Why do we have allergies?
mosaicscience.com
mosaicscience.com
"Why do we get allergies? No one has a firm answer, but what is arguably the leading theory suggests that allergies are a misfiring of a defense against parasitic worms. In the industrialized world, where such infections are rare, this system reacts in an exaggerated fashion to harmless targets, making us miserable in the process.
Medzhitov thinks that’s wrong. Allergies are not simply a biological blunder. Instead, they’re an essential defense against noxious chemicals–a defence that has served our ancestors for tens of millions of years and continues to do so today."
https://en.wikipedia.org/wiki/Inverted_pyramid
It's really about news vs. human interest pieces, and many outlets (like the NY Times) feature both. Seems possible to me that American outlets produce more of these, but it'd be hard to disentangle this from the general dominance of American outlets on the English-speaking internet, such that non-American pieces are more likely to be directly local and, so, news rather than human interest.
What could effectively solve this is if HN attached a short abstract to each article, written and updated by user submission. (The initial version could/should be provided by the submitter.) Maybe minimal GitHub-like version control with pull requests accepted by vote. This could be useful not just to save time, but also to keep article quality higher, if submitters are required to justify the intellectual value of the submission. The abstract would be more valuable than normal comments, so accepted modifications could get extra karma.
This would have similarities to summaries on slashdot (which are written by moderators and so not very scalable) and the "submission statement" required in certain subreddits.
https://www.reddit.com/r/geopolitics/comments/3yh1ll/introdu...
https://www.reddit.com/r/TrueReddit/comments/1p4gqg/new_poli...
Long-form science writing isn't inferior to news briefs or press release-style articles you're looking for; it can be a very effective method for engaging a reader and introducing them to a topic which they don't have detailed knowledge on (or which they just want to read about).
"People will read 3 words to decide if the topic is interesting. If they think it's worth their time, you have thirty words to hook them. If they take the hook, you can probably get them to read 300 words unless they have a focused interest in the topic."
It is, unfortunately, tied to much evil online (the quick-list ad blog ecosystem is basically application of 3-30-300 writ large), but useful for creating general-consumption articles.
About two decades ago I got a huge case of almost-asthma pollen allergy out of nowhere, almost overnight. I got the usual treatment (desensitization + meds) and it got somewhat better over the years. Simultaneously I developed other allergies though, for example, suddenly I was very allergic to cats (I had had cats earlier, so that was new).
A few years ago I was diagnosed with a case of chronic heavy-metal poisoning.
Now, many treatments with DMPS (the main chelator for mercury) and DMSA later, I have completely lost all allergies (and a long list of other "strange" problems, including a real medical miracle that left the endocrinologist repeating "I'm amazed" over and over after checking his ultrasound results twice, after asking me to lie down again because he did not trust his results).
End of anecdote.
------------------------------
EDIT: As someone who has taken hundreds of hours of anatomy, physiology, org. chem, statistics (focus on public health and use in medicine), neuroscience, I am aware that there is not "one path that explains all". There are soooooo many pathways, and different things can affect different parts leading to similar results. So I am NOT saying "this is the one and only way to get an allergy". In fact it is highly unlikely that there is only one possible cause. So if you have found an anecdote that seems to show that something else helped and/or caused it than "heavy metals" that's just fine and normal - and has nothing to do with my anecdote. You can get a flesh wound not just by cutting yourself with a kitchen knife, there are endless possibilities.
I'm glad you are feeling better.
Is it more of a reddit than HN of the time?
Had eaten barely anything for a week, so I did lose a ton of weight I suppose. The psychological damage on the other hand was the worst part. I avoided touching other people and was convinced parasitic eggs were everywhere on door handles etc.
Fun side note: the A&E was so over capacity and understaffed (Ireland) I had to awkwardly ask for the IV drip to be removed because it had finished and my blood was tracking back up the tube.... I was 17 and my parents weren't allowed in with me :(
Also, I don't think it's so clearcut that I have allergies because I'm missing 50 hookworm so much as because my immune system developed without a broad range of 'germs' and 'parasites' and other natural cofactors. As a treatment option for quality-of-life, though, it's pretty sound.
