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Parker W, Jirků K, Patel E, Williamson L, Anderson L, Laman JD. Reevaluating Biota Alteration: Reframing Environmental Influences on Chronic Immune Disorders and Exploring Novel Therapeutic Opportunities. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2024; 97:253-263. [PMID: 38947109 PMCID: PMC11202117 DOI: 10.59249/vunf1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Environmental mismatches are defined as changes in the environment that induce public health crises. Well known mismatches leading to chronic disease include the availability of technologies that facilitate unhealthy diets and sedentary lifestyles, both factors that adversely affect cardiovascular health. This commentary puts these mismatches in context with biota alteration, an environmental mismatch involving hygiene-related technologies necessary for avoidance of infectious disease. Implementation of hygiene-related technologies causes a loss of symbiotic helminths and protists, profoundly affecting immune function and facilitating a variety of chronic conditions, including allergic disorders, autoimmune diseases, and several inflammation-associated neuropsychiatric conditions. Unfortunately, despite an established understanding of the biology underpinning this and other environmental mismatches, public health agencies have failed to stem the resulting tide of increased chronic disease burden. Both biomedical research and clinical practice continue to focus on an ineffective and reactive pharmaceutical-based paradigm. It is argued that the healthcare of the future could take into account the biology of today, effectively and proactively dealing with environmental mismatch and the resulting chronic disease burden.
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Affiliation(s)
- William Parker
- Department of Psychology and Neuroscience, University
of North Carolina, Chapel Hill, NC, USA
- WPLab, Inc., Durham, NC, USA
| | - Kateřina Jirků
- Institute of Parasitology, Biology Centre, Czech
Academy of Sciences, České Budějovice, Czech Republic
| | | | - Lauren Williamson
- Department of Biological Sciences, Northern Kentucky
University, Highland Heights, KY, USA
| | | | - Jon D. Laman
- Department of Pathology & Medical Biology,
University Groningen, University Medical Center Groningen, Groningen, The
Netherlands
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2
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Dujon AM, Jeanjean J, Vincze O, Giraudeau M, Lemaître J, Pujol P, Ujvari B, Thomas F. Cancer hygiene hypothesis: A test from wild captive mammals. Ecol Evol 2023; 13:e10547. [PMID: 37745791 PMCID: PMC10515881 DOI: 10.1002/ece3.10547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023] Open
Abstract
The hygiene hypothesis, according to which the recent reduction of exposure to infectious agents in the human species would be the origin of various diseases, including autoimmune diseases and cancer, has often been proposed but not properly tested on animals. Here, we evaluated the relevance of this hypothesis to cancer risk in mammals in an original way, namely by using information on zoo mammals. We predicted that a higher richness of parasitic cohorts in the species' natural habitat would result in a greater occurrence of evolutionary mismatch due to the reduction of parasites in captive conditions. This, in turn, could contribute to an increased risk of developing lethal cancers. Using a comparative analysis of 112 mammalian species, we explored the potential relationship between cancer risk and parasite species richness using generalized phylogenetic least squares regressions to relate parasite species richness to cancer risk data. We found no strong evidence that parasite species richness increased cancer risk in zoo mammals for any of the parasite groups we tested. Without constituting definitive proof of the irrelevance of the hygienic hypothesis, our comparative study using zoo mammals does not support it, at least with respect to cancer risks.
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Affiliation(s)
- Antoine M. Dujon
- Geelong, School of Life and Environmental Sciences, Centre for Integrative EcologyDeakin UniversityWaurn PondsVictoriaAustralia
- CREEC/CANECEV (CREES), MIVEGEC, IRD 224–CNRS 5290–Université de MontpellierMontpellierFrance
| | - Jérémy Jeanjean
- CREEC/CANECEV (CREES), MIVEGEC, IRD 224–CNRS 5290–Université de MontpellierMontpellierFrance
| | - Orsolya Vincze
- Institute of Aquatic Ecology, Centre for Ecological ResearchDebrecenHungary
- Evolutionary Ecology Group, Hungarian Department of Biology and EcologyBabes‐Bolyai UniversityCluj‐NapocaRomania
- Littoral, Environnement et Sociétés (LIENSs), UMR 7266 CNRS‐La Rochelle UniversitéLa RochelleFrance
| | - Mathieu Giraudeau
- Littoral, Environnement et Sociétés (LIENSs), UMR 7266 CNRS‐La Rochelle UniversitéLa RochelleFrance
| | - Jean‐François Lemaître
- CNRS, UMR 5558, Laboratoire de Biométrie et Biologie EvolutiveUniversité de LyonVilleurbanneFrance
- Laboratory of Rare Human Circulating Cells (LCCRH)University Hospital of MontpellierMontpellierFrance
| | - Pascal Pujol
- CREEC/CANECEV (CREES), MIVEGEC, IRD 224–CNRS 5290–Université de MontpellierMontpellierFrance
- Centre Hospitalier Universitaire Arnaud de VilleneuveMontpellierFrance
| | - Beata Ujvari
- Geelong, School of Life and Environmental Sciences, Centre for Integrative EcologyDeakin UniversityWaurn PondsVictoriaAustralia
- CREEC/CANECEV (CREES), MIVEGEC, IRD 224–CNRS 5290–Université de MontpellierMontpellierFrance
| | - Frédéric Thomas
- CREEC/CANECEV (CREES), MIVEGEC, IRD 224–CNRS 5290–Université de MontpellierMontpellierFrance
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Parker W, Patel E, Jirků-Pomajbíková K, Laman JD. COVID-19 morbidity in lower versus higher income populations underscores the need to restore lost biodiversity of eukaryotic symbionts. iScience 2023; 26:106167. [PMID: 36785786 PMCID: PMC9908430 DOI: 10.1016/j.isci.2023.106167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
The avoidance of infectious disease by widespread use of 'systems hygiene', defined by hygiene-enhancing technology such as sewage systems, water treatment facilities, and secure food storage containers, has led to a dramatic decrease in symbiotic helminths and protists in high-income human populations. Over a half-century of research has revealed that this 'biota alteration' leads to altered immune function and a propensity for chronic inflammatory diseases, including allergic, autoimmune and neuropsychiatric disorders. A recent Ethiopian study (EClinicalMedicine 39: 101054), validating predictions made by several laboratories, found that symbiotic helminths and protists were associated with a reduced risk of severe COVID-19 (adjusted odds ratio = 0.35; p<0.0001). Thus, it is now apparent that 'biome reconstitution', defined as the artificial re-introduction of benign, symbiotic helminths or protists into the ecosystem of the human body, is important not only for alleviation of chronic immune disease, but likely also for pandemic preparedness.
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Affiliation(s)
| | | | - Kateřina Jirků-Pomajbíková
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, 370 05 České Budějovice, Czech Republic
- Faculty of Science, University of South Bohemia, 370 05 České Budějovice, Czech Republic
| | - Jon D. Laman
- Department of Pathology and Medical Biology, University Groningen, University Medical Center Groningen, Groningen, the Netherlands
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4
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Abstract
Healthy development and function of essentially all physiological systems and organs, including the brain, require exposure to the microbiota of our mothers and of the natural environment, especially in early life. We also know that some infections, if we survive them, modulate the immune system in relevant ways. If we study the evolution of the immune and metabolic systems, we can understand how these requirements developed and the nature of the organisms that we need to encounter. We can then begin to identify the mechanisms of the beneficial effects of these exposures. Against this evolutionary background, we can analyze the ways in which the modern urban lifestyle, particularly for individuals experiencing low socioeconomic status (SES), results in deficient or distorted microbial exposures and microbiomes. Thus, an evolutionary approach facilitates the identification of practical solutions to the growing scandal of health disparities linked to inequality.
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5
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Mitigation of Toxoplasma gondii-induced ileitis by Trichinellaspiralis infection pinpointing immunomodulation. J Parasit Dis 2022; 46:491-501. [DOI: 10.1007/s12639-022-01476-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/09/2022] [Indexed: 10/18/2022] Open
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Schrock JM, Sugiyama LS, Naidoo N, Kowal P, Snodgrass JJ. Greater chronic morbidity is associated with greater fatigue in six countries. Evol Med Public Health 2022; 10:156-169. [PMID: 35480567 PMCID: PMC9036556 DOI: 10.1093/emph/eoac011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/15/2022] [Indexed: 11/15/2022] Open
Abstract
Background and objectives Human susceptibility to chronic non-communicable disease may be explained, in part, by mismatches between our evolved biology and contemporary environmental conditions. Disease-induced fatigue may function to reduce physical activity during acute infection, thereby making more energy available to mount an effective immune response. However, fatigue in the context of chronic disease may be maladaptive because long-term reductions in physical activity increase risks of disease progression and the acquisition of additional morbidities. Here, we test whether cumulative chronic morbidity is associated with subjective fatigue. Methodology We constructed a cumulative chronic morbidity score using self-reported diagnoses and algorithm-based assessments, and a subjective fatigue score based on four questionnaire items using cross-sectional survey data from the Study on global AGEing and adult health, which features large samples of adults from six countries (China, Ghana, India, Mexico, Russia and South Africa). Results In a mixed-effects linear model with participants nested in countries (N = 32 455), greater cumulative chronic morbidity is associated with greater subjective fatigue (β = 0.34, SE = 0.005, P < 2e−16). This association replicates within each country and is robust to adjustment for key sociodemographic and physical covariates (sex, age, household wealth, physical function score, habitual physical activity, BMI and BMI2). Conclusions and implications Fatigue is a common but perhaps maladaptive neuropsychological response to chronic morbidity. Disease-induced fatigue may mediate a self-perpetuating cycle, in which chronic morbidity reduces physical activity, and less physical activity increases cumulative chronic morbidity. Longitudinal research is needed to test whether chronic morbidity, fatigue and physical activity form a cyclical feedback loop. Lay Summary: Fatigue during acute illness may promote recovery, but persistent fatigue in the context of chronic disease may make matters worse. We present evidence from six countries that more chronic disease is associated with more fatigue. This fatigue may reduce physical activity, which increases risks of acquiring additional chronic health problems.
