The mission critical cells in this tolerance process are the Treg cell and the dendritic cell. We will discuss these cells because they will be important in how we can overcome disease risk and hopefully live well.

Defined as the regulatory T cells, formerly known as suppressor T cells, are a sub population of T cells or thymic cells which modulate the immune system, maintain tolerance to self-antigens, and prevent autoimmune disease. Tregs are immunosuppressive and generally suppress or down regulate induction and proliferation of effector T cells.

If this cell is turned on appropriately, then the system maintains a normal response to immune activation. In other words, if for some reason your immune system starts to fight a pathogen, these Treg cells are necessary to dampen the fighters and prevent local damage when the pathogen is killed.

An analogy for this response is: imagine the army is fighting a war and the war is over, however the GIs are still hanging around the city and they decide to go to a bar for little relaxation. Invariably, they get rowdy and start to destroy stuff.
The military police are called in to stop the fracas and calm the situation, returning the army back to stand-down mode. The Tregs are our military police and we need them!

The second important cell, the dendritic cell, is a class of immune cell located in the intestinal lining whose primary job is to taste protein fragments of bacteria, food and anything in the intestinal lumen, and decide if they are friend or foe. The immune system historically is set up so that the dendritic cells learn from everything that they see.

Think about an industrial assembly line. If a product specialist is checking the production line and finds a defective product, they immediately remove it, look for more defects and then shut down the line if more are found.

This is ideally and simplistically what the dendritic cell does. It is on the lookout for specific trouble makers. If it finds them, it starts a chain of events that will cause the pathogen to die.

What is the process by which tolerance develops normally from an epigenetic perspective?

A few months ago, I discussed an article about asthma risk in Amish and Hutterite populations and the induction of immune tolerance. These two populations are genocentric-farming enclaves in the United States.

The major difference between these communities is that the Amish children live on the farm where the Hutterites live around the farm and do not have much exposure to the animals.

What the study found was profound for our understanding of disease development: the children from the youngest ages in the Amish households were exposed to large volumes of animal-based and soil-based bacteria that prevented the onset of allergic disease. Conversely, the Hutterite children had little exposure to animal bacteria and had a 30 percent+ risk of asthma and allergy.

The hypothesis from this study is that the bacteria from the animal exposure induced immune tolerance by selecting for a stable human microbiome, which maintains an educated and functional immune system.

This fits nicely into the biome depletion theory, which notes that the lack of microbial exposure is the major root cause of disease.

Whether it be via animal exposure, vaginal delivery, breastfeeding, benign parasite ingestion or other non-deadly microbial exposure, we need more time spent with microbes to keep our immune system functional and tolerant.

To put this into perspective, we hypothesize that we have been a culture of cleanliness for far too long and this is clearly putting us all at risk for disease.

We all would benefit from more exposure to animal and soil-based microbes from the earliest ages. We would also benefit from more vaginal deliveries and breastfed babies.

End of part 2

With great respect for Dr. Williams and his advice, Drs. Chris Magryta and Aerik Williams

Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at newsletter@salisburypediatrics.com

https://evmedreview.com/reconstituting-the-depleted-biome-to-prevent-immune-disorders/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784904/

https://www.salisburypediatrics.com/patient-education/dr-magryta-s-newsletter/306-autoimmune-disease

https://www.salisburypediatrics.com/patient-education/dr-magryta-s-newsletter/238-hygiene-hypothesis