The "Microflora Hypothesis" of allergic disease.

Predisposition to allergic disease is a complex function of an individual's genetic background and, as is the case with multi-gene traits, environmental factors have important phenotypic consequences. Over a span of decades, a dramatic increase in the prevalence of allergic disease in westernized populations suggests the occurrence of critical changes in environmental pressures. Recently, it has been shown that the microbiota (i.e. microflora) of allergic individuals differs from that of non-allergic ones and that differences are detectable prior to the onset of atopy, consistent with a possible causative role. Features of the westernized lifestyle that are known to alter the microbiota, such as antibiotics and diet, are also associated with allergy in humans. In this chapter, we discuss the "Microflora Hypothesis" for allergy which predicts that an "unhealthy" microbiota composition, now commonly found within westernized communities, contributes to the development of allergy and conversely, that restoring a "healthy" microbiota, perhaps through probiotic supplementation, may prevent the development of allergy or even treat existing disease. In testing this hypothesis, our laboratory has recently reported that mice can develop allergic airway responses if their microbiota is altered at the time of first allergen exposure.