Augut 22nd, 2022
When we look at risk of disease over time in humans, we need to take stock in what was supposed to be versus what is. If we become mismatched genetically to the environment that we find ourselves in, then we will begin to suffer disease. The work of Dr. William Parker and colleagues is very fascinating here. His understanding of our immune solvency takes us back to a time when macrobes like parasites lived with us in a semi-symbiotic way. Most of them were harmless where a few were pathogenic. This matters tremendously because as we are learning, the microbes that exist within us play a major role in tuning the immune system towards tolerance and effective pathogen killing. This refined understanding adds to a large body of evidence that we are too clean and not exposed to enough pathogens leaving us poorly tolerant of the normal and natural world. This poorly tolerant immune make up leads to allergic and autoimmune diseases.
Notice the figure that has the direct disease consequences of viral pathogens.
His group defines the term hygiene as a way of avoiding infection and this has absolutely helped humans live longer and without the constant threat of early death from an infectious organism. The two types of hygiene are personal hygiene and systems hygiene and they have very different effects on humans over time.
Personal hygiene, including hand washing and social distancing, helps prevent transmission of many infectious diseases, especially viruses including COVID-19 and the flu as well as bacterial pathogens in stool and on skin. Diseases prevented by personal hygiene are often dangerous and detrimental to immune function. Viruses that are prevented by hand washing and avoidance measures have significant positive effects on health as they are often the root cause of much inflammatory dysfunction as has been seen with SARS2. Keeping your local environment clean helps prevent the inflammation-inducing factors that include mold, insect-derived allergens and toxins.
Systems hygiene describes the implementation of modern sanitation including water treatment plants, sewage systems and indoor plumbing. It also includes the modern food processing and storage technology that prevent the pathogens found in food from taking hold at a volumetric level that causes disease. An example here would be sewers that take the microbes of typhoid, cholera and amoebic dysentery away from a central well or water source that could infect a whole village or city.
The unfortunate trade off to these forms of hygiene are the complete loss of parasitic organisms that have lived in the bodies of humans for thousands of years. Intestinal worms, called helminths, are one of the key species that have been all but driven extinct by systems hygiene in modern society. Although some worms are harmful parasites, many others cause little to no disease. In fact, the exposure to helminths appears to be necessary for healthy immune tolerance development and that their absence leaves us susceptible to pandemics of chronic, non-infectious inflammatory diseases that we know as allergy, autoimmunity and probably neuropsychiatric issues such as major depression, anxiety disorders and chronic fatigue syndrome.
Dr. Parker believes that reductions in personal hygiene measures like hand washing cannot reverse the detrimental loss of helminths caused by systems hygiene, but would actually cause more infectious diseases such as COVID-19. These nasty viral infections could lead to more inflammation per person and eventually worsen their immune status promoting autoimmunity and immune dysfunction.
He states that we cannot live without systems hygiene. Loss of systems hygiene in modern society would, in theory, reverse the detrimental loss of helminths caused by that type of hygiene. However, the resulting waves of deadly, infectious diseases would be catastrophic. Therefore, we are stuck in a pickle.
His groups has a plan: "The detrimental effects of the loss of intestinal worms, called helminths, caused by factors such as toilets and water treatment facilities can be readily reversed by domestication of select helminth species and artificial enrichment of the human body with those organisms. Considerable evidence supports the view that such an effort would greatly reduce the burden of allergy, autoimmunity and probably neuropsychiatric disorders currently experienced in high-income countries. It also seems very likely that these efforts would decrease the likelihood of having adverse reactions to infections with a wide range of viruses, including SARS-CoV-2. Work in the field of helminth therapy indicates that current trials based on pharmaceutical models fail to take into account critical issues, including individual-to-individual variation in the effective dose, risk/benefit ratios when selecting helminth species and the importance of specific husbandry conditions when cultivating and preserving helminths. Trials need to be conducted with appropriate methods of production of helminths, dosing regimens designed for helminth therapy and rational selection of helminth species. Although benign helminths are currently available for human testing, interest in conducting clinical trials is hampered by high costs and intellectual property issues. Given that therapies based on naturally occurring organisms cannot be patented, financial incentives for moving forward are lacking. In general, governments and research organizations need to focus on disease prevention by dealing with evolutionary mismatches rather than treatment of disease solely using pharmaceutical approaches. This principle applies to many facets of modern medicine, including how we deal with the adverse effects of the loss of helminths on our immune system."
He also had some timely question and answer type responses here:
"Will one or two years of social distancing for COVID-19 ‘crash our immune system’? No. The loss of particular organisms from within our bodies due to widespread use of sewage treatment facilities and water purification plants does indeed damage immune function and could lead to chronic inflammatory diseases and probably adverse reactions to viruses such as SARS-CoV-2. However, reducing personal hygiene would have no effect on this problem."
"Is it possible to restore specific lost species in our body and simultaneously maintain hygiene to avoid pandemics of infectious disease? The answer is absolutely yes—in theory. There is no evidence to suggest that we need to be exposed to disease causing organisms to have the appropriate array of organisms in our body for healthy immune function. We can domesticate the organisms we need and introduce them artificially. Long-standing evidence indicates that exposure to selected intestinal worms will be effective at reducing disease without causing health problems, if that solution can be implemented."
"What about the gut microbiota, the bacteria? Can we use bacteria to help restore healthy immune function to our bodies? The answer is unknown. Our diets are the major drivers of the microbiota community composition, and we don’t know if it’s possible to fix our microbiota without fixing our diets. Further, we do not know how important alterations in the microbiota are in terms of a causative agent of chronic inflammatory disease."
Well, that is a mouthful. However, after 3 plus years of deep study of the immune system, Covid and humans, I think that Dr. Parker is onto a big part of the puzzle. I am, as you know, convinced that diet is a humungous piece of the immune solvency question. I also believe that humans are missing friends in the microbial and macrobial zones of life. I also believe that toxins are a piece of the immune dysfunction puzzle. So much to ponder here.
Parker Evol Med Pub Health
Image above with permission from Dr. Parker