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Allergies seem nearly impossible to avoid — unless you're Amish

Allergies seem nearly impossible to avoid — unless you're Amish

Yahoo3 days ago
Whether triggered by pollen, pet dander or peanuts, allergies in this day and age seem nearly impossible to avoid. But one group appears virtually immune, a mystery to experts who study allergies.
Despite the increasing rate of allergic diseases, both in industrialized and in developing countries, the Amish remain exceptionally - and bafflingly - resistant. Only 7 percent of Amish children had a positive response to one or more common allergens in a skin prick test, compared with more than half of the general U.S. population. Even children from other traditional farming families, who still have lower rates of allergic disease than nonfarm children, are more allergic than the Amish.
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In fact, one Amish community living in northern Indiana is considered one of the least allergic populations ever measured in the developed world.
'Generally, across the country, about 8 to 10 percent of kids have asthma. In the Amish kids, it's probably 1 to 2 percent,' said Carole Ober, chair of human genetics at the University of Chicago. 'A few of them do have allergies, but at much, much lower rates compared to the general population.'
Now, Ober and other researchers are trying to discover what makes Amish and other traditional farming communities unique, in the hopes of developing a protective treatment that could be given to young children. For instance, a probiotic or essential oil that contains substances found in farm dust, such as microbes and the molecules they produce, could stimulate children's immune systems in a way that prevents allergic disease.
'Certain kinds of farming practices, particularly the very traditional ones, have this extraordinary protective effect in the sense that, in these communities, asthma and allergies are virtually unknown,' said Donata Vercelli, a professor of cellular and molecular medicine at the University of Arizona. 'The studies that have been done in these farming populations are critical because they tell us that protection is an attainable goal.'
The Amish are members of a Christian group who practice traditional farming - many live on single-family dairy farms - and use horses for fieldwork and transportation. As of 2024, around 395,000 Amish live in the United States, concentrated mostly in Pennsylvania, Ohio and Indiana.
Over the past century, the incidence of allergic diseases - including hay fever (allergic rhinitis), asthma, food allergies and eczema - has increased dramatically. Hay fever, or an allergic reaction to tree, grass and weed pollens, emerged as the first recognized allergic disease in the early 1800s, climbing to epidemic levels in Europe and North America by 1900.
The 1960s saw a sharp increase in the prevalence of pediatric asthma, a condition in which the airways tighten when breathing in an allergen. From the 1990s onward, there has been an upswing in the developed world in food allergies, including cow's milk, peanut and egg allergies.
Urbanization, air pollution, dietary changes and an indoor lifestyle are often cited as possible factors.
The 'hygiene hypothesis' - first proposed in a 1989 study by American immunologist David Strachan - suggests that early childhood exposure to microbes protects against allergic diseases by contributing to the development of a healthy immune system.
The study found that hay fever and eczema were less common among children born into larger families. Strachan wondered whether unhygienic contact with older siblings served as a protection against allergies.
Subsequent findings have given support to the hygiene hypothesis, such as that children who grow up with more household pets are less likely to develop asthma, hay fever or eczema. Perhaps even more beneficial than having older siblings or pets, however, is growing up on a farm. (More than 150 years ago, hay fever was known as an 'aristocratic disease,' almost wholly confined to the upper classes of society. Farmers appeared relatively immune.)
This 'farm effect' has been confirmed by studies on agricultural populations around the world, including in the United States, Europe, Asia and South America. But even among farming communities, the most pronounced effect appears to be in the Amish. In a study of 60 schoolchildren by Ober, Vercelli and their colleagues, the prevalence of asthma was four times lower in the Amish as compared with the Hutterites, another U.S. farming community with a similar genetic ancestry and lifestyle.
The prevalence of allergic sensitization - the development of antibodies to allergens and the first step to developing an allergy - was six times higher in the Hutterites. The researchers first ruled out a genetic cause; in fact, an analysis showed that the Amish and Hutterite children were remarkably similar in their ancestral roots. Instead, the main difference between these two populations seemed to be the amount of exposure as young children to farm animals or barns.
'The Hutterite kids and pregnant moms don't go into the animal barns. Kids aren't really exposed to the animal barns until they're like 12 or so, when they start learning how to do the work on the farm,' Ober said. 'The Amish kids are in and out of the cow barns all day long from an early age.'
