Autoimme diseases are

[ThinkGutBacteria]

Still more evidence...

 

Recently, researchers in Finland found the incidence of type 1 diabetes to be six times higher and the prevalence of celiac disease five times higher among Finnish children than among Russian children living just across the Finnish border in a region known as Karelia. [seiskari, 2007] The children were genetically similar (with the same distribution of MHC alleles implicated in atopic and autoimmune disorders) and were exposed to roughly the same level of vitamin D-inducing ultraviolet sunlight. The major difference emerged from their respective public hygiene facilities, being fully modernized in Finland but lacking considerably in Russian Karelia, especially in water treatment.

 

Studies by the same researchers further showed that Russian Karelian school children were 15 times more likely to test positive for antibodies to Helicobacter pylori than Finnish children, five times more likely for Toxoplasma antibodies, and 12 times more likely for antibodies to hepatitis A virus. Karelian children also had considerably more antibodies against the enterovirus Coxsackie B4. [seiskari, 2007]

 

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Keep in mind that in the US we vaccinate against HepA, pregnant women are kept far away from Toxoplasma (as they should, but it has consequences), and H. pylori infections are around 30% or less compared with over 90% just 30 years ago. Also remember the most critical period for exposure is in utero or in the first year of life. It's hard to understand that infections and microbes are not created equally in terms of risk for autoimmunity PLUS you have to consider the environmental impacts of dioxins, vitamin D, antibiotics, some vaccines, etc. on the early immune system.

Edited February 9, 2013 by ThinkGutBacteria

[ThinkGutBacteria]

I grew up in MO with no air conditioning and a Mother who liked to clean. Her mother (my Grandmother) was a nurse and they lived on a farm in the 1930's before they had electricity and modern cleaning products and had allergies and health issues. My mother had horrible allergies her whole life from the time she was little. She almost died after being stung by a bee when she was nine.

 

I was the youngest of seven children and had horrible allergies; my eyes used to swell shut in ragweed season when I was a kid in the 70s. I used to play in the dirt and slept with open windows every night in the spring, summer and fall. I will have an anaphylactic reaction if I have even a bite of melon.

 

My brother spent a month at the University of Missouri hospital in 1967 after he almost died from nephritis caused by an infection. It was an autoimmune reaction. You will never meet a rowdier guy who loved to be outside with the dogs, the cats, and dirt.

 

My husband and I live on a farm on a gravel road and my son played in the mud, had a cow that they maintained, and he has autoimmune disease. I think the hygene hypothesis is just another way of blaming moms for being "too clean", kind of like blaming Refrigerator Moms who were "too cold".

 

I think a genetic component is a more accurate basis for investigation with regards to our children having autoimmune disease!

 

About the blame thing, it's a pet peeve of mine too to blame the victim; however, this is precisely what the hypothesis does not do. According to the hypothesis, the rise in allergy, asthma, and autoimmunity does NOT come from personal or home cleanliness. It comes from a societal change. It comes from not being awash (so to speak) in microbes like Hepatitis A, toxoplasma gondii, lactobacilli, mycobacterium vaccae, and clostridia (the non-pathogenic species). The evidence is overwhelmingly in support of the hypothesis that some are calling it a theory (like gravity is a theory). And, like the theory of gravity, just because you see airplanes in the sky doesn't mean the theory of gravity is incorrect. It just means you have to step back and see the whole picture. An individual's immune system is affected by many, many things like one's mother's exposure to microbes when pregnant and vitamin D levels and how many helminths are in left in the soil you played in, how many antibiotics were given at a young age, whether your mom had a flu shot during pregnancy, whether or not your parents had allergies and on and on and on. Overall, looking at communities, the evidence in favor of the hypothesis is overwhelming. I can't possibly list it all here (just trying to give a few examples) but most experts accept the fact that our immune systems are educated by microbes and inflammation early in life (even before we're born) and autoimmune diseases are frequently the result of infections in people whose immune systems haven't been turned down by certain microbes.

 

Chronic inflammatory diseases like type 1 diabetes and asthma are ancient, with reports of their occurrence throughout medical history, way before the advent of sewers and antibiotics. But their incidences have been rising steadily, in some cases alarmingly so, since the industrial revolution. There is currently no better explanation for this rise than the hygiene hypothesis. We'd be wise to research what it has to say and put it to use to help our kids.

[ThinkGutBacteria]

I grew up in small town Oklahoma. That might seem like third world to some, lol. Had pets. Drank raw milk. Lived in an old house. No a/c, windows open all summer. We didn't do all the hand washing done today. My mom worked and she was not June Cleaver with the house cleaning. I have an autoimmune disorder.

 

See my note to cobble mommy. The hypothesis has nothing to do with how often you clean your house (thankfully). Also, I'm not really sure of the relevance of a/c and windows open. As far as anyone can tell so far, the important microbes tend to be orofecal and soil- and water-borne. Also, hookworms and other relevant organisms have been all but eradicated in the rural U.S. since 1914. Gotta take a global view of this issue.

[airial95]

I have often thought about - and somewhat agree with the concept - that we have "sanitized" our way to susceptibility for certain bacteria. Our pediatrician actually told us one benefit to placing our child in day care at a young age as that they will be exposed to a variety of germs that will help build their immune systems.

 

That being said - I also wnder at the timeframes mentioned in the literature you've posted. About this time as well - access to medical care in developed nations improved drastically while in lower socio-economic and rural areas medical care was still not easily accessible. How much does this have to do with the change in stats? If in the city an upper middle class family started running to the family doctor with every sneeze and sniffle - they are more likely to be told it's hay fever, or allergies, etc. Where in a rural setting, they wouldn't even consult a doctor until there was a severity of symptoms that couldn't be ignored.

