Is There A Rural/Urban Gradient In The Prevalence Of Eczema? A Systematic Review And What Can Be Done About It?
One in 10 schoolchildren in the western world suffers from eczema and even developing nations have also seen an increasing trend in the last few decades. There are many proposals to explain the increased incidence, one area of relevance is the environmental impact. Falling under the often misused ‘hygeine hypothesis’ title it has been proposed that there is a reflective difference in the gradient between rural and urban children. Implying the environmental impact on the developing immune system of children is different and therefore less protective in the urban setting.
This concept has now been studied in a recent article in the British Journal of Dermatology.[1] By conducting a Medline and Embase data base review studies that compared the incidence between the two environments were reviewed. Some 26 papers were assessed with 19 demonstrating a higher risk for eczema in an urbanised area, of these 11 were regarded as being statistically significant. A further 6 studies showed a lower risk of eczema in an urbanised area, of which just 1 was statistically significant.
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Neurological/Dietary Control Over the Immune System – The Role of Fats
The immune system in humans and animal is complex, all the more so because it crosses over all tissues. The traditional view has been that the immune system keeps itself in check, and that is mostly the case. However, for some years there has been a development of a neural feedback loop comprehension that helps to answer some of the complex mechanisms and remarkably ties in the role of a nutritional strategy for immune management. This is known as the inflammatory reflex.
The inflammatory reflex, a prototypical neural circuit that modulates innate immunity, is activated by the presence of cytokines or other inflammatory products in tissues that triggers afferent (a nerve that passes impulses from receptors toward or to the central nervous system) action potentials travelling in the vagus nerve. The ascending information is relayed to brainstem nuclei that control efferent (nerves that convey nervous stimulus from the brain to other parts) neural signals in the form of action potentials transmitted back to the periphery via the vagus nerve.
Whilst this may sound complex – few subjects that combine neurology and immunology aren’t… the outcome suggested meets simple strategies, based on complex mechanisms.
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A Bacteria Triggers Arthritis.
The gut microbiomes of humans and mice are broadly similar which is helpful as this paper has used the mouse model to explain how a resident bacteria in the gut can induce arthritis. In both hosts human and mouse upwards of ∼1000 different microbial species from ∼10 different divisions colonise the gastrointestinal tract, but just two bacterial divisions—the Bacteroidetes and Firmicutes—and one member of the Archaea appear to dominate, together accounting for ∼98% of the 16S rRNA sequences obtained from this site.[1] 16SrRNA is a laboratory method for analysing bacterial and provides species-specific signature sequences useful for bacterial identification but is not routinely used in diagnostic settings yet.
Their analysis revealed that despite the enormous species variation in the gut a single species of bacteria that lives here is able to trigger a cascade of immune responses that can ultimately result in the development of arthritis.[2] Gut-residing bacteria can also play a role in disorders of the immune system, especially autoimmune disorders in which the body attacks its own cells. The gut microbiota is now known to shape intestinal immune responses during health and disease with systemic effects.
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What Do Bacteria Do To Our Immune System?
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The germ theory that has so modernised medicine and driven us, the western world living human to regard all bugs as bad has been undergoing a dramatic rethink over the last few years. Firstly the recognition that your body is teeming with bacteria, providing a warm residence to approximately 10 times as many bacterial cells as human cells. Our mutual inhabitants live on skin, in the respiratory tract and throughout the digestive tract. Your digestive tract alone is home to between 1,000 and 40,000 bacterial species depending on your choice of journal.
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If Genes Are Protected By Nutrients – How Much Should We Eat?
Prof Bruce Ames has developed the concept of Triage consumption, where micronutrient needs and availability may not always be in synchronicity and has recommended that a larger overall consumption of micronutrients on a daily basis be considered a judicious way to limit DNA damage associated with aging and disease.
I have proposed that the expensive urine criticism is perhaps one of the most damaging of slights, and that Victor Herberts slur on the use of increased exogenous nutrients via supplementation has created more damage to human health than it has saved. A paper out in the American Journal of Nutrition, May 2010 has added some further clarity to this discussion.[1]
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Leaky Gut & Food Reactivity – What’s the Mechanism?
Michael Ash looks at leaky gut with a contemporary approach to investigation, relevance and restoration. It is quite clear that in order to extract nutrients and other sentinel information carrying agents the barrier that divides the contents of the gastric lumen from the host must be permeable. The question that has interested clinicians for many years is – when is it too permeable and what does that mean in terms of health and illness.
