The Microbial Role in Allergy: A Comprehensive Review
Article Sidebar
Main Article Content
Abstract
Background: The rise in allergic diseases in Western industrial nations has been paralleled by an increased understanding of the intricate relationship between microbial exposure and immune system responses. The hygiene hypothesis suggests a link between reduced exposure to infectious agents and an increase in allergies, emphasizing the need for a deeper investigation into the roles of various microbes in allergic reactions.
Objective: This review aims to elucidate the complex mechanisms underlying allergic reactions, specifically focusing on the roles of parasites, bacteria, fungi, and viruses. It seeks to explore the potential of microbial exposure as both a protective and pathogenic factor in the development of allergies, with an eye towards informing future therapeutic strategies.
Methods: An extensive literature review was conducted using databases such as Google Scholar, Scopus, PubMed, and Web of Sciences, focusing on studies published up to March 2024. The review synthesized findings on the impact of microbial exposure on allergic diseases, examining the roles of specific microbes, their interaction with the immune system, and the implications for allergic responses.
Results: The review highlights the dual nature of microbial exposure in allergies, with some microbes offering protection against allergic diseases through the modulation of immune responses, while others exacerbate allergic conditions. Notably, probiotics and certain parasitic infections demonstrate potential in modulating the immune system to prevent or reduce allergic responses. Conversely, specific bacterial, fungal, and viral exposures are linked to the exacerbation of allergic diseases.
Conclusion: Understanding the complex relationship between microbial exposure and allergic diseases is crucial for developing novel therapeutic and preventive strategies. This review underscores the potential of targeted microbial management in modulating immune responses to allergens, suggesting a promising avenue for reducing the global burden of allergic diseases.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Chang TW, Wu PC, Hsu CL, Hung AF. Anti‐IgE antibodies for the treatment of IgE‐mediated allergic diseases. Advances in immunology. 2007;93:63-119.
Turnbull J, Adams H, Gorard DA. The diagnosis and management of food allergy and food intolerances. Alimentary pharmacology & therapeutics. 2015;41(1):3-25.
Doña I, Blanca‐López N, Cornejo‐García J, Torres M, Laguna J, Fernández J, et al. Characteristics of subjects experiencing hypersensitivity to non‐steroidal anti‐inflammatory drugs: patterns of response. Clinical & Experimental Allergy. 2011;41(1):86-95.
Marshall JS, Warrington R, Watson W, Kim HL. An introduction to immunology and immunopathology. Allergy, Asthma & Clinical Immunology. 2018;14(2):1-10.
Katran ZY, Bulut İ, Babalik A, Keren M. Management of type 1 immediate hypersensitivity reactions to antituberculosis drug: succesful desensitization. Allergy, Asthma & Clinical Immunology. 2022;18(1):97.
Jiang L, Diaz PT, Best TM, Stimpfl JN, He F, Zuo L. Molecular characterization of redox mechanisms in allergic asthma. Annals of Allergy, Asthma & Immunology. 2014;113(2):137-42.
Allan J, Moss A, Wallwork J, McFarlane H. Immediate hypersensitivity in patients with cystic fibrosis. Clinical & Experimental Allergy. 1975;5(3):255-61.
Cruvinel WdM, Mesquita Júnior D, Araújo JAP, Catelan TTT, Souza AWSd, Silva NPd, et al. Immune system: Part I. Fundamentals of innate immunity with emphasis on molecular and cellular mechanisms of inflammatory response. Revista brasileira de reumatologia. 2010;50:434-47.
Averbeck M, Gebhardt C, Emmrich F, Treudler R, Simon JC. Immunologic principles of allergic disease. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2007;5(11):1015-27.
Janeway Jr CA, Travers P, Walport M, Shlomchik MJ. Hypersensitivity diseases. Immunobiology: The Immune System in Health and Disease 5th edition: Garland Science; 2001.