Helminthic therapy is pretty analogous to supplementing probiotics, and directly analogous to supplementing the subtype of probiotics known as soil-based organisms.
http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedur...
Generally inert in place and it has to be inhaled to be absorbed. However, drilling/removal/chipping can release absorbable particles.
Edit: Also note -- because they are inert in place so advice from the FDA is to leave them be as long as the fillings are in good condition and there is no decay beneath the filling. In other words -- don't panic and take an ice pick to your perfectly good fillings.
Some of the advice is crazy, or spooky. Women under 50 should eat less than one can of tuna per month according to my state DNR. I work with a low carb person who eats a can of tuna per day every day for lunch. Their blood mercury level must be off the charts. Like they could use the veins in their arm as a mercury thermometer or something.
Can you share how you were exposed to apparently toxic levels of heavy-metals?
I still attribute this to something else was in her system that triggered reaction in conjunction with the peanut proteins.
Every time I mention this people kind of look at me funny when I offer my co-trigger explanation as "some kind of bug", but I was reading Dawkins at the time and had come to stop thinking about unitary causes for phenotypic expressions.
Of course, that's not the easiest course of conversation to travel down with most people, so I just sort of accept the silence that follows. It does give me the fun little anecdote of how my daughter was deathly allergic to peanuts for a year, but then she got better.
The classic example is H. Pylori in stomach problems. I doubt that it's a lone outlier.
When I was 17 I started wearing contact lenses - and after that no more hay fever. I thought at first the contact lenses were blocking the pollen from getting into my eyes, but I've now reverted back to almost always wearing glasses. 10 years later and no more hay fever. Go figure...
(See also the recent discussions around lead including in Flint, Michigan)
I know from experience that taking steroids reduces the immune system response, so there is something to that.
Of note some of modern human allergies come from infant avoidance. Kids who eat peanuts younger are less likely to get peanut allergies for example. If you want to decrease allergies, let your infants get dirty, play with dogs, and liberalize their diet.
I'm Gen X (1979), grew up playing in dirt, house filled with dogs and cats. Ate a fair amount of things, apart from the things I was allergic too: apples mostly. Most of the food I ate was home cooked. My sisters do not have allergies.
It has since gone on to get much, much worse. I can no longer eat carrots or parsnips (which were my favourite). I'm now very allergic to dogs and cats and it wasn't because of a lack of exposure.
40 allergies.
Fuck me...
On the other hand, after puberty and a serious illness in my late teens that basically rebooted my immune system, I haven't had any issues with allergies ever since.
Note that the same treatment can be given via drops, a much less expensive option (but still considered off label use in the US). I haven't tried them (yet) but it seems like the research performed so far shows them to be just as effective (I'd guess also just as ineffective if the shots don't work for you).
To me surprising part is that immunotherapy is 100 years old treatment and we did not come up with anything better after a century of rapid advancements in science. Currently in US there are estimated 20 million people suffering from dust mite allergies alone and more than 50 million Americans suffer from allergies overall. Allergies are the 6th leading cause of chronic illness in the U.S. with an annual cost in excess of $18 billion.
One of new approaches for treatment of airborne allergies is what this company is doing http://www.circassia.com. They are working on new kind of therapy, which is trying to "teach" your immune system to not identify certain harmless airborne allergens (dust mites, grass, ragweed,...) as harmful. Treatment consists of 4 injection during a year period. They are in trial phase right now (I am not related to them).
http://www.quackwatch.com/01QuackeryRelatedTopics/mercury.ht...
A 24-hour urine collection might detect chronic heavy metals poisoning. Hair tests might also work, though I don't know what a "standard" hair test looks for, specifically. I also don't know if detecting poisonous elements comes with no additional effort added to those "standard" tests. If it costs extra, it usually doesn't get done.
Of course, even if someone came into a doctor's office complaining of all the typical symptoms of heavy metals poisoning, the doc still might not have an inkling unless the patient has some kind of occupational exposure to it.
If you don't mind, I wonder if you could explain how the heavy metal poisoning occurred ? Genuinely interested.
