May 22, 2017

I have long been frustrated by medical school education. We often used words like idiopathic or genetic to explain a disease that we did not understand. This lack of understanding of causality left us believing that our lives were predestined to be diseased based on our parent's history. We often subscribed a disorder to bad genes and tough luck when the truth is usually quite far from this. Recent science is showing that there are many triggers to disease that range from diet and lifestyle factors to chemicals to viral and bacterial infections. This is article is science heavy. Bear with it as the ending is worth the pain of the heavy science.

April's edition of the Journal Science has an article by Elena Verdu and Alberto Caminero that touches on this topic. They discuss the mechanistic evidence from Dr. Bouziat and colleagues' study in the same journal that links viral infections to food allergy and sensitivity.

Many people have posited that humans can develop celiac disease after a viral gastroenteritis infection, but the evidence has been lacking. Dr. Alessio Fasano is a preeminent researcher on this topic. His research isolated a protein called zonulin that is released inducing intestinal permeability or "leaky gut". A leaky gut" is essentially the breakdown of the gut immune barrier that allows for food proteins to pass into an area that should be free of pathogens and food particles.

In the current study by Dr. Bouziat, he writes, "Reovirus is an avirulent pathogen that elicits protective immunity, but we discovered that it can nonetheless disrupt intestinal immune homeostasis at inductive and effector sites of oral tolerance by suppressing peripheral regulatory T cell conversion and promoting Th1 immunity to dietary antigen." His group has shown that a benign reovirus can alter the ability of the immune system to recognize a benign food protein from a foreign pathogen leading to a pathogenic immune response. This is the genesis of food related disease.

There is this fancy immune cell called a dendritic cell that has the ability to send a hand up between gut cells and taste foods and pathogens as they cruise through the intestine determining whether a protein is good or bad. This is an amazing cell as it lives in the immune layer but can see the outside world of the gut through this fingerlike projection.

The reovirus causes the dendritic cell to shift to a pro inflammation pattern that is more likely to see a protein as dangerous. In its altered state the dendritic cell over responds to the gluten protein, for example, setting off a cascade of events that leads the immune system to target gluten as a foreign invader. This targeting event forever changes the way the gluten protein is tolerated. Now you have celiac disease.

After all of the years of reading on this topic, I take Dr. Bouziat's study as another piece of the puzzle that is autoimmunity and disease. A virus can induce disease by the loss of tolerance to food proteins in the immune cells. Why would this happen? Did God want such a thing to occur? Unlikely!

What is more likely is that we are making the human host environment more hospitable for these events to occur by our dysfunctional modern lifestyle choices. Over the years I have written about many different risk factors for disease. Here is a list of the top lifestyle choices that are hurting us by inducing immune shifts:

1) Lack of sun exposure. We are shunning the sun to our detriment. The sun induces the production of vitamin D in our skin which directly induces a gene Foxp3 which is necessary for the master immune dampener known as the T regulatory cell to default our reaction to non pathogenic food proteins. See more at this link.

2) Not enough early microbial exposure. We are too clean and this is messing up our natural immune priming. Remember the Amish/Hutterite article that proved that early and often bacterial endotoxin dust exposure is beneficial and priming the immune system. See link for article details.

3) Too many caesarian sections and not enough breastfeeding. Similar etiology as #2. See last weeks article.

4) A poorly diverse micro biome because of a high fat, high refined flour and sugar diet. The intestinal micro biome is a major player in immune competence and a poorly established flora leads to immune dysregulation and inflammation. Nutrition is the #1 way to heal a dysfunctional gut immune layer and prevent autoimmunity.

5) Low levels of minerals like zinc that are necessary cofactors for immune cell and intestinal cell function.

6) Over exposure to immune damaging toxins and chemicals from our poorly regulated chemical industry and modern industrial lifestyle.

7) Overuse of drugs like steroids, antibiotics and antacids which alter the gut micro biome, immune cells and also the gastric acidity. Each one of these drug classes has a negative effect on long term health.

Think about living and live free of autoimmune disease.

Dr. M

Celiac Article
Bouziat Article in Science
Verdu Article in Science