Cher DJ, Mosmann T. Two types of murine helper T cell clone. II. Delayed-type hypersensitivity is mediated by TH1 clones. Journal of immunology (Baltimore, Md: 1950). 1987;138(11):3688-94.
Poulter L, Seymour G, Duke O, Janossy G, Panayi G. Immunohistological analysis of delayed-type hypersensitivity in man. Cellular immunology. 1982;74(2):358-69.
Wani NA, Suhail S, Qayoom H, Nisar S, Sheikh BA, Mehraj U, et al. TYPE IV HYPERSENSITIVITY (DELAYED TYPE HYPERSENSITIVITY). THE FUNDAMENTALS OF HYPERSENSITIVITIES AND ALLERGIES.161.
Vegad JL. Comparative pathology of inflammation in the sheep: a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy at Massey University, Palmerston North, New Zealand: Massey University; 1967.
Knol EF. Requirements for effective IgE cross‐linking on mast cells and basophils. Molecular nutrition & food research. 2006;50(7):620-4.
White M. Mediators of inflammation and the inflammatory process. Journal of Allergy and Clinical Immunology. 1999;103(3):S378-S81.
Vocanson M, Hennino A, Rozieres A, Poyet G, Nicolas JF. Effector and regulatory mechanisms in allergic contact dermatitis. Allergy. 2009;64(12):1699-714.
Kim K-H, Jahan SA, Kabir E. A review on human health perspective of air pollution with respect to allergies and asthma. Environment international. 2013;59:41-52.
Barlean LM, Aungurencei A, Aungurencei O, Scutariu MM, Balcos C, Moisei M. Latex glove allergy among dentists in Iasi, Romania. Rev Chim(Bucharest). 2015;66(11):1877-80.
Boye JI. Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates. Clinical and translational allergy. 2012;2(1):1-9.
Kidon M, Blanca‐Lopez N, Gomes E, Terreehorst I, Tanno L, Ponvert C, et al. EAACI/ENDA Position Paper: Diagnosis and management of hypersensitivity reactions to non‐steroidal anti‐inflammatory drugs (NSAIDs) in children and adolescents. Pediatric Allergy and Immunology. 2018;29(5):469-80.
Haahtela T. A biodiversity hypothesis. Allergy. 2019;74(8):1445-56.
de Andrade CM, Carneiro VL, Cerqueira JV, Fonseca HF, Queiroz GA, Costa RS, et al. Parasites and allergy: Observations from Brazil. Parasite immunology. 2019:e12588.
Weiss ST. Parasites and asthma/allergy: what is the relationship? Journal of allergy and clinical immunology. 2000;105(2):205-10.
Wu Z, Wang L, Tang Y, Sun X. Parasite-derived proteins for the treatment of allergies and autoimmune diseases. Frontiers in microbiology. 2017;8:2164.
Killeen S, Wang J, Andrews E, Redmond H. Exploitation of the Toll-like receptor system in cancer: a doubled-edged sword? British journal of cancer. 2006;95(3):247.
Cooper D, Eleftherianos I. Parasitic nematode immunomodulatory strategies: recent advances and perspectives. Pathogens. 2016;5(3):58.
Melendez AJ, Harnett MM, Pushparaj PN, Wong WF, Tay HK, McSharry CP, et al. Inhibition of FcεRI-mediated mast cell responses by ES-62, a product of parasitic filarial nematodes. Nature medicine. 2007;13(11):1375-81.
Fitzsimmons CM, Falcone FH, Dunne DW. Helminth allergens, parasite-specific IgE, and its protective role in human immunity. Frontiers in immunology. 2014;5:61.
Ghogomu ET, Suresh S, Rayco-Solon P, Hossain A, McGowan J, Peña-Rosas JP, et al. Deworming in non-pregnant adolescent girls and adult women: a systematic review and meta-analysis. Systematic reviews. 2018;7(1):239.