Then again, I clearly got this from my mother who is in some ways worse (stays indoors during ragweed season, which doesn't bother me at all), my problems largely disappeared when I moved to the Boston area (different climate and allergens), returned when I moved to the D.C. area (very roughly the same as Joplin). But I'll think about this, I've never had a test for lead....
> Some of the mice are ordinary, but others are not: using genetic engineering techniques, Medzhitov’s team has removed the animals’ ability to make IgE. They can’t get allergies.
> The animals may be spared the misery of hay fever caused by the ragweed pollen that will inevitably drift into their box on currents of air. But Medzhitov predicts they will be worse off for it. Unable to fight the pollen and other allergens, they will let these toxic molecules pass into their bodies, where they will damage organs and tissues.
> “It’s never been done before, so we don’t know what the consequences will be,” says Medzhitov. But if his theory is right, the experiment will reveal the invisible shield that allergies provide us.
Why: Kinda. Paraphrasing the article its a mishmash of the establishment view is it was an evolutionary adaptation that was a net gain until recent civil engineering, and now is a net loss. The mash of the mish is fairly standard inflammation and chronic exposure to a very large and complicated semi-autonomous set of analog systems combined with very close monitoring of a very large populations means all the weird system crashes where balances go haywire will be documented.
So something like eating a peanut in 1700 was OK because your fish diet was clean and the person who died from a peanut was not noticed compared to the bodies stacked like cordwood due to cholera and typhoid and the plague and lack of clean water in general and intestinal parasites and food poisoning. But in 2016 dude eats a fish diet which is contaminated by mercury from coal burning power plants and that combined with low level exposure to a zillion things simultaneously that we know are bad at high level which means his immune system is perma-inflamed into being half way to blowing up all the time, and when he eats a peanut and dies people notice because in 2016, at least in the west, civil engineering means people are not dying of plagues all the time, so it gets documented and wondered about.
Some aspects of the article are not controversial. Consider the accepted establishment theory of epoxy, urethane, or polyester monomer sensitization. The controversy is you have an enormously large complicated system (like physics, or the entire immune system vs the entire planetary industrial era environment) and fans of various gross simplifications and rules of thumb love to argue about which is righter than the other and the borders of acceptable application of those simplifications.
I think I'd like to get that framed!
Are you talking about the TSA?
It sounds like they're still a blunder of some sort though, I somehow doubt that people allergic to tree pollen in the spring would actually be harmed if they lost their allergic reaction. I mean, we actually have that, in the form of allergy shots/sublinguals that make people lose that reaction, and those people are fine.
Maybe there's more to the story, but it's not a matter-of-fact simple defense against peanuts.
There might even be some correlation to increased rates of allergy in countries that raised the living standard and less allergies among farmers (supposedly because they roll around in pigs shit? The reasoning is a bit unclear.)
But I can't shake the feeling that there is something wrong with that theory. If you disregard large cities, 150 years ago, most people met very few people. Travelling was complicated and slow. Diseases was spreading of course, but decidedly in a slower pace than today - in most parts of the world.
I'm fairly sure that an average person 150 years ago came in contact with less people in a year than I pass by on my daily commute. Heck, the building I work in has 3500 people in it, my kids go to three different schools with a couple of hundred other kids in each and their parents most likely works in other large workplaces, and I eat at restaurants that serves hundreds of meals every day.
Is it not possible that an average person today are subjected to many -more- strains and variants of pathogens than ever. Maybe it is the increased load of _different_ pathogens that stresses the immune system?
I mean, even if I moved in into the pigsty for good, it's just me and the pig there... The only way to catch a new disease would be from birds and rats, or a random mutation.
MCAS = Mast Cell Activation Syndrome MCAD (Mast Cell Activation Disorder) = MCAS or mastocytosis
Great links here: http://strengthflexibilityhealtheds.com/2016/02/04/diagnosin...
http://www.mastattack.org/2014/10/mcad-general-information-p...
http://www.jacionline.org/article/S0091-6749(14)02927-3/full...
