Basic and clinical immunology
Coming back to a missing immune deviation as the main explanatory mechanism for the hygiene hypothesis

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    Since Th2 cells and their mediators have principal role to the pathophysiology of allergic asthma it has been suggested that the enhanced number and function of these Th2 cells is related to a decreased activation of Th1 cells probably caused by environmental factors (Camateros et al., 2006). This is the basis of the so-called hygiene hypothesis, which suggests that a lack of exposure to infective microorganisms during childhood increases susceptibility to allergic diseases and asthma due to deficient maturation of the immune system (Strachan, 2000; Romagnani, 2007). This hypothesis has been based on the presence of evidence that overcrowding unhygienic conditions, exposure to animals and infections (e.g. hepatitis A, measles) or immunisation with BCG result in a lower prevalence of atopic manifestations (Shaheen et al., 1996; Matricardi et al., 1997; Strachan, 1997; Douwes et al., 2007; Simpson et al., 2008).

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Disclosure of potential conflict of interest: The author has declared that he has no conflict of interest.

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