Mohammadzadeh I, Rostami A, Darvish S, Mehravar S, Pournasrollah M, Javanian M, et al. Exposure to Ascaris lumbricoides infection and risk of childhood asthma in north of Iran. Infection. 2019:1-9.
Ardura-Garcia C, Garner P, Cooper PJ. Is childhood wheeze and asthma in Latin America associated with poor hygiene and infection? A systematic review. BMJ open respiratory research. 2018;5(1):e000249.
Caraballo L, Acevedo N, Buendía E. Human ascariasis increases the allergic response and allergic symptoms. Current Tropical Medicine Reports. 2015;2(4):224-32.
Farnell EJ, Tyagi N, Ryan S, Chalmers IW, Pinot de Moira A, Jones FM, et al. Known allergen structures predict Schistosoma mansoni IgE-binding antigens in human infection. Frontiers in immunology. 2015;6:26.
Ayuso R, Lehrer S, Tanaka L, Ibanez M, Pascual C, Burks A, et al. IgE antibody response to vertebrate meat proteins including tropomyosin. Annals of Allergy, Asthma & Immunology. 1999;83(5):399-405.
Shaw RJ, McNeill MM, Maass DR, Hein WR, Barber TK, Wheeler M, et al. Identification and characterisation of an aspartyl protease inhibitor homologue as a major allergen of Trichostrongylus colubriformis. International journal for parasitology. 2003;33(11):1233-43.
Sereda MJ, Hartmann S, Lucius R. Helminths and allergy: the example of tropomyosin. Trends in parasitology. 2008;24(6):272-8.
Nordengrün M, Michalik S, Völker U, Bröker BM, Gómez-Gascón L. The quest for bacterial allergens. International Journal of Medical Microbiology. 2018;308(6):738-50.
D’Amato G, Holgate ST, Pawankar R, Ledford DK, Cecchi L, Al-Ahmad M, et al. Meteorological conditions, climate change, new emerging factors, and asthma and related allergic disorders. A statement of the World Allergy Organization. World Allergy Organization Journal. 2015;8(1):1-52.
Renz H, Brandtzaeg P, Hornef M. The impact of perinatal immune development on mucosal homeostasis and chronic inflammation. Nature Reviews Immunology. 2012;12(1):9-23.
Kubo M. Innate and adaptive type 2 immunity in lung allergic inflammation. Immunological reviews. 2017;278(1):162-72.
Le Floc’h A, Allinne J, Nagashima K, Scott G, Birchard D, Asrat S, et al. Dual blockade of IL‐4 and IL‐13 with dupilumab, an IL‐4Rα antibody, is required to broadly inhibit type 2 inflammation. Allergy. 2020;75(5):1188-204.
Varadé J, Magadán S, González-Fernández Á. Human immunology and immunotherapy: main achievements and challenges. Cellular & Molecular Immunology. 2021;18(4):805-28.
Gandhi GR, de Sousa Leão GC, da Silva Calisto VK, Vasconcelos ABS, Almeida MLD, Quintans JdSS, et al. Modulation of interleukin expression by medicinal plants and their secondary metabolites: A systematic review on anti-asthmatic and immunopharmacological mechanisms. Phytomedicine. 2020;70:153229.
Li J, Zhan L, Qin C. The double-sided effects of Mycobacterium Bovis bacillus Calmette–Guérin vaccine. npj Vaccines. 2021;6(1):1-11.
White MP. Innate immunomodulation with MIS416: mechanism of action in experimental autoimmune encephalomyelitis. 2015.
Shamaei M, Mirsaeidi M. Nontuberculous mycobacteria, macrophages, and host innate immune response. Infection and immunity. 2021:IAI. 00812-20.
Nhu'Tùng N, Cuc N, Kolamunnage-Dona R, Hope W, Day J. 3 Amphotericin B Deoxycholate in adults with Cryptococcal meningoencephalitis; a Population Pharmacokinetic Model and Meta-Analysis of Outcomes. THE PHARMACOKINETICS AND PHARMACODYNAMICS OF ANTIFUNGAL AGENTS FOR HIV-ASSOCIATED INVASIVE FUNGAL INFECTIONS. 2021:93.
