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Trends Immunol. 2009 Feb;30(2):67-74. doi: 10.1016/ Epub 2009 Jan 8.

Does hapten exposure predispose to atopic disease? The hapten-atopy hypothesis.

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Department of Cutaneous Allergy, St John's Institute of Dermatology, St. Thomas' Hospital, London SE1 7EH, UK.


Contact allergy data indicates that atopics have heightened oral tolerance to haptens (chemical allergens). We speculate here, that artificially increased oral exposure to chemicals compete with dietary proteins for the development of oral tolerance, predisposing to the acquisition of food protein allergy and representing one driver for the increasing prevalence of protein allergy and/or atopy. Hapten exposure via other surfaces such as the skin and airways might also be important in promoting atopic disease. Consistent with this hypothesis it is notable that over 40 years, with the huge increase in atopic disease, there has also been an increase in dietary hapten exposure through processed food, formula milk and oral antibiotic and drug use.

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