 

With allergies in particular - I agree that they are far more prevelant today than ever before. But I take my daughter as an example. She's allergic to pennicillin - mildly. She developed a dermititis rash after taking pennicillin for an ear infection that wouldn't clear up on it's own. It did not bother her - didn't itch, no anaphylaxis type reaction - just a spotted rash all over her body. She's now classified as a penicillin allergy. I guarnatee you 40 years ago - my mom wouldn't have even taken me to the doctor for such a rash. She would've waited a couple of days to see what happened - if it went away, she wouldn't have thought twice about it. Our doc even mentioned that she would likely outgrow it in a couple of years (a theory we have yet to test).

 

My question being - is it the change in environment that caused the shift in statistics - or the availability of diagnosis and treatment - or a combination of both??

[ThinkGutBacteria]

I know this is a popular topic nowadays, thanks to the autism debates. And it's true that health stats and definitions of diseases are tricky to nail down or often in flux (frustratingly so in the case of PANDAS/PANS/PITAND). However, there is a universal consensus that chronic inflammatory diseases are, on the whole, increasing in the developed world and now even in the undeveloped world as a direct result of modernization of sewers, water treatment facilities, and general living conditions in urban areas. Of course you can find exceptions to this trend--rheumatoid arthritis, for example, has slightly decreased in men since the 1990's. But overall, your hunch is correct that most diseases from chronic inflammation such as type 1 diabetes, multiple sclerosis, asthma, Crohn's disease, etc., are frankly too dire to have been dismissed or misdiagnosed. (Crohn's has a pretty interesting history. You should look it up sometime.) Also, medical records in industrialized nations have been fairly good throughout the 20th century, even in poor or rural areas. In fact, the penetration of health scouts into depressed areas was probably better than today in many cases. It's well documented that hay fever was never recorded before the mid-19th century in rural England not because of farmer stoicism or because no one knew what to call the sneezing and runny nose symptoms that occurred in country folk every summer, but because it simply didn't exist. The story of Charles Blackley and hay fever is pretty interesting and one I recommend reading up on if you're a history of medicine buff like me. Undoubtedly, awareness of these ailments is heightened for sure, but that's because they're more prevalent. No one talked about autism when I was a kid, but not because 1 in 54 "rainmen" were dismissed as being a little strange. (Here's a now famous graph from a 2002 article in the New England Journal of Medicine: http://www.cwr.uwa.edu.au/~jimberger/Life%20in%20a%20Changing%20Climate(New)/Resources_LCC/Visuals/4.02b_Immune%20Disorders%20Bach%20NEJM%202002.png)

 

As for your doctor telling you that daycare is protective, it was but is becoming less so. As viruses like Hepatitis A and bacteria like H. pylori are eliminated from our society (like hookworm and polio decades ago), so too are the protections they offered. Things like rhinovirus and streptococcus pyogenes that are currently "shared" amongst children are not likely to confer any protection against allergies/autoimmunity and have indeed shown to make them worse. Same with animals. Being around them used to be very protective. But now the heavy use of antibiotics and herbacides in the pastures has changed the equation. Likewise having lots of siblings. It doesn't protect like it did 40 years ago. The right microbes just aren't around anymore and as more of us develop allergic/autoimmune conditions, more of us are passing on the effects of our screwed up immunity to subsequent generations, accelerating the problem. Fortunately, we're starting to make some research headway, curing autoimmune diseases in animal models with certain bits of bacteria (as in the case of Sarkis Mazmanian at Cal. Tech. or Denise Faustman at Harvard) or helminths (Joel Weinstock). Let's hope we're not too far gone micro-ecologically by the time treatments reach human patients.

Edited February 12, 2013 by ThinkGutBacteria

[ThinkGutBacteria]

If you're tired of my yadda-yadda...there's a neat video by Homer Boushey, MD, an asthma expert at University of California, San Francisco.

 

[ThinkGutBacteria]

Regarding helminths, a 2006 meta-analysis of 33 studies testing the effect of specific parasites on asthma risk found infection by the giant roundworm nematode (Ascaris lumbricoides) associated with a 34% increased risk of asthma, whereas hookworm infection was associated with a reduced risk of 66% among the most severely infected and of 50% among the moderately infected.28 This study highlights the importance of species specificity when addressing whether “infections” protect against disease and may confound studies assessing the effect of broad deworming campaigns on allergic disease.

 

Similarly, University of Iowa gastroenterologist Joel Weinstock and colleagues showed disease abatement, even temporarily remission, after intentionally feeding eggs of a parasitic whipworm Trichuris suis to patients with Crohn’s disease and ulcerative colitis.29 Patients ingested 2,500 T. suis ova every 3 weeks. At week 24, 72% of patients were in remission. No adverse events were noted. Whipworms live in warm moist soil or food that has been contaminated by fecal matter. In animal studies, helminthic therapy has protected genetically predisposed mice against colitis, encephalitis, type I diabetes, and asthma.30 Clinical trials are underway testing helminths in humans with various autoimmune diseases. The following figure starkly illustrates the relationship between incidence of autoimmune disorders and helminth infestation worldwide.

 

Scroll down to the 7th powerpoint slide. (I couldn't insert my copy of the image).

http://www.faqs.org/sec-filings/120904/CORONADO-BIOSCIENCES-INC_8-K/d405471dex991.htm

Edited February 12, 2013 by ThinkGutBacteria