
Educate Your Immune System - qubitcoder
http://www.nytimes.com/2016/06/05/opinion/sunday/educate-your-immune-system.html
======
kome
Nice little article! And it confirms my anecdotal evidence, so it feels good.
;)

I had a wild childhood: it happened to me to eat hamster food from his cage,
eating dirt, eating sand, raw tomatoes directly from the plant, drinking
waters from random streams; drinking raw milk without boiling it few minutes
after milking it by hand, eating raw eggs, and when I wasn't in school, like
during the summer, I had one shower per week, or less...

Don't worry: growing up I am back to civilization. But I have to say that I am
_never_ sick. Also during winter.

I pity all those kids and their urban childhood, they will have to endure
weird intolerance to random things. I am grateful to my parents.

Back then growing children was still a simple thing, nowadays mothers and
fathers are so scared by society.

~~~
Lxr
I promise there are plenty of patients with autoimmune disease who had
childhoods just like yours. I don’t want to sound hostile but “I am not sick,
because I do/did X” is a) not scientifically useful and b) somewhat insulting
to patients who suffer from chronic illness. The truth is everyone has risk
factors for most diseases and there is still an incredibly large probabilistic
element involved - some people are just lucky. This will likely change in the
future as true causes are identified of course.

The hygiene hypothesis is interesting but it’s far from proven and there are
competing theories for many autoimmune diseases involving pathogens. The
trendy attitude of “people were so healthy back when society was simple”,
however, is blatantly false. People overall, by any reasonable metric, have
better health today than they have even had in the past. As we invent vaccines
and improve treatment options we simply forget about the burden of diseases
that no longer exist.

~~~
ellyagg
> not scientifically useful

This isn't a peer reviewed journal, we're just a community chatting about
stuff, so that's not really a germane standard. Anecdotes are a perfectly
reasonable input into our personal Bayesian inference filters, since no one
has all the answers yet (not even close).

~~~
Dr_tldr
But beyond being a humblebrag, it's also bordering on a just-world view of the
universe that's basically superstition.

Without reference to a larger dataset, the inference "I"m never sick because I
played in the woods and ate weird stuff. If you get sick a lot, it's partially
your fault because you didn't do that." could easily be replaced with "I'm
never sick because I prayed to the right god every day. If you get sick a
lot..."

~~~
kome
> it's partially your fault because you didn't do that

I never implied that. If something, I said that too much pressure by society
is making parents work harder, and that's not necessarily a good thing.

~~~
ngrilly
I'm wondering why you are downvoted for this comment?

~~~
Dr_tldr
It's placing blame for a general problem on the decisions and values of
certain people and societies.

In terms of logical structure, taking an anecdote and universalizing it
without a falsifiable explanatory mechanism is indistinguishable from blaming
faraway natural disasters on other people sinning against the gods.

In both cases, people and society are held to be at least partially culpable
for something bad that happened to them without presenting any evidence other
than that they don't do all the same things that you do, and you're doing
fine.

------
etangent
A wild hypothesis here. One thing I noticed in "pre-Western" diets that's
absent from modern ones is unpasteurized dairy. All milk sold in Western
countries is pasteurized (treated thermally to kill most of its bacteria). If
you leave on a shelf, it will remain unspoiled for quite a long time compared
to unpasteurized, but when it does spoil, it becomes completely undrinkable,
with foul smell. Unpasteurized milk, on the other hand, has a much shorter
shelf life, however the spoiled product is acidic and yogurt-like, has no foul
smell, and is (mostly) safe to consume, even by people with some degree of
lactose intolerance (it has had most of its lactose converted to lactic acid,
hence the sour taste). This so-called Soured milk
([https://en.wikipedia.org/wiki/Soured_milk](https://en.wikipedia.org/wiki/Soured_milk))
is extremely commonly consumed in many Eastern European countries that don't
have Western food safety standards.

While there may be other beneficial (to the immune system) things happening in
Russian Karelia, I can't help but wonder if the absence of unpasteurized dairy
is the single massive thing that causes failure of gut microbiomes in the
modern world.

~~~
dTal
Considering that eating dairy at all is a relatively modern invention (post-
agriculture), I suspect not. Is there any evidence at all for the beneficial
effect of bioactive dairy products on the gut microbiome, beyond yoghurt
commercials for middle-aged women?

~~~
baldfat
Name one mammal besides humans who drink milk as adults?

P.S. I love cheese and will forever eat it but I don't drink milk.

~~~
rosser
I find it really interesting that all of the replies to this comment take the
fact that animals will consume dairy _if it 's available_ as an argument in
favor of human consumption of it. Humans are the _only_ animals, that _as
adults_ , _take_ the milk of another mammal for their own consumption.

For that matter, other than the isolated, exceptional cases of a lactating
mammal adopting the orphans of another mammal and nursing them, humans are the
_only_ mammals that consume the milk of _a different species_.

Cats drinking from a saucer of milk put on the floor in front of them is
_nothing_ like milking a cow — except, I suppose, at the level of digesting
lactose.

