E-drug: Asthma associated with early antibiotic use (cont'd)
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Dear E-druggers,
This is indeed interesting and reading it reminded me of something
published in the BMJ a few years ago:
Howarth, PH. ABC of allergies - Pathogenic mechanisms: a rational
basis of treatment. BMJ 1998; 316: 758-761.
In the article, the pathogenesis of allergic disorders and asthma was
explained as being largely related to cytokines and other mediators;
some of which are produced by lymphocytes through a whole
cascade of events (I would suggest to read the above reference for a
much better explanation than what I can offer or elucidate here).
In the article, the hypothesis was made that the increase in allergic
disorders in the last few decades was due to a decrease in severe
infections in early infancy over the same period of time, and an
interaction between allergens and atmospheric pollution that
potentiates the tendency to sensitisation. Simply - having early
childhood infection would drive a T-helper cell subtype 1 (which is
anti-inflammatory) response and thus down regulate the tendency for
T-helper cell subtype 2 response (which is pro-inflammatory) and
hence related to do disease development. Thus, if antibiotics are
given early in life, infections would have been curbed and the next
progression more pro-inflammatory mediators would be produced,
leading to allergic disorder.
Wong Wai See
Senior Pharmacist
Hospital Pharmacy Services Section
Ministry of Health
Brunei Darussalam
e-mail: ycwong@brunet.bn
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