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Affiliation(s)
- Joshua M Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Avenue, Suite 14, Chicago, IL 60611, USA
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA
- Department of Anthropology, 1218 University of Oregon, 308 Condon Hall, Eugene, OR 97403, USA
- Corresponding author. Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Avenue, Suite 14, Chicago, IL 60611, USA. Tel: (312) 503-5408; E-mail:
| | - Lawrence S Sugiyama
- Department of Anthropology, 1218 University of Oregon, 308 Condon Hall, Eugene, OR 97403, USA
| | - Nirmala Naidoo
- Study on global AGEing and adult health (SAGE), World Health Organization, Avenue Appia 20, Geneva 1211, Switzerland
| | - Paul Kowal
- Study on global AGEing and adult health (SAGE), World Health Organization, Avenue Appia 20, Geneva 1211, Switzerland
- Centre for Women’s Health Research, University Drive, Callaghan, NSW 2308, Australia
| | - J Josh Snodgrass
- Department of Anthropology, 1218 University of Oregon, 308 Condon Hall, Eugene, OR 97403, USA
- Center for Global Health, University of Oregon, 1585 E 13th Avenue, Eugene, OR 97403, USA
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7
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Engelenburg HJ, Lucassen PJ, Sarafian JT, Parker W, Laman JD. Multiple sclerosis and the microbiota. Evol Med Public Health 2022; 10:277-294. [PMID: 35747061 PMCID: PMC9211007 DOI: 10.1093/emph/eoac009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Multiple sclerosis (MS), a neurological autoimmune disorder, has recently been linked to neuro-inflammatory influences from the gut. In this review, we address the idea that evolutionary mismatches could affect the pathogenesis of MS via the gut microbiota. The evolution of symbiosis as well as the recent introduction of evolutionary mismatches is considered, and evidence regarding the impact of diet on the MS-associated microbiota is evaluated. Distinctive microbial community compositions associated with the gut microbiota of MS patients are difficult to identify, and substantial study-to-study variation and even larger variations between individual profiles of MS patients are observed. Furthermore, although some dietary changes impact the progression of MS, MS-associated features of microbiota were found to be not necessarily associated with diet per se. In addition, immune function in MS patients potentially drives changes in microbial composition directly, in at least some individuals. Finally, assessment of evolutionary histories of animals with their gut symbionts suggests that the impact of evolutionary mismatch on the microbiota is less concerning than mismatches affecting helminths and protists. These observations suggest that the benefits of an anti-inflammatory diet for patients with MS may not be mediated by the microbiota per se. Furthermore, any alteration of the microbiota found in association with MS may be an effect rather than a cause. This conclusion is consistent with other studies indicating that a loss of complex eukaryotic symbionts, including helminths and protists, is a pivotal evolutionary mismatch that potentiates the increased prevalence of autoimmunity within a population.
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Affiliation(s)
- Hendrik J Engelenburg
- Department of Pathology and Medical Biology, University Medical Center Groningen , Groningen, The Netherlands
- Brain Plasticity Group, Swammerdam Institute for Life Sciences, University of Amsterdam , Amsterdam, The Netherlands
| | - Paul J Lucassen
- Brain Plasticity Group, Swammerdam Institute for Life Sciences, University of Amsterdam , Amsterdam, The Netherlands
- Center for Urban Mental Health, University of Amsterdam , Amsterdam, The Netherlands
| | | | | | - Jon D Laman
- Department of Pathology and Medical Biology, University Medical Center Groningen , Groningen, The Netherlands
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8
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Socio-medical studies of individuals self-treating with helminths provide insight into clinical trial design for assessing helminth therapy. Parasitol Int 2021; 87:102488. [PMID: 34737071 DOI: 10.1016/j.parint.2021.102488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 11/22/2022]
Abstract
The virtually complete loss of intestinal worms, known as helminths, from Western society has resulted in elimination of a range of helminth-induced morbidities. Unfortunately, that loss has also led to inflammation-associated deficiencies in immune function, ultimately contributing to widespread pandemics of allergies, autoimmunity, and neuropsychiatric disorders. Several socio-medical studies have examined the effects of intentional reworming, or self-treatment with helminths, on a variety of inflammation-related disorders. In this study, the latest results from ongoing socio-medical studies are described. The results point toward two important factors that appear to be overlooked in some if not most clinical trials. Specifically, (a) the method of preparation of the helminth can have a profound effect on its therapeutic efficacy, and (b) variation between individuals in the effective therapeutic dosage apparently covers a 10-fold range, regardless of the helminth used. These results highlight current limits in our understanding of the biology of both hosts and helminths, and suggest that information from self-treatment may be critical for clinical evaluation of the benefits and limits of helminth therapy.
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9
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Ortega VA, Mercer EM, Giesbrecht GF, Arrieta MC. Evolutionary Significance of the Neuroendocrine Stress Axis on Vertebrate Immunity and the Influence of the Microbiome on Early-Life Stress Regulation and Health Outcomes. Front Microbiol 2021; 12:634539. [PMID: 33897639 PMCID: PMC8058197 DOI: 10.3389/fmicb.2021.634539] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Stress is broadly defined as the non-specific biological response to changes in homeostatic demands and is mediated by the evolutionarily conserved neuroendocrine networks of the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system. Activation of these networks results in transient release of glucocorticoids (cortisol) and catecholamines (epinephrine) into circulation, as well as activation of sympathetic fibers innervating end organs. These interventions thus regulate numerous physiological processes, including energy metabolism, cardiovascular physiology, and immunity, thereby adapting to cope with the perceived stressors. The developmental trajectory of the stress-axis is influenced by a number of factors, including the gut microbiome, which is the community of microbes that colonizes the gastrointestinal tract immediately following birth. The gut microbiome communicates with the brain through the production of metabolites and microbially derived signals, which are essential to human stress response network development. Ecological perturbations to the gut microbiome during early life may result in the alteration of signals implicated in developmental programming during this critical window, predisposing individuals to numerous diseases later in life. The vulnerability of stress response networks to maladaptive development has been exemplified through animal models determining a causal role for gut microbial ecosystems in HPA axis activity, stress reactivity, and brain development. In this review, we explore the evolutionary significance of the stress-axis system for health maintenance and review recent findings that connect early-life microbiome disturbances to alterations in the development of stress response networks.
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Affiliation(s)
- Van A Ortega
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada
| | - Emily M Mercer
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Gerald F Giesbrecht
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Owerko Centre, The Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Marie-Claire Arrieta
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
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10
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Pfefferle PI, Keber CU, Cohen RM, Garn H. The Hygiene Hypothesis - Learning From but Not Living in the Past. Front Immunol 2021; 12:635935. [PMID: 33796103 PMCID: PMC8007786 DOI: 10.3389/fimmu.2021.635935] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/17/2021] [Indexed: 12/14/2022] Open
Abstract
Postulated by Strachan more than 30 years ago, the Hygiene Hypothesis has undergone many revisions and adaptations. This review journeys back to the beginnings of the Hygiene Hypothesis and describes the most important landmarks in its development considering the many aspects that have refined and generalized the Hygiene Hypothesis over time. From an epidemiological perspective, the Hygiene Hypothesis advanced to a comprehensive concept expanding beyond the initial focus on allergies. The Hygiene Hypothesis comprise immunological, microbiological and evolutionary aspects. Thus, the original postulate developed into a holistic model that explains the impact of post-modern life-style on humans, who initially evolved in close proximity to a more natural environment. Focusing on diet and the microbiome as the most prominent exogenous influences we describe these discrepancies and the resulting health outcomes and point to potential solutions to reestablish the immunological homeostasis that frequently have been lost in people living in developed societies.
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Affiliation(s)
- Petra I Pfefferle
- Comprehensive Biobank Marburg, Medical Faculty, Philipps University of Marburg, Comprehensive Biobank Marburg, Marburg, Germany.,German Center for Lung Research (DZL), Marburg, Germany.,German Biobank Alliance, Marburg, Germany
| | - Corinna U Keber
- Comprehensive Biobank Marburg, Medical Faculty, Philipps University of Marburg, Comprehensive Biobank Marburg, Marburg, Germany.,German Biobank Alliance, Marburg, Germany.,Institute for Pathology, Medical Faculty, Institute for Pathology, Philipps University of Marburg, Marburg, Germany
| | - Robert M Cohen
- Comprehensive Biobank Marburg, Medical Faculty, Philipps University of Marburg, Comprehensive Biobank Marburg, Marburg, Germany
| | - Holger Garn
- German Center for Lung Research (DZL), Marburg, Germany.,Translational Inflammation Research Division & Core Facility for Single Cell Multiomics, Medical Faculty, Biochemical Pharmacological Center, Philipps University of Marburg, Marburg, Germany
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11
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Sauer S, Beinart D, Finn SMB, Kumar SL, Cheng Q, Hwang SE, Parker W, Devi GR. Hymenolepis diminuta-based helminth therapy in C3(1)-TAg mice does not alter breast tumor onset or progression. EVOLUTION MEDICINE AND PUBLIC HEALTH 2021; 9:131-138. [PMID: 33738103 PMCID: PMC7953836 DOI: 10.1093/emph/eoab007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 02/07/2021] [Indexed: 12/28/2022]
Abstract
Background and objectives An individual's risk of breast cancer is profoundly affected by evolutionary mismatch. Mismatches in Western society known to increase the risk of breast cancer include a sedentary lifestyle and reproductive factors. Biota alteration, characterized by a loss of biodiversity from the ecosystem of the human body as a result of Western society, is a mismatch known to increase the risk of a variety of inflammation-related diseases, including colitis-associated colon cancer. However, the effect of biota alteration on breast cancer has not been evaluated. Methodology In this study, we utilized the C3(1)-TAg mouse model of breast cancer to evaluate the role of biota alteration in the development of breast cancer. This model has been used to recapitulate the role of exercise and pregnancy in reducing the risk of breast cancer. C3(1)-TAg mice were treated with Hymenolepis diminuta, a benign helminth that has been shown to reverse the effects of biota alteration in animal models. Results No effect of the helminth H. diminuta was observed. Neither the latency nor tumor growth was affected by the therapy, and no significant effects on tumor transcriptome were observed based on RNAseq analysis. Conclusions and implications These findings suggest that biota alteration, although known to affect a variety of Western-associated diseases, might not be a significant factor in the high rate of breast cancer observed in Western societies. Lay summary An almost complete loss of intestinal worms in high-income countries has led to increases in allergic disorders, autoimmune conditions, and perhaps colon cancer. However, in this study, results using laboratory mice suggest that loss of intestinal worms might not be associated with breast cancer.
