Anna Crist

student researcher , University of Oregon

This conversation is closed.

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 30 2013: As many people have brought up, we know very little about microbes and even if we did, it's not as simple as "good" microbes and "bad" microbes. This makes me skeptical that developing a single product like "Bacteriell" would be useful for the kinds of services we are hoping it would deliver (ex. reduce certain types of chronic diseases). Additionally, the premise of the argument seems to be that young kids need exposure to microbes. It's unclear whether "adding" microbes to your skin later in life will prove effective. Such a product would thus need to be catered to young children and probably wouldn't be analogous to Purell, but more like a supplement for babies in skin cream form.

    To address a point that's been raised several times--the nature lover in me wants to advocate for more time outdoors. We should be reconnecting with nature instead of producing synthesized and probably sub-par replacements. On the other hand, I had the privilege of growing up where I had almost constant access to the outdoors; my parents could send me outside without worrying that I would be unsafe. The reality is that most people in the US (and increasingly the world) live in cities, and with the wealth gap increasing, parents may not have the luxury of bringing their children out to the wilderness everyday. Because of this, my tendency is to lean toward a city planning solution over a commercial product. Emerging concepts of eco-cities take sustainability into account with city design. However, the focus is still on limiting impacts rather than being proactive about conservation. Most plans for parks or green areas focus on recreation and aesthetics over maintaining some kind of ecological diversity, both at the macro-fauna level and the microbial one. This kind of a focus could serve several purposes, including providing a place for kids to be exposed to microbes as well as reducing biotic homogenization. Any thoughts on this? Or existing examples?
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      Apr 30 2013: I agree with you Mika. I'm not so sure about adding "Bacteriell" alter on in adults will help to reduce certain diseases. In a mean while, we need more time and research on studying skin and human microbiome. I love outdoor activities. I exposed myself with nature most of the time when I was young. I think this definitely is one of the reason I rarely get sick. I think most of the reasons people live in the cities don't want kids to be outside because the severe air pollution in the city. After get used to Eugene extremely clean air, every time I went back to Taipei, Taiwan, I got skin and eye allergies. So my personal experience kind of tell me that my microbiome on my body has changed probably throughout these several years I lived in Eugene.

      I like your idea about city planning solution in the big cities. We all know city parks / gardens are really important to kids live in cities. To add on that, maybe a small area of "educational" ecosystem (include microbials) right beside the the park or gardens so that both parents and children are more willing to reconnect with the mother nature.
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      Apr 30 2013: The connection to natural areas within cities, or even constructed parks, is something I find very interesting. I also like the idea of looking to exposure in natural environments as a way to built strong immune systems through exposure to a variety of organisms found here. As a few other people have said below, until we know which microbes benefit our health I think looking to the Earth's natural environment, which we've evolved with over a long period of time, is currently the best bet for building strong immune systems in young people.
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    Apr 30 2013: Many people in this conversation have pointed out that it would be a better idea to encourage people to stray away from the use of antibiotics, rather than introduce themselves to microorganisms more frequently. While this is probably a good idea, the focus of the question is whether or not it is possible to develop immunity to microorganisms if you weren't exposed to them at a young age. We don't know enough about microbes at this point to be able to determine whether applying a culture of bacteria to ourselves would result in positive or negative outcomes, however the idea is a step in the right direction. Once we have determined which microbes have definitively positive influences on humans, it would be a good idea to allow ourselves to be exposed to them regularly. It may be hard to keep the organisms alive in a way that mimics purell, because nutrients may become limited quickly. In what other ways could we expose ourselves to these organisms, without having to worry that the culture will die?
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      Apr 30 2013: I agree that it would be hard to keep microbes in a lotion (they are already hard to culture in a lab as it is.) I mentioned to Ben Story that maybe humans themselves could be "microbe donors." Maybe without going so far as fecal transplants... But maybe children could just come in contact with people who are known to have a more diverse "microbe cloud" (and we had a future way to test this), say those who live on farms, and they could be exposed to the helpful microbes that way (which happens to a certain extent anyway, this would just be more deliberate and have more science behind it.) Also, using animals as carriers could be another way. Making sure children are taken to petting zoos with animals who are known to have beneficial microbes (like frogs!) :)
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      Apr 30 2013: Thinking about other ways to get exposure to microbes I kept thinking that the best ways to increase people's environmental exposure would be one that was sort of lo tech and easy and cheap to do. I was imagining something along the lines of a petting zoo, in fact it could just totally be a normal petting zoo. A place where children would be exposed to a variety of microbes naturally through no extra action of their own. Sticking to this basic approach is definitely less exciting than the development of some sort of bacterial concentrate to simulate natural exposure, but I think it would be far easier than isolating exactly which microbes someone needs to be exposed to in order to develop properly and extracting from the concoction the ones deemed unnecessary.
      The most challenging part of this would probably be the public health front of it in convincing parents to let their kids be kids and get dirty. I think in general that the best approach to solving problems like this is to utilize a natural approach as much as possible if it is effective, and I think that in this case that a traditional exposure regime would be the safest and most effective plan of action.
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    Apr 30 2013: Let your children eat dirt and for God's sake stop worming then. We evolved covered in dirt and with our gut full of parasites. You should only bother them if they start to bother you.
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      Apr 30 2013: That's why my grand kids and I always eat all of our meals off the floor, I've never had allergies and if it was good enough for me growing up then it's good enough for them LOL!

      God Bless

      - Todd C.
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      May 1 2013: This is excellent advice, Peter!
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    Apr 30 2013: I'm going to have to play the devil's advocate for this question.

    Although, studies support this theory, to me the premise alone seems a little unrealistic. I know very few people that use Purell (or similar) products on a very consistent basis, that one could consider over use. The moment a user's hands dry and they touch something (a book, a door handle, a railing, a chair, etc...) the bacteria living there are immediately transferred to the skin. Essentially, even a handshake would completely reverse the bacteria massacre that said individual had just preformed. It seems unrealistic that anybody could have sterile hands 24/7.

    I would also like to bring up an alternative hypothesis.that perhaps the disruption of skin microbiota is not significant in the development in these allergies. In the specific study cited by Anna, the researchers looked a particular antimicrobial chemical, Triclosan. They correlated its presence with allergic reactions. Although this revelation supports the conclusion reached by the authors, it doesn't rule out one basic alternative. Perhaps the Triclosan itself is causing an increase in allergies by aggravating the immune system. Studies have shown Triclosan to cause allergic reactions in some individuals.

    This conclusion would tie in well with another hypothesis, the pool chlorine hypothesis. The pool chlorine hypothesis suggests that an increase in time spent in chlorinated pools is correlated with an increase in asthma rates. The authors of this hypothesis suggest that is the chlorine per se that is causing the asthma.

    I believe that perhaps this is a similar situation to that involving Triclosan and that it is not the lack of microbes that are causing the problems, but the Triclosan itself.

    -Bhutani, T.; Jacob, SE. (May 2009). "Triclosan: a potential allergen in suture-line allergic contact dermatitis".
    -Campbell, L.; Zirwas, MJ. (Dec 2006). "Triclosan". Dermatitis
    -http://en.wikipedia.org/wiki/Pool_chlorine_hypothesis
    • Apr 30 2013: I agree with Ben, I don't think people are over using Purell or any other antibacterial substances, nor do I think we should cut down on using them or the cleanliness methods we have been taught. For example if people in food service started washing their hands less, I think many more people would get sick then the amount that would build up a stronger immunity. I think one of the biggest reasons people are getting sick more often is due to overuse of antibiotics. whether it's a doctor prescribing an antibiotic for a viral infection or a parent giving a child medication for something their body can fight on their own, people's immune systems are getting weaker. Instead of looking at adding bacteria to a person with a weaker immune system, maybe we should start by decreasing the medication use and then we will see a decrease in people with so many allergies and other serious conditions.
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        Apr 30 2013: I don't think that anyone is advocating that people in the food service industry start washing their hands less. I agree with your point that antibiotics is a contributing factor, however I think that it is a lack of early exposure to microbes that can cause lasting health consequences.
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          Apr 30 2013: I agree, we need exposure to all kinds of microbes at an early age so that our body's natural immune responses can be become stronger. It would be so cool to one day have the research and knowledge about what microbes are vital to be exposed to at an earlier age. If we could obtain this knowledge, we could facilitate exposure in people that were born with compromised immune systems, such as premature babies or cesarean births.
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          Apr 30 2013: Yes! Exposure to the microbial environment is extremely important in development of a child's immune system. Microbes naturally found in soil may be linked to releasing serotonin, changing a persons mood.
          http://www.medicalnewstoday.com/releases/66838.php
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          Apr 30 2013: Noel, that is very interesting! There may be a link between immune system imbalances and mood disorders.
        • Apr 30 2013: That is probably very true Eleni! I am not against exposing people to more microbes. I am exposed to all kinds every day at my little zoo of a home! I'm also thankful I have Purell and antibacterial soaps to use after exposing myself to these other microbial environments because it keeps me from getting sick. I think people go from one extreme to the next when things are discovered so my fear is if it's pushed that we are "too clean" and need more exposure to bacteria that people will start being a lot less clean.
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      Apr 30 2013: Thanks everyone!
      Ben- What I think you are missing that Eleni and Ashleigh pointed out is that exposure to microbes at an early age is what is important. I am certainly not trying to suggest that people have sterile hands because of overuse of Purell, "Bacteri-ell" is just a play on words. I am proposing that a lack of exposure to certain key microbes at an early age, due to an overall less natural environment in industrialized regions, is the cause behind increased frequency of allergies. You raise an interesting point that a handshake could reverse a lack of exposure to certain microbes. Maybe people who have a more complete "microbe cloud" (in the words of Jonathan Eisen), could serve as "microbe donors" to children who don't have access to the mrobe diversity in nature, such as that you would find on a farm.

      Your idea that chlorine and Triclosan themselves are the cause of allergies is definitely something to consider.

      Asleigh: Your comment is exactly what I am getting at! :) My idea definitely relies on our future ability to gain the knowledge you mentioned.
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    Apr 29 2013: Studies have shown that not just humans, but all mammals have microbes on their skin in the order of trillions, with thousands of different species. Also, studies have shown that when we have a more biologically diverse set of microbes, then we have a better immune response to many different pathogens and antigens. But I doubt that our bodies would be ready for an onslaught of microbes in gel form.
    We do need more helpful microbes on our skin, and in our gut, but disrupting the biodiversity by adding selected microbes we think are most important could upset our body's ecosystem. It could become, in a sense, like an invasive species problem on our skin.
    This is a good idea, but may be better used as a medical treatment for those with problems associated with possible "microbe deficiency." Or maybe it would be better for people to take more trips out into the country and get to know the ecosystem that surrounds the artificial one we made.

