Childhood Helminth Exposure Is Protective Against Inflammatory Bowel Disease

Chu, Kathryn; Watermeyer, Gillian; Shelly, Lauren J.; Janssen, Julia M.; May, Thaddaeus; Brink, Kerrigan; Benefeld, Gameda; Li, Xuhang

doi:10.1097/mib.0b013e31827f27f4

Cited by 51 publications

(35 citation statements)

References 30 publications

(33 reference statements)

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“…Research into the anti-inflammatory properties of helminth infection is inspired by the hygiene hypothesis 75 , and the eradication of helminths in the industrialized world, where autoimmune diseases are most prevalent. Indeed, a recent case control study in South Africa found childhood helminth infection to be protective against IBD (adjusted odds ratio = 0.2) 125 . The majority of studies use the porcine whipworm, Trichuris suis , due to its accessibility in large numbers, its ability to temporarily and safely colonize humans, and the lack of transmission between close human contacts 126 .…”

Section: Potential Solutions and Recommendationsmentioning

confidence: 99%

Why Is Initial Bacterial Colonization of the Intestine Important to Infants' and Children's Health?

Houghteling

Walker²

2015

J. pediatr. gastroenterol. nutr.

287

224

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Microbial colonization of the infant occurs during a critical time window for immune and gastrointestinal development. Infant colonization sets the stage for the adult microbiome. This review is a broad survey of the factors affecting infant colonization and the downstream effects on gastrointestinal health and disease. Major topics affecting colonization include initial inoculation dependent on birth mode, the impact of breastfeeding, and inside-out modulation of the developing microbiome by the immune system. Major outcomes of colonization include the timing-dependent education of the neonatal immune system, which is interconnected with barrier function and metabolism. These all engage in further continuing cross-talk with the microbiome, genetics and nutrition. This review will also briefly discuss mechanisms of disease resulting from disrupted colonization as well as nutritional and microbial therapies.

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Section: Potential Solutions and Recommendationsmentioning

confidence: 99%

Why Is Initial Bacterial Colonization of the Intestine Important to Infants' and Children's Health?

Houghteling

Walker²

2015

J. pediatr. gastroenterol. nutr.

287

224

View full text Add to dashboard Cite

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“…Furthermore, several studies have shown that children in farm environments have less allergic disease compared with those raised in urban environments, including Amish children in northern Indiana [41], children living in Alpine farm environments [42] and an Austrian study that showed there was more hay fever and asthma in children living in city versus farm environments, where a more diverse microbiome is likely to be acquired [43]. In addition, Azad et al utilized a natural experiment to show that microbial diversity increased in the guts of children exposed to pets, which simultaneously resulted in lower levels of atopy and allergic disease relative to children with lower levels of diversity in their gut flora [44], and in another experiment, patients who were inoculated with eggs from Trichuris suis , a flatworm that does not cause disease, saw a significant reduction in Crohn’s disease [45]. The results of this study are additionally supported by an unmatched case-control study in South Africa that showed that helminth infection was protective against both Crohn’s disease and ulcerative colitis [46].…”

Section: Essential Learning Objectivesmentioning

confidence: 99%

Evolutionary science as a method to facilitate higher level thinking and reasoning in medical training

Graves

Reiber

Thanukos

et al. 2016

EMPH

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Evolutionary science is indispensable for understanding biological processes. Effective medical treatment must be anchored in sound biology. However, currently the insights available from evolutionary science are not adequately incorporated in either pre-medical or medical school curricula. To illuminate how evolution may be helpful in these areas, examples in which the insights of evolutionary science are already improving medical treatment and ways in which evolutionary reasoning can be practiced in the context of medicine are provided. To facilitate the learning of evolutionary principles, concepts derived from evolutionary science that medical students and professionals should understand are outlined. These concepts are designed to be authoritative and at the same time easily accessible for anyone with the general biological knowledge of a first-year medical student. Thus, we conclude that medical practice informed by evolutionary principles will be more effective and lead to better patient outcomes. Furthermore, it is argued that evolutionary medicine complements general medical training because it provides an additional means by which medical students can practice the critical thinking skills that will be important in their future practice. We argue that core concepts from evolutionary science have the potential to improve critical thinking and facilitate more effective learning in medical training.

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“…Our cohort may have included a higher proportion of patients with ‘complicated’ disease as GSH and TBH are both referral based IBD centers. Poor socioeconomic status is associated with helminth infection and in South Africa helminth infection has been shown to be protective against IBD development [62]. Therefore it is entirely possible that within our cohort this may have influenced the severity of CD between the racial groups however this was not one of the variables evaluated in the present study.…”

Section: Discussionmentioning

confidence: 86%

The Association between Race and Crohn's Disease Phenotype in the Western Cape Population of South Africa, Defined by the Montreal Classification System

et al. 2014

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BackgroundInter-racial differences in disease characteristics and in the management of Crohn's disease (CD) have been described in African American and Asian subjects, however for the racial groups in South Africa, no such recent literature exists.MethodsA cross sectional study of all consecutive CD patients seen at 2 large inflammatory bowel disease (IBD) referral centers in the Western Cape, South Africa between September 2011 and January 2013 was performed. Numerous demographic and clinical variables at diagnosis and date of study enrolment were identified using an investigator administered questionnaire as well as clinical examination and patient case notes. Using predefined definitions, disease behavior was stratified as ‘complicated’ or ‘uncomplicated’.ResultsOne hundred and ninety four CD subjects were identified; 35 (18%) were white, 152 (78%) were Cape Coloured and 7(4%) were black. On multiple logistic regression analysis Cape Coloureds were significantly more likely to develop ‘complicated’ CD (60% vs. 9%, p = 0.023) during the disease course when compared to white subjects. In addition, significantly more white subjects had successfully discontinued cigarette smoking at study enrolment (31% vs. 7% reduction, p = 0.02). No additional inter-racial differences were found. A low proportion of IBD family history was observed among the non-white subjects.ConclusionsCape Coloured patients were significantly more likely to develop ‘complicated’ CD over time when compared to whites.

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Childhood Helminth Exposure Is Protective Against Inflammatory Bowel Disease

Cited by 51 publications

References 30 publications

Why Is Initial Bacterial Colonization of the Intestine Important to Infants' and Children's Health?

Why Is Initial Bacterial Colonization of the Intestine Important to Infants' and Children's Health?

Evolutionary science as a method to facilitate higher level thinking and reasoning in medical training

The Association between Race and Crohn's Disease Phenotype in the Western Cape Population of South Africa, Defined by the Montreal Classification System

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