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Affiliation(s)
- Scott Sauer
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Dylan Beinart
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Sade M B Finn
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Sereena L Kumar
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Qing Cheng
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Shelley E Hwang
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - William Parker
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Gayathri R Devi
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
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12
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Parker W, Sarafian JT, Broverman SA, Laman JD. Between a hygiene rock and a hygienic hard place: Avoiding SARS-CoV-2 while needing environmental exposures for immunity. Evol Med Public Health 2021; 9:120-130. [PMID: 33732461 PMCID: PMC7928958 DOI: 10.1093/emph/eoab006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/01/2020] [Indexed: 12/13/2022] Open
Abstract
Suboptimal understanding of concepts related to hygiene by the general public, clinicians and researchers is a persistent problem in health and medicine. Although hygiene is necessary to slow or prevent deadly pandemics of infectious disease such as coronavirus disease 2019 (COVID-19), hygiene can have unwanted effects. In particular, some aspects of hygiene cause a loss of biodiversity from the human body, characterized by the almost complete removal of intestinal worms (helminths) and protists. Research spanning more than half a century documents that this loss of biodiversity results in an increased propensity for autoimmune disease, allergic disorders, probably neuropsychiatric problems and adverse reactions to infectious agents. The differences in immune function between communities with and communities without helminths have become so pronounced that the reduced lethality of severe acute respiratory syndrome coronavirus 2 in low-income countries compared to high-income countries was predicted early in the COVID-19 pandemic. This prediction, based on the maladaptive immune responses observed in many cases of COVID-19 in high-income countries, is now supported by emerging data from low-income countries. Herein, hygiene is subdivided into components involving personal choice versus components instituted by community wide systems such as sewage treatment facilities and water treatment plants. The different effects of personal hygiene and systems hygiene are described, and appropriate measures to alleviate the adverse effects of hygiene without losing the benefits of hygiene are discussed. Finally, text boxes are provided to function as stand-alone, public-domain handouts with the goal of informing the public about hygiene and suggesting solutions for biomedical researchers and policy makers. Lay Summary: Hygiene related to sewer systems and other technology can have adverse effects on immune function, and is distinct from personal hygiene practices such as hand washing and social distancing. Dealing with the drawbacks of hygiene must be undertaken without compromising the protection from infectious disease imposed by hygiene.
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Affiliation(s)
- William Parker
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Joshua T Sarafian
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Sherryl A Broverman
- Department of Biology and the Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Jon D Laman
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, The Netherlands
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13
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Jirků M, Lhotská Z, Frgelecová L, Kadlecová O, Petrželková KJ, Morien E, Jirků-Pomajbíková K. Helminth Interactions with Bacteria in the Host Gut Are Essential for Its Immunomodulatory Effect. Microorganisms 2021; 9:microorganisms9020226. [PMID: 33499240 PMCID: PMC7910914 DOI: 10.3390/microorganisms9020226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/14/2022] Open
Abstract
Colonization by the benign tapeworm, Hymenolepis diminuta, has been associated with a reduction in intestinal inflammation and changes in bacterial microbiota. However, the role of microbiota in the tapeworm anti-inflammatory effect is not yet clear, and the aim of this study was to determine whether disruption of the microflora during worm colonization can affect the course of intestinal inflammation. We added a phase for disrupting the intestinal microbiota using antibiotics to the experimental design for which we previously demonstrated the protective effect of H. diminuta. We monitored the immunological markers, clinical parameters, bacterial microbiota, and histological changes in the colon of rats. After a combination of colonization, antibiotics, and colitis induction, we had four differently affected experimental groups. We observed a different course of the immune response in each group, but no protective effect was found. Rats treated with colonization and antibiotics showed a strong induction of the Th2 response as well as a significant change in microbial diversity. The microbial results also revealed differences in the richness and abundance of some bacterial taxa, influenced by various factors. Our data suggest that interactions between the tapeworm and bacteria may have a major impact on its protective effect.
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Affiliation(s)
- Milan Jirků
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, 370 05 České Budějovice, Czech Republic; (Z.L.); (O.K.); (K.J.P.)
- Correspondence: (M.J.); (K.J.-P.); Tel.: +420-38-777-5470 (M.J.); +420-38-777-5470 (K.J.P.)
| | - Zuzana Lhotská
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, 370 05 České Budějovice, Czech Republic; (Z.L.); (O.K.); (K.J.P.)
- Department of Medical Biology, Faculty of Science, University of South Bohemia, Branišovská 31, 370 05 České Budějovice, Czech Republic
| | - Lucia Frgelecová
- Department of Pathology and Parasitology, University of Veterinary and Pharmaceutical Sciences Brno, Palackého tř. 1/3, 612 42 Brno, Czech Republic;
| | - Oldřiška Kadlecová
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, 370 05 České Budějovice, Czech Republic; (Z.L.); (O.K.); (K.J.P.)
| | - Klára Judita Petrželková
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, 370 05 České Budějovice, Czech Republic; (Z.L.); (O.K.); (K.J.P.)
- Institute of Vertebrate Biology, Czech Academy of Sciences, Květná, 8603 65 Brno, Czech Republic
| | - Evan Morien
- Department of Botany, University of British Columbia, 3156-6270 University Blvd., Vancouver, BC V6T 1Z4, Canada;
| | - Kateřina Jirků-Pomajbíková
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, 370 05 České Budějovice, Czech Republic; (Z.L.); (O.K.); (K.J.P.)
- Department of Medical Biology, Faculty of Science, University of South Bohemia, Branišovská 31, 370 05 České Budějovice, Czech Republic
- Correspondence: (M.J.); (K.J.-P.); Tel.: +420-38-777-5470 (M.J.); +420-38-777-5470 (K.J.P.)
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14
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Ortiz Wilczyñski JM, Olexen CM, Errasti AE, Schattner M, Rothlin CV, Correale J, Carrera Silva EA. GAS6 signaling tempers Th17 development in patients with multiple sclerosis and helminth infection. PLoS Pathog 2020; 16:e1009176. [PMID: 33347509 PMCID: PMC7785232 DOI: 10.1371/journal.ppat.1009176] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/05/2021] [Accepted: 11/19/2020] [Indexed: 12/19/2022] Open
Abstract
Multiple sclerosis (MS) is a highly disabling neurodegenerative autoimmune condition in which an unbalanced immune response plays a critical role. Although the mechanisms remain poorly defined, helminth infections are known to modulate the severity and progression of chronic inflammatory diseases. The tyrosine kinase receptors TYRO3, AXL, and MERTK (TAM) have been described as inhibitors of the immune response in various inflammatory settings. We show here that patients with concurrent natural helminth infections and MS condition (HIMS) had an increased expression of the negative regulatory TAM receptors in antigen-presenting cells and their agonist GAS6 in circulating CD11bhigh and CD4+ T cells compared to patients with only MS. The Th17 subset was reduced in patients with HIMS with a subsequent downregulation of its pathogenic genetic program. Moreover, these CD4+ T cells promoted lower levels of the co-stimulatory molecules CD80, CD86, and CD40 on dendritic cells compared with CD4+ T cells from patients with MS, an effect that was GAS6-dependent. IL-10+ cells from patients with HIMS showed higher GAS6 expression levels than Th17 cells, and inhibition of phosphatidylserine/GAS6 binding led to an expansion of Th17 effector genes. The addition of GAS6 on activated CD4+ T cells from patients with MS restrains the Th17 gene expression signature. This cohort of patients with HIMS unravels a promising regulatory mechanism to dampen the Th17 inflammatory response in autoimmunity. Helminths have co-evolved with human civilization, and the rapid exclusion from their environment, in the last few decades, has tremendously affected the immune development and regulation. Moreover, several epidemiological studies have shown an inverse correlation between the exposure of these organisms and the development of autoimmunity in industrialized countries. In this sense, helminth therapy appears to be a promising concept to oppose chronic inflammatory and autoimmune diseases because they are master manipulators of host immunity, albeit the mechanisms remain poorly defined. For this reason, it is essential to decipher the main regulatory pathways to hijack the immune response in the absence of parasite infection. Our research described how helminth infection promotes regulatory mechanisms based on the tyrosine kinase TYRO3, AXL, MERTK (TAM) receptors, and their ligand GAS6 to dampen Th17 development and the inflammatory response in patients with multiple sclerosis (MS), a neurodegenerative autoimmune disorder. We show here that GAS6 plays a critical role in the regulation of pro-inflammatory cytokines, transcriptional programs, and plasticity of IL-17 subset. Our work substantiates the hypothesis that enhancing the TAM axis in a manner similar to helminth infection could be a promising alternative for autoimmune diseases.
