https://www.researchgate.net/publication/7540577_The_hygiene_hypothesis_revisited

Resumo

Ao final de 2002, eu publiquei um artigo que relatava “a observação clínica, citada empiricamente ao longo dos séculos”, que a “inibição das manifestações de doenças agudas em crianças poderia predispor ao aparecimento futuro de doenças crônicas”, conforme distintas linhas do pensamento médico: homeopatia (Hahnemann, Burnett, escola francesa), medicina antroposófica, patologia experimental (Maffei) e imunologia (hipótese higiênica). Explicada ao longo dos séculos segundo os conhecimentos da época, esta teoria assume importância na racionalidade científica moderna através da “hipótese higiênica”, sugerindo que existe “uma relação inversa entre doenças atópicas e a exposição aos patógenos causadores de doenças agudas na infância”. Nos últimos anos (2002-2005), tem ocorrido um grande aumento de trabalhos científicos que confirmam as hipóteses iniciais, tentando ampliar e esclarecer os pontos controversos desta teoria. Uma revisão sintética destes trabalhos está esquematizada ao final deste artigo. Apesar do progresso atingido pela hipótese higiênica nos últimos 15 anos, Strachan alerta: “The hygiene hypothesis remains a credible but non specific explanation for observed variations over time, place and person at risk for developing atopic allergic disorders. More prospective studies are needed to unravel which infectious agents exert a protective effect and the time period of importance for sensitization. The clinical implications of these advances in understanding the etiology of atopic allergic disorders are currently limited”.

Abstract

At the end of 2002, I published an article that related “the clinical observation, empirically cited over the centuries”, that “inhibition of acute disease manifestation in childhood can predispose to future chronic diseases”, according to distinct lines from medical thought: homeopathy (Hahnemann, Burnett, French school), anthroposophic medicine, experimental pathology (Maffei) and immunology (hygiene hypothesis). Explained along the centuries through own knowledge to the time, this theory assumed importance in the modern scientific way through the “hygiene hypothesis”, suggesting “an inverse relationship between atopic diseases and an environment that leads to increased pathogen exposure”. In the last years (2002-2005), there is a great amount of papers that confirm the hygiene hypothesis initial proposals, trying to enlarge and clear the controversial points. A synthetic revision of these articles is schematised at the end of the text. Perhaps the progress made by hygiene hypothesis in the 15 years following its introduction is made by Strachan himself: “The hygiene hypothesis remains a credible but non specific explanation for observed variations over time, place and person at risk for developing atopic allergic disorders. More prospective studies are needed to unravel which infectious agents exert a protective effect and the time period of importance for sensitization. The clinical implications of these advances in understanding the etiology of atopic allergic disorders are currently limited”.