    Check out this Nature article on allergies and microbes. There's some good background on the subject here.
    http://www.nature.com/nm/journal/v18/n4/full/nm.2723.html
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      Apr 30 2013: Good point! I did not think about the alteration of microbiome on our skin. I guess it might substitute for probiotic.
  • Apr 29 2013: According to the National Institute of Health it was found that from 1988-1994 more than 50% of Americans from ages 6-59 were sensitive to at least one allergen. However, a similar study done in 1980 found rates 2-5 times lower. The reason for this large increase in allergens is thought to be the more sterile lifestyles we now live. By disinfecting everything around us, we are severely limiting the amount of bacteria we are exposed to.

    Being exposed to different bacteria at a young age is very similar to receiving a vaccination. A vaccination works by stimulating an individual's immune system in order to develop an immunity to a pathogen. Our bodies immune systems are formed by being exposed to seemingly harmless substances around us, such as pollen, animals, foods, etc. When we do not receive these "vaccinations" of harmless substances at a young age, it can result in allergies later in life when they are finally encountered.
    Exposure to certain germs and allergens at a young age are important in the development of our immune systems. Without these exposures our bodies will be unable to fight off everyday substances later in life.
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      Apr 30 2013: Julia,
      That is a fantastic summary of the hygiene hypothesis and why it really seems like it is addressing the newer early immune hypothesis with its premise. It got me to thinking though, since so much of both hypotheses are based on early exposure and the conditioning of our immune systems for the rest of our lives, I have to wonder if there is any hope to the strategy of introducing the missing agents later in life in order to cure allergies or other auto immune diseases. I bet that if the supplementation of microbes, like with the "Bacteri-ell" discussed by Anna, was done early enough while the immune system was still plastic, it would be possible to avoid the development of autoimmune diseases including allergies. If this window of developmental plasticity is missed though, I don't think that this sort of treatment would be effective.
      I would love to know if there is any evidence that autoimmune diseases can be treated in this way later in life though, it isn't something I really follow so it wouldn't surprise me if there were some new developments since last I heard about the general theory.
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        Apr 30 2013: Thanks for your input! In my head I imagined parents lathering up their children with Bacteria-ell lotion, instead of trying to keep them germ-free with sanitizing agents like Purell.

        Support for the “hypothesis of early immune challenge” comes from a study by Douwes, et al (2008) which found that children raised on farms were not afflicted with asthma and neurodermitis as much as children who were raised in cities. This observation was even associated with contact of pregnant women to animals and soil, suggesting that prenatal exposure to certain microbes is also important in disease prevention. I thought this was really interesting!

        I am out of time right now so I will get back to you about adult studies I found! Or maybe someone else can contribute to that part of your comment.
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          Apr 30 2013: I guess the main thing that had me confused about the early immune challenge was how it was really differentiated from the older hygiene hypothesis. You said in the intro that "[The early immune challenge hypothesis] places less emphasis on excessive hygienic practices and focuses more on the insufficient exposure to specific environmental microbes," but wouldn't this lower exposure to microbes be a direct effect of the hygiene hypothesis. I guess it seems like the main differentiation between the two is where the microbes are coming from then, be it urban or rural areas, but I still feel like I'm missing some larger point of distinction between the two.
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        Apr 30 2013: I was also confused about the difference between the two at first. This quote, which I also mentioned to someone else, will hopefully help clear things up a little.

        "The risk of developing allergies is not necessarily caused by a lack of bugs and parasites in the environment per se, but rather by a lack of certain organisms that have, over the course of evolution, trained our immune system to be more tolerant.” (Rook et al, 2009)

        The first part (up until "per se") describes the hygiene hypothesis, or the idea that not being exposed to enough microbes *in general*, due to more sanitation, causes us to be more prone to certain diseases. Whereas the second part of the quote is more along the lines of the "early immune challege" hypothesis, the idea that lack of exposure to SPECIFIC bacteria is the cause of increased allergies. It's definitely a subtle difference, but I hope this helps!
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          Apr 30 2013: I was wondering that as well, and that clears it up for me at least. I think the early immune challenge hypothesis sounds more plausible, as i suspect that certain distinct specific microbes are what make the difference- however, it's possible that so many different specific microbes are needed that this nearly replicates the hygiene hypothesis. I suppose it depends on where one draws the line between "many many specific microbes" vs "a general diversity of microbes," however, with that said, i imagine more than a few denizens of our microbiome are innocuous or at least have no noticeable effect on human immune response.
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    Jon Cox

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    Apr 30 2013: "What do you think is the reason for increased allergy levels in industrialized countries?"

    It's a little off topic but one interesting reason is that back in the day, in the U.S. anyway, we chose to plant species of trees in our cities that happened to release very little pollen into the immediate atmosphere. Well 50 or 60 years ago we began planting more and more species in our urban environments that happen to produce LOTS of pollen. In addition to this, because they do not drop seedpods or fruit and are thus less "messy", male trees (some species produce flowers with both male and female parts while other species are made up of individuals which are either male OR female) are often very popular, and guess what male trees might make lots and lots of.... POLLEN. Our choice of landscaping in the last half century or so has greatly contributed to our allergy troubles.

    Here's a good article about it: http://www.nytimes.com/2010/04/06/opinion/06ogren.html
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      Apr 30 2013: Interesting point Jon! I think this is a very good explanation for increases in allergies in industrialized countries. I would think that we'd start to develop an immune response to this increased pollen. Now I know that 50-60 years in the evolutionary scheme of things, but seeing how quickly microbes can develop resistances to antibiotics (penicilin comes to mind), I would think that our own immune systems could adapt as quickly. I know that we do have many more cellular processes than prokaryotic organisms, which may be accounting for our increased time to develop allergic resistances?
    • May 1 2013: I agree. I believe that the increase in allergies in industrialized areas is due to multiple factors, not just the over-cleansing-of-bacteria. True, much has been pushed forth in terms of understanding the micro-biome, but I believe that a combination of ingesting pesticide/genetically-altered foods over multiple years, planting habits in industrialized societies, AND over-cleansing of our micro-biome have contributed to the increasing rate of allergies. I bet if we tackle this problem directly, we'll discover many more factors that have added to this condition, which exist at multiple scales, from the super-micro to the super-macro.
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        May 1 2013: Poor air quality is another major contributor. So yeah there are tons of reasons! And thinking about what Mario said about evolution of resistance to allergens in our immune systems, we should keep in mind that humans have rewritten the book when it comes to evolution thanks to medicine and technology, etc. Natural selection pretty much doesn't apply anymore. Being susceptible to pollen allergies doesn't decrease our chances of surviving and reproducing. Maybe it did in the past, but not anymore. A genetic mutation COULD arise that makes a person immune to pollen, and maybe this happens already, but they will not be more likely to survive and reproduce than anyone else.
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    Apr 30 2013: I suppose that it is possible for a probiotic product to be developing that would artificially inoculate our microbiome with the right microbes. My main concern is, how do we know what the right microbes are? We currently know so very little about microbial biodiversity. Even though thousands of species of microbes live in and on our bodies, even though we ARE part microbe in a sense, there is a lot we do not know. Is there a possibility that someone will attempt to develop a probiotic product (aka Bacteriell) and that without adequate knowledge of microbial ecology, it will be woefully ineffective, or even detrimental to our health? We have to tread carefully here.... there's a lot of potential in this idea, provided some pharmaceutical company isn't too hasty.
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      Apr 30 2013: Excellent point! My hope is that will be able to gain this knowledge in the future. It would definitely be scary if someone tried to make this product without adequate research beforehand!
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      Apr 30 2013: I love your point! Yes, there is a great potentiality of microbes that can influence our health. Before knowing the effect the bacteria on our body, we cannot make many microbe products in our food. In china, many yogurts state that it includes probiotics that are good for gastrointestinal function or have some other benefits. But can we make sure they are only good for our health, no detrimental effects or other influences?
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    Apr 30 2013: Thanks for all the great input! Here are the links to the two studies I referenced in the conversation starter. I had a glitch when uploading the talk so I didn't include them.

    1. Manuela Sironi, Mario Clerici, The hygiene hypothesis: an evolutionary perspective, Microbes and Infection, Volume 12, Issue 6, June 2010, Pages 421-427, ISSN 1286-4579, 10.1016/j.micinf.2010.02.002.
    (http://www.sciencedirect.com/science/article/pii/S128645791000050X)

    2. A. Kramer, S. Bekeschus, B.M. Bröker, H. Schleibinger, B. Razavi, O. Assadian, Maintaining health by balancing microbial exposure and prevention of infection: the hygiene hypothesis versus the hypothesis of early immune challenge, Journal of Hospital Infection, Volume 83, Supplement 1, February 2013, Pages S29-S34, ISSN 0195-6701, 10.1016/S0195-6701(13)60007-9.
    (http://www.sciencedirect.com/science/article/pii/S0195670113600079)
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    Apr 30 2013: It really is an understatement when we say microbes are important for the proper functioning of ecosystems, let alone us. Not only do they supply vital supporting ecosystem services with carbon recycling and nitrogen fixation, they also help build stronger immune systems in humans.

    Sadly, many of us only view microbes as pathogens, and not accomplices to a healthy lifestyle. The rise of allergies in industrialized countries could be due to the over use of antibiotics and cleaners that exterminate microbes. Thus, a child growing in an industrialized country may become more susceptible to allergic diseases than one growing up in a developing country due the lack of natural immune system development.

    Surely we can take probiotic supplements, but does that reverse the poor immune system of adults? Maybe those who would prosper most from a “Bacteri-ell” would be children.

    Exposure to microorganisms and other antigens (proteins from the exine of pollen, animal proteins, and foods) at an early age acts as a natural vaccination. Our body’s ability to produce antibodies and defend itself is a remarkable process. Bacteri-ell is already around us, we just need to be exposed to it at the right time.
    • Apr 30 2013: The point that most people only know bacteria as pathogens is a major issue for many things, but personal health and immune system function especially. I think a product like Bacteri-ell could have huge impacts on public perception however.