Dr. Anne Maitland’s presentation on Allergies & Mast Cell Activation Syndrome in EDS Patients. https://www.youtube.com/watch?v=ktFdr-9rpIM&feature=youtu.be
If your primary care physician has 2,000 patients (not unreasonable), s/he could reasonably expect to never encounter the disorder outside of a textbook.
Just as in programming, doctors avoid the 'premature optimization' - no need to test for a rare disorder until considerably more common ones, like allergies, are ruled out.
I'm not a researcher. Wait until the finding has been confirmed in lots of studies and is Boring Standard Medical Knowledge, then tell me. Until then, it's just going to give me the illusion of knowledge.
There's so much "MAYBE eating kelp will reduce your risk of LUPUS!" that we lose sight of "I should really exercise more."
"As Medzhitov searched for papers on this subject, he came across references to a 1989 essay written by Charles Janeway, an immunologist at Yale, titled “Approaching the Asymptote? Evolution and revolution in immunology.” Medzhitov was intrigued and used several months’ of his stipend to buy a reprint of the paper. It was worth the wait, because the paper exposed him to Janeway’s theories, and those theories would change his life."
http://www.cbc.ca/natureofthings/episodes/the-allergy-fix
Parasitic worms, and their modulation of the immune system (and the possible faulty human over-compensation for this) are one of a few different theories that are put forward. I thought I would link it here because it's fairly informative.
Take poison oak for example. I have a relative whos drinking water flows through these plants and he is now immune to it. I brought a friend to his house (never been exposed) and after sitting on his couch, within 24 hours I had to take them to the hospital over the poison oak which had spread to the majority of their body. They were given a shot and we left shortly after that.
Me? I've had allergies from a young age and actually had treatments for it. I remember laying on my stomache while the doctor pricked my back a bunch of times. I'll still sneeze around a bunch of pollen but not enough to prevent me from doing the work.
In short, I do not think there is a fixall, take a pill solution and that there are many many factors to consider when treating someone for an allergy, or anything else for that matter. My grandma was hospitalized from inhaling bat dung, and my father also after eating some peanuts. Both could probably be treated to be less allergic but, this would require a lengthy treatment plan which is not a normal solution.
Allergies has an important function. The problem is the severity of it. A weak allergic reaction is what protects us from toxins, viruses etc, however for some reason the system goes in overdrive in some people and that is not good.
It might seem like there is no significant difference between this an previous understanding. But the significance as far as I can tell is that previously we thought all allergic reactions no matter how small was useless and wrong by the body. The idea was that any allergic reaction is a misfiring, while this idea suggests it isn't firing which is the problem it is the magnitude which is the problem.
But understanding the purpose of allergies could lead to dramatic changes in how they’re treated. “One implication of our view is that any attempt to completely block allergic defences would be a bad idea,” he said. Instead, allergists should be learning why a minority of people turn a protective response into a hypersensitive one. “It’s the same as with pain,” said Medzhitov. “No pain at all is deadly; normal pain is good; too much pain is bad.”> Graduate school wasn’t much better. Medzhitov arrived at Moscow State University just as the Soviet regime collapsed. The university was broke, and Medzhitov didn’t have the equipment he needed to run experiments. “I was basically spending all of my time reading and thinking,” Medzhitov told me.
> Mostly, he thought about how our bodies perceive the outside world. We can recognise patterns of photons with our eyes and patterns of air vibrations with our ears. To Medzhitov, the immune system was another pattern recognition system – one that detected molecular signatures instead of light or sound.
> As Medzhitov searched for papers on this subject, he came across references to a 1989 essay written by Charles Janeway, an immunologist at Yale, titled ‘Approaching the Asymptote? Evolution and revolution in immunology’. Medzhitov was intrigued and used several months’ of his stipend to buy a reprint of the paper. It was worth the wait, because the paper exposed him to Janeway’s theories, and those theories would change his life.
Several months of stipend to buy a single paper?
Link: https://theconversation.com/your-season-of-birth-is-stamped-...
One thing I agree with, though, with no other data point than my experience, is that being in contact with allergens at a young age helps, or conversely that kids raised in sterile environments are more prone to allergies and have a weaker immune system.
