Hygiene Hypothesis as the Etiology of Kawasaki Disease: Dysregulation of Early B Cell Development

Kawasaki disease (KD) is an acute systemic vasculitis that occurs predominantly in children under 5 years of age. Despite much study, the etiology of KD remains unknown. However, epidemiological and immunological data support the hygiene hypothesis as a possible etiology. It is thought that more ste...

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Autor principal:	Jong-Keuk Lee
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	Kawasaki disease hygiene hypothesis B cells intravenous immunoglobulin Biology (General) QH301-705.5 Chemistry QD1-999
Acceso en línea:	https://doaj.org/article/ab799210005d4cc98a99db55301fb03a
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spelling	oai:doaj.org-article:ab799210005d4cc98a99db55301fb03a2021-11-25T17:55:29ZHygiene Hypothesis as the Etiology of Kawasaki Disease: Dysregulation of Early B Cell Development10.3390/ijms2222123341422-00671661-6596https://doaj.org/article/ab799210005d4cc98a99db55301fb03a2021-11-01T00:00:00Zhttps://www.mdpi.com/1422-0067/22/22/12334https://doaj.org/toc/1661-6596https://doaj.org/toc/1422-0067Kawasaki disease (KD) is an acute systemic vasculitis that occurs predominantly in children under 5 years of age. Despite much study, the etiology of KD remains unknown. However, epidemiological and immunological data support the hygiene hypothesis as a possible etiology. It is thought that more sterile or clean modern living environments due to increased use of sanitizing agents, antibiotics, and formula feeding result in a lack of immunological challenges, leading to defective or dysregulated B cell development, accompanied by low IgG and high IgE levels. A lack of B cell immunity may increase sensitivity to unknown environmental triggers that are nonpathogenic in healthy individuals. Genetic studies of KD show that all of the KD susceptibility genes identified by genome-wide association studies are involved in B cell development and function, particularly in early B cell development (from the pro-B to pre-B cell stage). The fact that intravenous immunoglobulin is an effective therapy for KD supports this hypothesis. In this review, I discuss clinical, epidemiological, immunological, and genetic studies showing that the etiopathogenesis of KD in infants and toddlers can be explained by the hygiene hypothesis, and particularly by defects or dysregulation during early B cell development.Jong-Keuk LeeMDPI AGarticleKawasaki diseasehygiene hypothesisB cellsintravenous immunoglobulinBiology (General)QH301-705.5ChemistryQD1-999ENInternational Journal of Molecular Sciences, Vol 22, Iss 12334, p 12334 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Kawasaki disease hygiene hypothesis B cells intravenous immunoglobulin Biology (General) QH301-705.5 Chemistry QD1-999
spellingShingle	Kawasaki disease hygiene hypothesis B cells intravenous immunoglobulin Biology (General) QH301-705.5 Chemistry QD1-999 Jong-Keuk Lee Hygiene Hypothesis as the Etiology of Kawasaki Disease: Dysregulation of Early B Cell Development
description	Kawasaki disease (KD) is an acute systemic vasculitis that occurs predominantly in children under 5 years of age. Despite much study, the etiology of KD remains unknown. However, epidemiological and immunological data support the hygiene hypothesis as a possible etiology. It is thought that more sterile or clean modern living environments due to increased use of sanitizing agents, antibiotics, and formula feeding result in a lack of immunological challenges, leading to defective or dysregulated B cell development, accompanied by low IgG and high IgE levels. A lack of B cell immunity may increase sensitivity to unknown environmental triggers that are nonpathogenic in healthy individuals. Genetic studies of KD show that all of the KD susceptibility genes identified by genome-wide association studies are involved in B cell development and function, particularly in early B cell development (from the pro-B to pre-B cell stage). The fact that intravenous immunoglobulin is an effective therapy for KD supports this hypothesis. In this review, I discuss clinical, epidemiological, immunological, and genetic studies showing that the etiopathogenesis of KD in infants and toddlers can be explained by the hygiene hypothesis, and particularly by defects or dysregulation during early B cell development.
format	article
author	Jong-Keuk Lee
author_facet	Jong-Keuk Lee
author_sort	Jong-Keuk Lee
title	Hygiene Hypothesis as the Etiology of Kawasaki Disease: Dysregulation of Early B Cell Development
title_short	Hygiene Hypothesis as the Etiology of Kawasaki Disease: Dysregulation of Early B Cell Development
title_full	Hygiene Hypothesis as the Etiology of Kawasaki Disease: Dysregulation of Early B Cell Development
title_fullStr	Hygiene Hypothesis as the Etiology of Kawasaki Disease: Dysregulation of Early B Cell Development
title_full_unstemmed	Hygiene Hypothesis as the Etiology of Kawasaki Disease: Dysregulation of Early B Cell Development
title_sort	hygiene hypothesis as the etiology of kawasaki disease: dysregulation of early b cell development
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/ab799210005d4cc98a99db55301fb03a
work_keys_str_mv	AT jongkeuklee hygienehypothesisastheetiologyofkawasakidiseasedysregulationofearlybcelldevelopment
_version_	1718411822474723328

Hygiene Hypothesis as the Etiology of Kawasaki Disease: Dysregulation of Early B Cell Development

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