological surveys, which report a prevalent increase among adults in industrialized countries between 1970s and 2000s, while in recently- developed countries this trend begun only at the end of 1980s. These arguments may lead to the conclusion that infections will manipulate the human immunity along generations, whereas actual antibiotics can increase the prevalence of respiratory allergies among a population only along an individual longevity. These findings may be beneficial in the development of future strategies for management of respiratory allergic or infective pathologies.
... This sharp increase in asthma and other allergic diseases between early 1960s and late 1980s is perceived to be a consequence of an intense migration from rural to urban regions, from poor, developing countries to rich, but heavily industrialized regions of Europe, Asia and Americas. Migration from the countryside to cities, from economically backward to economically developed countries has exposed migrants to a new set of harmful pollutants and allergens and changed their housing conditions, diet and access to medical services [1,2,4,5,7]. ...
... Many hypotheses link the allergy epidemic to stringent hygiene in early life, replacement of a traditional way of living by a westernized lifestyle and an accelerated pace of life [1,2,4,5,7,13]. There are epidemiological and experimental data to substantiate various hypotheses: ...
... • original hygiene hypothesis: improved hygiene in early life, reduction of family size and number of siblings [4,5,14,15], • extended hygiene hypothesis: replacement of traditional anthroposophic way of living, combining elements of conventional medicine (restrictive use of antibiotics, antipyretics and vaccination) with homeopathy and naturopathy (biodynamic diet) by modern lifestyle and new medical recommendations [6,13,16,17]; reduced early exposure to infectious and microbial agents [9,[17][18][19][20][21][22][23][24]; shorter period of breast feeding with unfavourable changes in the gut flora [2,11,25,26] [5,7,[48][49][50][51]. Replacement of traditional, fermented and antioxidant-rich diet by modern cuisine, limited natural early childhood exposure to microbes and excessive exposure to outdoor pollution in the industrialised regions seem to be the most important factors in the epidemiology of asthma, AR and AD [1,3,5,17,19,42,43]. ...
Atopic disorders are a major global health problem. The prevalence of asthma, allergic rhinitis and atopic dermatitis has been increasing over the last four decades, both in the industrialized and developing countries. It seems to be related to changes in the social structure, increasing industrialization, pollution and dietary changes. Many hypotheses link the allergy epidemic to stringent hygiene, dominance of a westernized lifestyle and an accelerated pace of life. Dietary antioxidants, lipids, sodium, vitamin D seem also to be implicated. We endeavour to review the most relevant theories with a special emphasis on the hygiene, antioxidative, lipid and air pollution hypotheses. It is however important to note that none of them explains all the aspects of unprecedented rise in the prevalence of allergic disorders. A complex interplay between host's immune response, invading pathogens, diversity of environmental factors and genetic background seems to be of a particular importance. Current allergy epidemic is multifactorial and basic and epidemiologic studies are warranted to further our understanding of this phenomenon.
... This sharp increase in asthma and other allergic diseases between early 1960s and late 1980s is perceived to be a consequence of an intense migration from rural to urban regions, from poor, developing countries to rich, but heavily industrialized regions of Europe, Asia and Americas. Migration from the countryside to cities, from economically backward to economically developed countries has exposed migrants to a new set of harmful pollutants and allergens and changed their housing conditions, diet and access to medical services [1,2,4,5,7]. ...
... Many hypotheses link the allergy epidemic to stringent hygiene in early life, replacement of a traditional way of living by a westernized lifestyle and an accelerated pace of life [1,2,4,5,7,13]. There are epidemiological and experimental data to substantiate various hypotheses: ...