~~~
etangent
What _I_ find interesting is that the health benefit (or non-benefit) of milk
for _adult_ humans is completely irrelevant to the discussion. Autoimmune
disease (the topic of the original article) develops at a very early age.

~~~
maxerickson
Many autoimmune diseases develop in adults.

------
Mz
_The scientists had periodically sampled the children’s microbes, and when
they looked back at this record, they discovered that the microbiome of
children who developed the disease changed in predictable ways nearly a year
before the disease appeared. Diversity declined and inflammatory microbes
bloomed. It was as if a gradually maturing ecosystem had been struck by a
blight and overgrown by weeds._

I wonder if they looked at antibiotic use. Wealthier countries often have
better medical access. Perhaps it isn't that poor countries are "dirtier" so
much as that when kids do get ill, they are less likely to get nuke-em-from-
orbit antibiotics, use of which is known to have a scorched earth effect on
the gut. The gut is about 70 percent of the immune system.

I really dislike the hygiene hypothesis. I have reversed a lot of the symptoms
of my so called auto immune disorder in part by staying impeccably clean and
avoiding exposure to germs as best I can. To me, this "a dirtier world is
better for you" line of reasoning just does not make sense. It would make a
great deal more sense to me if the conclusion was that casual use of
antibiotics does egregious harm to the biome in the gut, from which some
people never recover. Modern doctors are perfectly happy to prescribe
antibiotics and I don't think I have ever had one tell me that I need to
consume yogurt afterwards to foster healing of the damaged gut biome.

------
jonlucc
Interesting parallel study I saw recently:

Autoimmune disease rodent models don't translate well to the clinic, so an
academic group tried to look for reasons. They found that normal, healthy
humans have far more memory B cells than lab mice, which may be a major
factor.

So they looked at wild mice and pet store mice. Wild mice had a lot of memory
B cells, but pet store mice had the most. They found you can house pet store
mice with lab mice, and the lab mice will eventually increase the number of B
cells, but you lose about 20% of them.

~~~
dvtv75
Do you lose 20% of the lab mice, or the pet store mice, or the B cells?

~~~
jonlucc
Sorry for being unclear; you lose 20% of the lab mice.

------
kakoni
Few known facts (About Finnish children);

\- In Finland 80% of 3-year olds have had ear infection.

\- 53% of 2-year olds are in daycare. Due to various reasons group sizes are
getting bigger and bigger, new normal can be around 30 kids in a single
daycare group (=constant infections...)

\- Half of the kids have private health insurances (public outpatient care has
some issues..)

\- Typical treatment for ear infection(although many times unnecessary) is
antibiotics.(=to keep parents happy / easier for the doctor)

------
wsc981

      These findings are very preliminary, but they support a decades-old 
      (and unfortunately named) idea called the hygiene hypothesis. In 
      order to develop properly, the hypothesis holds — to avoid the 
      hyper-reactive tendencies that underlie autoimmune and allergic 
      disease — the immune system needs a certain type of stimulation 
      early in life. It needs an education.
    

George Carlin (RIP) also had a nice little piece on this:
[https://www.youtube.com/watch?v=CnmMNdiCz_s](https://www.youtube.com/watch?v=CnmMNdiCz_s)

I think it's funny that we Western people get so quickly sick from street-food
in Asian countries (e.g. Thailand), while most locals have no problem eating
the food.

~~~
thaumasiotes
> I think it's funny that we Western people get so quickly sick from street-
> food in Asian countries (e.g. Thailand), while most locals have no problem
> eating the food.

I can eat food in Shanghai without suffering from traveler's diarrhea
afterward. It took a while to get to that point.

With exposure, you'll develop tolerance for the local food. Hopefully, all of
the locals have already had that exposure.

------
afarrell
> After three years, 16 Finnish children and 14 Estonian children had these
> antibodies; only four Russian children did.

I am not a statistician, but wouldn't this be underpowered relative to what
you would need to draw a solid conclusion?

~~~
LionessLover
Depends on effect size and variance.

[https://www.ma.utexas.edu/users/mks/statmistakes/FactorsInfl...](https://www.ma.utexas.edu/users/mks/statmistakes/FactorsInfluencingPower.html)

A study with low power is perfectly alright for an exploratory study that is
not meant to prove anything but to check if it's worthwhile to spend a lot of
resources on an idea in the first place.

[http://lynn-library.libguides.com/researchmethods/researchme...](http://lynn-
library.libguides.com/researchmethods/researchmethodsd8)

> 1\. Exploratory research generally utilizes small sample sizes and, thus,
> findings are typically not generalizable to the population at large.

> 2\. The exploratory nature of the research inhibits an ability to make
> definitive conclusions about the findings.

> ...

The problem is when exploratory studies make it to the media and people
confuse them with studies meant to settle questions rather than just raise
them.

------
trhway
>The newborns were equally divided among Finland, Russia and Estonia, where
the prevalence of Type 1 diabetes is on the rise, but still well below
Finland’s.

very telling giving the history of Estonia during last 25 years.

------
pkaye
I wonder why they don't have Epstein Barr Virus vaccines yet.

