Safety and risk assessment for the human superorganism

Abstract

This editorial on safety evaluation and risk assessment for the human superorganism introduces a series of papers arguing for a fundamental shift in how we approach human health risk assessment. In this series emphasis is placed on the risk of infectious disease. Our 21 st st century understanding of human biology is that, as holobionts, we possess a majority of microbial cells and genes. In fact, our microbes fundamentally affect our interactions with the external environment, metabolism, physiology, and risk of both pathology and disease. As holobionts, we require our microbial partners for us to be both complete and healthy. Using the 20 th century understanding of human biology, we failed to capture the effects of the microbiome in evaluating health risks. But 21 st century risk assessments such as those associated with exposure to specific microbial pathogens need to include the human microbiome. Microbiome status will be central in determining the health risks for both individuals and populations.

Twentieth Century Dogmas Prevent Sustainable Healthcare

“…[ [55][56][57][58][59][60][61][62] 5. Noncommunicable diseases (NCDs) are completely noncommunicable.…”

“…Furthermore, the legacy of failure to identify prior risk to the human microbiome, as drugs, food, food additives and environmental chemicals were approved for use, means that countless drugs, food and food additives, and environmental chemicals are utilized that are toxic for human commensal microbiota. It means that we must think well beyond just antibiotics for products that damage/ destroy the human microbiome and promote both .communicable diseases and NCDs [55][56][57][58][59][60][61][62].…”

Microbiota and Dose Response: Evolving Paradigm of Health Triangle

“…The 20th-century paradigm for health risk, confounded by "fear of microbes coupled with over-sanitation of our built environments and over-pasteurization of our foods," represents "a fundamental misunderstanding of human biology," presuming that the "healthiest humans were generally free of microbes" (Dietert, 2017). Rather, the microbiome "completes" Homo sapiens and operationally connects host defenses (including innate and adaptive immune systems) with external environments often containing potential pathogens.…”

“…A regulatory implication of colonization resistance and enhanced barrier function (Dietert, 2017) is that the mere presence of a potential pathogen serotype or strain (e.g., E. coli O157:H7) or a pathogen genus (e.g., Salmonella) in air, food, or water is insufficient to assess, communicate, and perhaps manage risks to stakeholders. Just as "the dose makes the poison" in toxicology, the dose causes health or illness in interactions with our microbial partners and potential pathogens.…”

“…From a forward-looking perspective, research collaborations using the Health Triangle may accelerate development of biomarkers of health and colonization resistance involving ecosystem function (e.g., microbiome diversity and/or reflexivity, the time required for return to normal superorganism status from infection or dysbiosis). Such studies (Dietert, 2017;Dietert & Silbergeld, 2015) and biomarkers of health are essential to assessing, communicating, and effectively managing risks and benefits for human superorganisms in the 21st century and beyond.…”