Potential role of reduced environmental UV exposure as a driver of the current epidemic of atopic dermatitis

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  • Jacob P Thyssen
  • Matthew J Zirwas
  • Peter M Elias

The basis for the sudden and dramatic increase in atopic dermatitis (AD) and related atopic diseases in the second half of the 20th century is unclear. The hygiene hypothesis proposes that the transition from rural to urban living leads to reduced childhood exposure to pathogenic microorganisms. Hence instead of having the normal TH1 bias and immune tolerance because of repeated exposure to pathogens, urban dwellers have TH2 cell immune activity and atopic disease in a more sterile environment. Various other environmental exposures have been implicated in the explosion of AD (and atopic disorders in general), including breast-feeding, tobacco smoking, alcohol consumption, and exposure to domesticated furry pets. Notably, the key role of a compromised barrier of neonatal skin as a predisposing factor in the development of childhood AD has recently been demonstrated. In this article we review the salubrious effects of suberythemogenic doses of UVB irradiation for the skin barrier. We then discuss how the lack of sufficient UVB exposure could have contributed to the rapid increase in the incidence of AD in developed countries. This hypothesis offers a separate but not competing partial explanation, which should be viewed as not discounting the role of the etiopathogenic factors that also could influence the prevalence of atopic disorders.

Original languageEnglish
JournalThe Journal of allergy and clinical immunology
Volume136
Issue number5
Pages (from-to)1163-9
Number of pages7
ISSN0091-6749
DOIs
Publication statusPublished - Nov 2015

    Research areas

  • Animals, Dermatitis, Atopic, Epidemics, Humans, Hygiene Hypothesis, Immunity, Cellular, Incidence, Infant, Infant, Newborn, Radiation Exposure, Th2 Cells, Ultraviolet Rays, Urban Population

ID: 162247166