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Affiliation(s)
- Juan M. Ortiz Wilczyñski
- Institute of Experimental Medicine, CONICET-National Academy of Medicine, Buenos Aires, Argentina
| | - Cinthia M. Olexen
- Institute of Experimental Medicine, CONICET-National Academy of Medicine, Buenos Aires, Argentina
| | - Andrea E. Errasti
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Mirta Schattner
- Institute of Experimental Medicine, CONICET-National Academy of Medicine, Buenos Aires, Argentina
| | - Carla V. Rothlin
- Department of Immunobiology and Pharmacology, Yale University, Connecticut, United States of America
| | | | - Eugenio A. Carrera Silva
- Institute of Experimental Medicine, CONICET-National Academy of Medicine, Buenos Aires, Argentina
- * E-mail:
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15
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What is the resource footprint of a computer science department? Place, people, and Pedagogy. DATA & POLICY 2020. [DOI: 10.1017/dap.2020.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractInternet and Communication Technology/electrical and electronic equipment (ICT/EEE) form the bedrock of today’s knowledge economy. This increasingly interconnected web of products, processes, services, and infrastructure is often invisible to the user, as are the resource costs behind them. This ecosystem of machine-to-machine and cyber-physical-system technologies has a myriad of (in)direct impacts on the lithosphere, biosphere, atmosphere, and hydrosphere. As key determinants of tomorrow’s digital world, academic institutions are critical sites for exploring ways to mitigate and/or eliminate negative impacts. This Report is a self-deliberation provoked by the questionHow do we create more resilient and healthier computer science departments: living laboratories for teaching and learning about resource-constrained computing, computation, and communication?Our response for University College London (UCL) Computer Science is to reflect on how, when, and where resources—energy, (raw) materials including water, space, and time—are consumed by the building (place), its occupants (people), and their activities (pedagogy). This perspective and attendant first-of-its-kind assessment outlines a roadmap and proposes high-level principles to aid our efforts, describing challenges and difficulties hindering quantification of the Department’s resource footprint. Qualitatively, we find a need to rematerialise the ICT/EEE ecosystem: to reveal the full costs of the seemingly intangible information society by interrogating the entire life history of paraphernalia from smartphones through servers to underground/undersea cables; another approach is demonstrating the corporeality of commonplace phrases and Nature-inspired terms such as artificial intelligence, social media, Big Data, smart cities/farming, the Internet, the Cloud, and the Web. We sketch routes to realising three interlinked aims: cap annual power consumption and greenhouse gas emissions, become a zero waste institution, and rejuvenate and (re)integrate the natural and built environments.
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16
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Association of genes with phenotype in autism spectrum disorder. Aging (Albany NY) 2019; 11:10742-10770. [PMID: 31744938 PMCID: PMC6914398 DOI: 10.18632/aging.102473] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/08/2019] [Indexed: 12/27/2022]
Abstract
Autism spectrum disorder (ASD) is a genetic heterogeneous neurodevelopmental disorder that is characterized by impairments in social interaction and speech development and is accompanied by stereotypical behaviors such as body rocking, hand flapping, spinning objects, sniffing and restricted behaviors. The considerable significance of the genetics associated with autism has led to the identification of many risk genes for ASD used for the probing of ASD specificity and shared cognitive features over the past few decades. Identification of ASD risk genes helps to unravel various genetic variants and signaling pathways which are involved in ASD. This review highlights the role of ASD risk genes in gene transcription and translation regulation processes, as well as neuronal activity modulation, synaptic plasticity, disrupted key biological signaling pathways, and the novel candidate genes that play a significant role in the pathophysiology of ASD. The current emphasis on autism spectrum disorders has generated new opportunities in the field of neuroscience, and further advancements in the identification of different biomarkers, risk genes, and genetic pathways can help in the early diagnosis and development of new clinical and pharmacological treatments for ASD.
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17
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Hooks KB, O'Malley MA. Contrasting Strategies: Human Eukaryotic Versus Bacterial Microbiome Research. J Eukaryot Microbiol 2019; 67:279-295. [PMID: 31583780 PMCID: PMC7154641 DOI: 10.1111/jeu.12766] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/11/2019] [Accepted: 09/25/2019] [Indexed: 12/25/2022]
Abstract
Most discussions of human microbiome research have focused on bacterial investigations and findings. Our target is to understand how human eukaryotic microbiome research is developing, its potential distinctiveness, and how problems can be addressed. We start with an overview of the entire eukaryotic microbiome literature (578 papers), show tendencies in the human‐based microbiome literature, and then compare the eukaryotic field to more developed human bacterial microbiome research. We are particularly concerned with problems of interpretation that are already apparent in human bacterial microbiome research (e.g. disease causality, probiotic interventions, evolutionary claims). We show where each field converges and diverges, and what this might mean for progress in human eukaryotic microbiome research. Our analysis then makes constructive suggestions for the future of the field.
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Affiliation(s)
- Katarzyna B Hooks
- CBiB, University of Bordeaux, Bordeaux, 33076, France.,CNRS/LaBRI, University of Bordeaux, Talence, 33405, France
| | - Maureen A O'Malley
- School of History and Philosophy of Science, University of Sydney, Sydney, NSW, 2006, Australia
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18
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Sobotková K, Parker W, Levá J, Růžková J, Lukeš J, Jirků Pomajbíková K. Helminth Therapy - From the Parasite Perspective. Trends Parasitol 2019; 35:501-515. [PMID: 31153721 DOI: 10.1016/j.pt.2019.04.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/22/2019] [Accepted: 04/24/2019] [Indexed: 12/23/2022]
Abstract
Studies in animal models and humans suggest that intentional exposure to helminths or helminth-derived products may hold promise for treating chronic inflammatory-associated diseases (CIADs). Although the mechanisms underlying 'helminth therapy' are being evaluated, little attention has been paid to the actual organisms in use. Here we examine the notion that, because of the complexity of biological symbiosis, intact helminths rather than helminth-derived products are likely to prove more useful for clinical purposes. Further, weighing potential cost/benefit ratios of various helminths along with other factors, such as feasibility of production, we argue that the four helminths currently in use for CIAD treatments in humans were selected more by happenstance than by design, and that other candidates not yet tested may prove superior.
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Affiliation(s)
- Kateřina Sobotková
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, 370 05 České Budějovice, Czech Republic
| | - William Parker
- Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA
| | - Jana Levá
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, 370 05 České Budějovice, Czech Republic; Faculty of Science, University of South Bohemia, 370 05 České Budějovice, Czech Republic
| | - Jiřina Růžková
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, 370 05 České Budějovice, Czech Republic
| | - Julius Lukeš
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, 370 05 České Budějovice, Czech Republic; Faculty of Science, University of South Bohemia, 370 05 České Budějovice, Czech Republic
| | - Kateřina Jirků Pomajbíková
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, 370 05 České Budějovice, Czech Republic; Faculty of Science, University of South Bohemia, 370 05 České Budějovice, Czech Republic.
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19
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Řežábková L, Brabec J, Jirků M, Dellerba M, Kuchta R, Modrý D, Parker W, Jirků Pomajbíková K. Genetic diversity of the potentially therapeutic tapeworm Hymenolepis diminuta (Cestoda: Cyclophyllidea). Parasitol Int 2019; 71:121-125. [PMID: 30980897 DOI: 10.1016/j.parint.2019.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 12/31/2022]
Abstract
The cestode Hymenolepis diminuta is highly prevalent in wild rat populations and has also been observed rarely in humans, generally causing no apparent harm. The organism has been studied for decades in the laboratory, and its colonization of laboratory rats has recently been shown as protective against some inflammation-associated disorders. Recently, H. diminuta has become a leading candidate for helminth therapy, an emerging method of "biota enrichment" used to treat or prevent inflammatory diseases of humans in Western society. While most of the experimental isolates of H. diminuta are identified based on typical morphological features, hymenolepidid tapeworms may represent complexes of cryptic species as detected by molecular sequence data. In the present study, we explored the diversity of laboratory-kept strains using partial sequences of two genes (lsrDNA and cox1) and determined that H. diminuta isolates currently considered for therapeutic purposes in the US and Europe belong to a single, genetically nearly uniform lineage, showing only little genetic deviation from wild-caught isolates.
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Affiliation(s)
- Lucie Řežábková
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, České Budějovice 370 05, Czech Republic; Department of Medical Biology, Faculty of Science, University of South-Bohemia, Branišovská 31, České Budějovice 370 05, Czech Republic
| | - Jan Brabec
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, České Budějovice 370 05, Czech Republic; Natural History Museum of Geneva, P.O. Box 6134, CH-1211 Geneva, Switzerland
| | - Milan Jirků
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, České Budějovice 370 05, Czech Republic
| | - Marc Dellerba
- Biome Restoration Ltd., White Cross Business Park, Lancaster, United Kingdom
| | - Roman Kuchta
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, České Budějovice 370 05, Czech Republic
| | - David Modrý
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, České Budějovice 370 05, Czech Republic; Department of Pathology and Parasitology, University of Veterinary and Pharmaceutical Sciences Brno, Palackého tř. 1/3, Brno 621 42, Czech Republic
| | - William Parker
- Department of Surgery, Duke University School of Medicine, NC, USA
| | - Kateřina Jirků Pomajbíková
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, Branišovská 31, České Budějovice 370 05, Czech Republic; Department of Medical Biology, Faculty of Science, University of South-Bohemia, Branišovská 31, České Budějovice 370 05, Czech Republic.
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20
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Pêgo B, Martinusso CA, Bernardazzi C, Ribeiro BE, de Araujo Cunha AF, de Souza Mesquita J, Nanini HF, Machado MP, Castelo-Branco MTL, Cavalcanti MG, de Souza HSP. Schistosoma mansoni Coinfection Attenuates Murine Toxoplasma gondii-Induced Crohn's-Like Ileitis by Preserving the Epithelial Barrier and Downregulating the Inflammatory Response. Front Immunol 2019; 10:442. [PMID: 30936867 PMCID: PMC6432985 DOI: 10.3389/fimmu.2019.00442] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/19/2019] [Indexed: 12/11/2022] Open
Abstract
Background and aims: Mice orally infected with T. gondii develop Crohn's disease (CD)-like enteritis associated with severe mucosal damage and a systemic inflammatory response, resulting in high morbidity and mortality. Previously, helminthic infections have shown therapeutic potential in experimental colitis. However, the role of S. mansoni in T. gondii-induced CD-like enteritis has not been elucidated. Our study investigated the mechanisms underlying T. gondii-induced ileitis and the potential therapeutic effect of S. mansoni coinfection. Methods: C57BL/6 mice were infected by subcutaneous injection of cercariae of the BH strain of S. mansoni, and 7–9 weeks later, they were orally infected with cysts of the ME49 strain of T. gondii. After euthanasia, the ileum was removed for histopathological analysis; staining for goblet cells; immunohistochemistry characterizing mononuclear cells, lysozyme expression, apoptotic cells, and intracellular pathway activation; and measuring gene expression levels by real-time PCR. Cytokine concentrations were measured in the serial serum samples and culture supernatants of the ileal explants, in addition to myeloperoxidase (MPO) activity. Results:T. gondii-monoinfected mice presented dense inflammatory cell infiltrates and ulcerations in the terminal ileum, with abundant cell extrusion, apoptotic bodies, and necrosis; these effects were absent in S. mansoni-infected or coinfected animals. Coinfection preserved goblet cells and Paneth cells, remarkably depleted in T. gondii-infected mice. Densities of CD4- and CD11b-positive cells were increased in T. gondii- compared to S. mansoni-infected mice and controls. MPO was significantly increased among T. gondii-mice, while attenuated in coinfected animals. In T. gondii-infected mice, the culture supernatants of the explants showed increased concentrations of TNF-alpha, IFN-gamma, and IL-17, and the ileal tissue revealed increased expression of the mRNA transcripts for IL-1 beta, NOS2, HMOX1, MMP3, and MMP9 and activation of NF-kappa B and p38 MAPK signaling, all of which were counterregulated by S. mansoni coinfection. Conclusion:S. mansoni coinfection attenuates T. gondii-induced ileitis by preserving mucosal integrity and downregulating the local inflammatory response based on the activation of NF-kappa B and MAPK. The protective function of prior S. mansoni infection suggests the involvement of innate immune mechanisms and supports a conceptually new approach to the treatment of chronic inflammatory diseases, including CD.