      Despite the potential benefits, I find that strategy ironic. I the same way fake tans or daily vitamins can be sold, Bacteri-ell would too. Create a solution to problem, then let the consumer create the problem for them self... the irony stemming from the good intentions to turn a profit.
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        Apr 30 2013: I never really thought of it that may. Maybe Bacteri-ell may become the norm when we recognize the importance of our microbial cloud.
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      May 1 2013: I do agree with the idea that too much cleanliness actually decreases the ability of immune response. According to a medical investigation in German, children in rural areas are less likely to suffer from allergies than children from urban areas. This is because rural children have more chance to get contact with nature. When they play with mud, their skin will contact with diverse microbes in the soil. The development of human’s immune system depends on external stimuli. Immunological strength is proportional to the contact with outside environment. The more chance of contact with the outside stimuli, the stronger the immunological strength will be. Thus, rural children’s immune system will establish its understanding of diverse bacteria from childhood, resulting in certain diseases resistance. Most children will not get skin allergies easily. I am not sure the applicability of “bacteri-ell” substitute that you pointed out. However, I think this is a good starting point, since people already did a good job on putting lactic acid bacteria and yeast into yogurt. In order to increase our immune response, I think people should increase their contact with nature resources, and do not pursue too much cleanliness by over-use antibiotics. What is more, educate the public that microbes are not always doing bad things and lead them to a better lifestyle to live with beneficial microbes.
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    May 1 2013: In case folks have not seen it yet here is a greatTEDxEugene talk by Brendan Bohannan on the human microbiome: http://www.youtube.com/watch?v=Dfy2qYfUWE0
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      May 1 2013: I really liked the part at the end when he tells us that we need to be "affiliated with the ciliated" Good talk!
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    Apr 30 2013: I found a program through The Human Food Project that works to analyze different microbes found in participants' guts and associate them with different lifestyle patterns (ie vegetarian, c section, pet owner etc.). You send in a sample as well as a lifestyle questionnaire and they send you back a list of the bacterial community in your gut and how it compares to other incoming samples. I thought this was an interesting way to gain more widespread samples of the microbial gut for scientists while involving the public and raising awareness about the diversity and importance of microbes.

    http://humanfoodproject.com/americangut/
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      May 1 2013: This is the best thing ever. If they could crowd source it or something and do the sampling for free by mail I bet it would be extremely popular and would glean a lot of cool information about the biodiversity and person to person differences of human microbe ecosystems! I for one would love to know what lives in my mouth and intestines but the $99 price tag is kinda prohibitive. It's all about priorities I guess. I'm tempted to do it.
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    Apr 30 2013: You said "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?" and I find that this sort of a product would be impossible. I say this because our bodily immune systems are built little by little, not i huge strides. Pushing that many bacteria into your body at once will not help your immune system, it will devastate it, even if they are mostly beneficial microbes.

    A better question would be: Could there be a series of drinks in which a person is exposed to all the bacteria that could strengthen the bodies natural processes and it immune system?
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      May 1 2013: That is a great point, Clinton. Our immune system is something we develop slowly over time. Slow exposure to different microbes, whether pathogenic or not, allow our bodies to properly function and build up necessary immunities we need to survive. Even though biomedical technology is currently doing amazing things and new, unimaginable medicines are being created, I don't think there would be a way to subject the body to a "bacteria-elle" without doing serious damage to the overall immune system. The immune system cannot be built up instantaneously, and it could be very dangerous, even life threatening, to expose the body to an exorbitant number of (possibly foreign) microbes at one time.
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      May 1 2013: I liked this idea as well and thought that a variety of drinks could be interesting new way to shape our microbial community for the type of life style we want to live. But in reality I do not think anything will ever be as unanimously effective as nature can be on developing this community
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        May 1 2013: The point isn't to replace natures role, the point is to fill in a role nature should play, but can't. Not everyone has the time to take their kids hiking and camping that often, so this would be able to counteract the effects of not being able to.
  • Apr 30 2013: I think this is quite a brilliant idea, however I would change a few things. Instead of having 1 general kind of "Bacteri-ell" maybe there are multiple kinds, one general kind can have microbes that have been proven to have positive effects, with a cocktail of microbes that can vary based off the specific kind and what the desired affects are, for example the bliss microbe mentioned by Jessica green in her TED talk on bioinformed design. (http://www.ted.com/talks/jessica_green_good_germs_make_healthy_buildings.html).

    As well an answer to the original question of strengthening the immune system, this could be done by applying a different kind that could have trace amounts of microbes that are detrimental and are required to build a strong immune system, those being ideal for children as discussed by so many previously in this conversation.

    Although there may be probiotics in existence that do what I have discussed I feel as if in time as we grasp a better understanding of microbial diversity, alongside new methods of analyzing the human micro-biome, that we will have options like this "Bacteri-ell" as opposed to needing to receive the resistance first hand.
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      Mario R

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      Apr 30 2013: This seems like a really cool idea Benjamin! It only makes sense that our bodies would have a carrying capacity for microbes though. One questions that I can think of, what happens if the microbes start to become so abundant that they start to compete for the available resources that our bodies offer? Would this lead to a decrease in certain microbe species, and an increase in other microbe species as they do compete for? Maybe that would be the point of making multiple concoctions of microbes? This way they may be less likely to start competing with each other, or if one species does out compete another, the out competed species could be reintroduced with a different "Bacteri-ell" concoction.
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        Apr 30 2013: That's a really good point... It is really difficult for us to predict how our current microbiomes would respond to regular probiotic exposure! I'm not even sure how we would go about studying that kind of interaction... in vitro research could never replicate the complexity of a complete, functioning microbiome, and there is so much diversity (beta diversity??) amongst people, let alone between species, that the applicability of animal models would be questionable.
      • Apr 30 2013: That's a great point. I feel as of we would need a lot more research dedicated to the microbial diversity of humans, and to test the products unfortunately the only thing I would suggest would be testing the products on a closely related species. Maybe chimps, however that raises the question of does genetic or phylogenetic similarities correlate to microbial similarities.
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      Apr 30 2013: I mentioned this to someone else, but I was also wondering about the necessity of different kinds of "Bacteri-ell" Maybe "Bacteri-ell" would have to be tailored to the individual (maybe his and hers? haha.) However, maybe there is an ideal universal combination for our "microbe cloud." Obviously, we aren't very close to having this knowledge at this time. Thanks for bringing up this point!
      • Apr 30 2013: No thank you for this idea! Haha, yes we have much to learn about microbial diversity especially in relation to our personal biome.
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    May 1 2013: While it is disturbing that microbes are so under appreciated in globalized society, it is heartening to see microbiology reversing that trend. Given the historical aversion to germs and the strong cultural association that we have with things we can't see and sickness, I am happy to see more research into positive aspects of microbes.
    As far as a product to help ensure a healthy microbiome on our bodies, I would be concerned about the leaving curve of the product. An earlier comment mentions Johnathon Eisner's talk on microbiomes in which he attributes his development of type-1 diabetes to having a compromised microbiome. He also notes how the human microbiome influences our health and resiliency in other ways. With that in mind, my concern is that by developing a creme or lotion for promote microbe growth, we could disrupt peoples' microbiomes further. Just as early ecology (think introduced species) has had disastrous effects, I think adding a bunch of new microbes to a complex ecosystem could potentially do more harm than good (in some cases, anyway). So, while the idea of appreciation one's microbiome as another organ of our body (I think Eisner said that in his talk, too) is a really important step to take, I don't think that means that we should necessary slather ourselves in bacteria lotion without first better understanding how our microbiome works, and what it needs to be healthy. Is more bacteria always better? How can we nourish the microbiome we already have?
  • May 1 2013: I think in cetain level of future bacteri-ell help to strengthen or rebuild human micro biome, but the replacement may not happen. Because a significant level of microbes are encoded by the individual human DNA and there are some deviation among individual human being. It means my micro-biome is not same as yours. Then, if someone introduce a "generic bacteri-ell" to a individual, it may cause to destory his or her own micro-biome which would be worse than weaken biome.
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      May 1 2013: This has been my biggest problem with this bacteri-ell. By bring in a generic singular bacteria we aren't doing that much, since we would only be adding a single microbe like kimboucha. This isn't enough to establish a healthy microbiome. First off i don't know how this one bacteria would be able to out compete the established community of 1000s of bacteria. Then even if we did establish a bacteria, why is this the best bacteria? It could actually be causing problems with some people microbiomes. You would need a variety of different bacteria for establishing in different gut environments based on what the normal diet of the person is. This is the most logical way to create universal microbes that could help establish healthy communities.
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    May 1 2013: I think that if our society ever decides that exposure to microbes is a good thing most people would simply stop using sanitizer on certain things or try to run into particular microbes "naturally". I can totally see, however, a new health trend to be ingesting certain microbes in a very expensive bottle.
    We already encourage pro-biotic ingestion of things like kombucha and yogurt that are marketed as being full of different strains of things that are good for you.
    However popular culture still rails against the idea of not washing everything. In one episode of "The Office" Dwight is laughed at for this propensity for people sneezing on him to "increase his resistance".
    There are examples of relatively famous people actually believing in exposure to germs creating resistance. One example is Yvon Chouinard (He started Black Diamond Gear and owns of Patagonia clothing company . In an interview he says he used to encourage his kids to not wash their hands after playing outside, yet nobody is calling him crazy due to his success in life. Perhaps one day all of society will feel the same way he does, but I have a feeling it is going to take a long time before anything like that happens.
  • May 1 2013: I think the idea of "Bacteri-ell" is interesting, but I'm not sure how it would pan out. Although it is possible true that we have been over-cleansing our bacterial make up of each of our micro-biomes, they have also been discussing that each individual's micro-biome is unique to them. That means that all of the bacteria that is floating on the surface of my skin, although may consist of the similar kinds of bacteria, is in fact unique to me, just like my genetic make up. As a result, I find it hard to imagine them finding a way to mass produce a product which interacts with everyone's bacterial make up in the same way. Although it could be possible - they have found that people who are dog owners often share nearly identical bacterial micro-biomes. (http://www.npr.org/blogs/health/2013/04/18/177746969/bacteria-on-dog-lovers-skin-reveal-their-affection?utm_source=NPR&utm_medium=facebook&utm_campaign=20130418) Not only that, but "Bacteri-ell" must function similarly to natural exposure, with all the good bacteria that we want, almost like a screening effect. I find it hard to see how we can mass produce a product that can imitate the manner in which the natural world interacts with our micro-biome.
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    Apr 30 2013: I read one article that suggested increased allergies also stem from the fact that families are becoming smaller and smaller, and thus children are exposed to less bacteria to which siblings would normally expose them. I happen to be an only child, along with three of my best friends, and we all have terrible allergies compared to any of our other friends who have multiple siblings. On top of this, hyper-sanitized homes and bodies prevent the body’s immune system from strengthening at an early age. It is easy to make the analogy to weight lifting—your body won’t become stronger unless you expose it to some resistance. However, it is important to consider that people’s bodies might react to different microbes differently. A community of microbes that might help one person’s immune system might cause harm to another’s. The idea of a product containing microbes meant to help expose people and strengthen their immune system is very interesting and has great potential for the future. It may just take some trial and error to determine which microbes would universally benefit its consumers without major side effects. Also, it may be important to note that such a product may not benefit older age groups whose bodies did not become used to microbe exposure at an early age.

    http://www.sciencedaily.com/releases/2007/09/070905174501.htm
    http://www.mayoclinic.com/health/hygiene-hypothesis/an02114
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    Apr 30 2013: To add another personal anecdote, I do not have allergies of any kind and I am a huge fan of Purell. I, too, am rarely ever ill. I'm not sure if I was a particularly "germy," dirty kid but I did spend a lot of time around animals. Of course, personal anecdotes dont necessarily represent the norm, but still one has to wonder.

    Honey is absolutely amazing in terms of it's healing powers. I volunteer at a marine mammal hospital and we use honey to treat shark bite wounds on the seals and sea lions by spreading it over the wounds. I have personally seen several cases where absolutely massive injuries almost disappear within a week. We use it because it is cheap, but maybe hospitals should start using honey instead of powerful antibiotics? I don't know much about how honey ranks with traditional antibiotics in terms of microbe killing power, but maybe it works so well because it leaves some good microbes left?

