臨床検査55巻2号

2011年02月発行

今月の主題 腸内細菌叢 各論 〈腸内細菌叢と疾患〉

アレルギー疾患

著者： 岩田敏¹

所属機関： ¹慶應義塾大学医学部感染制御センター

ページ範囲：P.143 - P.148

アレルギー疾患の原因として，ヘルパーT細胞であるTh1とTh2のバランスがTh2に傾き，Th2型サイトカインが増加して，IgEが産生される機序が考えられている．腸内細菌叢の形成が未熟な新生児や腸内細菌叢が形成されていない無菌動物の免疫系はTh2に傾いており，Th1/Th2の適切なバランスの発達には，腸内細菌叢の形成による経口免疫寛容が重要な役割を果たしている．この機序を利用して，プロバイオティクスのアレルギー疾患に対する効果が検討されている．

参考文献

1) Holgate ST:Genetic and environmental interaction in allergy and asthma. J Allergy Clin Immunol　104：1139-1146，1999

2) von Mutius E:Infection:friend or foe in the development of atopy and asthma? The epidemiological evidence. Eur Respir J　18：872-881，2001

3) Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema:ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet　351：1225-1232，1998

4) Strachan DP:Hay fever, hygiene, and household size. Br Med J　299：1259-1260，1989

5) Yazdanbakhsh M, Kremsner PG, van Ree R:Allergy, parasites, and the hygiene hypothesis. Science　296：490-494，2002

6) Braun-Fahrlander C, Riedler J, Herz U, et al:Allergy and Endotoxin Study Team:Environmental exposure to endotoxin and its relation to asthma in school-age children. N Engl J Med　347：869-877，2002

7) Grammatikos AP:The genetic and environmental basis of atopic diseases. Ann Med　40：482-495，2008

8) Sepp E, Julge K, Vasar M, et al:Intestinal microflora of Estonian and Swedish infants. Acta Paediatr　86：956-961，1997

9) Bjorksten B, Naaber P, Sepp E, et al:The intestinal microflora in allergic Estonian and Swedish 2-year-old children. Clin Exp Allergy　29：342-346，1999

10) Bjorksten B, Sepp E, Julge K, et al:Allergy development and the intestinal microflora during the first year of life. J Allergy Clin Immunol　108：516-520，2001

11) Sepp E, Julge K, Mikelsaar M, et al:Intestinal microbiota and immunoglobulin E responses in 5-year-old Estonian children. Clin Exp Allergy　35：1141-1146，2005

12) Kirjavainen PV, Arvola T, Salminen SJ, et al:Aberrant composition of gut microbiota of allergic infants:a target of bifidobacterial therapy at weaning? Gut　51：51-55，2002

13) He F, Ouwehand AC, Isolauri E, et al:Comparison of mucosal adhesion and species identification of bifidobacteria isolated from healthy and allergic infants. FEMS Immunol Med Microbiol　30：43-47，2001

14) Penders J, Thijs C, van den Brandt PA, et al:Gut microbiota composition and development of atopic manifestations in infancy:the KOALA Birth Cohort Study. Gut　56：661-667，2007

15) Adlerberth I, Strachan DP, Matricardi PM, et al:Gut microbiota and development of atopic eczema in 3 European birth cohorts. J Allergy Clin Immunol　120：343-350，2007

16) Suzuki S, Shimojo N, Tajiri Y, et al:Differences in the composition of intestinal Bifidobacterium species and the development of allergic diseases in infants in rural Japan. Clin Exp Allergy　37：506-511，2007

17) Suzuki S, Shimojo N, Tajiri Y, et al:A quantitative and relative increase in intestinal bacteroides in allergic infants in rural Japan. Asian Pac J Allergy Immunol　26：113-119，2008

18) Songjinda P, Nakayama J, Tateyama A, et al:Differences in developing intestinal microbiota between allergic and non-allergic infants:a pilot study in Japan. Biosci Biotechnol Biochem　71：2338-2342，2007

19) 八村敏志：経口免疫寛容現象の機構追究．炎症と免疫　14：752-758，2006

20) Sudo N, Sawamura S, Tanaka K, et al:The requirement of intestinal bacterial flora for the development of an IgE production system fully susceptible to oral tolerance induction. J Immunol　159：1739-1745，1997

21) Tsuda M, Hosono A, Yanagibashi T, et al:Intestinal commensal bacteria promote T cell hyporesponsiveness and down-regulate the serum antibody responses induced by dietary antigen. Immunol Lett　132：45-52，2010

22) Tsuda M, Hosono A, Yanagibashi T, et al:Prior stimulation of antigen-presenting cells with Lactobacillus regulates excessive antigen-specific cytokine responses in vitro when compared with Bacteroides. Cytotechnology　55：89-101，2007

23) 白川太郎：生活習慣関連病モデルとしてのアレルギー疾患の予防戦略の構築　原因遺伝子解析からフィールドにおける予防実施疫学研究へ．最新医学　59：136-189，2004

24) Kalliomaki M, Salminen S, Arvilommi H, et al:Probiotics in primary prevention of atopic disease:a randomised placebo-controlled trial. Lancet　357：1076-1079，2001

25) Kalliomaki M, Salminen S, Poussa T, et al:Probiotics and prevention of atopic disease:4-year follow-up of a randomised placebo-controlled trial. Lancet　361：1869-1871，2003

26) Kukkonen K, Savilahti E, Haahtela T, et al:Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases:a randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol　119：192-198，2007

27) Taylor AL, Dunstan JA, Prescott SL:Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children:a randomized controlled trial. J Allergy Clin Immunol　119：184-191，2007

28) Matsumoto M, Aranami A, Ishige A, et al:LKM512 yogurt consumption improves the intestinal environment and induces the T-helper type 1 cytokine in adult patients with intractable atopic dermatitis. Clin Exp Allergy　37：358-370，2007

29) Xiao JZ, Kondo S, Yanagisawa N, et al:Effect of probiotic Bifidobacterium longum BB536 ［corrected］ in relieving clinical symptoms and modulating plasma cytokine levels of Japanese cedar pollinosis during the pollen season. A randomized double-blind, placebo-controlled trial. J Investig Allergol Clin Immunol　16：86-93，2006

30) Xiao JZ, Kondo S, Yanagisawa N, et al:Probiotics in the treatment of Japanese cedar pollinosis:a double-blind placebo-controlled trial. Clin Exp Allergy　36：1425-1435，2006

31) Yonekura S, Okamoto Y, Okawa T, et al:Effects of daily intake of Lactobacillus paracasei strain KW3110 on Japanese cedar pollinosis. Allergy Asthma Proc　30：397-405，2009