Welcome to Eczema Matters the Eczema Voice Newsletter – June 2008
Is our zeal for cleanliness making us ill?
A debate is raging among scientists about what is to blame for allergy epidemics - leaving most of us confused. We try to find the answers.
It is hard to know if the rash of headlines about allergy epidemics is real or hype. Over the past few weeks, anyone reading a variety of quality newspapers would have found themselves thoroughly perplexed. Last week our news pages quoted a study from the National Research Centre for Environmental Health in Munich saying that children lessen their risk of being sensitive to allergens if they grow up with a dog. Professor Joachim Heinrich and colleagues found that children raised with a dog had fewer allergy markers, such as antibodies to pollen, house-dust mites, cat and dog dander and mould spores. He told the European Respiratory Journal that a dog's presence in early childhood encourages the immune system to develop less sensitivity to allergies such as asthma, eczema and hay fever. But earlier reports from researchers at Portsmouth University claimed that the incidence of food hypersensitivity - which embraces allergy and intolerance - has not changed in the past 20 years. And they added that parents were too quick to put their children's gripes down to food allergies; people are worrying unduly. On the letters page of The Times, however, a group of allergists and scientists claimed that we are “in the midst of an allergy epidemic, with about 20 million children and adult allergy sufferers in the UK”. So what is the truth? There is an idea called the “Hygiene Theory”, or “Hygiene Hypothesis”, which considers whether modern life has become too clean; that in our increasingly sanitised, antibacterial and deodorised age, children's immune systems are not exposed to enough germs to develop normally. According to the market research firm Mintel, Britons spent £612 million on bathing products in 2005; in 2011, the estimated figure will be £709 million. We have certainly declared war on germs, but has it come at a price? The incidence of certain illnesses - asthma, eczema and respiratory allergy and autoimmune diseases such as arthritis and multiple sclerosis - has soared. Britain now tops the asthma league in Europe. Scientists are still searching for a reason. One clue is that these illnesses afflict only the developed world; they are rare or non-existent in poorer, dirtier countries (where, admittedly, more harmful diseases such as cholera and typhoid are prevalent). There are other clues: children in bigger families are less likely than those in smaller ones to suffer allergies. One theory is that they are exposed through siblings to more childhood infections, which benefits health. Likewise for children who, while babies, were brought up with household pets or on farms; they are less prone to animal allergies. What do all these factors have in common? Germs. Siblings, pets and poor neighbourhoods carry them in abundance. That has led to the idea that the sterility of modern urban life is making us ill. A recent book, Good Germs, Bad Germs, by Jessica Snyder Sachs, explores the idea that modern medicine and sanitation has expunged harmless germs along with the bad, and that these harmless microbes are responsible for protecting against allergy. Some scientists argue that we should restore some germs to their rightful place - back inside us. The Hygiene Hypothesis, formulated by the epidemiologist David Strachan about 20 years ago, argued that children's immune systems were not being sufficiently challenged - because of falling family size and increasingly sterile homes - to learn how to fend off diseases. The result was that once harmless invaders, such as cat hair, triggered immune overreactions (this is what constitutes an allergy). In the late Nineties, the evidence for Strachan's hunch was snowballing: kids in daycare showed lower rates of asthma than infants kept at home, suggesting that immunity might be conferred by early contact with other children. But in recent years there has been a backlash against the Hygiene Hypothesis, especially from experts on infectious diseases. They worry be-cause the hygiene hypothesis lulls people into thinking that poor hygiene is OK, or beneficial, when the opposite is true. Poor hygiene allows bad germs to flourish, and the prevalence of gastrointestinal infections and MRSA, along with norovirus, show we should not drop our guard. Professor Sally Bloomfield, an expert on infectious diseases at the London School of Hygiene and Tropical Medicine, is one who finds the persistence of Strachan's unproven thesis counterproductive. “When we have unacceptable levels of gastrointestinal disease, norovirus - and Sars and a possibile flu pandemic - the idea that hygiene is unnatural is frightening. We need to support cleanliness and hygiene. I still find people who think it's proven that we are too clean. We must dispel this.” How has this error come about? Bloomfield says that while exposure to microbes seemed pivotal in the prevention of