A review and update of an important topic
By William Parker and Rajendra A. Morey
Departments of Surgery (WP) and Psychiatry (RAM)
Duke University Medical Center, Durham, NC 27707
The story of resolving immune dysfunction in Western society is one of uncovering a profound evolutionary mismatch. The story began 39 years ago when a parasitologist, John Turton, intentionally colonized himself with the human hookworm and eliminated his own hayfever . Sadly, the story is littered with long pauses, and Turton’s observations went unappreciated for decades. The story took a new turn in the late 1980s when David Strachan pointed an accusing finger at some aspects of modern sanitation as being responsible for the plague of chronic immune disease affecting Western society . Over the next 20 years, Strachan’s “hygiene hypothesis” evolved into “biome depletion theory” , as a large body of work identified the loss of biodiversity from the human body rather than hygiene, per se, as the underlying “evolutionary mismatch” [4, 5]. Graham Rook and others pointed toward the loss of eukaryotic symbionts in particular as being one of the most dramatic changes in the body’s ecosystem as a result of Westernization . Further, a wide range of studies in animal models as well as a limited number of studies in humans pointed toward helminths as potential candidates for biological therapeutics that might alleviate the mismatch [6-8]. Given this information, a solution for chronic immune disease seemed apparent; enrich the depleted biome present in Westernized humans to eliminate pandemics of allergic, autoimmune, and other inflammatory-related diseases. The use of helminths appeared to be a very good place to start.
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