Cardiovascular disease and type 2 diabetes in evolutionary perspective: A critical role for helminths?

Blackwell, Aaron D., Finch, Caleb, Gurven, Michael, Kaplan, Hillard, Michalik, David, Stieglitz, Jonathan and Trumble, Benjamin C. (2016) Cardiovascular disease and type 2 diabetes in evolutionary perspective: A critical role for helminths? Evolution, Medicine, and Public Health. pp. 338-357.

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Abstract

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.

Item Type: Article
Language: English
Date: 2016
Refereed: Yes
Uncontrolled Keywords: atherosclerosis diabetes helminths ecological immunology hygiene hypothesis old friends hypothesis
Subjects: B- ECONOMIE ET FINANCE
Divisions: TSE-R (Toulouse)
Site: UT1
Date Deposited: 14 Feb 2017 15:04
Last Modified: 07 Mar 2018 13:24
OAI ID: oai:tse-fr.eu:31185
URI: http://publications.ut-capitole.fr/id/eprint/23003

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