Atopy, asthma, and experimental approaches based on the linear model of T cell maturation.

The linear model of maturation of IFN-gamma-producing cells from a proliferative pool of type 2 cytokine-producing T cells represents a fundamental shift in interpreting how changes in cytokine production by T cell populations are regulated. A major tenet of this model is antigen-independent, bystander proliferation of type 2 T cells and their maturation to IFN-gamma+ cells. Both clinical observations and prevailing theories of immune system development in asthma are consistent with this highly interpretative in vitro model, which allows unambiguous characterization of the modulation of the intrinsic features of T cell proliferation and differentiation by environmental and genetic factors. Hypotheses based on the linear model of T cell maturation are readily testable and should lead to a greater understanding of not only allergen-specific responses, but also the non-specific, bystander effects associated with specific responses to allergens or pathogens. Topics to be discussed in the context of the linear model of T cell maturation in this review include: (1) allergic responses to an inciting allergen that may enhance sensitivity to subsequent yet different allergens; (2) dampening the preferential accumulation of type 2 T cells during a typical immune response against viral and bacterial pathogens; (3) allergen-independent sensitization in asthmatics: (4) the 'hygiene hypothesis' for the reported increased allergy development in industrialized countries; (5) elevated IFN-gamma levels in asthmatics, in addition to the expected high levels of type 2 cytokines; (6) testing the effects of inflammatory mediators, as well as various anti-inflammation therapies on T cell maturation; and (7) testing the influence of gene variation on T cell maturation.