A review of: Newberry RD, Stenson WF, Lorenz RG 1999 Cyclooxygenase-2-dependent arachidonic acid metabolites are essential modulators of the immune response to dietary antigen. Nature Med 5:900–906.

Studies of the basis of immunological tolerance are of increasing concern to pediatricians because of a reported increase of immune dysregulation in developed-world children. Apparently, this has not occurred within the developing world, except in relatively few privileged children. The effects of altered early environmental conditioning have been observed in children within former East Germany following reunification (1), and are beginning to be felt in other countries with rapid social progression, such as Singapore (2). The consequences potentially go beyond classic atopy to include marked increases of more severe immunopathology such as childhood Crohn's disease, in which tolerance to the enteric flora is lost, and possibly autism, in which there is initial evidence of dysregulated mucosal immunity.

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