Hohlfeld R. Biotechnological agents for the immunotherapy of multiple sclerosis. Principles, problems and perspectives. Brain: a journal of neurology. 1997;120(5):865-916.
Rozario H, Gandhi A, Sarkar A, Sehgal R, Kumar A, Devasia V. Block-4 General Areas of Social Work Practice. Indira Gandhi National Open University, New Delhi; 2021.
Koidl L, Untersmayr E. The clinical implications of the microbiome in the development of allergy diseases. Expert Review of Clinical Immunology. 2021;17(2):115-26.
Rana AW, Asghar S, Haider Z, Davies S. Assessment of value chain system for horticulture in Khyber Pakhtunkhwa including Newly Merged Districts (former FATA): Intl Food Policy Res Inst; 2021.
Nino G, Rodriguez-Martinez CE, Gutierrez MJ. Early Microbial–Immune Interactions and Innate Immune Training of the Respiratory System during Health and Disease. Children. 2021;8(5):413.
Scaparrotta A, Attanasi M, Di Pillo S, Chiarelli F. Pediatric Lower Respiratory Infections. OMICS Group eBooks. 2013;731:003.
Beem MO, Saxon EM. Respiratory-tract colonization and a distinctive pneumonia syndrome in infants infected with Chlamydia trachomatis. New England Journal of Medicine. 1977;296(6):306-10.
YAMADA S. Chlamydia pneumoniae infection in children with lower respiratory tract infections. The Kurume medical journal. 1995;42(2):107-20.
Zhang Q, Li S, Zhou W, Zheng L, Ren Y, Dong L, et al. Application of metagenomic next-generation sequencing (mNGS) combined with rapid on-site cytological evaluation (ROSCE) for the diagnosis of Chlamydia psittaci pneumonia. International journal of clinical and experimental pathology. 2021;14(4):389.
Paul R, Ostermann E, Wei Q. Advances in point-of-care nucleic acid extraction technologies for rapid diagnosis of human and plant diseases. Biosensors and Bioelectronics. 2020;169:112592.
Welp AL, Bomberger JM. Bacterial community interactions during chronic respiratory disease. Frontiers in cellular and infection microbiology. 2020;10:213.
Ensari A. Gluten sensitivity: The cellular and molecular biology of mucosal inflammation: The University of Manchester (United Kingdom); 1993.
Titball RW, Tweten RK. 20 Membrane Active Toxins. Handbook on Clostridia. 2005:451.
Musa UK. Assessment of House to House Inspection Manual in the Control of Sanitation Related Diseases in Gombe Metropolis: Kwara State University (Nigeria); 2018.
Wang Y, Wang M, Shan A, Feng X. Host defense cathelicidins in avian: structure, expression, biological functions and potential therapeutic applications. Poultry Science. 2020.
Khardori NM. Biologic Response Modifiers in Infectious Diseases, An Issue of Infectious Disease Clinics-E-Book: Elsevier Health Sciences; 2011.
Bradshaw A. Inflammation in the Tumor Microenvironment: Experimental Models of Metastatic Melanoma Therapy: University of Pittsburgh; 2021.
Nicholas MN, Jeschke MG, Amini-Nik S. Methodologies in creating skin substitutes. Cellular and molecular life sciences. 2016;73(18):3453-72.
Phong BL, D’Souza SJ, Baudier RL, Wu E, Immethun VE, Bauer DL, et al. IgE-activated mast cells enhance TLR4-mediated antigen-specific CD4+ T cell responses. Scientific reports. 2021;11(1):1-13.
Geerdink RJ, Pillay J, Meyaard L, Bont L. Neutrophils in respiratory syncytial virus infection: A target for asthma prevention. Journal of Allergy and Clinical Immunology. 2015;136(4):838-47.
