ReviewNature reviews. Immunology2018
The hygiene hypothesis in autoimmunity: the role of pathogens and commensals.
Review in Nature reviews. Immunology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 261 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
261 citing papers in PubMed, 3 syntheses or guidelines pooled it, 525 citations in OpenAlex.
- Microbiome and pediatric leukemia, diabetes, and allergies: Systematic review and meta-analysis.PloS one · 2025Pooled it
- Efficacy and safety of gut microbiota-based therapies in autoimmune and rheumatic diseases: a systematic review and meta-analysis of 80 randomized controlled trials.BMC medicine · 2024Pooled it
- A systematic review and meta-analysis for association of Helicobacter pylori colonization and celiac disease.PloS one · 2021Pooled it
- Trial
- Life-course hygiene exposures and disorders of gut-brain interaction: a multinational cross-sectional study.Internal and emergency medicine · 2026Article
- An Epidemiology-Constrained Framework for Mechanistic Hypothesis Restriction and Prioritization in Complex Disease.Journal of evaluation in clinical practice · 2026Article
- The TPx Protein ofCells · 2026Article
- Co-occurrence of acute leukemia and type 1 diabetes among children: a caseseries.Journal of medical case reports · 2026Article
- Evolutionary Mismatch, Stress, and Competition: Making Sense of Psychosocial Problems in the Polycrisis Era.Behavioral sciences (Basel, Switzerland) · 2026Review
- Morphometric analysis of the thymic epithelial cell network using integrated and orthogonal digital pathology approaches.Communications biology · 2026Article
- Autoimmune Diseases and Mycobacterial Infection.Diseases (Basel, Switzerland) · 2026Review
- In Vitro Evaluation of Escherichia coli and Staphylococcus aureus Translocation in 3D Printed Material.Journal of biomedical materials research. Part A · 2026Article
- Childhood acute leukemia and type 1 diabetes in children: A nationwide case-control study.International journal of cancer · 2026Article
- Article
- Pathogens as commensals: microbial priming of the immune system and heterologous protection.Microbiology (Reading, England) · 2026Review
- Article
- Saccharomyces cerevisiae UFMG A-905 acts in an animal model of asthma by modulating Th17/Treg responses and increasing fatty acid production.BMC microbiology · 2026Article
- Endotoxin Tolerance Impinges on T Cell Activation and Chemoattraction in Autoimmune Diabetes.Journal of immunology research · 2026Article
- Molecular mimicry revisited: novel perspectives on autoimmune disease initiation and progression.Frontiers in immunology · 2026Review
- Adaptive bandwidth of immunity: a systems-level framework for understanding immune regulation across time.Frontiers in immunology · 2026Review
201 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The incidence of autoimmune diseases has been steadily rising. Concomitantly, the incidence of most infectious diseases has declined. This observation gave rise to the hygiene hypothesis, which postulates that a reduction in the frequency of infections contributes directly to the increase in the frequency of autoimmune and allergic diseases. This hypothesis is supported by robust epidemiological data, but the underlying mechanisms are unclear. Pathogens are known to be important, as autoimmune disease is prevented in various experimental models by infection with different bacteria, viruses and parasites. Gut commensal bacteria also play an important role: dysbiosis of the gut flora is observed in patients with autoimmune diseases, although the causal relationship with the occurrence of autoimmune diseases has not been established. Both pathogens and commensals act by stimulating immunoregulatory pathways. Here, I discuss the importance of innate immune receptors, in particular Toll-like receptors, in mediating the protective effect of pathogens and commensals on autoimmunity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.