Biography:

Prof. Graham A.W. Rook, BA MB BChir MD FIBiol, studied basic natural sciences at the University of Cambridge, UK, before qualifying in clinical medicine in the University of London. Since 1994 Prof. Rook has held the post of Professor of Medical Microbiology at University College London.

Prof. Rooks research has led to more than 290 peer-reviewed publications and more than 80 other reviews and book chapters. The theme of his research was initially the immunopathology of tuberculosis (TB). This broadened to include the endocrinology and immunoendocrinology of TB, and more recently, allergies and Darwinian Medicine. His approach is interdisciplinary, with emphasis on integrative physiology, leading to publications on endocrinology, immunology, microbiology and neuroscience. G.R. co-founded a biotech company (recently renamed Silence Therapeutics plc.), and is co-inventor of numerous patents.
Prof. Rooks current major interest is the increasing incidence in developed countries of chronic inflammatory disorders such as allergies, autoimmune disease and inflammatory bowel disease. This increase is in part attributable to failed control mechanisms within the immune system. The modern Western lifestyle deprives our immune systems of inputs that it has evolved to require, and without these inputs, its regulatory systems fail. This topic is becoming a major component of Darwinian Medicine, as we try to understand which inputs that were present in the hunter-gatherer environment are missing from the modern environment, and necessary for correct control of the immune system. The aim is to find substitutes so that the epidemic of chronic inflammatory disorders can be reversed.

Abstract:

Darwinian Medicine and the Hygiene or Old Friends hypothesis

The current synthesis of the Hygiene Hypothesis suggests that the recent increase in chronic inflammatory disorders is at least partly attributable to immunodysregulation resulting from lack of exposure to microorganisms that have evolved an essential role in the establishment of the immune system. This document provides background for discussion of the following propositions.

1) The essential role of these organisms is an example of evolved dependence

2) The most relevant organisms are those that coevolved with mammals, and already accompanied early hominids in the Paleolithic.

3) More recently evolved childhood infections are not likely to have evolved this role, and recent epidemiology supports this contention.

4) This mechanism is interacting with other modern environmental changes that also lead to enhanced inflammatory responses (inappropriate diet, obesity, psychological stress, vitamin D deficiency, pollution (dioxins) etc).

5) The range of chronic inflammatory disorders that is affected is potentially larger than usually assumed (allergies, autoimmunity, inflammatory bowel disease, but also vascular disease, some cancers, depression/anxiety (when accompanied by raised inflammatory cytokines), and perhaps neurodegenerative disorders and Type 2 diabetes.