    I think its important to remember that while antibacterials can do harm, but they can also do incredible healing.
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      Apr 30 2013: A particular powerful aspect of using honey is that it can used to abed the allergies that are often associated with over sterilization. There is a catch though, the honey needs come from local bees so that it is produced with local pollen. Consuming the honey builds the immune response so that allergies aren't so severe!
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      May 1 2013: I work in a deli and have at least five pretty bad burns from various HOT things I clean at my job. I apply honey immediately after getting burned and virtually receive no visible scar. I'm not sure why this is, but I agree with you about honey. It's amazing!
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    Apr 30 2013: Our bodies are teaming with microbes and from the research that we now know each of us seem to have our own set of microbes covering every inch of our bodies. Culture, community and genetics may all affect the different microbes that support our bodies. Every human has been living in a symbiotic relationship their entire lives, but no one knows it due to the fact that microbes are microscopic. Advertisements and media portray most microbes as pathogens that can cause serious illnesses. When in reality they are the key to life, as we know it. Our society over uses antibacterial cleaners but as fascinating as an idea as “Bacteri-ell” sounds I would hope that it is only used for specific medical needs. The thought that people would have to wake up in the morning to apply microbes to increase there immune system would be a horrifying. Enjoying the world around us and increasing our immune system naturally seems like the best cure.
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    Apr 30 2013: Going back to a point that was brought up a couple of hours ago--that industrialized countries need more interaction with nature to acquire these microbes-- I totally agree! The hygiene and early immune challenge hypotheses could be joined with a myriad of others acting as metaphors for how far removed much of Western civilization is from the natural world.

    To me, this is less an issue of discovering, making, and selling a bacterial concoction that humans currently lack. This is not addressing the root issue, and pushing us further away from it if anything. The root issue is that many of us never spend real time in a forest, around animals, wild plants, or most importantly, any of their microbes! Reconnecting with the microbes many of us currently lack could be solved through a reconnection with the natural world, which many of us also lack. This would not only make us healthier individuals in the sense of microbes, but also through the many other ways that nature has been proven to make us happier people.
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    Apr 30 2013: In our haste to tout antibacterial products, let's not forget the amazing benefits sanitization provides us as well! Do we really want a world where surgeons don't have to sterilize their hands or run their instruments through an autoclave before performing an operation? Where sushi chefs are free to touch as they please? Joseph Lister, Ignaz Semmelwies, and Lupe Hernandez performed a great service to society with the inventions of antiseptic and antibacterial hand washes.

    I question the argument that overuse of antibacterials causes a rise in allergies. For one thing, antibiotic agents have been around for a very long time. Honey is a natural and very effective antimicrobial that humans have been in contact for at least 8,000 years and was used by the Ancient Egyptians as an embalming agent.

    Furthermore, there is a big question of correlation vs. causality. It could be that our overly sterile lifestyle is causing an influx of allergies, or it could simply be that globalization and market integration have allowed people access to foods that they have not eaten before and thus discover new allergies. Food allergies are also very affected by ancestry. Lactose intolerance (or 'tolerance' as my high school bio teacher liked to say) evolved from a rare mutation that allowed humans to digest mammalian milk. Humans are the only mammals that consume another mammals milk as adults, and the majority of the worlds population is naturally lactose intolerant. Due to this one genetic mutation, a portion of the population can digest lactose. Lactose 'tolerance' has a distinct clinal distribution (geographic pattern) that shows the evolution of this gene occurred in Europe and North America, coincidentally the regions more recently inhabited by humans, and not in Africa and Asia where the earliest human populations came from. Approaching from a more anthropological perspective, we see there may be a simpler explanation for food allergy prevalence.
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    Eun Min

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    Apr 30 2013: Microbes were thought to be bad and dirty, pathogen. Although we have found that many microbes are good and necessary for the whole ecosystem, not only for human, some people still think microbes are pathogen; it reminds me of a rotten apple in a barrel. I do not know that not exposure to certain microbes causes or increase allergy levels, which might be related.
    As Jonathan Eisen said in the video that probiotic, poo-tea and fecal transplant, microbes are used to treat unhealthy animal. I guess bacteri-ell might come out the market soon or similar one; it is good way to get good microbes! Maybe we can buy a can of good microbes; we can sort microbes, which are necessary and help our health, and culture them and put in a can although culturing microbes are hard! Then, we can put the microbes directly on our body or put on a bed to last longer, growing them on your own bed!
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      Apr 30 2013: Thanks for pointing out the practicality of "Bacteri-ell"! One of the problems I thought of is exactly what you pointed out: microbes are hard to culture! We already have trouble with creating cultures of bacteria, would we really be able to maintain them in "Bacteri-ell?" Can you think of yet another method we could use to expose people to helpful microbes (besides poo-tee and fecal transplant...)? I was thinking that another possible medium could be animals. Maybe petting zoos with animals that definitely have helpful microbes on them (e.g. frogs!) that people could take their children to. :)
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        Apr 30 2013: Animals can do that too, but I worry about the stress what animals get and safety issue. I guess we can select an individual who is healthy and test what kind of microbes the healthy person has by collecting microbes from the person and sequencing the microbes if there is a pathogen. If not, we can let the person wear a shirt for a day and take the shirt from the healthy person and put it on a sick person, transferring microbes naturally. It sounds disgusting, but we can try?
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      Apr 30 2013: I definitely agree. It's not a matter of eliminating microbes but selecting for the beneficial ones to our health and eliminating the detrimental ones. How we select between these two still needs development however, could revolutionize our buildings and the possibility of integrating microbes environments to the surface of everyday objects.
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    Apr 29 2013: These are both good points. There is also the factor of people being overprescribed antibiotics. After time the antibiotics no longer are effective on that individual because the bacteria have become immune to it. Or there are completely resistant strains of bacteria, like MRSA for example, which is a strain of staph bacteria that has become resistant to all antibiotics that normally treat staph infections. Maybe the solution should not be to come up with a concoction of good bacteria to replace what we have already killed, but instead stop over-using antibiotics and teach people to realize that cleaner does not always mean better.
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      Apr 29 2013: I think I agree with some of your points here. People can easily over-use antibiotics and their bodies can become immune to even the good bacteria. Like you said above, too much of a good thing can be a bad thing, and this goes with cleanliness as well. We can over clean our own bodies and take away needed species of microbes from our skin. I think probiotics will become a bigger part of the industrial world that Anna is referring to. Being able to take living microbes back into our systems is one way to undo the damage of over-using antibiotics. Also just bringing into our industrial world pieces of nature like live plants can make a huge difference as well. Sometimes just opening the windows in an office can be enough to diversify the indoor microbes with some new species.
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      Apr 30 2013: Breena: The good bacteria is not really supposed to replace what has already been killed, but rather as a means to expose people to microbes that they haven't even encountered yet. I agree that the use of antibiotics, especially in children, needs to be investigated further in order to prevent adverse effects.

      Marissa: I like your point about bringing more nature into industrial regions. There was a TED conversation you might be interested in (link below) where a guy suggested that cities should have "controlled" muddy playground for children. The idea is that these playgrounds would allow youths to be exposed to good microbes, as they are on farms. http://www.ted.com/conversations/12518/should_cities_create_dirty_mud.html
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        Apr 30 2013: That makes sense. Sometimes I am just like, "if this wasn't around in the world everything would be great, so lets get rid of it!" Which doesn't actually work in the real world. I looked at the TED talk you recommended for Marissa, very interesting. I was reading someone's idea about creating technology that can have a symbiotic relationship with specific microbes. What do you think of that idea?
      • May 1 2013: Anna, does this remind you of the "pox parties" kids had/have growing up where every parent flocked to the first child that got chicken pox so that they could get it out of their children's systems? I'm not sure if that was a thing when you guys were young, but it was when I was. Wouldn't it be a funny sight to see all of the "urban" kids sent to the farm while their immune systems were still pretty plastic so that they could potentially be exposed to good microbes!?

        (P.S. most doctors don't recommend "pox parties")
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          May 1 2013: Now that you mention it, I totally remember that! Parents definitely used to be on the look out for the first chance to expose their child to someone else with chicken pox. Hopefully urban kids do get a chance to visit farms, for various reasons.

          Thanks for bringing up pox parties. I had totally forgotten about that; pretty amusing.
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    Apr 29 2013: I think it’s important to get microbes from nature into our houses and into us. The bacteria we are exposed to right when we are born sets up our bacterial species composition that persists and evolves throughout the years. What effect this has on human health is still poorly understood. There are however studies which show that bacterial compositions do have some effects on health. For instance, it has been shown that obese people have a different gut bacterial compositions than those who are not. In one study, rats that were genetically predisposed to obesity, when given fecal transplants from rats that were not overweight, lost their excess weight and kept it off. Studies like this one have been cited to encourage the ingestion of probiotics, however, it’s still unclear if these (after passing through the acidic conditions of the stomach) are effective at colonizing the already colonized human gut.

    In many industrialized nations, various food items are irradiated, which goes a long way towards preventing foodborne pathogens but also kills good bacteria as well, so we are likely not getting exposed to the amounts and types of bacteria we evolved with. I do see a future when we will be lathering up with and ingesting more bacteria but until then, I’d say were better off safe than sorry and not going overboard with cleanliness (unless we know we’ve been exposed to pathogens) and making sure we get enough outings in nature wouldn’t hurt.
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      Apr 30 2013: In reference to gut bacteria, the food we ingest has an effect on the bacteria in it as the bacteria do on us. Essentially, we eat food and take what we can/need from it, then the bacteria digest the majority of what we don't.
      For instance, if a lactose intolerant person (lacking the ability to produce lactase, the enzyme that breaks down lactose, a sugar in dairy products) drinks milk or eats a slice of cheese, they don't digest it, but the microbes in their gut do. The digestion of lactose by gut bacteria then causes excess gas and abdominal cramps. What they ate directly affected the activity of those microbes. In contrast, when we eat foods that are lower in fiber our cholesterol levels rise.
      Fiber has a two fold effect on our health. First, it swells in our large intestine and works like a scrubbing pad on its walls. Second, it feeds the majority of good bacteria that reside in out gut. Both of these effects work in unison to maintain lower LDL cholesterol and promote a healthy cardiovascular system as well as a healthy digestive system.
      My point is, there are almost always natural ways of changing the biodiversity of our personal microbiome and we should take advantage of them.
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        Apr 30 2013: I definitely agree with you about finding the more natural ways of accruing the biodiversity of microbes that we need. Why try and use synthetic ways when a natural way is there?
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      Apr 30 2013: I think it is really interesting that there are differences in gut microbes between obese people and those who are not. Do you think this is genetically linked or do obese people house these microbes because of their lifestyle? I also agree that taking the natural way to help change our personal microbiome may be a better solution than possibly introducing a "baceri-ell" that could then cause more problems since we know so little about microbes.
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        Apr 30 2013: I think the mice in the study I mentioned were reared the same way, so same diet and everything but the experimental group was genetically predisposed to obesity. I tried looking for the paper but couldn't find it. Here's an interesting article that mentions a similar study though: http://blogs.scientificamerican.com/brainwaves/2012/09/12/the-food-fight-in-your-guts-why-bacteria-will-change-the-way-you-think-about-calories/
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          May 1 2013: I also have read a study of sterile mice vs normal mice and the effects that microbes have on body weight. The sterile mice were fed autoclaved food while the normal mice received non-sterilized food. The mice without microbes were significantly obese and nutrient-deficient. With all the sterile food products in today's world, no wonder we see problems in diet and an increase in problems linked to our microbiomes. When sterile mice were inoculated with gut flora from the non-sterile mice, a decrease in body fat was seen and the mice were indeed healthier.

