A prescription for clinical immunology: The pills are available and ready for testing. A review

Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Current Medical Research and Opinion (Impact Factor: 2.65). 05/2012; 28(7):1193-202. DOI: 10.1185/03007995.2012.695731
Source: PubMed

ABSTRACT OBJECTIVE: Modern immunology has been extremely successful in elucidating many features of the immune system, but not in stemming pandemics of non-infectious, immune-related disease associated with industrialized populations. These pandemics involve a broad range of allergic, autoimmune, and inflammatory diseases, potentially including neuroinflammatory-associated disorders. It is the purpose of this review to outline the literature pointing toward the causes and potential treatments of these problems. CONCLUSIONS: A wide range of evidence from the fields of clinical medicine, biomedical research, evolutionary biology, anthropology, epidemiology, immunology, and ecology point to the conclusion that pandemics of non-infectious, immune-related conditions arise from consequences of industrialization. Primary among these consequences is the loss of helminths from the ecosystem of the human body, the 'human biome'. In this view, helminths comprise a 'keystone species' of the human biome, and their loss is profoundly felt as pandemics of non-infectious, immune-related disease. Fortunately, evidence indicates that the consequences of industrialization that cause immune disease, such as helminth depletion, can be effectively avoided. Using this approach, it is expected that further pandemics of immune disease may be prevented, although it remains to be established whether prophylaxis rather than treatment of disease is required for some disorders. Thus, it is predicted that those who will succeed in curing and preventing immune-related disease will focus on addressing 'evolutionary mismatches' rather than simply on the molecular and genetic underpinnings of immunological disorders.

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    • "As a result, a profound depletion of the diversity of the ''human biome,'' the life associated with the ecosystem of the human body, has impacted human health dramatically (Bilbo et al., 2011; Parker and Ollerton, 2013). Relevant animal models, particularly less complex models such as Ciona, will serve as invaluable means to address not only the ramifications of this ''biome depletion'' for host–microbe interactions, but also the anticipated biome enrichment procedures (Parker et al., 2012 "
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    ABSTRACT: The animal gut serves as a primary location for the complex host-microbe interplay that is essential for homeostasis and may also reflect the types of ancient selective pressures that spawned the emergence of immunity in metazoans. In this review, we present a phylogenetic survey of gut host-microbe interactions and suggest that host defense systems arose not only to protect tissue directly from pathogenic attack but also to actively support growth of specific communities of mutualists. This functional dichotomy resulted in the evolution of immune systems much more tuned for harmonious existence with microbes than previously thought, existing as dynamic but primarily cooperative entities in the present day. We further present the protochordate Ciona intestinalis as a promising model for studying gut host-bacterial dialogue. The taxonomic position, gut physiology and experimental tractability of Ciona offer unique advantages in dissecting host-microbe interplay and can complement studies in other model systems.
    Developmental & Comparative Immunology 06/2014; 47(1). DOI:10.1016/j.dci.2014.06.011 · 2.82 Impact Factor
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    • "As an example, the vertebrate immune system evolved in the presence of an intestinal fauna that becomes largely absent in modern hygienic environments. In their absence, the immune system develops antibodies to inappropriate antigens, creating an entire class of inflammatory diseases that affect behavior in addition to physiology (Jackson, Friberg, Little, & Bradley, 2008; Parker, Perkins, Harker, & Muehlenbein, 2012). As a second example, many modern health problems are based on a mismatch between our ancestral and contemporary diets (Lindeberg, 2010). "
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    ABSTRACT: The Association for Contextual Behavioral Science (ACBS) is one of the many islands in an archipelago of human-related disciplines that are largely isolated from each other. Evolution provides a unifying theoretical framework that can unite the Ivory Archipelago, achieving the goal of consilience, or unity of knowledge. ACBS can both gain from and contribute to this integration, which is already in progress.
    Journal of Contextual Behavioral Science 12/2012; 1(s 1–2):39–42. DOI:10.1016/j.jcbs.2012.09.005
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    ABSTRACT: Industrialized society currently faces a wide range of non-infectious, immune-related pandemics. These pandemics include a variety of autoimmune, inflammatory and allergic diseases that are often associated with common environmental triggers and with genetic predisposition, but that do not occur in developing societies. In this review, we briefly present the idea that these pandemics are due to a limited number of evolutionary mismatches, the most damaging being 'biome depletion'. This particular mismatch involves the loss of species from the ecosystem of the human body, the human biome, many of which have traditionally been classified as parasites, although some may actually be commensal or even mutualistic. This view, evolved from the 'hygiene hypothesis', encompasses a broad ecological and evolutionary perspective that considers host-symbiont relations as plastic, changing through ecological space and evolutionary time. Fortunately, this perspective provides a blueprint, termed 'biome reconstitution', for disease treatment and especially for disease prevention. Biome reconstitution includes the controlled and population-wide reintroduction (i.e. domestication) of selected species that have been all but eradicated from the human biome in industrialized society and holds great promise for the elimination of pandemics of allergic, inflammatory and autoimmune diseases.
    04/2013; 2013(1):89-103. DOI:10.1093/emph/eot008
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