Th1/Th2 Polarization in Early Life and Atopic Predisposition: An Analysis of Immunological, Microbiological, and Environmental Factors
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Abstract
Objective: To identify in the scientific literature the main mechanisms involved in Th1 and Th2 polarization in early life and their relationship with the development of allergic diseases in childhood, while also considering genetic, environmental, microbiological, and gestational factors associated with the modulation of the neonatal immune system and atopic predisposition. Methods: An integrative literature review was conducted through searches in the PubMed database, complemented by institutional documents from Brazilian Ministry of Health. Descriptors related to Th1/Th2 polarization, allergic diseases, asthma, atopic dermatitis, neonatal immunity, microbiota, and childhood were used and combined with the Boolean operator “AND”. Articles published between 1996 and 2024 were considered according to previously established inclusion and exclusion criteria. At the end of the selection process, 25 scientific studies were included in the review. Results: The analyzed evidence demonstrated a physiological predominance of Th2 responses during the neonatal period and slower maturation of the Th1 pathway, with alterations in this process being associated with atopic predisposition. However, the allergic response in childhood was shown to be more complex than the Th1/Th2 dichotomy, involving other immunological pathways and regulatory mechanisms. Susceptibility to atopic diseases was also associated with the interaction among genetic and familial factors, intestinal microbiota, and early environmental and gestational exposures. Conclusion: Allergic diseases in childhood have a multifactorial nature, resulting from the interaction among neonatal immune maturation, genetic susceptibility, and microbiological, environmental, and gestational influences. An integrated understanding of these mechanisms may contribute to the identification of atopic vulnerability and to the development of more targeted preventive strategies.
Keywords: Neonatal immunity. Th1/Th2 polarization. Allergic diseases.
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