Die Zeit: Eine neue Dimension in der Diskussion um die Prävention allergischer Erkrankungen

Zusammenfassung

Während die Pharmakotherapie des Asthma bronchiale eine effektive Kontrolle der Symptome ermöglicht, fehlen kausale Therapiekonzepte, sodass eine Heilung dieser chronischen Erkrankung bisher nicht möglich ist. Präventiven Maßnahmen kommt daher eine herausragende Bedeutung zu, da sie die einzige Chance darstellen, der zunehmenden Inzidenz allergischer Erkrankungen effektiv zu begegnen. Eine der großen Herausforderungen der allergologischen Forschung war in den vergangenen Jahren die Identifikation von protektiven Faktoren in Bezug auf die Entstehung von allergischen Erkrankungen. Eine neue Dimension ist ganz aktuell in den Mittelpunkt des Interesses gerückt: die Zeit. Epidemiologische und tierexperimentelle Studien haben gezeigt, dass sich das zeitliche Fenster, in dem das Asthma- und Allergierisiko des Kindes durch Umgebungsfaktoren beeinflusst werden kann, sehr früh öffnet – und möglicherweise auch früh wieder schließt. Demnach sollten präventive bzw. protektive Maßnahmen früh einsetzen, um einen optimalen, dauerhaften Schutz zu erzielen. Erste Hinweise sprechen dafür, dass die Auseinandersetzung mit Allergenen bereits intrauterin beginnt, sodass Umgebungsfaktoren schon während der Schwangerschaft einen Einfluss auf das spätere Allergie- und Asthma-Risiko des Kindes haben. Möglicherweise beeinflusst sogar das immunologische Gedächtnis, das die Mutter bereits vor der Schwangerschaft erworben hat, die Immunreaktion des Kindes bei der späteren Auseinandersetzung mit potenziellen Allergenen.

Summary

Symptoms of patients with asthma can be efficiently controlled by pharmacotherapy. However, no therapeutic strategies/options exist that directly influence the aetiology of this chronic disease and subsequently, a cure of asthma is not achievable/possible so far. Preventive measures, to avoid the development of asthma from the beginning, are therefore most important. They currently represent the only option to effectively decrease the increasing incidence of allergic diseases. Over the last years, the identification of several protective factors and risk factors for the development of allergic diseases was the great challenge/achievement of research in the field of allergy. A new dimension came into the focus of interest: the time. Epidemiological studies and animal models suggest that the risk for the development of asthma or allergy through the influence of environmental factors might be especially high during a short period of time in early life (maybe even before birth). Subsequently, preventive and protective measures should be initiated as early in life as possible to achieve an optimal and long lasting protection. Preliminary data suggest that the immune status of the mother may play a crucial role for the risk of the child to develop allergy or asthma.

Schlüsselwörter

Allergie - Prävention - Neonatologie - Toleranz

Keywords

Allergy - prevention - neonatology - tolerance

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