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Anna Crist

student researcher , University of Oregon

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Purell now, Bacteri-ell later?

The hygiene hypothesis, the idea that “too much cleanliness prevents the development of a well-balanced immune response”(Sironi and Clerici, 2010), has received a lot of support and also criticism. It has recently been challenged by the hypothesis of “early immune challenge”, which states that a lack of appropriate immune stimulation during early childhood might account for the increased development of allergies in industrialized countries (Kramer et al, 2013). This proposal places less emphasis on excessive hygienic practices and focuses more on the insufficient exposure to specific environmental microbes, particularly those from non-urban environments, as the reason behind the rise of atopic disease. While different, both hypotheses point to the beneficial health affects of some microbes.

What do you think is the reason for increased allergy levels in industrialized countries? Do you think that a concoction of the “right” microbial species in the form of a lotion, drink, or inhalant (aka "Bacteri-ell") could be a future replacement for natural exposure to beneficial microbes?
Instead of using hand sanitizers like Purell, do you see a future where people from some regions of the world are unsanitizing their hands with “Bacteri-ell”?

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    Apr 29 2013: Humans are sterile until they are born and become colonized by their mother microbome. In the preceding years of life, we are exposed to vaccinations, antibiotics, harsh chemicals in body products, and being other substances that change our microbial make up. Just like an immune response, your body creates a response to exposure of certain bacteria. The bacteria can be harmful and antigens and antibodies respond or they can be harmful. In the times, when they are harmful people react with antibiotics too rapidly. Yes, there are circumstances where antibiotics and sterilization methods are necessary but as a whole it has gotten out of hand.

    The real issue of over sterilization and being too hygienic is that good bacteria is killed along with the bad bacteria. I don't know if a product with "unsanitizing" factors is the answer but a product with high selectivity for a particularly strain may work. The promotion of probiotics is a great way to combat some of the damage but this only increases a small amount of the good bacteria.
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      Apr 30 2013: Unfortunately so far the main focus of the public is the bad bacteria and because we are so bad at battling the bad bacteria, we just get rid of it all. I think a probiotic cleanser that actually contains good microbes is a great idea. Maybe the microbes would be specific to your family's microbial biome. Maybe instead of vaccinations we can have hair depurifiers that put pathogens into the air. Unfortunately we know so little about our microbes and their functions that if we introduced microbes to replenish or help our personal microbes, would they upset a delicate balance that our bodies maintain?
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        Apr 30 2013: I'm glad that you pointed out that we know so little about our microbes and their functions that any attempts a making "bacteri-ell" would, in my opinion, create a whole new set of issues at this point. While the idea is intriguing, I am a big proponent of figuring out the root of problems and attempting to change or ameliorate our life styles first. For example, I have read a couple papers regarding children that were raised in very clean environments, and mostly inside environments as compared to a child who is raised with plenty of outside time, around animals, and less stringently kept "clean". By "less stringently kept clean" I mean children who play in the dirt (or eat dirt in my case as a child), interact with pets, are allowed to play on floors, etc. The child that was raised in a very "clean" environment experienced more atopic disease later in life than the child that was exposed to microbes as a child. So, personally I think a great first step for learning how to live most harmoniously with our microbes would be continuing research and beginning to educate the public about all the beneficial microbes out there and what types of life styles or practices lend themselves to exposure.

        As our growing population continues to cram into urban environments, packing cities and causing them to expand I could see an issue with being able to expose your child or yourself to beneficial microbes. Maybe we will know all there is to know about microbes and our microbiome by the time our environment becomes overly packed with "bad" microbes... but at this point I think people should let their kids play outside and not worry quite as much about being overly hygienic.
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          Apr 30 2013: I agree that the main idea is very far-fetched based on our current knowledge of microbes and their beneficial functions for humans. My idea relies on our ability to eventually figure these things out.

          Your second paragraph is more along the lines of what I was trying to get at, that is, the future. Right now it is easy to just let your kids play outside more (I used to go digging for worms in my yard!), but as the world becomes very industrialized and people lose access to nature, do you think something like "Bacteri-ell" would be a possible or necessary substitute?
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          Apr 30 2013: The idea of a bacteri-ell is fascinating but I am a firm believer in prescribing interaction with the environment for our children as they benefit not only in a more diverse microbiome but their lives will have more richness to them. As we learn more about the human microbiome we may be able to come up with the magical concoction and get rid of some of the diseases that come about from not having these bacteria but should we? I personally feel like the more we turn to synthetic means of living the more we are moving into a world like that found in the movie WALL-E.

          Should we have our future doctors prescribing spending time outdoors and with animals or a bottle of bacteri-ell?
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          May 1 2013: Understanding how hard it is to replace certain microbes is one of the biggest issues i saw with this idea because of all the unique functions of each type of bacteria. It is good to notice that the environments of "city" children, versus those of "rural" children, are very different and create different microbiomes within each of them. You won't have the same diets, lifestyles, or environment, so you reasonably should have these changes in the microbe population that result in different functioning abilities. I think that the idea of capturing those "good" microbes is ideal to help rehabilitate weakened systems, but the problem is what may be good bacteria to have when living in San Diego may not be the same microbes that you'd want living on a different diet, in a different environment such as London. So i think that it's a little too optimistic to think we could actually classify what is a "good" or "bad" microbes since their fitness changes depending on the lifestyle of the human host. So i would really hope that we don't start making more bacteria cultures because i feel like its just asking to help spread bacteria like an invasive species around the world in new and different locations.
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        Apr 30 2013: I like your idea about making the microbes specific to your family's microbiome! I was also thinking that the bacterial concoction might have to be tailored to the individual (a flaw within my main idea.) As we heard during Eisen's TED Talk in class today, individuals have their own unique microbiomes. However, the variations could be the reasons behind differential susceptibility to diseases. For instance, maybe someone is lacking a microbe and as a result is more likely to get hay fever. So maybe there IS a universal ideal combination of microbes that keeps susceptibility to a minimum across the board.
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          Apr 30 2013: I've been doing some research about lacking a particular microbe and I found an interesting example with Helicobacter pylori. This bacteria is actually a good and bad microbe....It is associated with gastric ulcers but when its missing there are a number of health consequences. So the treatment of this particular species can cause far worse illness. These health consequences includes an increased rate of esophageal cancer in a population without these species. Additionally, the production of the hormones, gehrelin and leptin, is disturbed which can lead to weight gain. Asthma and allergy reactions are more common when H. pylori is missing too.

          This is just one example but i'm sure there are more out there. I have to be hopeful and agree with you that there is an ideal combination of microbes that can balance the absence of one vital missing one. It makes me wonder if there is a microbial tipping point that is reached when these consequences become apparent? What if these limits were understood? Treatment and sterilization could involve killing the bad while administering the good during a critical window?

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