... • original hygiene hypothesis: improved hygiene in early life, reduction of family size and number of siblings [4,5,14,15], • extended hygiene hypothesis: replacement of traditional anthroposophic way of living, combining elements of conventional medicine (restrictive use of antibiotics, antipyretics and vaccination) with homeopathy and naturopathy (biodynamic diet) by modern lifestyle and new medical recommendations [6,13,16,17]; reduced early exposure to infectious and microbial agents [9,[17][18][19][20][21][22][23][24]; shorter period of breast feeding with unfavourable changes in the gut flora [2,11,25,26] [5,7,[48][49][50][51]. Replacement of traditional, fermented and antioxidant-rich diet by modern cuisine, limited natural early childhood exposure to microbes and excessive exposure to outdoor pollution in the industrialised regions seem to be the most important factors in the epidemiology of asthma, AR and AD [1,3,5,17,19,42,43]. ...
Exposure of nasal mucosa to various allergic and/or non-allergic stimuli might result in rhinitis. Allergic rhinitis affects 10-25% of population making it the most prevalent allergic disorder. Seasonal and perennial allergic rhinitis affect up to 30% and 10% of pediatric population, respectively. Prevalence of allergic rhinitis varies between studies: in Poland, Breborowicz et al. reported allergic rhinitis in 16.7% of children aged 6-7, whereas Emeryk et al. observed perennial allergic rhinitis in 3.6% and seasonal allergic rhinitis in 6.2% of 8-15 year olds. Allergic rhinitis similarly to other diseases results in direct, indirect and hidden costs. In the USA (2002) direct costs were estimated at 665 millions (total of $4.863 billions). Allergic rhinitis co-exists with multiple respiratory conditions, significantly increasing treatment costs incurred by patients' and places additional burden on public finances. It also has a detrimental effect on patients' and their families' quality of life. Allergic rhinitis--although non-life threatening--significantly worsens quality of daily life and as such should be perceived as a serious medical condition not only by patients but also by medical professionals who are in position to diagnose it and implement appropriate therapeutic interventions.
Background: Febrile disease is very common among pregnant women in developing countries and sometimes not given relevant due diligence and perceived as a minor or common malaria situation. However, febrile disease most times is accompanied with some major disease condition which is life threatening to the pregnant women. This is a serious health problem that contributes greatly to morbidity and mortality in most developing economies including Uganda. In Mityana District of Uganda, 4 in 10 pregnancy deaths are malaria related and mothers who do not seek treatment in health facilities when they experience febrile illnesses. This is a major health challenge.
Aim: The present study was undertaken to identify factors associated with treatment-seeking behavior among pregnant women suffering from febrile illnesses suspected to be malaria in Ssekanyonyi Sub-County in Mityana District, Uganda.
Methods: A cross-sectional study in which questionnaires were administered to 198 expectant mothers to generate data on their socio-demographics and treatment seeking behaviour. SPSS software version 20.0 was used for data analysis and a Logistic Regression model was fitted to identify factors that independently influenced their treatment-seeking behavior. Relevant REC authorization and standard operating procedures of the Uganda Ministry of Health were duly followed.
Results: Out of the198 expectant mothers enrolled in the study, 42.9% were aged 15-25 years, 73.7% had achieved Secondary education, and 46.5% were married. The treatment-seeking behavior was found to be standing at only 56.6%. Among the different factors studied, health education on malaria (AOR = 3.68, P = 0.000), the attitude of midwives (AOR = 1.45, P = 0.003), patient care (AOR = 0.33, P = 0.030), and attitude of the pregnant mother (AOR = 5.38, P = 0.000) were found to be statistically significantly associated with treatment-seeking behavior among pregnant mothers with febrile illnesses. The results show that the attitude of midwives is significantly associated with treatment-seeking behavior for febrile illnesses assumed to be malaria among pregnant mothers.
Conclusion: The study concluded that health education and awareness on malaria, attitude of midwives and pregnant mothers, and how the pregnant mothers are handled are the most important factors in positively affecting treatment seeking behavior among pregnant mothers with febrile illnesses.
Recommendations: Health education on malaria, midwives' attitudes, patient treatment, and pregnant mothers' attitudes must all be addressed in order to prevent febrile infections. The Ministry of Health and other responsible stakeholders must reinforce health education programs for women of reproductive age about the dangers of febrile illnesses during pregnancy. It is also critical to assist midwives in addressing issues related to their attitudes toward pregnant mothers.
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