How does microbial exposure protect us from allergies and other chronic inflammatory diseases?
The link between microbial exposure and immune diseases
The concept of a link between reduced microbial exposure and the rise in allergic disease was first proposed by David Strachan in 1989 and was named the Hygiene Hypothesis.
Although the basic concept still appears to be correct, the proposal of a link to infectious disease and hygiene is now largely discounted. Refinements to the original hypothesis now offer a more plausible explanation.
The Old Friends (OF) Mechanism
The Old Friends of Mechanism was proposed by Graham Rook in 2003.
He proposed that the required microbial exposures are not infectious diseases (colds, flu, measles, norovirus etc) which evolved only over the last 10,000 years, but the microbes we co-evolved with in hunter gatherer times when the human immune system was developing.
Although these microbes are still there, through modern lifestyle changes we have lost our exposure to them
The Hygiene Hypothesis has been variously renamed as:
The Old Friends Mechanism
Microbiome Depletion Hypothesis
Microbial Diversity Hypothesis
Evolved dependency on microbial exposure
Our immune systems have become so dependent on these exposures that they cannot function properly without them.