Ogra PL. Respiratory syncytial virus: the virus, the disease and the immune response. Paediatric respiratory reviews. 2004;5:S119-S26.
Wise SK, Lin SY, Toskala E, Orlandi RR, Akdis CA, Alt JA, et al., editors. International consensus statement on allergy and rhinology: allergic rhinitis. International forum of allergy & rhinology; 2018: Wiley Online Library.
Mims JW, editor Asthma: definitions and pathophysiology. International forum of allergy & rhinology; 2015: Wiley Online Library.
Poduri R, Joshi G, Jagadeesh G. Drugs targeting various stages of the SARS-CoV-2 life cycle: Exploring promising drugs for the treatment of Covid-19. Cellular signalling. 2020;74:109721.
Sayed BA, Christy A, Quirion MR, Brown MA. The master switch: the role of mast cells in autoimmunity and tolerance. Annu Rev Immunol. 2008;26:705-39.
Sarin S, Undem B, Sanico A, Togias A. The role of the nervous system in rhinitis. Journal of Allergy and Clinical Immunology. 2006;118(5):999-1014.
Rossi GA, Colin AA. Infantile respiratory syncytial virus and human rhinovirus infections: respective role in inception and persistence of wheezing. European Respiratory Journal. 2015;45(3):774-89.
Chakrabarty A, Pang KR, Wu JJ, Narvaez J, Rauser M, Huang DB, et al. Emerging therapies for herpes viral infections (types 1–8). Expert opinion on emerging drugs. 2004;9(2):237-56.
Nam HH, Ison MG. Respiratory syncytial virus infection in adults. bmj. 2019;366.
Rea TD, Russo JE, Katon W, Ashley RL, Buchwald DS. Prospective study of the natural history of infectious mononucleosis caused by Epstein-Barr virus. The Journal of the American Board of Family Practice. 2001;14(4):234-42.
Hay KA. DETECTION OF VIRUS-ASSOCIATED ANTIGENS EXPRESSED BY HERPES SIMPLEX VIRUS-INFECTED AND-TRANSFORMED HAMSTER CELLS: The Pennsylvania State University; 1978.
Revelas A. Acute gastroenteritis among children in the developing world. Southern African Journal of Epidemiology and Infection. 2012;27(4):156-62.
Offit PA, Quarles J, Gerber MA, Hackett CJ, Marcuse EK, Kollman TR, et al. Addressing parents’ concerns: do multiple vaccines overwhelm or weaken the infant’s immune system? Pediatrics. 2002;109(1):124-9.
Blaas D, Fuchs R. Mechanism of human rhinovirus infections. Molecular and cellular pediatrics. 2016;3(1):1-4.
Calderón MA, Linneberg A, Kleine-Tebbe J, De Blay F, de Rojas DHF, Virchow JC, et al. Respiratory allergy caused by house dust mites: what do we really know? Journal of Allergy and Clinical Immunology. 2015;136(1):38-48.
Jobard M, Rasconi S, Sime-Ngando T. Diversity and functions of microscopic fungi: a missing component in pelagic food webs. Aquatic Sciences. 2010;72:255-68.
Bush RK, Portnoy JM, Saxon A, Terr AI, Wood RA. The medical effects of mold exposure. Journal of Allergy and Clinical Immunology. 2006;117(2):326-33.
Burge HA. Fungus allergens. Clinical Reviews in Allergy. 1985;3(3):319-29.
Mazur LJ, Kim J, Health CoE. Spectrum of noninfectious health effects from molds. Pediatrics. 2006;118(6):e1909-e26.
Baumgardner DJ. Disease-causing fungi in homes and yards in the Midwestern United States. Journal of Patient-Centered Research and Reviews. 2016;3(2):99-110.
Kumar P, Kausar MA, Singh A, Singh R. Biological contaminants in the indoor air environment and their impacts on human health. Air Quality, Atmosphere & Health. 2021;14(11):1723-36.
