Conclusions
PHM colonization and cross-reacting antigen exposures leading to
increased susceptibility to acute and/or chronic secondary infections
may be a plausible explanation for the heterogeneity common in many
chronic inflammatory disorders, the frequent comorbidities, the dietary
effects, the relationship with xenobiotic/pollution exposures, the
periodic exacerbations, and the varied target organs/tissues.
Disease could result from effects of PHM colonization/infection and/or
the immune system’s defensive reactions against PHM antigens that
cross-react with environmental and self-antigens.
Allergy/hypersensitivity reactions would enhance intestinal permeability
and microbial translocation. Rare microbes could have significant
effects since their effects could be magnified via hypersensitivity,
cross-reactions, and the synergistic effects of multiple PHM. Treatments
might aid the elimination/reduction of PHM (e.g., dietary changes,
anti-microbials, microbiota manipulation, allergen avoidance, stress
reduction methods, and immunotherapy). Treatments might also enhance PHM
toleration.
Given the ubiquity and adaptability of microbes, the changes in sources
of microbial exposures accompanying westernization, the frequent
cross-reactions, and the ability of some environmental microbes to
infect thru “dual use” virulence, it seems reasonable to consider the
PHM hypothesis. If this hypothesis is valid, it might lead to reduced
morbidity through adequate knowledge of PHM and associated neurological,
immunological and hormonal effects.