          Looking back in history we see a trend of preserving food by the addition of bacteria and other cultures. There are so many beneficial microbes used in food processing including: beer, wine, bread, yogurt, cheese, keifer, and kombucha. These cultures have been an integral part of the human gut flora and have benefited humans for centuries. Not to mention the digestion of the probiotic cultures themselves is extremely nourishing for your body.

          For instance, when I was young my mom gave us kombucha (this took away heartburn and stomach aches almost instantly). My mom said it was a Chinese mushroom, but actually it is a biotic mat of anaerobic and aerobic bacteria. Our family has cultured this probiotic for years and the diversity of the different scobies is astounding. Depending on what kind of scoby you aquire does make a difference in the flavor and properties of your kombucha. Most people think of probiotics as just yogurt or acidophilus, but really humans have been using them for years to survive and treat medical issues. Why throw this method out with the bathwater? We should listen to our history, not fight against it.
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        May 1 2013: Everything in your gut microbiota is influenced by lifestyles that you engage in after birth. Originally for the environment of the gut, it is sterile and must be colonized. This is why as soon as you first feed the baby it starts to gain some microbes, and as he continues to process more food, more microbes begin to colonize this new environment. This is why as you raise your child, deciding what you feed them causes massive shifts in how their gut microbiota will form
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          May 1 2013: Also, it is interesting to observed the differences in mothers who breastfeed their children vs ones that give them formula. Children fed formula do not receive the beneficial enzymes and microbes in breast milk often develop serious allergies and colic. There are some probiotics in formula, but I still don't think they are better than nature's version. I agree with everyone in saying, maybe nature is just the best answer.
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    May 1 2013: Hi Anna,
    I think part of the reason for increased allergy levels and increased cancer, is that our environment is becoming more toxic, which compromises our immune systems.
  • May 1 2013: If a silver-bullet bacteri-ell was hypothetically produced, do you think drug and body care companies would simply not fund the product? Would the risk it would pose for loss of profits, considering a silver-bullet bacteri-ell would solve many many health issues and negating the need for many more products, be too big?
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    May 1 2013: I almost feel like there's no point in creating a product like "bacteri-ell" to replace purell in our society. It seems like it would be a silly thing that people wouldn't want to use, because since their polar opposites, they serve entirely different functions. People use Purell to keep themselves from coming in contact with other people's illnesses or to get ready to eat or just for general hygiene, and a lot of these things that things that bacteri-ell wouldn't help prevent. I do understand that it makes sense to have a higher level of exposure to microbes that can help with immune response and such things, but I think this should be accomplished in a more natural way, by such things as letting kids play outside and interact with other people at a young age, so they can be naturally exposed to a range of microbes while they're still young enough to combat anything harmful they may come in contact with. I know that as a child I was allowed to do these things and I have a very healthy immune system. I very rarely get sick and I don't have any allergies because I think I was exposed to these things enough in my daily life as a child that they're already incorporated into my body. I don't think a product like bacteri-ell would be necessary, really.
    • May 1 2013: I agree with Melissa. There are definitely services antibacterials provide that keep plenty of us healthy everyday. Purell prevents the spreading of viruses, and I use it regularly throughout the winter to prevent sickness during exam time. Exposure to the right bacteria should happen early, as Melissa said, and regular outdoor activity should theoretically be enough to maintain the microbes, as well as introduce new ones, on and in the human body.
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        May 1 2013: Yeah, I definitely think that a natural exposure is the way to go. That's how many cultures and how people historically gained exposure to bacteria and it's worked this long, so why change it? While medical advances have been great and something like a bacteria lotion seems convenient, it seems like something along that line could go terribly wrong, as it takes out the necessity for outdoor exposure. I feel as though it would be less effective to be introduced to airborne allergens and microbes through the air, rather than through our skin, as that it not the main way we have exposure to these things in the real world, so our resistance may not be as effective or strong.
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    May 1 2013: It may be possible to use microbes for future replacement rather than sanitizers like Purell. However, for realizing this, several things have to be achieved: understanding almost map of microbes' species, perfectly classifying species of microbes,and analyzing their traits and effects on human body. With modern studies in microbiology, the classification of microbes' species is still difficult because we do not have enough experimental tool to classify the species. Without ovecoming these limits, the future replacement using microbes doesn't seem to be realized.
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    May 1 2013: If there is a way to let our immune system to distinguish beneficial microbes from bad microbes, this way could be carried out. Of course, microbes is a part of our organisms, like the TED talk we look on the class said. I think that microbes in our body is a balanced and homeostasis system, so we shouldn't disrupt it both "too much cleaning" and "adding microbes in".
    I thought there could be two reasons why allergy levels in industrialized countries is high. Firstly, people is more sensitive than before. They clean everything everyday, so even normal microbes can even arouse allergy. Secondly, the microbes turn to be more abundant and various by mutation or some other environmental factors, which people never met them before.
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    May 1 2013: Our country and others has become afraid of everything and i greatly think that this fear of nature is causing the rise in medical problems that arise. The healthy person has a strong gut microbiota, which contains a variety of bacteria that we must come into contact with as we grow. If we do not add these microbes to our body at specific ages, then we create an altered population that won't provide the services that we need to survive. I think these increased allergy levels are the result of not allowing our children and ourselves to maintain healthy microbiomes. I think the idea of Bacteri-ell is a very hopeful outlook for the future, yet very unlikely due to the reality of these microbiomes. They are not simply a single bacteria or even a few different species. Rather they are a mass collection of 1000s of bacteria that occupy every region of our bodies. They vary greatly from one spot to the next and especially from one person to the next. Our gut microbiota is actually highly sensitive to what we eat and creates a population that has the maximum fitness in this environment. If we were to create the "right" concoction of microbial species that we want for one person, it will not be the "right" concoction for another. Depending whether you like to eat fish and a salad or a steak and potato for dinner can alter your microbiome. So in order for this to work you would need an array of microbial lotions and drinks in order to be beneficial to different individuals in different areas.
    • May 1 2013: I'd like to think of Bacteri-ell like a custom suit (but maybe increased by a few factors of complexity). With the proper measurements for each individual, an outline can be made and then tailored to required specifications. This maybe too expensive and complex at first, but surly there's an ass for every seat... more realistically, people with extreme immune system deficiencies conditions could benefit from this. In example, my cousin had Hodgkin's lymphoma. After returning home from treatment, she was needed to be in near sterile environments (which limits you to... almost every where). Maybe, a Bacteri-ell could have sped up her recovery or at least act as a buffer, allowing her to be subjected to less sterile conditions for periods of time.
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        May 1 2013: That's a really good use that i didn't seem to think about, but helping out in a medical recovery sense would be a very helpful use even if we couldn't make these products for everyday use. It could still be very helpful in small dosages but seems to be similar to what we would already have with probiotic medicine. Was she on any kinds of probiotics when she was recovering?
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    May 1 2013: I'm not sure how long MRSA has been around. a few million years or more, perhaps.

    You can argue anything, given a set of rules within an environment. Washing and cleaning in infected water might not help. A proper cleaning event would be augmented by an understanding of why we are cleaning and how effective it is in effecting our environment.

    I think cleaning is a natural function of nature. Animals clean themselves but their soap is the enzymes in their saliva (a natural form of anti-biotic). Many animals like to swim i water, etc.

    The tenacity of life makes it hard to have a germ free environment. I'm sure that the space craft we've sent to Mars, have released hitch-hiking microbes.
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    May 1 2013: Your inquiry reminds me of the problem with chicken pox. I'm not excessively educated in the subject, but I think if you fall sick with chicken pox very late in life, the sickness is many times more severe than if you got it at a young age. This is a good example of the decline of the immune system throughout life. I think this concept can also be applied to your question about microbes. Exposing humans to harmful viruses or bacteria early in life may save them later on, because their immune systems may be able to sufficiently deal with the threat due to its versatility in making antibodies. It's quite unfortunate that the human immune system declines (literally turns into fat) and becomes less able to compensate with foreign invaders throughout life.
    On another note, I'm surprised at the lack of products containing microbes these days. While there are a few (yogurt, kombucha, etc), science has proven that micro-organisms are extremely important to human health, both inside and outside the body. We all have Escherichia coli in our bodies, so what's wrong with adding additional (unharmful) bacteria into our systems? Because we must be careful with ingesting new strains of these kinds of organisms, I think additional research into health benefits and new methods of intaking these microbes should be conducted.
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    May 1 2013: The idea of reintroducing beneficial microbes back into our system is nothing new, people take probiotics for their stomach all the time. How many of us know someone who loves their Kombucha? It seems so common to have allergies these days; food allergies, pollen, animals, there's an allergy for everyone. Personally, I think the lack of diversity in our diets and the distance we spend away from nature is making us sick. While a lotion or something similar may be helpful, I think that this could be a problem that can't necessarily be solved by medical technology. Like the frogs that couldn't produce Alkaloid Toxins researchers wanted because they weren't receiving the right nutrients while in captivity. There is no guarantee that cultured microbes can be as beneficial as "wild" microbes. So maybe we need to stop cleaning everything, and take a hike.
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      May 1 2013: I agree. In Jonathan Eisen's talk, he mentions that the microbiome is not necessarily the same for each person. Some people that have a certain disease might be missing some crucial bacteria that could cure them. A lotion would be most beneficial to people if it could be individualized to fit people's needs. This most likely will not happen any time soon, or ever. And like you mentioned, we do not know if this would even work. I would think that this would work as well as taking probiotics. Anyone know how effective that is?