When analyzing samples of Amish and Hutterite house dust, they found a microbial load almost seven times higher in Amish homes. Later experiments showed that the airways of mice that inhaled Amish dust had dramatically reduced asthmalike symptoms when exposed to allergens. Mice that inhaled Hutterite dust did not receive the same benefit.
Now, Ober and Vercelli are beginning to identify the protective agents in Amish dust that prevent allergic asthma. In 2023, their analysis of farm dust found proteins that act like delivery trucks, loaded with molecules produced by microbes and plants. When these transport proteins deliver their cargo to the mucus that lines the respiratory tract, it creates a protective environment that regulates airway responses and prevents inflammation.
'We don't really talk about the hygiene hypothesis as much anymore because we now understand that it's not really about how hygienic you're living,' said Kirsi Järvinen-Seppo, director of the Center for Food Allergy at the University of Rochester Medical Center. 'It's more like a microbial hypothesis, since beneficial bacteria that colonize the gut and other mucosal surfaces play a significant role.'
During the first year or two of life, a baby's immune system is rapidly developing and highly malleable by environmental stimuli, such as bacteria. Some experts believe that exposing young children to certain types of beneficial bacteria can engage and shape the growing immune system in a way that reduces the risk of allergic diseases later in life. Farm dust contains a hodgepodge of bacteria shed from livestock and animal feed that isn't harmful enough to cause illness, but does effectively train the immune system to become less responsive to allergens later in life.
In 2021, Järvinen-Seppo and her colleagues compared the gut microbiomes of 65 Old Order Mennonite infants from a rural community in New York with 39 urban/suburban infants from nearby Rochester. Like the Amish, the Old Order Mennonites follow a traditional agrarian lifestyle. Almost three-fourths of Mennonite infants in the study were colonized with B. infantis, a bacterium associated with lower rates of allergic diseases, in contrast to 21 percent of Rochester infants.
'The colonization rate is very low in the United States and other Western countries, compared to very high rates in Mennonite communities, similar to some developing countries,' Järvinen-Seppo said. 'This mirrors the rates of autoimmune and allergic diseases.' These clues about the origin of the farm effect represent a step toward the prevention of allergic diseases, Järvinen-Seppo says.
Whatever form the treatment takes, the impact on prevention of allergic diseases, which affect millions of people worldwide and reduce quality of life, could be enormous, experts say.
'I don't know that we can give every family a cow. … But we are learning from these time-honored and very stable environments what type of substances and exposures are needed,' Vercelli said. 'Once we know that, I don't think there will be any impediment to creating protective strategies along these lines.'
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That scientist and another I spoke with couldn't believe that some of Geier's work had ever been published in the first place. David Geier is currently listed as a senior data analyst in HHS's staff directory, though what exactly he's doing for the department is unclear. The Wall Street Journal has reported that Geier is using his new position to continue his search for a link between thimerosal-containing vaccines and autism. New York magazine floated the possibility that he will attempt to repeat a study from the early 2000s that anti-vaccine activists cite as proof that inoculations harm developing brains. Kennedy has denied that Geier is running the agency's project to find out what causes autism, and testified that he has instead been hired by a contractor to determine whether information disappeared from the database. (Mark Geier died in March, and David Geier did not respond to interview requests. Reached for comment, an HHS spokesperson pointed to a lengthy X post by Kennedy in which he defends Geier's record and notes his 'extensive background as a research scientist.') Under any other administration, Geier's history would almost certainly have disqualified him from any role at HHS. In the mid-2000s, after Mark Geier had established a profitable sideline of testifying as an expert witness in lawsuits that alleged injury from vaccines, the father and son claimed to have discovered a method of treating autism. What they touted as a miracle drug was Lupron, a testosterone-suppressing medication used in many cases of premature puberty. They ran a laboratory out of the basement of their Maryland home and administered the drug to children based on their unfounded theory, advertising their supposed breakthrough on the autism-conference circuit. In 2012, Mark, a physician, was stripped of his license, and David was sanctioned for practicing medicine without one. (The Geiers sued the Maryland Board of Physicians in 2012 for releasing information about medications Mark Geier had prescribed to family members. They were awarded a total of nearly $5 million for the invasion of their privacy and attorneys' fees, but that judgment was reversed after a different court ruled that Maryland Board of Physicians members were immune from such claims.) The Geiers' work is well known among autism researchers, though not well respected. 