Paradigm Change

From „Germ Theory“ to „Microrbiom & Superorganism“

I enjoyed reading “The Systems View of Life” (PL Luisi and F. Capra), but missed a chapter regarding microbiom research. This rapidly expanding field of knowledge is rather important in the context of complex living systems.

Ökosystem
Ecosystem

Humans can be described as superorganisms including bacteria, cells and inner-cellular bacteria (mitochondria).

see: References

Gut and brain are intertwined, eg.  tryptophan-production as a precursor to the neurotransmitters serotonin and melatonin

Nevertheless the germ theory is the main paradigm in medicine, not only regarding infections but also cancer treatment: “identify, isolate, fight, kill, destroy …” Such war-like strategies also applied in the recent middle-east wars and they are failing. Because always s.th. un-expected happens. E.g. in medicine antibiotic resistance …

The late Nobel Laureate Joshua Lederberg was one of the first microbiologists suggesting that we should revise our behavior in order to avoid the emergence of new germs through the environment or health care associated sources. And we should use the war metaphor in infectiology only in cases of life threatening emergencies and otherwise replace it with an ecological one.

Blaser and many other microbiologists and system-biologists think that virulence of a disease may not have been due to phenotype only. Other factors than microbial genetics, such as environment, vector dynamics and host susceptibility, should be at the forefront of epidemiological discussions.

Therefore inflammation can be regarded as a complex form of communication. Understanding inflammatory and anti-inflammatory reflexes may lead to better treatment outcomes and to the development of new drugs or even devices to reprogram inflammation instead of suppressing.

Cholera is a good example. 2010 it was introduced to Haiti by UN Peacekeeping forces from Nepal. None of the soldiers was suffering from cholera when they arrived in Haiti. Why could it happen?

  1. Epidemics arise as a consequence of various social factors (Rudolf Virchow 150 years ago ) And if the social conditions change, the incidence decreases (Dolin 1997)
  2. Otherwise harmless microorganism which would transform itself in the presence of excrements and dirt into something dangerous. (Theory of the almost forgotten Max von Pettenkofer, like Virchow an effective organizer of urban health) He was right in assuming that causative agents of cholera (a part of the natural microbiome a crustacean, copepod) vary over time in an endemic setting due to ecological factors. Explosive outbreaks are caused by biofilm-induced infectivity. The formation of biofilm-derived Vibrio’s necessitates a passage through the human intestine. These hyper-infective forms are quite different from those of planktonic cells and very short lived. They decay in lower infectiousness states within hours. (Hartely 2005). Therefore in the case of cholera the Human-to-human Transmission is crucial. Also heavy rainfall and overflow of pit latrines increases the risk and may start an epidemic. If these factors are monitored, which has been done in a study in Zanzibar, the fluctuation of epidemics could be predicted.
  3. Infections are a consequence of bad health: a theory of Antoine Béchamp, one of the most important microbiologists in the 19th century. He identified “little bodies” 15 years in advance of his colleague and later opponent Pasteur. And he described infections as a result of efforts of the host organism to control them. (Hume D: Bechamp or Pasteur: A Lost Chapter in the History of Biology, 1942:  – Louis Pasteur Vs Antoine Béchamp and The Germ Theory of Disease Causation. Béchamp proved to be on the right track, not only because he invented the idea of intracellular bacteria (like chlamydia) and viruses. Morbidity and mortality of cholera depended on pre-existing health and nutrition status, duration of dehydration and last but not least on the quality of care, avoiding hospital infections like pneumonia. (Ryan 2000) And in the treatment of cholera care is more important than treatment (160 years ago: Florence Nightingale: She found out that the chances for survival increased dramatically if the patients received a certain quality of care and enough clean drinking water.)
  4. Cholera now lingers in many coastal Ecosystems. Ecuador is an example. It experienced a cholera epidemic 1991. The red line indicates the cholera cases which came to zero. Nevertheless cases of severe diarrhea went up steadily, indicating that water supply and living conditions have not improved since. Therefore it seems to be only a question of time when the next outbreak in Quito will occur. A trigger could be treating diarrhea with antibiotics some times for prophylactic purposes, thus favoring antibiotic resistant strains.
  5. The health system is often a system causing diseases: 20 years ago I conducted a study in urban Projet SIDA (Kinshasa, 1987-1997): 28% of blood bags ready for transfusion had bacterial contamination. Health care in this setting was very dangerous to health, and the situation since has not changed very much in many parts of the world.
  6. Disease is not the aim of a microorganism, it`s destiny is to reproduce. Virulence often results from “screw-ups” by the host’s immune system. Therefore we should concentrate more on the interaction between microorganisms, the ecological systems in which they evolve and the factors of host response.

2010 West-Africa counted >100.000 Cholera-Infections and the rich countries didn’t care. 2015 Ebola seemed to be a threat, therefore the international rushed to “fight” against Ebola. The analysis of the President of Libera Mrs. Sirleaf proposing a Marshall-plan for West-Africa, remained unheard. Now Brasil is “at war” with Zika, using a lot of pesticides, and the CDC is sure the Zika is the (only!) cause of microcephaly, so neglecting other possibly associated factors (like pesticides).

More

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Author: Helmut Jäger