Mycobacterium-Induced Th1, Helminths-Induced Th2 Cells and the Potential Vaccine Candidates for Allergic Asthma: Imitation of Natural Infection

Front Immunol. 2021 Aug 3;12:696734. doi: 10.3389/fimmu.2021.696734. eCollection 2021.


Bronchial asthma is one of the most chronic pulmonary diseases and major public health problems. In general, asthma prevails in developed countries than developing countries, and its prevalence is increasing in the latter. For instance, the hygiene hypothesis demonstrated that this phenomenon resulted from higher household hygienic standards that decreased the chances of infections, which would subsequently increase the occurrence of allergy. In this review, we attempted to integrate our knowledge with the hygiene hypothesis into beneficial preventive approaches for allergic asthma. Therefore, we highlighted the studies that investigated the correlation between allergic asthma and the two different types of infections that induce the two major antagonizing arms of T cells. This elucidation reflects the association between various types of natural infections and the immune system, which is predicted to support the main objective of the current research on investigating of the benefits of natural infections, regardless their immune pathways for the prevention of allergic asthma. We demonstrated that natural infection with Mycobacterium tuberculosis (Mtb) prevents the development of allergic asthma, thus Bacille Calmette-Guérin (BCG) vaccine is suggested at early age to mediate the same prevention particularly with increasing its efficiency through genetic engineering-based modifications. Likewise, natural helminth infections might inhabit the allergic asthma development. Therefore, helminth-derived proteins at early age are good candidates for designing vaccines for allergic asthma and it requires further investigation. Finally, we recommend imitation of natural infections as a general strategy for preventing allergic asthma that increased dramatically over the past decades.

Keywords: BCG; Th1/Th2; allergy; asthma; helminths; immunotherapy; mycobacteria; vaccines.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Asthma / immunology
  • Asthma / microbiology
  • Asthma / parasitology
  • Asthma / prevention & control*
  • BCG Vaccine / adverse effects
  • BCG Vaccine / therapeutic use*
  • Helminth Proteins / adverse effects
  • Helminth Proteins / therapeutic use*
  • Helminthiasis / immunology*
  • Helminthiasis / parasitology
  • Humans
  • Hygiene Hypothesis*
  • Immunotherapy* / adverse effects
  • Th1 Cells / immunology*
  • Th1 Cells / metabolism
  • Th1 Cells / microbiology
  • Th2 Cells / immunology*
  • Th2 Cells / metabolism
  • Th2 Cells / parasitology
  • Tuberculosis / immunology*
  • Tuberculosis / microbiology


  • BCG Vaccine
  • Helminth Proteins