A paper in the March edition of Mucosal Immunology explores this concept in some detail and delivers some much needed information and potential direction in terms of dietary management and risk.[1]
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What is the Best Test for Coeliac Diagnosis?
Coeliac disease is regarded as a common disorder, yet many clinicians miss the cardinal signs that indicate further investigation is warranted. Coeliac disease is becoming an increasingly recognised autoimmune enteropathy caused by a permanent intolerance to gluten. Once thought to be a rare disease of childhood characterised by diarrhoea, coeliac disease is actually a multisystemic disorder that occurs as a result of an immune response to ingested gluten in genetically predisposed individuals and includes non gastrointestinal symptoms such as depression.
So how can practitioners decide if their patient has wheat intolerance or is requiring strict gluten avoidance to reduce the risk of linked diseases.
A paper out in the Journal of The American Medical Association on May the 5th looks at a variety of papers published since 1947 until 2009 to determine the evolution of investigative tests and to see which was most accurate. Two principle mechanisms for valid confirmation were identified.[1]
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Could a ‘Bacterial Thali’ Resolve Inflammation? – A Novel Strategy
Michael Ash BSc(Hons) DO, ND, DipION reviews the possibility that strategically selected foods and food concentrates represent a valid therapy for inflammatory illnesses.
There is substantive interest in the potential translation from bench to bedside of simple safe strategies to modify the adverse effects of inflammation. Approaching from a preventative and restorative angle the numbers of papers being published on the role of orally ingested bacteria (probiotics) and in this article – the herb Tumeric (active ingredient of which is curcumin) is presenting increasingly supportive evidence for their reasonable and safe clinical use.
Modern analytical techniques are helping to reveal novel opportunities for inflammation control in the gut and the systemic tissues in new ways that even a few years ago would have been thought of as very alternative!
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Antibiotics Can Cause Gut Related Diseases
Michael Ash BSc (Hons), DO, ND FDipION reviews the current understanding of the role of antibiotics in the initiation of gut associated inflammation and local and systemic health problems, and briefly explores some strategies to prevent and manage this.
What is perhaps the greatest medicinal discovery in the last 100 years has a sting in its tail, the tremendous success in managing bacterial infection has encouraged over and inappropriate use of antibiotics, the problems of which have been well documented. This review explores the developing comprehension that even a single day of antibiotic use has consequences that may produce transient and long term effects that compromise the health and well being of the patient and their bacterial co-habitants.
Sir Alexander Fleming discovered the antibiotic substance penicillin in 1928 and was awarded a co share in the Nobel Prize in Medicine in 1945.
It was a discovery that would change the course of history. The active ingredient in that mould, which Fleming named penicillin, turned out to be an infection-fighting agent of enormous potency. When it was finally recognised for what it was—the most efficacious life-saving drug in the world—penicillin would alter forever the treatment of bacterial infections. By the middle of the century, Fleming’s discovery had spawned a huge pharmaceutical industry, churning out synthetic penicillin’s that would conquer some of mankind’s most ancient scourges, including syphilis, gangrene and tuberculosis. (Time Magazine April 1999)
However, as the combined benefits of decent engineering for sanitation, prevention via vaccination and bacterial infection control through antibiotics have contributed to life extension, they have also produced microbe and human disturbances. The incidence of immune mediated disorders is continuing to increase and the gastrointestinal tract is continuing to gain traction as a site of significant origination.[1],[2]
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Apples and Nuts Reduce Inflammation Via Mucosal Immune System
In the context of the ever increasing relationship between inflammation and diseases of our western lifestyle the idea that the old adage of ‘an apple a day keeps the Dr away’ this recent paper has some attractive evidence.
The university of Illinois team of researcher have written a paper due to be published in the prestigious Journal Brain Behaviour and Immunity later in the year around May.[1]
Looking at a mouse model – and we are aware of how diet affect mouse studies from a post written a few days ago- Food Choice Affects Lab Outcomes this group have extended the concept further, and presented the mice with a specially enriched diet. This study fed a low fat diet to both groups for six weeks differentiated by one having soluble fibre and the other non soluble fibre.
When challenged using a microbial wall particle called lipopolysaccharide (LPS) the group on the soluble fibre had a 50% reduction in symptoms compared to the insoluble group. They also recovered 50% faster. It seems that just 6 weeks of an increased soluble fibre intake change their immune responses in a very positive manner.
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