~~~
op00to
No money in it?

~~~
dredmorbius
Dark.

------
hackaflocka
"It was as if a gradually maturing ecosystem had been struck by a blight and
overgrown by weeds."

An unfortunate analogy. It is exactly weeds that our microbiome needs. Not
manicured lawns.

------
HillaryBriss
> Preventing autoimmune disorders may require emulating aspects of that
> “dirtier” world: safely bottling the kinds of microbes that protect the
> Russian kids, so we can give them to everyone

Ok, so where's the productization? Where's the startup?

Surely this product/service already exists in some form or other, _somewhere_

~~~
hrc2
I like your thinking, kinda surprised you got downvoted on HN for it.

One angle is the use of parasites to treat autoimmune diseases. It wasn't
mentioned in the article, but hookworms are being studied for their ability to
secrete a wide range of immune-modulating molecules. Companies are trying to
determine which molecules are especially useful, and in what combination, so
they can synthesize them and sell them.

But, you can get their beneficial effect right now, which is very appealing to
people with major autoimmune diseases. Some companies are selling parasite
eggs by mail to people who otherwise can't get them. I have MS, I take them.

It's not a lucrative business, and there are a lot of regulatory hurdles, but
the treatment is quite safe.

Most people are disgusted by the idea of infecting their self with parasites.
The reality is that humans evolved with parasites constantly inside of their
bodies. It's only in the last 100 years that widespread anti-parasitic
medication has wiped them out.

That did a lot of good for society in general, but we took it too far,
essentially, by wiping out parasites entirely. There are a lot of benign
"parasites", which should be thought of as symbiotes.

The way that big pharma is dealing with this is as mentioned above: they're
trying to synthesize the right stew of immune-modulating chemicals to deal
with this. But the immediate solution is to educate people, and sell them
clean, safe parasites (or their eggs).

It's also nice if they live a long time in their host, and don't reproduce
inside of the host. This is why Necator Americanus is mostly used; it fits all
of these characteristics.

~~~
refurb
_The way that big pharma is dealing with this is as mentioned above: they 're
trying to synthesize the right stew of immune-modulating chemicals to deal
with this. But the immediate solution is to educate people, and sell them
clean, safe parasites (or their eggs)._

Coronado Biosciences was running clinical trials using pig whipworm ova to see
if it had an impact on inflammatory bowel disease (Crohn's and ulcerative
colitis). Turns out there was no observable effect.

------
wapapaloobop
Animated pic gives me formication. Perhaps not inappropriately...

~~~
stephengillie
Animated pic made me motion-sick and prevented me from reading the article.

Edit: read it on mobile with JavaScript off.

------
LionessLover
Thank's for your valuable anecdote. We can now safely ignore all the people
who _did_ get a disease or toxins doing the same.

~~~
iak8god
Be civil. Don't say things you wouldn't say in a face-to-face conversation.
Avoid gratuitous negativity.

~~~
LionessLover
Why would I not say that face to face? Do you think any negative reply to
anyone is bad? What horrible rose-colored world do you live in? How about
_you_ adjust your sensitivity setting? It's on an unhelpfully low level that
prevents normal function and utilization of normal communication.

I also find it how remarkably consistent my experience is that people who
complain about "tone" never, ever have anything to say about the actual
subject.

~~~
o_____________o
You could have communicated the same idea without petty, hostile sarcasm.

~~~
LionessLover
Sarcasm is a valuable tool in the human communication arsenal. If you want to
do without it, be my guest, but don't try to dictate your subjective
preferences to others who have what I would claim is a more mature and more
healthy attitude towards the beauty and variety in human language.

And the "petty" is all in _your head_. There are too many people who blame
others for what's in their own head.

~~~
o_____________o
Sarcasm can be very valuable. It can also be used to contemptuously insult
someone when a simple rebuttal would suffice.

The latter is an immature, weak intellectual position (see Appeal to Ridicule
and Question Begging Epithet) that says nothing more than "you are so wrong as
to look asinine".

This only fosters more emotional, insult-riddled dialogue, which is why the
user above quoted HN guidelines, which you are now impotently raging against.
This is a pretty civil place, we like to keep it that way.

