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IS CLEANLINESS REALLY NEXT TO GODLINESS? By Margaret Mielczarek. Preoccupation with hygiene measures has increased during the Covid era, so this month Retail Pharmacy looks at what impact the trend is having on our immune systems, especially on the development of those in infants, toddlers and young children. A balanced approach to hygiene Some researchers are asking what the long-term effects of the pandemic and the measures taken to curb the spread of Covid-19 will be on gut health and immune systems. While it’s known that the microbiome plays a significant role in the development of the immune system, the authors of an article published last year in mSphere, an open-access journal of the American Society for Microbiology, wrote that while the “hygienic measures imposed to control the spread of ... Covid-19 have proven effective in controlling the pandemic, these measures could impact the human microbiome ... acting as a double-edged sword in human health”. The authors propose that “new studies \\\\\\\\\\\\\\\[should be undertaken\\\\\\\\\\\\\\\] combining the pandemic control of Covid-19 with the diversity of the human microbiome”.1 In his article published in The Conversation3, ‘A year of Covid-19 lockdown is putting kids at risk of allergies, asthma and autoimmune diseases’, Byram W. Bridle, Associate Professor of Viral Immunology, Department of Pathobiology, University of Guelph, Ontario, Canada, says the development of our immune system starts at birth and “our interactions with microbes after birth are extremely important to educate our immune systems to function properly”. “The interactions we have with our environment early in life are essential for our immune systems to learn to differentiate between safe and dangerous disease-causing microbes,” Associate Professor Bridle wrote. “If infants, toddlers and young children are not sufficiently exposed to the microbial world around them, their ability to properly regulate their own immune systems can be compromised ... In plain terms, this scenario can promote allergies, asthma and autoimmune diseases.” He suggests “moderation and targeted hygiene” as the best approach. “Specifically,” he wrote, “we need to practise proper hygiene in the context of trying to prevent infectious diseases, but still allow our immune systems to interact with safe and essential microbes.” However, Professor Bridle warns that perhaps the responses “that have been enacted to help prevent the spread of Covid-19 may be contradicting the recommendations to ensure the proper immunological development in children”. “The youngest among us have had their immunological development compromised for one year and growing,” he wrote. “The more immature the immune system is, the more prone it will be to becoming dysregulated during the pandemic.” He asks what the long-term legacy of the pandemic will be, suggesting it HEALTH MOTHER AND BABY 51 In a 2016 “review of the burden of allergic and infectious diseases and the evidence for a link to microbial exposure in the human microbiome and immune system” published in Perspectives in Public Health, the authors describe the immune system as follows: “The immune system is a learning device, and at birth it resembles a computer with hardware and software but few data. Additional data must be supplied during the first years of life, through contact with microorganisms from other humans and the natural environment. “If these inputs are inadequate or inappropriate, the regulatory mechanisms of the immune system can fail. As a result, the system attacks not only harmful organisms, which can cause infections, but also innocuous targets such as pollen, house dust and food allergens, resulting in allergic disease”.2 TO PAGE 52 RETAIL PHARMACY • MAY 2021