      Even if this was possible, the public would have to get this notion of 'all bacteria is bad' out of their heads. Obviously those that take probiotics and some others know that bacteria and other microbes are necessary for good health. Unfortunately we live in a world where Lysol and other products pride themselves on killing 99.9% of bacteria, even though most of those probably are not bad for you. It will take some time for the public to change their minds about microbes. Hopefully people will go outside more and get in touch with nature until that happens.
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    May 1 2013: There are about 200 hundred kinds of baterias which will contact human body, some of them stay on our skin for a long time like living in our skin, some of them just "visit" our skin occasionally. Actually, the bateria is the part of our bodies, if there is no bacteria exist, human can't live. Some bacteria on our skin will cause disease, but some of them are very benifit for human being. Staphylococcus, streptococcus, propionibacterium and corynebacterium are the four main bacteria on human's skin. I'll talk about the staphylococcus a little bit. Only if this bacteria go into the inner memberane of human's skin, it will make the inflammentory reaction and damage our bodies. Otherwise, it won't hurt people. Few years later, some researchers found something new. The metabolite of staphylococcus will inhibit the inflammentory reaction and it will be controlled by the keratinocytes of the staphylococcal lipoteichoic acid. If we over wash our hands by using the Purell, the metabolite of the staphylococcus will be wash out, which is not good for human. But we need to explore more and more in this area.
  • May 1 2013: People choose to use or not to use sanitizers like Purell. This means that people who want to get rid of the microbes on their hands (for good or ill) will choose to use them, while those that do not, won't. Oversanitation is not yet unavoidable, and until it is, a product like "Bacteri-ell" would suit no one. Those that would see it favorably don't need it, and those that need it (due to overuse of sanitation products) wouldn't see it favorably. The only answer to the issue of oversanitation is to combat the stigma that "germs are bad."
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      May 1 2013: I think this is an interesting point. I can see how a "Bacteri-ell" product would be marketable, but you could be right in that it would target the audience that doesn't need it. I agree that overcoming the stigma against microbes is a bigger issue...perhaps instead of focusing our resources on developing Bacteri-ell, we should focus them on creating antibacterial products that only target microbes that will make us sick. Sanitation obviously has its benefits but maybe there's a more effective and nuanced way of going about it.
    • May 1 2013: But in the same way there's a nuanced way of eliminating bad bacteria, surly there's a way to introduce good bacteria in a nuanced way. Being skeptical of the public's perception is quite short-sited... just figure out a way it could be marketed to also say it will help you lose weight and you got yourself the newest fad.
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    May 1 2013: I definitely agree that we need to know a whole lot more about our own microbiome before we can truly start to use microbes to cure or treat diseases. I think you're right that it will probably take a while for the concept of "good" bacteria or parasites to become accepted in our society, since we tend to love "clean" and "antibacterial" products. The process of infecting a person with hookworms is pretty gross -- I can't see many people today going for it!
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    May 1 2013: I think this topic is really interesting! I definitely think that it is important for children to be exposed to certain microbes early on in their lives so that they can begin building up their immune systems. I know that there are now so many parents who clean all of their children's toys right when they are done playing with them with sanitizing wipes, but I think that this plays a role in possibly causing children to have a weaker immune system. Like many other people have said, when I was little, I also spent a lot of time outside probably interacting with all different microbes. I was still hygienic and washed my hands, but my parents never excessively put hand sanitizer on me after every little thing I touched. I think that the mindset that people have about microbes being these negative entities is really hindering their potential beneficial uses.

    Your idea about creating some sort of bacteri-ell is really interesting, but I'm wondering how, with all the microbes that are part of the human biome, one can figure out which ones are good and which are bad? Also, since everybody is different, isn't there a possibility that some microbes can be harmful to some people but helpful to others? In that case, can you create a bacteri-ell that could work for everyone? Finally, I know that it is often a lot worse to get sick with viruses like the chicken pox when you're an adult than when you're a kid. So could the use of some sort of bacteri-ell have this same effect and be worse for adults than children?
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      May 1 2013: That is an interesting thought about the different effects of bacteri-ell on children and adults. If it were to become a possible product then effects on different people and age groups would be something that would need to be looked into. There would definitely need to be a lot of research and effort put into finding the right combinations of microbes and creating a product that would not back fire.
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        May 1 2013: These are key points. Scientists are currently working towards answering this basic question about how to assess which microbes or microbial communities are "good" and which are "bad". And yes different individuals - who vary in their age, genes, traits, environments, may respond different to different microbes. There is some interesting research being done at the University of Oregon META Center for Systems Biology using zebrafish and stickleback as model systems to begin to make some progress in this area http://meta.uoregon.edu/.
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    May 1 2013: I agree, a petting zoo of some kind seems much safer than an artificially grown mixture of microbes. This would also eliminate the concern of whether the "bacteri-ell" would have negative outcomes.
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    May 1 2013: Interesting idea. Mommy birds regurgitate their food to feed the young. This also gives the young a good dose of mommies gut floras. Other animals do similar things to introduce their offspring to the world microbes.

    Cleanliness is a state of mind. Not taking a bath everyday can become quite normal after awhile. I was raised, as a child, without air-conditioning, polio shots and showers. The order of the day was cleanliness keeps away sickness.

    It only takes one experience with MRSA to instill the idea that, clean hands and environment, is the safest road to travel.
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      May 1 2013: Of course you could argue that too much cleanliness externally and internally (anti-biotics) is what created MRSA
  • Apr 30 2013: "Bacteri-ell" would be a very difficult concept to bring to fruition. Assuming they follow the same ratios as other microbes, we'd only be able to culture a tiny percentage of the necessary microbes to simulate exposure. When factoring in those microbes that wouldn't support industrial scale production, or those that wouldn't survive transport from point of production to point of use, or those that wouldn't be conducive with the application method, the resulting product probably wouldn't surpass the paltry diversity found in "probiotics" already on sale.

    Logistically, I do not suspect that a supplement could ever equal natural exposure.
    • May 1 2013: Current computer modeling research is hoping to create a blueprint for mapping the entire universe, or how about the global climate models... I think in comparison to these, mapping the human microbiome is quite reasonable. Its easy to point out what we don't know currently, but exploring the world of the unknown and making mistakes is the most human thing possible. After all, think of how many patient who have died in the pursuit of advancing medicine.
      • May 1 2013: It isn't simply a matter of figuring out what is in us. Only a tiny fraction of the microbes a "bacteriell" product would need to contain can be supported outside the body in a carefully controlled laboratory setting. The product would require them to survive in a bottle on a truck travelling between the production facility and the store 2 timezones away.

        "Mapping the universe" is a romantic but thoroughly inappropriate comparison. A better metaphor would be kelp farming in the Sahara.
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    Apr 30 2013: I think this hygiene hypothesis is a great idea that people hardly ever think about. I agree with the statement, " Too much cleanliness prevents the development of well-balanced immune response" because by using products that eliminate the microbial communities on our skin will take away the natural "good" microbes that we need for survival. I believe the increase in allergy levels in industrialized countries is because these microbes evolving. In response to the statement, "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?" I do not agree with this because of how much microbial species you must introduce to a person in order for this to replace natural exposure to beneficial microbes. Is there even a way to separate "good" vs "harmful" microbes in order for only the good ones to be exposed to humans? And do we know an estimate of how much natural microbes we should on average be exposed to that is going to benefit our immunity system?
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    Apr 30 2013: I think this would be a very tricky idea to introduce to people. There is a great amount of knowledge out there that yes being to hygienic is not necessarily going to mean you get sick less often or have a better immune system. However, asking people to willingly "dirty" their hands would be a hard sell because that is how most people would view it, as dirtying their hands. I think that with a greater amount of research and testing this could be possible. I like the idea but people in the non-science community have barely begun to scratch the surface on their knowledge of microbes that scientists have known for a while longer. Getting people much more knowledgeable about microbes and specifically what certain microbes can do would be the best way to start. Considering the main goal of every business is to make a profit, no business will not to manufacture a hand lotion that people may view in a negative way because their sales would be atrocious.

    That being said I like this idea and I think there could be a lot of potential breakthroughs in the study of microbes that could bring about the need for a product like this.
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      Apr 30 2013: I don't think it would take people long to get used to the idea of "dirtying" their hands with beneficial bacterial species. Have you heard of maggot medicine*? Many people trust medical experts, and if people can get used to the idea of maggots cleaning their wounds, I don't think they will mind a lot of invisible organisms on their hands.

      *http://www.youtube.com/watch?v=6Xt6NWkgydM
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        May 1 2013: It's true that maggot medicine and probiotics are becoming popular, but in what sector? Who can actually afford these things in our current economy. Especially when most families are struggling just to get food on the table, who has the extra money to pay for these medical remedies when their families survival may be on the line. I think these things are a very high-end clientele type of product that only gain interest from people who can afford health insurance in which their doctors recommend them. Much of the U.S. doesn't even have health insurance because it is to expensive. I like the idea, but as a poor college student I think it is going to be left to the higher end tax bracket and everyone else will just have to get our microbes naturally.
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          May 1 2013: I agree with you Shelby. Most of these remedies are for the high end clientele and what we need is a lost cost way of being able to get these microbes without breaking the bank. My thought is if we can get the microbes we need by spending more time outside than why not. Spending time in the outdoors is free and provides may health benefits. Many companies have came out with ways of getting probiotics like in yogurt, drinks and even in pills that people can take. It seems like people are covering the internal microbes, but not the ones that live on the surface of our bodies. I think until a way of replenishing them on our bodies is found then maybe we just need to use old school techniques and go back outside.
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    Apr 30 2013: The hygiene hypothesis and the early immune challenge bring up important points about our immune system development and the necessity for introduction of bacteria and allergens to build up an immunity. The increased allergy levels seen in industrialized countries is directly related to the excessive cleanliness in these areas. Certain airborne allergens are known to bind a specific antibody class, the IgE class, in the body which leads to the inflammation associated with an allergy attack. By introducing allergens at an early age by spending time outdoors the body becomes accustomed to these allergens by slowly building up the body's major IgG antibody class. After building up this form of acquired immunity the body no longer reacts in the same way to those allergens due to a major reduction in IgE antibody binding and subsequent mast cell stimulation leading to a histamine type allergy reaction. I know this process too well from my personal experiences with seasonal allergies. I was born and lived the first 5 years of my life in a high altitude desert of Arizona where very few types of allergen producing plants and animals lived. It was also very hot with intense sunlight so I spent most of my time indoors and didn't get exposed to many airborne allergens. Once my family and I moved to Oregon, the so-called "grass seed capital of the world", I had somewhat severe seasonal allergies. My body was in a sense over-reacting to airborne allergies it had not previously encountered. I eventually had enough and decided to go through allergy shots which slowly introduced increasingly concentrated amounts of these allergens into my body so it could develop the normal immune response which was absent from spending my baby and toddler years in an excessively clean environment. After a few years I no longer had any allergies to the life in Oregon. This demonstrates pretty clearly that introduction to bacteria and allergens at a young age is crucial for a good immune system.
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    Apr 30 2013: That's an interesting point, I know an only child with a severe peanut allergy. I could totally see how only children would not have as many chances to encounter the bacteria they need to when young, from their siblings bringing them into the home. In my opinion Bacteria-ell would just be an attempt for all the Sheldon Coopers out there to live in a fake sterile environment. Instead, why not have your kids go to the park every once in a while. Over prescription of antibiotics is another thing, lots of people just assume antibiotics are purely good things.