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Affiliation(s)
- Beatriz Pêgo
- Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Claudio Bernardazzi
- Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Hayandra F Nanini
- Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Marta Guimarães Cavalcanti
- Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Infectious Diseases Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Heitor S P de Souza
- Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
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21
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Yu JJ, Manus MB, Mueller O, Windsor SC, Horvath JE, Nunn CL. Antibacterial soap use impacts skin microbial communities in rural Madagascar. PLoS One 2018; 13:e0199899. [PMID: 30125279 PMCID: PMC6101359 DOI: 10.1371/journal.pone.0199899] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 06/15/2018] [Indexed: 11/18/2022] Open
Abstract
The skin harbors diverse communities of microorganisms, and alterations to these communities can impact the effectiveness of the skin as a barrier to infectious organisms or injury. As the global availability and adoption of antibacterial products increases, it is important to understand how these products affect skin microbial communities of people living in rural areas of developing countries, where risks of infection and injury often differ from urban populations in developed countries. We investigated the effect of antibacterial soap on skin microbial communities in a rural Malagasy population that practices subsistence agriculture in the absence of electricity and running water. We quantified the amount of soap used by each participant and obtained skin swab samples at three time points: prior to soap use, immediately after one week of soap use, and two weeks after soap use was discontinued. Soap use did not significantly impact ecological measures of diversity and richness (alpha diversity). However, the amount of soap used was a predictor of community-level change (beta diversity), with changes persisting for at least two weeks after subjects stopped using soap. Our results indicate that the overall species richness of skin microbial communities may be resistant to short-term use of antibacterial soap in settings characterized by regular contact with the natural environment, yet these communities may undergo shifts in microbial composition. Lifestyle changes associated with the use of antibacterial soap may therefore cause rapid alterations in skin microbial communities, with the potential for effects on skin health.
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Affiliation(s)
- James J. Yu
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, United States of America
| | - Melissa B. Manus
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, United States of America
- Duke Global Health Institute, Durham, North Carolina, United States of America
| | - Olaf Mueller
- Department of Molecular Genetics and Microbiology, Duke University, Durham, North Carolina, United States of America
- Center for the Genomics of Microbial Systems, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Sarah C. Windsor
- Genomics & Microbiology Research Lab, North Carolina Museum of Natural Sciences, Raleigh, North Carolina, United States of America
| | - Julie E. Horvath
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, United States of America
- Genomics & Microbiology Research Lab, North Carolina Museum of Natural Sciences, Raleigh, North Carolina, United States of America
- Department of Biological and Biomedical Sciences, North Carolina Central University, Durham, North Carolina, United States of America
| | - Charles L. Nunn
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, United States of America
- Duke Global Health Institute, Durham, North Carolina, United States of America
- * E-mail:
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22
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Manus MB. Evolutionary mismatch. EVOLUTION MEDICINE AND PUBLIC HEALTH 2018; 2018:190-191. [PMID: 30159142 PMCID: PMC6109377 DOI: 10.1093/emph/eoy023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/02/2018] [Indexed: 01/30/2023]
Affiliation(s)
- Melissa B Manus
- Department of Evolutionary Anthropology, Duke University, Durham, NC, USA.,Triangle Center for Evolutionary Medicine Duke University, Durham, NC, USA
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23
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Abstract
In this Review, I present evidence supporting a multifactorial causation of childhood acute lymphoblastic leukaemia (ALL), a major subtype of paediatric cancer. ALL evolves in two discrete steps. First, in utero initiation by fusion gene formation or hyperdiploidy generates a covert, pre-leukaemic clone. Second, in a small fraction of these cases, the postnatal acquisition of secondary genetic changes (primarily V(D)J recombination-activating protein (RAG) and activation-induced cytidine deaminase (AID)-driven copy number alterations in the case of ETS translocation variant 6 (ETV6)-runt-related transcription factor 1 (RUNX1)+ ALL) drives conversion to overt leukaemia. Epidemiological and modelling studies endorse a dual role for common infections. Microbial exposures earlier in life are protective but, in their absence, later infections trigger the critical secondary mutations. Risk is further modified by inherited genetics, chance and, probably, diet. Childhood ALL can be viewed as a paradoxical consequence of progress in modern societies, where behavioural changes have restrained early microbial exposure. This engenders an evolutionary mismatch between historical adaptations of the immune system and contemporary lifestyles. Childhood ALL may be a preventable cancer.
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Affiliation(s)
- Mel Greaves
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK.
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24
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Lorimer J. Hookworms Make Us Human: The Microbiome, Eco-immunology, and a Probiotic Turn in Western Health Care. Med Anthropol Q 2018; 33:60-79. [PMID: 30003599 DOI: 10.1111/maq.12466] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 05/17/2018] [Accepted: 06/05/2018] [Indexed: 12/27/2022]
Abstract
Historians of science have identified an ecological turn underway in immunology, driven by the mapping of the human microbiome and wider environmentalist anxieties. A figure is emerging of the human as a holobiont, composed of microbes and threatened by both microbial excess and microbial absence. Antimicrobial approaches to germ warfare are being supplemented by probiotic approaches to restoring microbial life. This article examines the political ecology of this probiotic turn in Western health care. It focuses on Necator americanus-a species of human hookworm-and its relations with immunologists. The analysis moves from a history of human disentanglement from hookworm, to contemporary anxieties about their absence. It examines the reintroduction of worms for helminthic therapy and explores emerging trajectories for probiotic health care involving the synthesis, modification, and/or restoration of worms and their salutary ecologies. The conclusion differentiates these trajectories and identifies an emerging model of "post-paleo" microbiopolitics.
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Affiliation(s)
- Jamie Lorimer
- School of Geography and the Environment, University of Oxford
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25
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The benign helminth Hymenolepis diminuta ameliorates chemically induced colitis in a rat model system. Parasitology 2018; 145:1324-1335. [DOI: 10.1017/s0031182018000896] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractThe tapeworm Hymenolepis diminuta is a model for the impact of helminth colonization on the mammalian immune system and a candidate therapeutic agent for immune mediated inflammatory diseases (IMIDs). In mice, H. diminuta protects against models of inflammatory colitis by inducing a strong type 2 immune response that is activated to expel the immature worm. Rats are the definitive host of H. diminuta, and are colonized stably and over long time periods without harming the host. Rats mount a mild type 2 immune response to H. diminuta colonization, but this response does not generally ameliorate colitis. Here we investigate the ability of different life cycle stages of H. diminuta to protect rats against a model of colitis induced through application of the haptenizing agent dinitrobenzene sulphonic acid (DNBS) directly to the colon, and monitor rat clinical health, systemic inflammation measured by TNFα and IL-1β, and the gut microbiota. We show that immature H. diminuta induces a type 2 response as measured by increased IL-4, IL-13 and IL-10 expression, but does not protect against colitis. In contrast, rats colonized with mature H. diminuta and challenged with severe colitis (two applications of DNBS) have lower inflammation and less severe clinical symptoms. This effect is not related the initial type 2 immune response. The gut microbiota is disrupted during colitis and does not appear to play an overt role in H. diminuta-mediated protection.
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26
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Villeneuve C, Kou HH, Eckermann H, Palkar A, Anderson LG, McKenney EA, Bollinger RR, Parker W. Evolution of the hygiene hypothesis into biota alteration theory: what are the paradigms and where are the clinical applications? Microbes Infect 2018; 20:147-155. [DOI: 10.1016/j.micinf.2017.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/30/2017] [Accepted: 11/02/2017] [Indexed: 12/26/2022]
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27
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Ek WE, Karlsson T, Hernándes CA, Rask-Andersen M, Johansson Å. Breast-feeding and risk of asthma, hay fever, and eczema. J Allergy Clin Immunol 2018; 141:1157-1159.e9. [PMID: 29132959 DOI: 10.1016/j.jaci.2017.10.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/13/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Weronica E Ek
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
| | - Torgny Karlsson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Carlos Azuaje Hernándes
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Mathias Rask-Andersen
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Åsa Johansson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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Intestinal worms eating neuropsychiatric disorders? Apparently so. Brain Res 2018; 1693:218-221. [PMID: 29402395 DOI: 10.1016/j.brainres.2018.01.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 01/15/2018] [Accepted: 01/19/2018] [Indexed: 01/05/2023]
Abstract
A number of factors in Western society, including inflammatory diets, sedentary lifestyles, vitamin D deficiency and chronic psychological stress, are known to induce inflammation and to be associated with neuropsychiatric disorders. One factor that is emerging as a potential inflammation inducing factor is biota depletion, or loss of biodiversity from the ecosystem of the human body as a result of industrialization. Originally known as the "hygiene hypothesis", biota alteration theory describes the effects of biota alteration on the human immune system. Work on this topic has pinpointed depletion of helminths as a key loss to the body's ecosystem in Western society, and suggests that some exposure to helminths, ubiquitous prior to the modern era, may be necessary for normal immune system development. Socio-medical studies of humans "self-treating" with helminths as well as limited studies in animal models strongly suggest that helminth therapy may be a productive approach toward treating a range of neuropsychiatric disorders, including chronic fatigue, migraine headaches, depression and anxiety disorders. However, helminth therapy faces some daunting hurdles, including the lack of a financial incentive for development, despite a tremendous potential market for the organisms. It is argued that benevolent donation for early trials as well as changes in regulatory policy to accommodate helminth therapy may be important for the field to develop. It is hoped that future success with some high-profile trials can propel the field, now dominated more by self-treatment than by clinical trials, forward into the main stream of medicine.
