By Dr. Paul Ehrlich
Star Trek Beyond, Jason Bourne, Finding Dory—summer is the season of movie sequels, and for once, allergic medicine has its own blockbuster entry. The New England Journal of Medicine published “Innate Immunity and Asthma Risk in Amish and Hutterite Farm Children.” It also made both the front page and the op-ed page of the New York Times. I am particularly attentive to this research because my former resident at NYU Dr. Mark Holbreich did the seminal Amish study. He wrote about it on this website four years ago and I have commented on it repeatedly.
The new study shows that the incidence of asthma on Amish farms is substantially lower than the population as a whole, and also the cohort of Hutterites who are similar genetically but who practice a different model of farming. Basically, the Amish live on single-family farms with no electricity and use horses instead of tractors. Their kids are in and out of the barns and are exposed to all the microbes associated with traditional farming and fewer chemicals. They develop immune defenses based on microbial exposure dominated by a white blood cell called a neutrophil, which fights infections (although it is associated with non-allergic asthma symptoms).
The Hutterites farm communally using industrial, mechanized methods, which skews their immunity towards the eosinophil, which is tied to allergic asthma. As I have also previously noted, Hutterite women don’t work in the barns at all and they, too, have asthma. Not all farms are created equal.
The new study analyzed the dust from the house dust collected at the respective farms and found that the Amish dust was teeming with debris from bacteria, while that from Hutterites was more sterile.
This is great research and as close as we come to validation of the Hygiene Hypothesis, which we used to call the “pound of dirt” theory when I was training, on the idea that a child needed to eat a pound of dirt to develop a healthy immune system (not all at once I must add).
The question becomes what to do about it. Can these microbes be packaged for home use?