Introduction: The changing microbial environment, Darwinian medicine and the hygiene hypothesis

  • Graham A. W. Rook
Part of the Progress in Inflammation Research book series (PIR)


Man has undergone rapid cultural and rechnological evolution, with little simultaneous geneticevolution. Thus our physiology is adapted to the microbial exposures that prevailed in the huntergatherer environment, rather than to the clean living conditions of the rich industrialised countries. There is increasing evidence that lack of exposure to organisms that were part of mammalian evolutionary history is leading to disordered regulation of the immune system, and hence to increases in several chronic inflammatory disorders. The concept began with the allergic disorders, but there are now good reasons for extending it to autoimmunity, inflammatory bowel disease, neuroinflammatory disorders, atherosclerosis, depression associated with raised inflammatory cytokines, and some cancers. We discuss these possibilities in the context of Darwinian medicine. This approach enables one to identify some of the organisms that are important for the ‘hygiene’ or ‘old friends’ hypothesis, and to point to their potential exploitation in novel prophylactics and treatments, with applications in several branches of medicine.


Allergy Clin Immunol Intestinal Microbiota Allergic Disorder Chronic Inflammatory Disorder Hygiene Hypothesis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Birkhäuser Verlag Basel/Switzerland 2009

Authors and Affiliations

  • Graham A. W. Rook
    • 1
  1. 1.Centre for Infectious Diseases and International Health, Windeyer Institute of Medical SciencesUniversity College LondonLondonUK

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