Xing H, Wang J, Sun Y, Wang H. Recent Advances in the Allergic Cross-Reactivity between Fungi and Foods. Journal of Immunology Research. 2022;2022.
Hess-Kosa K. Indoor air quality: sampling methodologies: CRC Press; 2010.
Gates D, Schatz L. The body ecology diet: recovering your health and rebuilding your immunity: Hay House, Inc; 2011.
Yike I. Fungal proteases and their pathophysiological effects. Mycopathologia. 2011;171(5):299-323.
Simon-Nobbe B, Denk U, Pöll V, Rid R, Breitenbach M. The spectrum of fungal allergy. International archives of allergy and immunology. 2007;145(1):58-86.
Schmid P, Simon D, Simon H, Akdis C, Wuthrich B. Epidemiology, clinical features, and immunology of the" intrinsic"(non-IgE-mediated) type of atopic dermatitis (constitutional dermatitis). ALLERGY-COPENHAGEN-. 2001;56(9):841-9.
Bachert C. Persistent rhinitis–allergic or nonallergic? Allergy. 2004;59:11-5.
Moore WC, Bleecker ER, Curran-Everett D, Erzurum SC, Ameredes BT, Bacharier L, et al. Characterization of the severe asthma phenotype by the national heart, lung, and blood institute's severe asthma research program. Journal of Allergy and Clinical Immunology. 2007;119(2):405-13.
Vlahakis NE, Aksamit TR, editors. Diagnosis and treatment of allergic bronchopulmonary aspergillosis. Mayo Clinic Proceedings; 2001: Elsevier.
Virchow JC, Bachert C. Efficacy and safety of montelukast in adults with asthma and allergic rhinitis. Respiratory medicine. 2006;100(11):1952-9.
Kostner L, Anzengruber F, Guillod C, Recher M, Schmid-Grendelmeier P, Navarini AA. Allergic contact dermatitis. Immunology and Allergy Clinics. 2017;37(1):141-52.
Jenerowicz D, Silny W, Danczak-Pazdrowska A, Polanska A, Osmola-Mankowska A, Olek-Hrab K. Environmental factors and allergic diseases. Annals of Agricultural and Environmental Medicine. 2012;19(3).
Patel G, Greenberger PA, editors. Allergic bronchopulmonary aspergillosis. Allergy & Asthma Proceedings; 2019.
Scadding G, Durham S, Mirakian R, Jones N, Leech S, Farooque S, et al. BSACI guidelines for the management of allergic and non‐allergic rhinitis. Clinical & Experimental Allergy. 2008;38(1):19-42.
Hellings PW, Dobbels F, Denhaerynck K, Piessens M, Ceuppens JL, De Geest S. Explorative study on patient’s perceived knowledge level, expectations, preferences and fear of side effects for treatment for allergic rhinitis. Clinical and translational allergy. 2012;2(1):1-8.
Johnson PC, Wheat LJ, Cloud GA, Goldman M, Lancaster D, Bamberger DM, et al. Safety and efficacy of liposomal amphotericin B compared with conventional amphotericin B for induction therapy of histoplasmosis in patients with AIDS. Annals of internal medicine. 2002;137(2):105-9.
Zhang AY, Camp WL, Elewski BE. Advances in topical and systemic antifungals. Dermatologic clinics. 2007;25(2):165-83.
Dillon HK, Miller JD. Field guide for the determination of biological contaminants in environmental samples: Aiha; 2005.
McNeil JC, Palazzi DL. Ustilago as a cause of fungal peritonitis: case report and review of the literature. Journal of the Pediatric Infectious Diseases Society. 2012;1(4):337-9.
Liu X, Fan S, Peng Y, Zhang H. Species distribution and susceptibility of Candida isolates from patient with vulvovaginal candidiasis in Southern China from 2003 to 2012. Journal de mycologie medicale. 2014;24(2):106-11.