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Parker W. Not infection with parasitic worms, but rather colonization with therapeutic helminths. Immunol Lett 2017; 192:104-105. [DOI: 10.1016/j.imlet.2017.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 07/11/2017] [Indexed: 01/15/2023]
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Smyth K, Morton C, Mathew A, Karuturi S, Haley C, Zhang M, Holzknecht ZE, Swanson C, Lin SS, Parker W. Production and Use of Hymenolepis diminuta Cysticercoids as Anti-Inflammatory Therapeutics. J Clin Med 2017; 6:jcm6100098. [PMID: 29064448 PMCID: PMC5664013 DOI: 10.3390/jcm6100098] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 10/04/2017] [Accepted: 10/17/2017] [Indexed: 12/22/2022] Open
Abstract
Helminthic therapy has shown considerable promise as a means of alleviating some inflammatory diseases that have proven resistant to pharmaceutical intervention. However, research in the field has been limited by a lack of availability to clinician scientists of a helminth that is relatively benign, non-communicable, affordable, and effectively treats disease. Previous socio-medical studies have found that some individuals self-treating with helminths to alleviate various diseases are using the rat tapeworm (cysticercoid developmental stage of Hymenolepis diminuta; HDC). In this study, we describe the production and use of HDCs in a manner that is based on reports from individuals self-treating with helminths, individuals producing helminths for self-treatment, and physicians monitoring patients that are self-treating. The helminth may fit the criteria needed by clinical scientists for clinical trials, and the methodology is apparently feasible for any medical center to reproduce. It is hoped that future clinical trials using this organism may shed light on the potential for helminthic therapy to alleviate inflammatory diseases. Further, it is hoped that studies with HDCs may provide a stepping stone toward population-wide restoration of the biota of the human body, potentially reversing the inflammatory consequences of biota depletion that currently affect Western society.
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Affiliation(s)
- Kendra Smyth
- University Program in Ecology, Duke University, Durham, NC 27708, USA.
| | - Claire Morton
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
| | - Amanda Mathew
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
| | - Sahil Karuturi
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
| | - Cliff Haley
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
| | - Min Zhang
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
| | - Zoie E Holzknecht
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
| | - Chelsea Swanson
- The Duke Brain Imaging & Analysis Center, Duke University Medical Center, Durham, NC 27710, USA.
- Mental Illness Research Education and Clinical Center for Post Deployment Mental Health, Durham VA Medical Center, Durham, NC 27710, USA.
| | - Shu S Lin
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
- Department of Immunology, Duke University Medical Center, Durham, NC 27710, USA.
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA.
| | - William Parker
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
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Beinart D, Ren D, Pi C, Poulton S, Holzknecht ZE, Swanson C, Parker W. Immunization enhances the natural antibody repertoire. EXCLI JOURNAL 2017; 16:1018-1030. [PMID: 28900382 PMCID: PMC5579407 DOI: 10.17179/excli2017-500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/20/2017] [Indexed: 11/10/2022]
Abstract
The role of immunization in the production of antibodies directed against immunogens is widely appreciated in laboratory animals and in humans. However, the role of immunization in the development of "natural antibodies" has not been investigated. Natural antibodies are those antibodies present without known history of infection or immunization, and react to a wide range of targets, including "cryptic" self-antigens that are exposed upon cell death. In this study, the ability of immunization to elicit the production of natural antibodies in laboratory rats was evaluated. Laboratory rats were immunized with a series of injections using peanut extracts (a common allergen), a high molecular weight protein conjugated to hapten (FITC-KLH), and a carbohydrate conjugated to hapten (DNP-Ficall). Significantly greater binding of antibodies from immunized animals compared to controls was observed to numerous autologous organ extracts (brain, kidney, liver, lung, prostate, and spleen) for both IgM and IgG, although the effect was more pronounced for IgM. These studies suggest that immunization may have at least one unforeseen benefit, enhancing networks of natural antibodies that may be important in such processes as wound repair and tumor surveillance. Such enhancement of natural antibody function may be particularly important in Western society, where decreased exposure to the environment may be associated with a weakened natural antibody repertoire.
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Affiliation(s)
- Dylan Beinart
- Duke University Medical Center, Box 2605, Department of Surgery, Durham, NC 27710
| | - Daniel Ren
- Duke University Medical Center, Box 2605, Department of Surgery, Durham, NC 27710
| | - Cinthia Pi
- Duke University Medical Center, Box 2605, Department of Surgery, Durham, NC 27710
| | - Susan Poulton
- Duke University Medical Center, Box 2605, Department of Surgery, Durham, NC 27710
| | - Zoie E Holzknecht
- Duke University Medical Center, Box 2605, Department of Surgery, Durham, NC 27710
| | - Chelsea Swanson
- Duke University Medical Center, Box 2605, Department of Surgery, Durham, NC 27710
| | - William Parker
- Duke University Medical Center, Box 2605, Department of Surgery, Durham, NC 27710
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Hill LJ, Williams AC. Meat Intake and the Dose of Vitamin B 3 - Nicotinamide: Cause of the Causes of Disease Transitions, Health Divides, and Health Futures? Int J Tryptophan Res 2017; 10:1178646917704662. [PMID: 28579801 PMCID: PMC5419340 DOI: 10.1177/1178646917704662] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/15/2017] [Indexed: 12/26/2022] Open
Abstract
Meat and vitamin B3 - nicotinamide - intake was high during hunter-gatherer times. Intake then fell and variances increased during and after the Neolithic agricultural revolution. Health, height, and IQ deteriorated. Low dietary doses are buffered by 'welcoming' gut symbionts and tuberculosis that can supply nicotinamide, but this co-evolved homeostatic metagenomic strategy risks dysbioses and impaired resistance to pathogens. Vitamin B3 deficiency may now be common among the poor billions on a low-meat diet. Disease transitions to non-communicable inflammatory disorders (but longer lives) may be driven by positive 'meat transitions'. High doses of nicotinamide lead to reduced regulatory T cells and immune intolerance. Loss of no longer needed symbiotic 'old friends' compounds immunological over-reactivity to cause allergic and auto-immune diseases. Inhibition of nicotinamide adenine dinucleotide consumers and loss of methyl groups or production of toxins may cause cancers, metabolic toxicity, or neurodegeneration. An optimal dosage of vitamin B3 could lead to better health, but such a preventive approach needs more equitable meat distribution. Some people may require personalised doses depending on genetic make-up or, temporarily, when under stress.
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Affiliation(s)
- Lisa J Hill
- Neuroscience and Ophthalmology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Adrian C Williams
- Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Nascimento Santos L, Carvalho Pacheco LG, Silva Pinheiro C, Alcantara-Neves NM. Recombinant proteins of helminths with immunoregulatory properties and their possible therapeutic use. Acta Trop 2017; 166:202-211. [PMID: 27871775 DOI: 10.1016/j.actatropica.2016.11.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 11/13/2016] [Accepted: 11/15/2016] [Indexed: 02/06/2023]
Abstract
The inverse relationship between helminth infections and the development of immune-mediated diseases is a cornerstone of the hygiene hypothesis and studies were carried out to elucidate the mechanisms by which helminth-derived molecules can suppress immunological disorders. These studies have fostered the idea that parasitic worms may be used as a promising therapeutic alternative for prevention and treatment of immune-mediated diseases. We discuss the current approaches for identification of helminth proteins with potential immunoregulatory properties, including the strategies based on high-throughput technologies. We also explore the methodological approaches and expression systems used for production of the recombinant forms of more than 20 helminth immunomodulatory proteins, besides their performances when evaluated as immunotherapeutic molecules to treat different immune-mediated conditions, including asthma and inflammatory bowel diseases. Finally, we discuss the perspectives of using these parasite-derived recombinant molecules as tools for future immunotherapy and immunoprophylaxis of human inflammatory diseases.
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Liddicoat C, Waycott M, Weinstein P. Environmental Change and Human Health: Can Environmental Proxies Inform the Biodiversity Hypothesis for Protective Microbial–Human Contact? Bioscience 2016. [DOI: 10.1093/biosci/biw127] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Slattery J, MacFabe DF, Frye RE. The Significance of the Enteric Microbiome on the Development of Childhood Disease: A Review of Prebiotic and Probiotic Therapies in Disorders of Childhood. Clin Med Insights Pediatr 2016; 10:91-107. [PMID: 27774001 PMCID: PMC5063840 DOI: 10.4137/cmped.s38338] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 08/30/2016] [Accepted: 09/05/2016] [Indexed: 02/07/2023] Open
Abstract
Recent studies have highlighted the fact that the enteric microbiome, the trillions of microbes that inhabit the human digestive tract, has a significant effect on health and disease. Methods for manipulating the enteric microbiome, particularly through probiotics and microbial ecosystem transplantation, have undergone some study in clinical trials. We review some of the evidence for microbiome alteration in relation to childhood disease and discuss the clinical trials that have examined the manipulation of the microbiome in an effort to prevent or treat childhood disease with a primary focus on probiotics, prebiotics, and/or synbiotics (ie, probiotics + prebiotics). Studies show that alterations in the microbiome may be a consequence of events occurring during infancy and/or childhood such as prematurity, C-sections, and nosocomial infections. In addition, certain childhood diseases have been associated with microbiome alterations, namely necrotizing enterocolitis, infantile colic, asthma, atopic disease, gastrointestinal disease, diabetes, malnutrition, mood/anxiety disorders, and autism spectrum disorders. Treatment studies suggest that probiotics are potentially protective against the development of some of these diseases. Timing and duration of treatment, the optimal probiotic strain(s), and factors that may alter the composition and function of the microbiome are still in need of further research. Other treatments such as prebiotics, fecal microbial transplantation, and antibiotics have limited evidence. Future translational work, in vitro models, long-term and follow-up studies, and guidelines for the composition and viability of probiotic and microbial therapies need to be developed. Overall, there is promising evidence that manipulating the microbiome with probiotics early in life can help prevent or reduce the severity of some childhood diseases, but further research is needed to elucidate biological mechanisms and determine optimal treatments.