I'm born in winter, my siblings as well, we were raised in the country, had dogs/cats, didn't live in a very clean house and haven't found anything we're allergic to and get very rarely sick.
But yeah, N=1
"Born in summer" implies greater exposure to sunlight (in northerly latitudes) vs. winter birth. Sunlight induces vitamin D formation in the skin. Vitamin D is implicated in normal immune system development so low D levels in infancy could conceivably be a factor in later development of allergies, etc.
"Playing in mud" suggests contact with organisms present in the natural environment. Deprivation of this exposure has been discussed (here on HN a few days ago) as the "old friends hypothesis".
Basically the idea is that through evolution our immune system "outsourced" certain functions to co-evolving microorganisms. When contact with these "friends" is lacking our immune systems are compromised and abnormal hypersensitivities develop.
That's actually how the brain works. Once you form a habit, for example, you follow the developed pattern (now moved outside of the conscious level) without thinking about it much anymore. It's how people learn how to walk, talk, and basically do everything else they once learned in life with relative ease... It's the brain's method of freeing up resources for other, new things.
It doesn't sound all that implausible to me that certain other mechanisms of the body might perform in a very similar way.
I have my own suspicion that it was the result of her having antibiotics when she was a baby. A blocked tear duct was causing an infection in her eye. Her pediatrician prescribed antibiotics.
When we eventually were able to get an appointment with an eye specialist, she recommended just wiping the eye out with mild soap.
I have seen a few articles posted on HN that talked about the lack of gut bacteria ( killed by antibiotics ) as the reason why children develop allergies.
As a counterpoint, I've had a lot of antibiotics early in life. The kind that caused tooth damage (most of my dental fillings are form that). Not as young, though.
I had asthma triggered by dust, very frequently. We had an inhaler at home plus asthma medications. My brother and sister had the same issue, but they had no antibiotics prior to their symptoms.
As adults, we have no known allergies.
Your antibiotics are probably unrelated. Also, if the gut was severely affected by the antibiotics prescribed for the eye condition, you should have seen major gastrointestinal problems. Did you?
Always did seem normal to be irritated by irritants, with some people more irritated than others by different things.
Seems like each person can only handle a certain amount of total irritants before they experience discomfort.
I remember intentionally overcoming an allergy to cats. Researchers have since indicated that the suspected irritant is the cat's saliva rather than just the hair itself. Regardless, it was not unexpected to become more sensitive to less-often-encountered things completely unrelated to animal hair or saliva as a tradeoff after reducing the feline sensitivity.
Anyway, I wouldn't be surprised if allergy, like many things in biology, are caused by multiple factors instead of just one.
As a side-effect, the system gets primed against the actual threat but also primed against benign foreign chemicals as well. The change in the ecosystem that has caused this defense mechanism to become a hindrance is the introduction of novel chemicals to our daily lives that trip low levels of immuno-response (or increase in chronic exposure to those chemicals due to a general shift to indoor living, where the chemicals just sit in the environment and bathe us in them), providing the opportunity for the immune system to sensitize to frequenltly-contacted benign chemicals.
This also spends more time discussing what only appears in the last few paragraphs above the "*" in the OP, regarding Westernization efects and what I think are the more controversial aspects.
It's clear that there's a process, presumably a good one, that sometimes goes haywire, and really that's all most people care about.
We may never know why people have allergies.
It seems like the "parasite" theory is a more specific example of the "fast reaction to toxins" theory being presented. Are there bigger differences that I'm not understanding, or is the resistance to the idea just that the new theory is overgeneralizing?
I have never had any allergies and I think this may be the reason (both my parents have seasonal allergies).
Holy crap, really? I looked it up and yeah, it's true. I had no idea sepsis killed that many people.
Maybe I am different that I want to read science articles to learn new things and not to be entertained. The writer proves how hard it is to do both.
Wormwood/nutmeg/Black Walnut. Nasty stuff.
Its good as a last resort if the conventional stuff does not kill the parasites
This is what happened to me.
"The juice of freshly macerated unripe hulls of the black walnut (Juglans nigra) has been used for many years in folk medicine as a treatment for localized, topical fungal infections such as ringworm."
http://onlinelibrary.wiley.com/doi/10.1002/ptr.2650040104/ab...
