An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases

We’ve spent generations cleaning up the bad organisms that once burrowed inside the human gut—but may want to put some of them back, writes science journalist Velasquez-Manoff in this ambitious survey of how evolution and ecology affect our biology and health. Allergies, asthma, type-1 diabetes, psoriasis, lupus, and celiac diseases have all become more frequent in the past 30,000 years while our exposure to parasites and microbes that normally take up residence in the gut has plummeted. But these organisms, far from being harmful, actually contribute to an ecological balance in our bodies that also balances the immune system. Velasquez-Manoff, who suffers from eczema, alopecia, and asthma, investigates the “hookworm underground” to score a supply to abate his own storm of autoimmune maladies—with queasy, mixed results. But there are more positive returns for others, including a 21-year-old woman suffering from Crohn’s disease who believes that whipworms saved her life. Velasquez-Manoff also investigates how microbes prevent allergic diseases and may even play a role in autism. If the parasite cure seems hard to swallow, the message is not: medicine will have to take account of patients’ inner and outer ecology if we’re ever to unravel the cause and treatment of disease. Agent: Kristine Dahl, ICM. (Sept.)