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Affiliation(s)
- John Slattery
- Arkansas Children’s Research Institute, Little Rock, AR, USA
- Division of Neurology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Derrick F. MacFabe
- The Kilee Patchell-Evans Autism Research Group, Departments of Psychology (Neuroscience) and Psychiatry, Division of Developmental Disabilities, University of Western Ontario, London, ON, Canada
| | - Richard E. Frye
- Arkansas Children’s Research Institute, Little Rock, AR, USA
- Division of Neurology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Bono-Lunn D, Villeneuve C, Abdulhay NJ, Harker M, Parker W. Policy and regulations in light of the human body as a ‘superorganism’ containing multiple, intertwined symbiotic relationships. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/10601333.2016.1210159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Practices and outcomes of self-treatment with helminths based on physicians' observations. J Helminthol 2016; 91:267-277. [DOI: 10.1017/s0022149x16000316] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractThe successful use of helminths as therapeutic agents to resolve inflammatory disease was first recorded 40 years ago. Subsequent work in animal models and in humans has demonstrated that the organisms might effectively treat a wide range of inflammatory diseases, including allergies, autoimmune disorders and inflammation-associated neuropsychiatric disorders. However, available information regarding the therapeutic uses and effects of helminths in humans is limited. This study probes the practices and experiences of individuals ‘self-treating’ with helminths through the eyes of their physicians. Five physicians monitoring more than 700 self-treating patients were interviewed. The results strongly support previous indications that helminth therapy can effectively treat a wide range of allergies, autoimmune conditions and neuropsychiatric disorders, such as major depression and anxiety disorders. Approximately 57% of the self-treating patients observed by physicians in the study had autism. Physicians reported that the majority of patients with autism and inflammation-associated co-morbidities responded favourably to therapy with either of the two most popular organisms currently used by self-treaters, Hymenolepis diminuta and Trichuris suis. However, approximately 1% of paediatric patients experienced severe gastrointestinal pains with the use of H. diminuta, although the symptoms were resolved with an anti-helminthic drug. Further, exposure to helminths apparently did not affect the impaired comprehension of social situations that is the hallmark of autism. These observations point toward potential starting points for clinical trials, and provide further support for the importance of such trials and for concerted efforts aimed at probing the potential of helminths, and perhaps other biologicals, for therapeutic use.
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38
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Demas GE, Sylvia KE. There's no place like biome: Can helminths restore the body's ecosystem? Brain Behav Immun 2016; 51:12-13. [PMID: 26381206 DOI: 10.1016/j.bbi.2015.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 09/13/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Gregory E Demas
- Department of Biology, Program in Neuroscience and Center for the Integrative Study of Animal Behavior, Indiana University, Bloomington, IN 47405, USA.
| | - Kristyn E Sylvia
- Department of Biology, Program in Neuroscience and Center for the Integrative Study of Animal Behavior, Indiana University, Bloomington, IN 47405, USA
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39
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Hygiene and other early childhood influences on the subsequent function of the immune system. Brain Res 2015; 1617:47-62. [DOI: 10.1016/j.brainres.2014.04.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 02/17/2014] [Accepted: 04/05/2014] [Indexed: 02/08/2023]
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Bao K, Reinhardt RL. The differential expression of IL-4 and IL-13 and its impact on type-2 immunity. Cytokine 2015; 75:25-37. [PMID: 26073683 DOI: 10.1016/j.cyto.2015.05.008] [Citation(s) in RCA: 191] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 05/11/2015] [Accepted: 05/12/2015] [Indexed: 01/06/2023]
Abstract
Allergic disease represents a significant global health burden, and disease incidence continues to rise in urban areas of the world. As such, a better understanding of the basic immune mechanisms underlying disease pathology are key to developing therapeutic interventions to both prevent disease onset as well as to ameliorate disease morbidity in those individuals already suffering from a disorder linked to type-2 inflammation. Two factors central to type-2 immunity are interleukin (IL)-4 and IL-13, which have been linked to virtually all major hallmarks associated with type-2 inflammation. Therefore, IL-4 and IL-13 and their regulatory pathways represent ideal targets to suppress disease. Despite sharing many common regulatory pathways and receptors, these cytokines perform very distinct functions during a type-2 immune response. This review summarizes the literature surrounding the function and expression of IL-4 and IL-13 in CD4+ T cells and innate immune cells. It highlights recent findings in vivo regarding the differential expression and non-canonical regulation of IL-4 and IL-13 in various immune cells, which likely play important and underappreciated roles in type-2 immunity.
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Affiliation(s)
- Katherine Bao
- Department of Immunology, Duke University Medical Center, Durham, NC 27710, United States
| | - R Lee Reinhardt
- Department of Immunology, Duke University Medical Center, Durham, NC 27710, United States.
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41
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McKenney EA, Williamson L, Yoder AD, Rawls JF, Bilbo SD, Parker W. Alteration of the rat cecal microbiome during colonization with the helminth Hymenolepis diminuta. Gut Microbes 2015; 6:182-93. [PMID: 25942385 PMCID: PMC4615828 DOI: 10.1080/19490976.2015.1047128] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The microbiome is now widely recognized as being important in health and disease, and makes up a substantial subset of the biome within the ecosystem of the vertebrate body. At the same time, multicellular, eukaryotic organisms such as helminths are being recognized as an important component of the biome that shaped the evolution of our genes. The absence of these macroscopic organisms during the early development and life of humans in Western culture probably leads to a wide range of human immunological diseases. However, the interaction between the microbiome and macroscopic components of the biome remains poorly characterized. In this study, the microbiome of the cecum in rats colonized for 2 generations with the small intestinal helminth Hymenolepis diminuta was evaluated. The introduction of this benign helminth, which is of considerable therapeutic interest, led to several changes in the cecal microbiome. Most of the changes were within the Firmicutes phylum, involved about 20% of the total bacteria, and generally entailed a shift from Bacilli to Clostridia species in the presence of the helminth. The results point toward ecological relationships between various components of the biome, with the observed shifts in the microbiome suggesting potential mechanisms by which this helminth might exert therapeutic effects.
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Affiliation(s)
| | | | - Anne D Yoder
- Departments of Biology; Duke University; Durham, NC, USA,Evolutionary Anthropology; Duke University; Durham, NC, USA
| | - John F Rawls
- Molecular Genetics and Microbiology; Duke University; Durham, NC, USA
| | - Staci D Bilbo
- Psychology & Neuroscience; Duke University; Durham, NC, USA
| | - William Parker
- Department of Surgery; Duke University Medical Center; Durham, NC, USA,Correspondence to: William Parker;
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Allen-Blevins CR, Sela DA, Hinde K. Milk bioactives may manipulate microbes to mediate parent-offspring conflict. Evol Med Public Health 2015; 2015:106-21. [PMID: 25835022 PMCID: PMC4512713 DOI: 10.1093/emph/eov007] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 03/24/2015] [Indexed: 02/06/2023] Open
Abstract
Among mammals, milk constituents directly influence the ecology of the infant's commensal microbiota. The immunological and nutritional impacts of breast milk and microbiota are increasingly well understood; less clear are the consequences for infant behavior. Here, we propose that interactions among bioactives in mother's milk and microbes in the infant gut contribute to infant behavioral phenotype and, in part, have the potential to mediate parent-offspring conflict. We hypothesize that infant behavior likely varies as a function of their mother's milk composition interacting with the infant's neurobiology directly and indirectly through the commensal gut bacteria. In this article, we will explore our hypothesis of a milk-microbiota-brain-behavior dynamic in the context of the coevolution between human milk oligosaccharides, bacteria, the gut-brain axis and behavior. Integrating established features of these systems allows us to generate novel hypotheses to motivate future research and consider potential implications of current and emerging clinical treatments.
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Affiliation(s)
- Cary R Allen-Blevins
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA; Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA; Department of Organismal and Evolutionary Biology, University of Massachusetts, Morrill Science Center, Amherst, MA 01003, USA; Brain, Mind, and Behavior Unit, California National Primate Research Center, UC Davis, Davis, CA 95616, USA
| | - David A Sela
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA; Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA; Department of Organismal and Evolutionary Biology, University of Massachusetts, Morrill Science Center, Amherst, MA 01003, USA; Brain, Mind, and Behavior Unit, California National Primate Research Center, UC Davis, Davis, CA 95616, USA Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA; Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA; Department of Organismal and Evolutionary Biology, University of Massachusetts, Morrill Science Center, Amherst, MA 01003, USA; Brain, Mind, and Behavior Unit, California National Primate Research Center, UC Davis, Davis, CA 95616, USA
| | - Katie Hinde
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA; Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA; Department of Organismal and Evolutionary Biology, University of Massachusetts, Morrill Science Center, Amherst, MA 01003, USA; Brain, Mind, and Behavior Unit, California National Primate Research Center, UC Davis, Davis, CA 95616, USA Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA; Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA; Department of Organismal and Evolutionary Biology, University of Massachusetts, Morrill Science Center, Amherst, MA 01003, USA; Brain, Mind, and Behavior Unit, California National Primate Research Center, UC Davis, Davis, CA 95616, USA
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Kettleson EM, Adhikari A, Vesper S, Coombs K, Indugula R, Reponen T. Key determinants of the fungal and bacterial microbiomes in homes. ENVIRONMENTAL RESEARCH 2015; 138:130-5. [PMID: 25707017 PMCID: PMC4385485 DOI: 10.1016/j.envres.2015.02.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 01/30/2015] [Accepted: 02/03/2015] [Indexed: 05/22/2023]
Abstract
BACKGROUND The microbiome of the home is of great interest because of its possible impact on health. Our goal was to identify some of the factors that determine the richness, evenness and diversity of the home's fungal and bacterial microbiomes. METHOD Vacuumed settled dust from homes (n=35) in Cincinnati, OH, were analyzed by pyrosequencing to determine the fungal and bacterial relative sequence occurrence. The correlation coefficients between home environmental characteristics, including age of home, Environmental Relative Moldiness Index (ERMI) values, occupant number, relative humidity and temperature, as well as pets (dog and cat) were evaluated for their influence on fungal and bacterial communities. In addition, linear discriminant analysis (LDA) was used for identifying fungal and bacterial genera and species associated with those housing determinants found to be significant. RESULTS The fungal richness was found to be positively correlated with age of home (p=0.002), ERMI value (p=0.003), and relative humidity (p=0.015) in the home. However, fungal evenness and diversity were only correlated with the age of home (p=0.001). Diversity and evenness (not richness) of the bacterial microbiome in the homes were associated with dog ownership. Linear discriminant analysis showed total of 39 putative fungal genera/species with significantly higher LDA scores in high ERMI homes and 47 genera/species with significantly higher LDA scores in homes with high relative humidity. When categorized according to the age of the home, a total of 67 fungal genera/species had LDA scores above the significance threshold. Dog ownership appeared to have the most influence on the bacterial microbiome, since a total of 130 bacterial genera/species had significantly higher LDA scores in homes with dogs. CONCLUSIONS Some key determinants of the fungal and bacterial microbiome appear to be excess moisture, age of the home and dog ownership.
