From the Hygiene Hypothesis to bacterial dysbiosis: a new understanding of the early origins of asthma
March 21 @ 5:30 pm - 6:30 pmFree
Format: Virtual • CME available? Yes
Fernando Martinez, MD
University of Arizona Health Sciences Asthma and Airway Disease Research Center
During the last decade, there has been a major change in our understanding of the pathogenesis of wheezing lower respiratory illnesses (WLRI) in early childhood, which are often the first manifestations of asthma. Until recently, these illnesses were considered to be due to viral infections, and bacteria were thought to have no role in their etiology. New data suggest that children who have recurrent WLRI have an alteration in the composition of the bacterial communities that inhabit their gut and their airways. It has been shown, for example, that the airways of these children are more likely to be colonized with pathogenic bacteria such as H influenzae, M catarrhalis, or S pneumonia, and these 3 species are more often isolated from the nasopharynx of children having an acute WLRI than from unaffected children. A potential explanation for these findings is a modification of the so-called hygiene hypothesis. In its current form, this hypothesis postulates that the developing immune system needs to be trained by progressive exposure to environmental microbes in order to develop the capacity to distinguish friend from foe. In the absence of such training, the normal balance between commensal bacteria and local immune responses fails to develop, and this imbalance, called dysbiosis, predisposes the young child to overact to viral infections and allergen exposures, both of which are major triggers of early wheezing and predisposing factors for the development of asthma.
During this session, clinicians will learn about the basics of the Hygiene Hypothesis, and how measures to modify a child’s environmental exposures might change the course of their “allergic march.”
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Arizona Medical Association (ArMA). The Southern Arizona AHEC (SAAHEC) is accredited by ArMA to provide continuing medical education for physicians.
SAAHEC designates this live activity for a maximum of 1.00 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.