    Yet another factor is the constant bombardment of microwaves from cell phoned and wireless internet that could be affecting our immune systems. These things became standard overnight despite the fact that we know very little about how a lifetime of exposure could affect someone internally. Consider going to the dentist and having the large doormat thing placed on you to protect you from the rays, or the radiation sickness created by an atomic bomb. While these are quick exposures of a lot of radiation, microwaves do not penetrate as deeply but they are always around. Kids half my age have grown up with iPhones always on hand, and an old apple commercial, as disorienting as ever, ended with some little kid with huge eyes using his iPhone which made me shudder. The potential long term effects spooked me a long time ago, I insisted on not having a wireless modem and I almost never carry my phone around.
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    Apr 30 2013: I think that Bacteri-ell would be a great idea, but I think we also need to find a way of making people not so afraid of germs. Yeah, germs make us sick and can can even end up killing people, but can't the same thing happen by wiping away all the germs from your body? The germs on our bodies help to build our immune systems and keep us from getting ill, so having a lotion like bacteri-ell in a world full of germaphobes is an amazing idea, but will it help in solving the problem or just cover it up?
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      May 1 2013: This is an important point, that the publics idea of bacteria needs to change. National Geographic pushed in the right direction recently with a feature on microbes. In the link below there are some amazing pictures of different bacteria and viruses. I think that this visual representation, along with all of the new data on the importance of our microbiome will be a huge part of changing their image. If we can only get the BBC and David Attenborough to make a series on microbes, people will change their tune.

      http://ngm.nationalgeographic.com/2013/01/microbes/oeggerli-photography#/05-intestinal-bacteria-670.jpg
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    Apr 30 2013: Everything in moderation. If you use too much Purell, it will take away the good bacteria as well as the bad....That goes double for Manorapid. If used sparingly, it will not erase every bacteria.
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    Apr 30 2013: As a child I grew up playing outside all the time. If I had a minor fall of some kind and would run home to mom and she would brush me off and say, "you're o.k. a little dirt never hurt you". This simple phrase has stayed with. Anna, I do not understand the science of it all but, I see ads touting if you use this and that product here and there all over your home, you'll evade illness caused by all these horrible Microbes, a.k.a. germs.These ads can make one a germ-a-phobic! Now I am a believer in washing your hands frequently, I do sanitize areas of our home and personal hygiene is important. I never come from the notion that it's me against the nation of germs! I gotta' believe spraying this and that cleaner in my home and securing every milometer of it from the outside environment can't be a good thing. These is surely a balance here.
    Do children go outside and play anymore? maybe a piece of the puzzle lies here?
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      Jon Cox

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      Apr 30 2013: I definitely think that is a piece of the puzzle! Regular interactions between children and the natural world have been increasingly replaced by highly stimulating toys and electronics. Instead of exploring the outdoors in real life, many children (and adults, too) spend their free time exploring the virtual worlds of video games or watching TV or whatever. Here's a chunk of an AWESOME Ed Ayres article (http://www.worldwatch.org/system/files/EP123B.pdf) from 1999:

      "The disconnection is worsened by systemic misuses of technology. Consider, for example, the marketing of children’s play—the soaring dissemination of
      automated toys and games that provide the propulsion, conflict, or imagery once provided by children’s arms, legs, and imaginations. Not only does
      that vastly enlarge the amount of plastics and metals
      needed to bring up children, but it renders the children more passive and dependent on still greater
      stimulation. Mega-dollar marketing campaigns,
      aimed at driving ever greater material consumption,
      replace the woods and fields that once kept kids
      connected to their planet. In a Toys-R-Us world, we
      spend more and more to bring up kids who are less
      and less connected to what keeps them alive."

      This disconnection from the world and "what keeps them alive" certainly impacts a child's exposure to microbes. I don't think a magic potion is the answer to this or any problem. Education and a shift in priorities is the first step.
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        Apr 30 2013: I also grew up playing outside all the time :)

        I mentioned this to someone else, but there are a lot of comments so you probably didn't see it. I found a study which found that children raised on farms were not afflicted with asthma and neurodermitis as much as children who were raised in cities. This observation was even associated with contact of pregnant women to animals and soil, suggesting that prenatal exposure to certain microbes is also important in disease prevention.*

        *Douwes J, Cheng S, Travier N, et al. Farm exposure in utero may
        protect against asthma, hay fever and eczema. Eur Respir J 2008;
        32:603 611.
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          Apr 30 2013: While I definitely believe there could be a crucial connection between contact with healthy microbes at a young age and development of a strong immune system, viewing asthma affliction rates in the country vs. city as a problem caused by less exposure to outdoor microbes can be problematic. Development of asthma in a city environment is often caused by poor air quality, which is the result of airborne pollutants released by fossil fuels consumer for transporation, commercial/industrial manufacturing, and other various factors. If higher rates of asthma are found in cities, maybe this is more an issue of exposure to the wrong microbes (or maybe just pollutants) that are not found in the country, where asthma rates are lower? http://erj.ersjournals.com/content/early/2013/03/20/09031936.00031112.abstract
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          May 1 2013: Wow Anna that is really interesting, I want to look into that study! It's crazy to think that exposure during gestation can actually have a significant impact. I wonder if visiting farms and a wide variety of other ecosystems / natural environments is currently a practice that's advocated for pregnant women... if not, maybe it should be!
        • May 1 2013: Well, it is a interesting point that healthy microbes help to build stronger immune system. I agree that. But Not only healthy micorbes but also harmed microbes halp to strengthen human immune system by exposure. Human T cells have a interesting ability that, sometimes, reconbine past memories of infections and form new antigens against new infection. I assume that in countries sides, there is more chances to expose minor harm and useful micorbes of which leads more learning chances. Thus, human immune system of countries people have more "life long wisdom" in their hand.
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      Apr 30 2013: After sleeping on this issue, I think that the problem isn't over sanitization of the hands. I think the real problem is over-prescribing antibiotics.

      The problem with health care today is people expect doctors to be magical wizards that can cure all diseases with a simple spell (amoxicillin, zofran, cipro, zithro, {insert common abx here}, etc...) People show up to their PCP or in the ER, when they are sick, and demand medication to make them better. Often people have viral infections (common cold = rhinoviruses) and there are really no known medications that a prescribed for that kind of infections. Yet the people expect something from their doctor and so the doctors in order to get these patients out of the hospital, so they can help the next person with actual problems, they often prescribe antibiotics (abx) even though they know that it won't do much to help.

      Obviously we all know what this leads to (AKA MRSA) but on top of that it also disrupts gut microbiota, which in my point of view is the most important of all. Without the proper species in your gut you would likely starve to death no matter how much food you at.

      In conclusion, I would say use as much Purell as you want. Killing microbes on one part of your body (hands) isn't going to have that drastic an effect in the long-term. What I would caution people about is abx. Only take abx when you really need to because otherwise you are just disrupting your gut microbiota and potentially opening yourself up to infection by other virulent bacteria.
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        Apr 30 2013: I agree! Taking a peel gives us more problems, and some doctors do not think about what side effects their patients get, especially neuronal or hormonal drug. so bad! It also true that people think that the infection will be gone when they take antibiotic without thinking what the drug does to their body. Some people would ask their doctor to get more antibiotics than what they really need, overdose that more is always better!
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    Apr 30 2013: I'm curious to see if we can integrate specific microbes into households and everyday objects. Would it be possible to eliminate the need for a "Bacteri-ell" by creating a symbiotic relationship between technology and microbes. If it is possible to tailor specific microbes to grow preferentially on items such as phones, faucet handles, socks, we could select for the immune boosting concoction of "right" microbial species. We could make it possible to harbor the "right" microbes based on different locations in our house for the greatest beneficial health affects.
    • Apr 30 2013: Would it be easier to spread these "right" microbes or eliminate only the "wrong" microbes?
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      Apr 30 2013: The problem with this is that as far as we know, there isn't a handful of "right" microbes that are beneficial to us. As I understand it, what makes our exterior microbial systems work is the diversity of a huge range of different microbes, which changes across different areas of our body. I would think that attempting to introduce a select few microbes would be a lot like introducing one or two species into a specific area. For example, say you somehow introduced like 10,000 deer into a state park. They're either going to be problematic due to their large numbers, or they're going to die off because the environment can't sustain the increased population, so they will return to their original numbers.

      To sum this up, I believe that our microbial systems are far too immense and diverse to alter in a beneficial way.
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        Apr 30 2013: I didn't make it clear in my original post, but I was thinking the "Bacteri-ell" would have a ton of microbial species, not just one or two. Otherwise, as Professor Green pointed out in class, it wouldn't be any more beneficial than yogurt, which only contains about 5 probiotics.

        I agree that we don't know enough about the "right" microbes currently, but this was more an idea of something that might be possible/necessary in the future. :)
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          Apr 30 2013: Seeing as (I assume) we develop our external microbial environments from our environment, do you think using "Bacteri-ell", as you call it, even under ideal conditions, would be more effective than our normal environmental interactions?

          I hope I don't sound like I'm criticizing you here, but I would think that because our environments change so much (unless you're stuck in a room 24/7), our microbial diversity would change with that, and any attempt to influence that would be somewhat behind the curve. That said, I have no idea how quickly and to what extent that diversity changes, so I could be completely wrong.
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          Apr 30 2013: Also, I'm not sure if this has been mentioned yet, but perhaps instead of "adding more", as you suggest via some sort of microbial cocktail, maybe we could just "take away less". For example, it may be possible to develop soaps and shampoos and that like that will clean your skin without essentially nuking the microbial populations that live there.
        • Apr 30 2013: This is along the lines of what I was thinking. Taking away some of the bad microbes might be an easier way to do things then trying to add the mass amounts of healthy ones
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        Apr 30 2013: Would any of you consider having a feces transplant? As weird as that sounds, it might be the most efficient way of creating a healthy gut ecosystem until we understand the complex cast that's needed for good digestion.
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          May 1 2013: Depends what way it goes in ;)
          But in all seriousness, probably not. Seems a bit overkill to me. Humans have been doing just fine for thousands of years without that kind of thing. But that's just my opinion.
  • Apr 30 2013: First of all, I know nothing about this cleanliness and health connection. My personal opinion is that allergies come about by what we eat, not by what we touch.

    We moved from the Netherlands to Canada close to 40 years ago. When we came here I was very much surprised by the severity of allergies. One of our kids went into a hospital for a small operation and my wife was reprimanded for not having filled-out his allergy list at the foot of his bed. When she said he did not have any, the were very surprised.

