• Andrew H Liu.
• Department of Pediatrics/Section of Pulmonary Medicine, Children's Hospital Colorado and the University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo; National Jewish Health, Denver, Colo. Electronic address: Andrew.Liu@childrenscolorado.org.
• J. Allergy Clin. Immunol. 2015 Oct 1; 136 (4): 860-5.

AbstractThe hygiene hypothesis, which describes the protective influence of microbial exposures in early life on the development of allergy and asthma, has continued its swell of academic interest, investigation, and evolution. This article is focused on studies published in the past 3 years that have furthered the substance and shape of hygiene theory, primarily as it relates to allergic airways and asthma. Recent investigations have furthered an overarching "microbiome hypothesis" to home features, medical practices, and cleanliness behaviors that are suspects in the hygiene effect. Relatively crude markers of the protective microbial environment have been supplanted by culture-independent microbiome science, distinguishing the characteristics of potentially protective microbiomes from pathologic features. Understanding how the microbiome is shaped and affects healthful versus harmful outcomes in the human host is relatively nascent. Good clues are emerging that give mechanistic substance to the theory and could help guide microbe-based therapeutics to fill the allergy and asthma management gap in prevention and disease modification.Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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