allergies, Strachan went farther, suggesting that it was disease-causing microbes (pathogens) that offered protection: “He made the link between exposure to infection and protection from allergy, but it could be benign microbes, rather than disease-causing ones, that are providing protection. It could be that as we've improved water and food, knocked out the benign bacteria along with the pathogens. Or it could be nothing to do with microbes.” Bloomfield is a member of the International Scientific Forum on Home Hygiene, which suggested several years ago that the Hygiene Hypothesis be renamed the Microbial Exposure Hypothesis. It would convey the growing conviction that it is our modern relationship with microbes, rather than extra cleanliness, that is making us ill. Scientists are warming to the idea that the benign microbes colonising our guts and skin, rather than full-blown diseases, defend against allergy. A recent study published in the Journal of Allergy and Clinical Immunology showed that British, Swedish and Italian newborn babies with a narrow range of bacteria in their stools are more likely to have developed eczema at 18 months than newborns with a wider range of bacteria (researchers, from Lund University, Sweden, speculate that antibiotics given during delivery might be killing off beneficial bacteria). Another way of smuggling “good” microbes back into the body is to consume probiotic yoghurt drinks or fruit juices. These products contain so-called friendly bacteria. But the science on whether they improve health remains contradictory. And that's the rub: we don't yet know if extreme hygiene has propelled the rise of allergies. What we do know, to our cost, is that a lack of cleanliness is leading to an explosion in preventable, transmissible infections at home and in hospitals.
Searching for the good microbes in your gut.
Scientific attention is now focusing on the gut, home to benign microbes that have colonised human beings throughout our history. For every one of your own cells, there are ten microbial cells. Most moved in on you just after birth, evading your immature immune system and then setting up permanent residence. Scientists have a scant knowledge of these teeming creatures; they do not know if the microbes in your body are anything like the ones in mine. The mystery attached to microbes has inspired the Human Microbiome Project, akin to the Human Genome Project. This huge undertaking - to catalogue the microbes that live on and inside humans and work out how they affect our health - began last year, funded by the National Institutes of Health in America.
From Times Online
Baby Friendly Bacteria Can Help Prevent Development Of Eczema
23 Apr 2008
Eczema is a distressing condition for both parents and babies - the raw, red skin is painful to see and it is difficult to stop small children from scratching it. At worst, it can mean having to wet wrap wriggly toddlers each day with bandages soaked in moisturisers. It usually starts in the first year of life and affects about 10% of infants. Although most children eventually grow out of it, about half will go on to develop another allergic condition, such as asthma or hayfever. Recent progress in understanding the role of gut bacteria in the development of the infant's immune system has led to the hope that some of this suffering can be prevented in the future. Clinical studies, presented at the International Symposium on Early Nutrition Programming in Granada (Wednesday 23rd April 2008) have found that certain types of bacteria residing in the gut of babies with a family history of allergic conditions can reduce the number of babies who go on to develop eczema. "New and exciting insights on how gut bacteria affect immune function are emerging from these studies which we hope will support the use of pro- and prebiotics in primary disease prevention in the future," said Dr Yolanda Sanz, presenting the research in the Immune Function session of the Early Nutrition Programming Symposium. Dr Sanz is from the Institute of Agrochemistry and Food Technology (CSIC) in Valencia, Spain. Babies' guts are colonized by bacteria after birth and acquiring the right balance of the different bacterial strains is important for developing effective gut immunity. Gut immunity is the first line of defence and prevents the absorption and over-reaction to any trigger molecule causing allergy. Breast milk contains antibodies and natural prebiotics which promote the establishment of a healthy balance of gut bacteria and exclusively breast fed babies are less likely to develop eczema. The studies presented at the International Symposium offer hope that, with the use of the right bacterial strains and appropriate prebiotic mixtures, babies' natural defences can be boosted and their risk of eczema reduced. "This is exciting new scientific information that suggests a fairly straightforward way to help ease the burden of this condition on infants and their families," said Professor Philip Calder (University of Southampton, UK) Chair of the Immune Function session at the EARNEST Symposium.