    I think all food there was organic and I hope it still is.
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      Apr 30 2013: Same here! I was surprised that many people have allergies or asthma when I moved to Hawaii. Until moving to Hawaii, I rarely see people who have allergies or asthma. I think that developing allergies and asthma is more associated with the environment, chemicals and pollutant. I mean microbes might be associated but more related to the environment?
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      Apr 30 2013: Yes, and not only to the present-day environmental conditions but years and years of human evolutionary history as well. There are distinct regional patterns in food allergies that can be explained by when those areas where first inhabited by humans many thousands of years ago. Since then, genetic mutations and genetic drift have changed the genome of certain individuals and those changes subsequently get reflected in the general population. A phenomenon in anthropology called "isolation by distance" basically means that there is little to no gene flow between certain populations because they are too geographically isolated from one another. The reason why we see allergies in some places and not others has to do with a genetic mutation that was maintained in one population but not introduced into another population because there was no interbreeding.
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        Apr 30 2013: Good point! I like that!
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      Apr 30 2013: I noticed a similar change in myself when I moved from Illinois to Oregon, a much less drastic change in environment than your move from the Netherlands to Canada. I never personally experienced allergies in the midwest but in Oregon I have them worse than ever. While it is possible that your child's allergy experience was due to food, I believe that this phenomenon is more likely to occur from the difference in the microorganisms present in the two environments. Being that most ecosystems differ from each other in their microbial makeup, is it possible that, upon moving, we are exposed to organisms that we have never encountered, causing reactions in our bodies (like allergies)?
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        Apr 30 2013: Yes, definitely! Diet matters! Food is one of good sources to get microbes, and where it is grown! Different habitat carries different biodiversity!
      • Apr 30 2013: Seems this was so much the case ages ago when Europeans went to South and North America and Mexico, which killed so many natives with them just being there.

        Now we have to get shots when going to many other parts of the world.

        Carty "While it is possible that your child's allergy experience was due to food,.."
        The point was he never, and still does not have any allergies.
        Does it not say, You are what you eat? :)
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        Apr 30 2013: I think environment absolutely plays a role, but not necessarily because of the microbial make up. Here in Eugene there is very heavy pollen in the spring and summer, so much so that I have heard many people say they didn't have allergies until they came here. We are indeed exposed to different organisms in different environments, and this is what can trigger an allergic reaction. Exposure is the key: you don't know you're allergic to something until you encounter it. Is it that more people are naturally becoming allergic to peanuts, or is it that--due to market integration and transportation--more people are eating peanuts now and discovering their allergies?

        I also think there is a lot of over-reporting/over-diagnosing with allergies. If someone has a negative experience with something it is easy to label it as an allergy. It is hard to tell the difference between hayfever and a common cold. If you get a cold in the springtime, and people ask if you have allergies, I believe most people would assume they did without second thought. The same is seen in the skyrocketing of ADHD diagnosis is children recently. Is it really that more than 50% of all children in the US are born with ADHD? Maybe their behavior is due to the fact they are confined in classrooms for longer hours everyday in school. When you really think about it, how can you expect a 7 year old not to be fidgety sitting at a desk all day; doesn't mean they have ADHD. Correlation vs. causation!
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          Eun Min

          • +1
          Apr 30 2013: Oh, yes! As you said, you don't know if you have an allergy until you expose to it!
          In terms of high increase ADHD in children, I agree with you that it might be environmental matter! Another thing I noticed was how we assess children. I used to volunteer preschools and a traveling preschool which run by Maui county called "tutu and me traveling school." When people assess the children, they show cards with objects printed on. Then, children need to answer what the objects are. I thought it was ridiculous that one of card is a coat. Of course, children do not know what a coat is due to not seen it before. The weather in HI is hot, so we don't wear a coat, but a jacket.
          Children get marked off because they do not know what a coat is!
          When people assess children, they need to consider more about the environment where the children grow up with!
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      Apr 30 2013: Yes, as another anecdotal aside, as a kid, whenever I found an object, anywhere, the first step I took was to put it in my mouth. I was always getting in trouble for this. It was a problem. My sister was more obedient or less orally-fixated or something, so she did not do this.

      Growing up, even though my sister ate healthier than me and participated in more sports, she got sick MUCH more often than I did- not a crazy amount, but maybe a few times a year. I pretty much never got sick, and still don't. I can't recall the last time I was sick, and I had always wondered if these things were related, if I had strengthened my immune system with unsanitary habits as a child. Obviously this could be due to many other things, but it certainly could have played a large part; my sister and I are genetically similar (obviously) and were exposed to much of the same environments.

      CONFOUNDINGLY, however, I have had bad pollen allergies my entire life, especially grasses, while she has never had any notable allergies. This part makes me question aspects of the early immune challenge as well as the hygiene hypotheses, as I was certainly exposed to grass pollen as a child. I'm still waiting to be struck with my multi-annual hay fever up here in the grass seed capital of the world. . . . maybe all that local honey has done me some good.
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    Apr 29 2013: The biggest issue is how to find the good microbes and figure out a way to distribute it to people who might benefit from its affects. I have never had any food or environmental allergies, that I know of. I consider myself one of the lucky few. I think the key is to look at people like myself and the kind of microbes I carry in order to get an idea of the types that potentially help to prevent allergens and possibly disease. In the case of disease my family on both my mother's and father's side are predisposed to high blood pressure, high cholesterol, heart disease, obesity and diabetes. Could these things be influenced by my microbes and can I be exposed to microbes from people with a lower probability of developing diabetes, heart disease or high cholesterol in order to "immunize" myself? Can my genetics be influenced by my microbes. Its an exciting thought but is it plausible or silly?
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      Eun Min

      • +1
      Apr 30 2013: There are many studies have found the relationship between human health and microbes. Here is a good paper to read: http://www.ncbi.nlm.nih.gov/pubmed/23594389
      I guess that the disease your family predisposed can be genetic, life style including food, and microbes. I think that food is a good indicator of what kind of microbes you carry in your gut because your food creates habitat for gut microbes! The microbes alter your metabolism due to their metabolism that is related in development of obesity and diabetes!
      I notice that I gained a lot since I moved to US from Korea where I used to eat fresh vegetables, fruits, and fish. Changing diet altered my gut microbes.
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      Apr 30 2013: I think your point on how microbes interact to possibly affect diseases and allergies is really interesting, innovative idea and should be the topic for further researcher. Could a certain concoction of microbes potentially protect you from heart disease? or make you more susceptible? this is incredibly intriguing. Unfortunately as many of the other participants have pointed out the lack of knowledge in regards to our skin micro biome is incredible. The bacteria and how they all interact together has not really been studied and needs to be researched in order for any advances in disease prevention or allergy prevention can even be studied.
    • Apr 30 2013: Paige, I really like your point about finding the good microbes. I was thinking along the same lines about finding the good and bad microbes and mapping them and how that is a must. However I disagree slightly with using someone like you. As you said, its likely that you have not been exposed to all the allergens that are out there. While yes we need to know the good microbes and using someone who does not have allergies would be good if we ever were to need such "bacteri-ell". To hopefully avid this I think comparing people who do have allergies and seeing what similar microbes they have is also extremely important. That is, it might be better to figure out what the bad microbes are and work on eliminating them. I have to believe that, at the moment, the amount of harmful microbes is substantially less than the helpful ones. It might be more manageable to find these harmful ones and try to target those. Possibly attacking only these harmful microbes in soaps and other sanitizers may eliminate the need for a bacteria-ell solution. Any thoughts?
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        Apr 30 2013: i completely agree that targeting only harmful microbes in soaps and other sanitizers may eliminate the need for a bacteri-ell. But how would this be possible? So many antimicrobial agents target cells that have similar components so the use of them would destroy many different kinds of bacteria good and bad. I believe this is the problem currently, because the antimicrobial agents target both good and bad bacteria. I do not know how it would be possible to just target the bad bacteria. Again more research is needed to identify fully what are the good and bad microbes on the skin. Also, since everyone has different microbes on their skin you would have to custom make this type of sanitizer to cater for peoples specific differences on their skin. We also dont know if a bad microbe on someone is actually acting like a good microbe on another
        • May 1 2013: Nicole made a really good point about how the effects of a "bad microbe" in an individual's microbiome may be good to another - and even in that person's own body it may be better to have a "bad" microbe than not. An example was mentioned earlier of the Helicobacter pylori bacteria responsible for stomach ulcers. When this bacteria is gone from the system (through antibiotics), increased levels of the hormone ghrelin hold steady and in essence tell the brain that it should keep eating, which obviously could have a negative downstream effect on weight. Lack of H. pylori is also associated with increased gastric reflux, which is known to be a factor for asthma and esophageal diseases. My point being is that it is extremely difficult as a researcher or doctor right now to be able to tell a patient in some cases, "Hey, so either you have this ailment caused by this microbe and deal with it, or we get rid of it and something else negative may happen." I'd be interested in seeing more medical research looking at the positive and negative interactions of each microbe. I read that the NIH awarded one of the scientists that found the H. pylori and ghrelin correlation funds for more research and the same NIH awarded $115 million to the Human Microbiome Project. With that project wrapping up in the next couple of years. I wouldn't be surprised to see more exciting ground breaking news on the human microbiome.

          http://www.nytimes.com/2011/11/01/health/scientist-examines-possible-link-between-antibiotics-and-obesity.html?_r=0
          http://www.hmpdacc.org/
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    Apr 29 2013: I don't think increased allergy levels can necessarily be ascribed to too much cleanliness, but I do think that exposure to the right microbes must be important. It's a definite possibility that at some time in the future, people who were not naturally exposed to the necessary microbes could be exposed later in life through some alternative mechanism. For example, one thing I've been reading about often in the news and during research for other classes is "hookworm therapy". While not a microbe (the hookworm is a nematode), hookworms, like some microbes, have been shown to have beneficial effects for people with allergies or overactive immune systems (Strachan 1989). People that are infected with hookworms are less likely to have asthma or hay fever. Most of the reading about hookworms I've done has been in regards to Celiac Disease (gluten allergy), where in trials they have found that giving a patient hookworms has greatly improved their condition (the same has been found for type I diabetes). Then again, in developing countries hookworms are a leading cause of death in children, so obviously this method would need to be carefully controlled.
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      Apr 30 2013: I completely agree with your first sentence! Here is a great supporting quote I didn't end up including in my conversation starter. "The risk of developing allergies is not necessarily caused by a lack of bugs and parasites in the environment per se, but rather by a lack of certain organisms that have, over the course of evolution, trained our immune system to be more tolerant.” (Rook et al, 2009)

      I, too, came across some articles about the benefits of hookworm infection. Thanks for bringing up an interesting point!
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      Apr 30 2013: They have also started using hookworms in experimental treatments for Multiple Sclerosis (MS) which I found really interesting. This makes me wonder if there are other ways such as introducing good microbes in later stages of diseases that could "cure" or lead to a remission of these diseases. The problem being that we currently know very little about the good and bad bacteria in our bodies. Some bacteria are even both good and bad depending on conditions.
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        Apr 30 2013: I came across an article that detailed the experience of Jasper Lawrence, a man who infected himself with hookworms in Africa in order to treat his severe allergies and is now selling the hookworms to others for similar reasons. However, the FDA did not approve of him doing this and now he is on the run from the law, so I think until we can somehow make the idea of 'good' bacteria or parasites a social norm, people won't necessarily agree with it (unless they are desperate like in Lawrence and his clients' cases). The article mentions the hygiene hypothesis and Lawrence is quoted saying that "everyone is concerned about biodiversity in the outside world, and saving the rainforest, but we've also screwed up the biodiversity inside us." I think this is an interesting point that relates to the question at hand.
        http://www.guardian.co.uk/lifeandstyle/2010/may/23/parasitic-hookworm-jasper-lawrence-tim-adams
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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?