Prevention and Causal Therapy of Asthma
Asthma is the most common chronic disease in
children and in adult . In allergic and asthma subjects the activity
of T helper cells type 2 (Th2) predominates over that of
T-helper cells type 1 (Th1).
T-helper cells type 2 (Th2) with their cytokines such as IL-5 and
IL-13 are responsible for increased synthesis of IgE , the activation
and degranulation of mast cells and basophils , the differentiation
and activation of eosinophils and their migration into the target
organs and the enhanced expression of IgE receptors and adhesion
molecules on various cell types.
The mechanism of specific immunotherapy (SIT) may involve a
reorientation of the Th2 dominated response to the Th1 cells .
Purified naive and high molecular allergens unused in conventional
immunotherapy increase the activity of Th1, but on the other hand may
react with existing IgE and B cell epitopes which enhance the activity
of Th2 and diminish the desired immunomodulatory effect .
T cells orientated specific immunotherapy is a new modified specific
immunotherapy in which B cell epitopes are strongly reduced or
eliminated , but T cell epitopes are retained by using allergoid
preparation. Our study showed that this form of immunotherapy in
patients with bronchial asthma modulates the immune system and
improves the disturbed balance between Th1 and Th2 and leads to a
remarkable and continuous clinical improvement.
Another interesting aspect is to prevent the occurrence of asthma in
high risk children with a family history of atopy and in children with
For the first time we have been able to show that a oral systemic
treatment with selenium ( sodium selenite ) improves remarkably the
skin condition of children with atopic dermatitis. Our data indicate
that apart from its scavenger properties ,selenium modulates the
immune system and improves especially disturbed balance between Th1
and Th2 and possibly between CD8+ cytotoxic T cells type 1 (Tcl) and
CD8+ cytotoxic T cells type 2 (Tc2).
Follow-up examinations within our patients over 7 years did not show
any occurrence of asthma in the study group compared with the control
group. In several studies , the oral administration of non-pathogenic
probiotic bacteria such as Lactobacillus and Bifid bacterium in
children with atopic dermatitis showed a significant improvement of
the skin condition and suppression of lymphocyte proliferation and
down-regulation of IL-4 production. Fellow-up examinations within
these patients over a number of years are necessary to evaluate
whether probiotic therapy is able to prevent the switch of atopic
dermatitis to asthma.