The Hygiene Hypothesis and Darwinian Medicine

Man has moved rapidly from the hunter-gatherer environment to the living conditions of the rich industrialised countries. The hygiene hypothesis suggests that the resulting changed and reduced pattern of exposure to micro-organisms has led to disordered r

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Series Editor Prof. Michael J. Parnham PhD Director of Preclinical Discovery Centre of Excellence in Macrolide Drug Discovery GlaxoSmithKline Research Centre Zagreb Ltd. Prilaz baruna Filipovic´a 29 HR-10000 Zagreb Croatia Advisory Board G. Z. Feuerstein (Wyeth Research, Collegeville, PA, USA) M. Pairet (Boehringer Ingelheim Pharma KG, Biberach a. d. Riss, Germany) W. van Eden (Universiteit Utrecht, Utrecht, The Netherlands)

Forthcoming titles: Inflammatory Cardiomyopathy (DCMi) – Pathogenesis and Therapy, H.-P. Schultheiß, M. Noutsias (Editors), 2009 Occupational Asthma, T. Sigsgaard, D. Heederick (Editors), 2009 Endothelial Dysfunction and Inflammation, A. Karsan, S. Dauphinee (Editors), 2010 (Already published titles see last page.)

The Hygiene Hypothesis and Darwinian Medicine

Graham A.W. Rook Editor

Birkhäuser Basel · Boston · Berlin

Editor Graham A.W. Rook Centre for Infectious Diseases and International Health Windeyer Institute for Medical Sciences University College London 46 Cleveland Street London W1T 4JF United Kingdom

Library of Congress Control Number: 2009927790

Bibliographic information published by Die Deutsche Bibliothek Die Deutsche Bibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data is available in the internet at http://dnb.ddb.de

ISBN 978-3-7643-8902-4 Birkhäuser Verlag AG, Basel – Boston – Berlin The publisher and editor can give no guarantee for the information on drug dosage and administration contained in this publication. The respective user must check its accuracy by consulting other sources of reference in each individual case. The use of registered names, trademarks etc. in this publication, even if not identified as such, does not imply that they are exempt from the relevant protective laws and regulations or free for general use. This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, re-use of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. For any kind of use, permission of the copyright owner must be obtained. © 2009 Birkhäuser Verlag AG Basel · Boston · Berlin P.O. Box 133, CH-4010 Basel, Switzerland Part of Springer Science+Business Media Printed on acid-free paper produced from chlorine-free pulp. TCF d Cover design: Markus Etterich, Basel Cover illustration: by Anne Rook, with friendly permission Printed in Germany ISBN 978-3-7643-8902-4 987654321

e-ISBN 978-3-7643-8903-1 www.birkhauser.ch

Contents

List of contributors

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vii

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xi

Graham A.W. Rook Introduction: The changing microbial environment, Darwinian medicine and the hygiene hypothesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

George J. Armelagos The paleolithic disease-scape, the hygiene hypothesis, and the second e