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2018 ; 93
(3
): 1518-1557
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No effects without causes: the Iron Dysregulation and Dormant Microbes hypothesis
for chronic, inflammatory diseases
#MMPMID29575574
Kell DB
; Pretorius E
Biol Rev Camb Philos Soc
2018[Aug]; 93
(3
): 1518-1557
PMID29575574
show ga
Since the successful conquest of many acute, communicable (infectious) diseases
through the use of vaccines and antibiotics, the currently most prevalent
diseases are chronic and progressive in nature, and are all accompanied by
inflammation. These diseases include neurodegenerative (e.g. Alzheimer's,
Parkinson's), vascular (e.g. atherosclerosis, pre-eclampsia, type 2 diabetes) and
autoimmune (e.g. rheumatoid arthritis and multiple sclerosis) diseases that may
appear to have little in common. In fact they all share significant features, in
particular chronic inflammation and its attendant inflammatory cytokines. Such
effects do not happen without underlying and initially 'external' causes, and it
is of interest to seek these causes. Taking a systems approach, we argue that
these causes include (i) stress-induced iron dysregulation, and (ii) its ability
to awaken dormant, non-replicating microbes with which the host has become
infected. Other external causes may be dietary. Such microbes are capable of
shedding small, but functionally significant amounts of highly inflammagenic
molecules such as lipopolysaccharide and lipoteichoic acid. Sequelae include
significant coagulopathies, not least the recently discovered amyloidogenic
clotting of blood, leading to cell death and the release of further inflammagens.
The extensive evidence discussed here implies, as was found with ulcers, that
almost all chronic, infectious diseases do in fact harbour a microbial component.
What differs is simply the microbes and the anatomical location from and at which
they exert damage. This analysis offers novel avenues for diagnosis and
treatment.