Role of Antibiotics and Infection-Host Interactions in the Prevalence of Respiratory Atopy: Experience and Perspective

Alketa H. Bakiri1, 2, Ervin Ç Mingomataj*, 3, 4, Alkerta Ibranji5
1 Hygeia Hospital Tirana, Outpatients Service, Allergology Consulting Room, Tirana, Albania
2 Albanian University, Faculty of Medical Sciences, Department of Preclinical Disciplines, Tirana, Albania
3 “Mother Theresa” School of Medicine, Department of Allergy & Clinical Immunology, Tirana – Albania
4 University of Medicine, Faculty of Technical Medical Sciences, Department of Preclinical Disciplines, Tirana, Albania
5 "At Luigji Monti” Policlinic, “Our Lady of Good Counsel University”, Department of Allergy & Clinical Immunology, Tirana, Albania

© 2015 Bakiri et al;

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Rruga Myslym Shyri, P. 47, Apt. 15, Tirana, Albania; E-mail:


We have witnessed a dramatic increase in the prevalence of respiratory allergies during the last decades. The role of infections in the prevalence of respiratory allergic diseases is attributed to the antagonism between: a) induction of T helper (Th) 1 immune response by human organism; and b) manipulation of the human immune response toward Th2 profile by common infective agents in order to increase their surviving opportunity. This review proposes an important role of massive antibiotics exposure during neonatal and early childhood on the increasing epidemiological trend. It is believed that the antibiotics exposure during early childhood has also provided better surviving opportunity for atopic individuals with an inadequate immune defense against common infections, deviating therefore the genetic background of general population toward Th2 profile. Taking this into account, we suggest that Th2 profile frequency (and consequently atopic phenotype prevalence) can be increased along an individual lifespan after initial massive antibiotic introduction, until the entire population is exposed to them during childhood. This hypothesis may explain findings on epidemiological surveys, which report a prevalent increase among adults in industrialized countries between 1970s and 2000s, while in recently- developed countries this trend begun only at the end of 1980s. These arguments may lead to the conclusion that infections will manipulate the human immunity along generations, whereas actual antibiotics can increase the prevalence of respiratory allergies among a population only along an individual longevity. These findings may be beneficial in the development of future strategies for management of respiratory allergic or infective pathologies.

Keywords: Antibiotics exposure, common infections, early childhood, prevalence trend, respiratory allergies.