'They were seen as not representing the best of autism science,' Craig Newschaffer, a Penn State scientist who has studied how genetics and environmental factors contribute to autism, told me, putting it more gently than others I spoke with. Marie McCormick met the Geiers when she chaired a 2004 review of immunization safety by the Institute of Medicine (now known as the National Academy of Medicine), a nonprofit group that advises the federal government. McCormick, now an emeritus professor at Harvard's School of Public Health, recalled that the Geiers' presentation had 'really made no sense': It was a slideshow of vaccine vials with labels indicating that they contained mercury, but it didn't have much else in the way of evidence. The committee's report identified a host of 'serious methodological flaws' in the Geiers' research, such as a failure to explain how they had sorted their subjects into groups. The Geiers' work from the 2010s likewise has such glaring flaws that the experts I spoke with were baffled as to how the studies had been published at all. Jeffrey Morris, a biostatistics professor at the University of Pennsylvania, recently examined a series of papers on which the Geiers were authors that used data from the Vaccine Safety Datalink. One representative 2017 study purportedly showed that the hepatitis B vaccine was associated with an increased risk of autism. Morris quickly noticed that the paper's approach rendered its findings meaningless. It compared a group of children with autism to a control group of children without the diagnosis, to see how vaccination rates differed between the two. But these groups of children also differed in another crucial way: The children diagnosed with autism were born during the eight-year span from 1991 to 1998, whereas the control group—children not diagnosed with autism—were born in 1991 or 1992. That's more than a minor inconsistency. In 1991, the CDC's vaccine-advisory committee recommended that all infants in the United States receive the hepatitis B vaccine, and so the percentage of vaccinated children rose steadily throughout the decade, from fewer than 10 percent to approximately 90 percent. That meant that babies born later in the '90s (who were overrepresented in the autism group) were very likely to have gotten the shot, whereas those born earlier in the decade (who were overrepresented in the control group) were not. By picking a control group in which relatively few kids would have been vaccinated, and an autistic population in which most were, the Geiers made finding a connection between immunization and autism inevitable. Using this approach, you could blame the vaccine for all manner of maladies. According to Morris, the Geiers did exactly that in at least nine papers, published from 2015 to 2018, that used data from the vaccine-safety database. One of their studies linked hep-B vaccination to childhood obesity. Others showed an association with tic disorders, emotional disturbance, and premature puberty, among other conditions, some of which rose during the '90s and early 2000s at least in part because of new diagnostic criteria and increased awareness. That likely also explains why autism rates began to climb significantly in the '90s. Many flawed scientific papers include a regrettable but understandable oversight, Morris told me, but the Geiers employed 'an absolutely invalid design that biases things so enormously that you could throw out the results of all these papers.' Newschaffer reviewed Morris's critique and told me he doesn't believe that a study with such a serious problem should have been published in the first place. 'I would characterize that as a 'miss' in the peer review,' he said. (I also contacted Dirk Schaumlöffel, the editor in chief of the Journal of Trace Elements in Medicine and Biology, which published the Geiers' paper connecting the hep-B vaccine to autism. He took issue with Morris's 'polemical allegations' and defended the paper, noting that it 'does not argue against vaccination, but merely questions the role of thimerosal.' He told me that he would prefer that the matter be debated in the pages of his journal.) If David Geier were merely an independent researcher publishing in lesser-known journals, his errors, although egregious, would be of little more than academic concern. But his influence on Kennedy runs deep. In 2005, Kennedy highlighted the Geiers' research in an essay outlining how he'd come to believe that thimerosal-containing vaccines could cause autism. He wrote about them again that year in 'Deadly Immunity,' an article—eventually retracted by both Salon and Rolling Stone after multiple corrections and intense criticism—that alleged that government health agencies had covered up evidence indicating that thimerosal in vaccines was to blame for the rise in autism rates. In his 2014 book, Thimerosal: Let the Science Speak, Kennedy cites the Geiers dozens of times, portraying them as determined truth-tellers battling uncooperative government agencies—the very ones Kennedy has now been appointed to oversee. Thanks to Kennedy, Geier seemingly is being handed the keys to the same database he's proved himself unfit to study. People who are familiar with Geier's history worry that he'll use his position on the inside not to defend the truth but to resurrect thoroughly debunked claims, twisting the data to support what he and Kennedy have long believed.

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