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Affiliation(s)
- Eric M Kettleson
- University of Cincinnati, Department of Environmental Health, P.O. Box 670056, 3223 Eden Ave., Cincinnati, OH 45267-0056, United States; ZF Steering Systems NACAM Corp, 15 Spiral Drive, Florence, KY 41042, United States.
| | - Atin Adhikari
- University of Cincinnati, Department of Environmental Health, P.O. Box 670056, 3223 Eden Ave., Cincinnati, OH 45267-0056, United States; Department of Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Drive, Statesboro, GA 30460, United States.
| | - Stephen Vesper
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, 26 West M. L. King Drive, Cincinnati, OH 45268, United States.
| | - Kanistha Coombs
- University of Cincinnati, Department of Environmental Health, P.O. Box 670056, 3223 Eden Ave., Cincinnati, OH 45267-0056, United States.
| | - Reshmi Indugula
- University of Cincinnati, Department of Environmental Health, P.O. Box 670056, 3223 Eden Ave., Cincinnati, OH 45267-0056, United States.
| | - Tiina Reponen
- University of Cincinnati, Department of Environmental Health, P.O. Box 670056, 3223 Eden Ave., Cincinnati, OH 45267-0056, United States.
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Bilbo SD, Nevison CD, Parker W. A model for the induction of autism in the ecosystem of the human body: the anatomy of a modern pandemic? MICROBIAL ECOLOGY IN HEALTH AND DISEASE 2015; 26:26253. [PMID: 25634608 PMCID: PMC4310853 DOI: 10.3402/mehd.v26.26253] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/01/2014] [Accepted: 12/01/2014] [Indexed: 02/06/2023]
Abstract
Background The field of autism research is currently divided based on a fundamental question regarding the nature of autism: Some are convinced that autism is a pandemic of modern culture, with environmental factors at the roots. Others are convinced that the disease is not pandemic in nature, but rather that it has been with humanity for millennia, with its biological and neurological underpinnings just now being understood. Objective In this review, two lines of reasoning are examined which suggest that autism is indeed a pandemic of modern culture. First, given the widely appreciated derailment of immune function by modern culture, evidence that autism is strongly associated with aberrant immune function is examined. Second, evidence is reviewed indicating that autism is associated with ‘triggers’ that are, for the most part, a construct of modern culture. In light of this reasoning, current epidemiological evidence regarding the incidence of autism, including the role of changing awareness and diagnostic criteria, is examined. Finally, the potential role of the microbial flora (the microbiome) in the pathogenesis of autism is discussed, with the view that the microbial flora is a subset of the life associated with the human body, and that the entire human biome, including both the microbial flora and the fauna, has been radically destabilized by modern culture. Conclusions It is suggested that the unequivocal way to resolve the debate regarding the pandemic nature of autism is to perform an experiment: monitor the prevalence of autism after normalizing immune function in a Western population using readily available approaches that address the well-known factors underlying the immune dysfunction in that population.
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Affiliation(s)
- Staci D Bilbo
- Department of Psychology & Neuroscience, Systems & Integrative Neuroscience Group, Duke University, Durham, NC, USA
| | - Cynthia D Nevison
- Institute for Arctic and Alpine Research, University of Colorado Boulder, Boulder, CO, USA
| | - William Parker
- Department of Surgery, Duke University Medical Center, Durham, NC, USA;
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Ferretti CJ, Hollander E. The Role of Inflammation in Autism Spectrum Disorder. CURRENT TOPICS IN NEUROTOXICITY 2015. [DOI: 10.1007/978-3-319-13602-8_14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Cheng AM, Jaint D, Thomas S, Wilson JK, Parker W. Overcoming Evolutionary Mismatch by Self-Treatment with Helminths: Current Practices and Experience. ACTA ACUST UNITED AC 2015. [DOI: 10.4303/jem/235910] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dishaw LJ, Cannon JP, Litman GW, Parker W. Immune-directed support of rich microbial communities in the gut has ancient roots. DEVELOPMENTAL AND COMPARATIVE IMMUNOLOGY 2014; 47:36-51. [PMID: 24984114 PMCID: PMC4146740 DOI: 10.1016/j.dci.2014.06.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/30/2014] [Accepted: 06/21/2014] [Indexed: 05/12/2023]
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.
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Affiliation(s)
- Larry J Dishaw
- Department of Pediatrics, University of South Florida Morsani College of Medicine, USF/ACH Children's Research Institute, 140 7th Avenue South, St. Petersburg, FL 33701, USA.
| | - John P Cannon
- Department of Pediatrics, University of South Florida Morsani College of Medicine, USF/ACH Children's Research Institute, 140 7th Avenue South, St. Petersburg, FL 33701, USA
| | - Gary W Litman
- Department of Pediatrics, University of South Florida Morsani College of Medicine, USF/ACH Children's Research Institute, 140 7th Avenue South, St. Petersburg, FL 33701, USA; Department of Molecular Genetics, All Children's Hospital-Johns Hopkins Medicine, 501 6th Avenue South, St. Petersburg, FL 33701, USA
| | - William Parker
- Department of Surgery, Duke University Medical Center, Box 2605, Durham, NC 27710, USA
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Bouchery T, Kyle R, Ronchese F, Le Gros G. The Differentiation of CD4(+) T-Helper Cell Subsets in the Context of Helminth Parasite Infection. Front Immunol 2014; 5:487. [PMID: 25360134 PMCID: PMC4197778 DOI: 10.3389/fimmu.2014.00487] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/22/2014] [Indexed: 12/13/2022] Open
Abstract
Helminths are credited with being the major selective force driving the evolution of the so-called “type 2” immune responses in vertebrate animals, with their size and infection strategies presenting unique challenges to the immune system. Originally, type 2 immune responses were defined by the presence and activities of the CD4+ T-helper 2 subset producing the canonical cytokines IL-4, IL-5, and IL-13. This picture is now being challenged by the discovery of a more complex pattern of CD4+ T-helper cell subsets that appear during infection, including Tregs, Th17, Tfh, and more recently, Th22, Th9, and ThGM. In addition, a clearer view of the mechanisms by which helminths and their products selectively prime the CD4+ T-cell subsets is emerging. In this review, we have focused on recent data concerning the selective priming, differentiation, and functional role of CD4+ T-helper cell subsets in the context of helminth infection. We argue for a re-evaluation of the original Th2 paradigm and discuss how the observed plasticity of the T-helper subsets may enable the parasitized host to achieve an appropriate compromise between elimination, tissue repair, containment, and pathology.
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Affiliation(s)
- Tiffany Bouchery
- Malaghan Institute of Medical Research , Wellington , New Zealand
| | - Ryan Kyle
- Malaghan Institute of Medical Research , Wellington , New Zealand
| | - Franca Ronchese
- Malaghan Institute of Medical Research , Wellington , New Zealand
| | - Graham Le Gros
- Malaghan Institute of Medical Research , Wellington , New Zealand ; Victoria University of Wellington , Wellington , New Zealand
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Abstract
In the last 50 years, environmental factors such as helminth infections have been proposed to explain why autoimmunity is less prevalent in the developing world; this proposal has been termed the hygiene or old friends hypothesis. The epidemiology of MS shows an inverse correlation with helminth infections. Positive effects of helminths in animal models of MS and observational studies in people with MS naturally infected with helminths suggest that those organisms can act as immune regulators and led to clinical trials of helminth therapy. The goal of helminth therapy is to introduce parasitic organisms into people with MS in a controlled and predictable fashion, and to prevent immune-mediated disease without increasing the risk of pathology with high parasite load. This chapter focuses on intestinal worms as they are the current choice as a therapeutic strategy in a number of autoimmune diseases, including MS. Here we review current data regarding the rationale and the current state of research in the field of helminth therapies in MS.
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Sanders NL, Bollinger RR, Lee R, Thomas S, Parker W. Appendectomy and Clostridium difficile colitis: Relationships revealed by clinical observations and immunology. World J Gastroenterol 2013; 19:5607-5614. [PMID: 24039352 PMCID: PMC3769896 DOI: 10.3748/wjg.v19.i34.5607] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 07/17/2013] [Accepted: 08/06/2013] [Indexed: 02/05/2023] Open
Abstract
Advances in understanding the interaction between the human immune system and the microbiome have led to an improved understanding of the function of the vermiform appendix as a safe-house for beneficial bacteria in the colon. These advances have been made despite long standing clinical observations that the appendectomy is a safe and effective procedure. However, more recent clinical data show that an appendectomy puts patients at increased risk for recurrent Clostridium difficile (C. difficile)-associated colitis, and probably other diseases associated with an altered microbiome. At the same time, appendectomy does not apparently put patients at risk for an initial onset of C. difficile-associated colitis. These clinical observations point toward the idea that the vermiform appendix might not effectively protect the microbiome in the face of broad spectrum antibiotics, the use of which precedes the initial onset of C. difficile-associated colitis. Further, these observations point to the idea that historically important threats to the microbiome such as infectious gastrointestinal pathogens have been supplanted by other threats, particularly the use of broad spectrum antibiotics.
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