Inflammatory diseases such as asthma and diabetes are rising in industrialized countries and the modern lifestyle that is associated with lower exposure to microbes has been held responsible for the increasing prevalence of these diseases. Several studies have shown an inverse association between pathogen-exposure and allergy or autoimmunity. The mechanisms behind such protective effects have been investigated at the epidemiological, cellular and molecular level and have provided data on the ability of lipids either derived directly from pathogens or up-regulated as a result of an infection to down-regulate immune responses and thereby control inflammatory diseases. In this mini-review, recent findings and new concepts relating to the immunosuppressive effects of endogenous lipids and those encountered upon exposure to bacteria, protozoa and particularly helminths are discussed. The overview focuses on the modulation of interactions between the antigen-presenting compartment and T cells to start an anti-inflammatory "program" with potential to regulate disease processes. PGJ 2 Lyso-PA: Lysophosphatidic acid Lyso-PC: Lysophosphatidylcholine Lyso-PS: Lysophosphatidylserine LXA4: Lipoxin A4 TLR2: Toll-like receptor 2 Treg cell: Regulatory T cell
The inverse relationship between infections and allergiesThe prevalence of allergies has increased significantly over the last few decades, particularly in industrialized countries. Within these countries, a negative association has been found between certain childhood infections and allergic diseases [1,2]. Lifestyles such as anthroposophy or traditional farming -thought to be associated with higher exposure to pathogens or pathogen-derived products -have been shown to be protective against atopic disorders [3,4]. Furthermore, in low-income countries, where exposure to pathogens is higher, the prevalence of allergy is often lower than in industrialized countries [5]. Studies examining the relationship between allergies and parasitic infections in areas where transmission is intense have revealed that children with chronic helminth infections have a lower risk of wheeze or of skin-prick-test positivity for house-dust mite [6,7].The question of how infections can prevent allergies has received much attention in the last few years. Although many bacteria and viruses induce Th1 responses, which in turn may prevent the development of Th2 responses, helminths -which are potent Th2 inducers -are surprisingly also protective [7]. This has led to the question of what additional mechanisms, acting downstream of the induction/initiation phase, suppress allergic inflammation. Such mechanisms downstream of T cell polarization would work to protect not only from Th2 inflammation but also from Th1 inflammation, and their absence would explain the concurrent rise at the population level in allergies (Th2 diseases) and autoimmunities (often Th1 diseases) [8]. The possibility that immunosuppressive regulatory responses stimulated during repeated/intense exposure to pathogens or pathogenderi...