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2016 ; 2016
(1
): 338-357
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Cardiovascular disease and type 2 diabetes in evolutionary perspective: a
critical role for helminths?
#MMPMID27666719
Gurven MD
; Trumble BC
; Stieglitz J
; Blackwell AD
; Michalik DE
; Finch CE
; Kaplan HS
Evol Med Public Health
2016[Jan]; 2016
(1
): 338-357
PMID27666719
show ga
Heart disease and type 2 diabetes are commonly believed to be rare among
contemporary subsistence-level human populations, and by extension prehistoric
populations. Although some caveats remain, evidence shows these diseases to be
unusual among well-studied hunter-gatherers and other subsistence populations
with minimal access to healthcare. Here we expand on a relatively new proposal
for why these and other populations may not show major signs of these diseases.
Chronic infections, especially helminths, may offer protection against heart
disease and diabetes through direct and indirect pathways. As part of a strategy
to insure their own survival and reproduction, helminths exert multiple
cardio-protective effects on their host through their effects on immune function
and blood lipid metabolism. Helminths consume blood lipids and glucose, alter
lipid metabolism, and modulate immune function towards Th-2 polarization - which
combined can lower blood cholesterol, reduce obesity, increase insulin
sensitivity, decrease atheroma progression, and reduce likelihood of
atherosclerotic plaque rupture. Traditional cardiometabolic risk factors, coupled
with the mismatch between our evolved immune systems and modern, hygienic
environments may interact in complex ways. In this review, we survey existing
studies in the non-human animal and human literature, highlight unresolved
questions and suggest future directions to explore the role of helminths in the
etiology of cardio-metabolic disease.
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