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Anna Crist

student researcher , University of Oregon

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Purell now, Bacteri-ell later?

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

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

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    Apr 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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