From medicalnewstoday
Researcher uncovers eczema gene
A NORTH-EAST researcher has shown that a gene called Filaggrin is an important cause of eczema in children. A skin specialist from Newcastle University, based at the Centre for Life, visited 41 schools in West Cumbria involving over 800 children in this groundbreaking study. Dermatologist Dr Sara Brown found 24 per cent of children in the region had some degree of eczema. She said: "We were surprised by the fact that nearly one in four children has eczema. The number of people we're seeing with eczema has increased over the past 10 to 20 years, possibly caused by environmental factors, although we know that our genetic make-up is also important." Researchers found that the gene Filaggrin causes dry skin and eczema in about four per cent of these cases. While this may sound a low figure, for those who make up the four per cent, this gene plays an important part in their eczema. "Eczema often runs in families. Children inherit one copy of the Filaggrin gene from each of their parents. If one of the genes they inherit is faulty then they will have a 25 per cent risk of getting eczema. If the child inherits genes from both parents that contain the fault then they will have a 90 per cent risk of having eczema." This research moves scientists one step nearer to finding better treatments for this very common and distressing skin condition. Dr Brown adds, "We wouldn't have been able to carry out this important study without the co-operation of the schools and the help of the 7 to 9 year old children who took part with the support of their parents." Using blood samples stored from birth as part of a unique resource, the North Cumbria Community Genetics Project (NCCGP), the researchers were able to test the children's DNA for the eczema gene. Many of the mothers who delivered their babies at the West Cumberland Hospital in Whitehaven between 1996 and 2003 agreed to donate a small sample of the baby's umbilical cord blood. This means that scientists can study a child's DNA without having to take another blood sample. The research, which received funding from the British Skin Foundation, Action Medical Research, the Newcastle Healthcare Charity and the Wellcome Trust, is published in the Journal of Allergy and Clinical Immunology.
From North East Echo
Why probiotics ARE a boon in pregnancy
Pregnant women should take probiotic supplements if they want to reduce the risk of their babies suffering from childhood allergies, a study has found. Infants exposed to "friendly bacteria" were less likely to suffer from eczema, researchers said. Probiotics - normally sold to adults in pills, drinks or yoghurts - are living organisms designed to restore a healthy balance in the gut and prevent stomach upsets. Some scientists believe they can also stimulate the growth of the immune system and play a role in preventing asthma, eczema and allergies. The research contradicts previous studies which found no benefits from probiotics. The scientists involved emphasised that food supplements should not be given to young babies without a doctor's advice. The study, led by Emma Marschan at the University of Helsinki, treated 1,223 pregnant women from the eighth month of pregnancy with doses either of probiotic bacteria or a placebo. The women or their partners had a history of allergies, making their babies predisposed also to suffer from allergies, New Scientist Online reported. Some women dropped out, but the researchers continued giving small, regulated daily doses of probiotics and placebos to 925 babies for six months after birth. The children were examined at three and six months, and again at two years, by doctors who were unaware whether they had the probiotics or a placebo. The scientists also took blood samples from 98 randomly chosen babies. Children given the "friendly bacteria" were 30 per cent less likely than the untreated babies to develop atopic eczema - an itchy skin condition which can be an early sign of other types of allergy. They also found that levels of proteins associated with inflammation of bodily tissue were 50 per cent higher in the blood of babies given probiotics. Inflammation is thought to trigger and strengthen the immune system and make allergies less likely. The findings are reported in the journal Clinical and Experimental Allergy. Dr Errki Savilahti, one of the researchers, said: "It seems clear that we need to stimulate the infant's immune system as early and as vigorously as is safe, for inflammation seems to go hand-in-hand with allergy prevention." There is growing evidence that the epidemic of allergies in the Western world is linked to homes being 'too clean', so children are not exposed to germs that could stimulate their immune system.
From The Daily Mail
BBC TWO Study
Hi there
I was wondering if you could help me! I am working on a new transmittable pilot for BBC TWO about natural medicines and we are looking for sufferers of any skin complaints, like acne and eczema to take part. We are interested in speaking to people who are willing to try to an all-natural, organic alternative to the traditional over the counter options. I have been looking through your site and I wondered if you knew of anyone who would be particularly interested or if there was any chance you could help us by possibly placing a small ad on your site??
Juliet Redden .
if anyone is interested please e-mail info@eczemavoice.com with your contact details and we'll forward them on - please put BBC TWO in the subject line, thank you.
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