Analysis of variability of high sensitivity C‐reactive protein in lowland ecuador reveals no evidence of chronic low‐grade inflammation

McDade, Thomas W.; Tallman, Paula S.; Madimenos, Felicia C.; Liebert, Melissa A.; Cepon, Tara J.; Sugiyama, Lawrence S.; Snodgrass, J. Josh

doi:10.1002/ajhb.22296

Cited by 85 publications

(87 citation statements)

References 44 publications

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“…Similarly, older women in the Philippines (35-69 y) have higher median CRP at 0.9 mg/L, but this concentration is still substantially lower than 2.02 mg/L, the median CRP for older American women (51). Additionally, in lowland Ecuador, median CRP for adults ages 18-50 y is 0.5 mg/L, despite a prevalence of infectious disease that is even higher than the Philippines (52).…”

Section: Early Environments and The Eco-logics Of Inflammationmentioning

confidence: 99%

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Early environments and the ecology of inflammation

McDade

2012

Proc. Natl. Acad. Sci. U.S.A.

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Recent research has implicated inflammatory processes in the pathophysiology of a wide range of chronic degenerative diseases, although inflammation has long been recognized as a critical line of defense against infectious disease. However, current scientific understandings of the links between chronic low-grade inflammation and diseases of aging are based primarily on research in high-income nations with low levels of infectious disease and high levels of overweight/obesity. From a comparative and historical point of view, this epidemiological situation is relatively unique, and it may not capture the full range of ecological variation necessary to understand the processes that shape the development of inflammatory phenotypes. The human immune system is characterized by substantial developmental plasticity, and a comparative, developmental, ecological framework is proposed to cast light on the complex associations among early environments, regulation of inflammation, and disease. Recent studies in the Philippines and lowland Ecuador reveal low levels of chronic inflammation, despite higher burdens of infectious disease, and point to nutritional and microbial exposures in infancy as important determinants of inflammation in adulthood. By shaping the regulation of inflammation, early environments moderate responses to inflammatory stimuli later in life, with implications for the association between inflammation and chronic diseases. Attention to the eco-logics of inflammation may point to promising directions for future research, enriching our understanding of this important physiological system and informing approaches to the prevention and treatment of disease.

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Section: Early Environments and The Eco-logics Of Inflammationmentioning

confidence: 99%

“…We sought to answer these questions by documenting the pattern of CRP variability in lowland Ecuador (52). We collected blood samples from 52 adults over four weekly intervals, and during this time, almost two-thirds of the participants reported at least one episode of infectious disease.…”

Section: Vaccine Responsiveness In Adolescence Predicts Crp In Youngmentioning

confidence: 99%

Early environments and the ecology of inflammation

McDade

2012

Proc. Natl. Acad. Sci. U.S.A.

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185

154

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“…A failure to do this is regularly seen in highincome countries where persistently raised levels of C-reactive protein (CRP) are common (discussed in ref. 31). Persistently raised inflammatory mediators lead to increased risk of cardiovascular disease (32) and depression (27,33,34).…”

Section: Hygiene Hypothesis and The "Old Friends" Mechanismmentioning

confidence: 99%

“…Persistently raised inflammatory mediators lead to increased risk of cardiovascular disease (32) and depression (27,33,34). In contrast, a longitudinal study of adults in a rural low-income country where there is exposure to high microbial burdens in childhood showed that they were able to shut off the inflammatory response when there was no need for it (31). More work is needed to discover whether the same is true in other low-income settings, whether biomass or biodiversity was more important, and whether the effect was attributable to bacteria, fungi, protozoa, helminths, or other organisms.…”

Section: Hygiene Hypothesis and The "Old Friends" Mechanismmentioning

confidence: 99%

“…Moreover dogs were domesticated between 33,000 and 11,000 y ago, so humans have coevolved with dog microbiota for many millennia (106). Considered together with the protective effects of early exposure to cowsheds (79), other animal-derived strains (85), or animal feces (31), this might suggest that animals are a particularly important component of the natural environment. However, other humans are also relevant in this context.…”

Section: Microbiota From Animals and Other Peoplementioning

confidence: 99%

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Regulation of the immune system by biodiversity from the natural environment: An ecosystem service essential to health

Rook

2013

Proc. Natl. Acad. Sci. U.S.A.

613

456

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Epidemiological studies suggest that living close to the natural environment is associated with long-term health benefits including reduced death rates, reduced cardiovascular disease, and reduced psychiatric problems. This is often attributed to psychological mechanisms, boosted by exercise, social interactions, and sunlight. Compared with urban environments, exposure to green spaces does indeed trigger rapid psychological, physiological, and endocrinological effects. However, there is little evidence that these rapid transient effects cause long-term health benefits or even that they are a specific property of natural environments. Meanwhile, the illnesses that are increasing in high-income countries are associated with failing immunoregulation and poorly regulated inflammatory responses, manifested as chronically raised C-reactive protein and proinflammatory cytokines. This failure of immunoregulation is partly attributable to a lack of exposure to organisms (“Old Friends”) from mankind’s evolutionary past that needed to be tolerated and therefore evolved roles in driving immunoregulatory mechanisms. Some Old Friends (such as helminths and infections picked up at birth that established carrier states) are almost eliminated from the urban environment. This increases our dependence on Old Friends derived from our mothers, other people, animals, and the environment. It is suggested that the requirement for microbial input from the environment to drive immunoregulation is a major component of the beneficial effect of green space, and a neglected ecosystem service that is essential for our well-being. This insight will allow green spaces to be designed to optimize health benefits and will provide impetus from health systems for the preservation of ecosystem biodiversity.

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Hygiene and Other Early Childhood Influences on the Subsequent Function of the Immune System

Rook

2012

Immunity to Parasitic Infection

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Hygiene Depression a b s t r a c tThe immune system influences brain development and function. Hygiene and other early childhood influences impact the subsequent function of the immune system during adulthood, with consequences for vulnerability to neurodevelopmental and psychiatric disorders. Inflammatory events during pregnancy can act directly to cause developmental problems in the central nervous system (CNS) that have been implicated in schizophrenia and autism. The immune system also acts indirectly by "farming" the intestinal microbiota, which then influences brain development and function via the multiple pathways that constitute the gut-brain axis. The gut microbiota also regulates the immune system.Regulation of the immune system is crucial because inflammatory states in pregnancy need to be limited, and throughout life inflammation needs to be terminated completely when not required; for example, persistently raised levels of background inflammation during adulthood (in the presence or absence of a clinically apparent inflammatory stimulus) correlate with an increased risk of depression. A number of factors in the perinatal period, notably immigration from rural low-income to rich developed settings, caesarean delivery, breastfeeding and antibiotic abuse have profound effects on the microbiota and on immunoregulation during early life that persist into adulthood. Many aspects of the modern western environment deprive the infant of the immunoregulatory organisms with which humans co-evolved, while encouraging exposure to nonimmunoregulatory organisms, associated with more recently evolved "crowd" infections.

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Analysis of variability of high sensitivity C‐reactive protein in lowland ecuador reveals no evidence of chronic low‐grade inflammation

Cited by 85 publications

References 44 publications

Early environments and the ecology of inflammation

Early environments and the ecology of inflammation

Regulation of the immune system by biodiversity from the natural environment: An ecosystem service essential to health

Hygiene and Other Early Childhood Influences on the Subsequent Function of the Immune System

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