The Triple T Allergy Hypothesis

The early induction of allergy is a complex process involving protective and destructive gene variants, environmental and nutritional co-factors as well as allergen exposure. Although critical doses, interactions and susceptible time frames have not been identified so far, late gestation and early childhood seem to be important time periods for allergic sensitization. At least three risk factors can be distinguished based on altered early Th1 lymphocyte development. First, the number of children with an inborn maturation defect may have increased since the beginning of the last century, when this condition would otherwise have had a lethal outcome without antibiotics and other modern health care (survival hypothesis). Second, another group of children in industrialized countries may have a deficit of environmental Th1 triggers during early life (hygiene hypothesis). A third factor may also be found predominantly in western societies. The prophylaxis of rickets with vitamin D has the apparent side effect of suppressing Th1 development (vitamin hypothesis). Experimental as well as epidemiological studies now provide evidence for the vitamin hypothesis, which is examined in this paper by a time-course analysis of vitamin D application in Germany. Also paper studies in Swedish anthroposophic school children, the Tristan da Cunha islanders, and Swiss, Austrian and Bavarian farmers may be linked to either excessive or absent early vitamin D exposure.