"Nutmeg (Myristica fragrans Houtt.) is the seed kernel of inside the fruit. It has been studied to having number of ethnopharmacological properties. Essential oils are secondary metabolites which originated from different parts of plants and made up of volatile compounds. In the present study, the essential oil extracted from nutmeg was investigated for its in vitro cytotoxicity on Vero cell line (normal cell line) and anti-parasitic activity against Toxoplasma gondii parasite. Nutmeg essential oil showed very low cytotoxic activity against Vero cells with IC 50 value of 24.83µg/mL. In the in vitro anti-T.gondii assay, the oil extract showed significant inhibiting activity with EC 50 value of 24.45µg/mL. This result was comparable to the standard drug clindamycin (EC 50 =16.57µg/mL.). Based on the promising results, nutmeg essential oil may be further studied for its mechanism of action against T.gondii and to isolate the bioactive compound(s) to treat toxoplasmosis."
https://www.researchgate.net/publication/236031031_Anti-Para...
--
I found these within 5 minutes of googling.
In the recent generations there are definitely more of them. EE was notoriously lax with pollution and industrial waste. So I think that toxins are not to be blamed.
The sterility hypothesis seems like a better explanation.
I was born in 1977, and also remember all the anti-biotics injections I got as a child until they finally tested me for allergies at the age of 12.
I'd say the majority of medical doctors in this area got aware on allergies in early 90's.
Being slightly allergic to something noxious makes sense, but being violently, potentially fatally allergic to a foodstuff? No...
"As for why allergies are seemingly on the rise, this work does nothing to dispel or support the so-called hygiene hypothesis, which links allergies to modern hyperclean environments. With the advent of clean water and childhoods devoid of consuming much dirt (and the millions of bacteria and viruses that come with them) the immune system does not receive the early training it needs to function correctly, the hypothesis says. A healthy exposure to those invaders leads the body to invest more in type 1 responses, including strong microbe defense, rather than type 2 reactions such as allergies."
I was tested for celiac disease, but I do not have it thankfully. However, I decided to stop eating wheat in early 2015 for other reasons. I noticed that when spring came, I had almost no issues with pollen. I mentioned it to my internist and he said he wasn't surprised given the typical immune reaction to gluten. This year, another repeat performance. Almost no problems with pollen season. I had one or two episodes where I sneezed, but that was it. My area of the US is one of the highest allergy areas due to the density of foliage.
As to why this has happened, I can only speculate. I suspect that it's mostly due to the fact that the wheat we eat in the U.S. isn't the same wheat we ate 40+ years ago- it's been genetically altered and there are NO long term studies on the affect of these GMOs on health - they haven't been available on the market long enough to really know. I haven't tried eating non-GMO wheat products so I can't say whether my theory is correct. For me, not eating wheat was the way to go for better health overall. But.. I do miss eating warm bread from the oven now and then.
Every time people speak out against GMO crops, they are following their own faith instead of science. Golden rice could have saved hundreds of thousands of people from death or malnutrition, but those people died because of people that spout this nonsense.
There is nothing out there to disprove what people fearfully claim either. The long term effects on a large were never tested, and it is being tested while in production. Unfortunately, there is no control case to compare against.
>and people had allergies long before GMO crops ever existed.
Sure there were people with allergies long before GMOs but they were in smaller numbers.
There has been a growing trend of abnormalities and scientists cannot understand why. GMOs cannot be ruled out.
That's not how burden of proof works.
> Sure there were people with allergies long before GMOs but they were in smaller numbers.
Besides the fact that you've made this assertion based on no data what so ever, even if the data existed from the 1800s it's unlikely it would be that good as most people would just not report it and had no access to medical treatment.
> There has been a growing trend of abnormalities and scientists cannot understand why.
Such as?
To your point, yes people have always had allergies but I can only speak for myself. I didn't have them as a kid, didn't have them as a teenager or young adult. I developed them in the '90s and now they're gone by eliminating wheat. My wife also had the same experience. Just a data point, but to discount it out of hand isn't much of an argument.