The epithelial barrier hypothesis proposes a comprehensive understanding of the origins of allergic and other chronic noncommunicable diseases 2022,

[Sly Saint]

Cezmi A. Akdis

A steep increase in the prevalence of many chronic noncommunicable diseases occurred during the last 60 years, bringing them to a pandemic size.1 Our research and efforts to explain the reasons for this rise in their prevalence helped to develop the epithelial barrier hypothesis.

This hypothesis posits that disturbance of the epithelial barriers by laundry and dishwasher detergents, household cleaners, surfactants, enzymes and emulsifiers used in the food industry, cigarette smoke, particulate matter, diesel exhaust, ozone, nanoparticles, and microplastics cause tissue inflammation and microbial dysbiosis and play a role in many chronic noncommunicable diseases.1

The “epithelial barrier hypothesis” proposes mechanisms for the development of diseases of allergic, autoimmune, and neurodegenerative nature, with inflammation and tissue damage in the directly affected organs or distant organs that are not located directly at the skin and mucosal surfaces; accepts and embraces the hygiene and biodiversity hypotheses and links them to epithelial barrier defects and microbial dysbiosis; demonstrates possible ways of prevention of allergic and autoimmune diseases; and suggests future research directions.1

There is a need to support science and advance the understanding of the factors and molecular mechanisms associated with leaky epithelial barriers and inform policymakers of the detrimental effects of the potential causal or contributing substances. Here, I summarize the molecular and cellular mechanisms of the “epithelial barrier hypothesis” and supporting evidence.

https://www.jacionline.org/article/S0091-6749(21)01767-X/fulltext

 

[Sly Saint]

see also:

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and

https://academic.oup.com/intimm/article/36/5/211/7560334

 

[Creekside]

A steep increase in the prevalence of many chronic noncommunicable diseases occurred during the last 60 years, bringing them to a pandemic size.

Is that actually true, or is it just society's recognition of those as actual diseases rather than just "complaints". I assume that the number of official diagnoses of ADHD steeply rose after that term was coined, but that doesn't mean that the number of people who had attention problems rose faster than general population growth.

Micro/nanoparticles of synthetic products gets news coverage, as do new noxious chemicals, but the natural world has been producing micro/nanoparticles since it formed. Do dust mites and houseflies not produce nanoparticles? Do plants and fungi not produce new noxious chemicals during their ongoing battle against attackers? I'm certainly not saying that none of the products developed in the last 60 years might be causing new health problems, but humans evolved dealing with new chemicals and particles, although at a much slower rate than today.

 

[Jonathan Edwards]

Is that actually true

Not that I am aware of.
Actually it is quite obviously the opposite since people are living much longer.
When I trained as a doctor I was responsible for about 50 people in bed dying of chronic non-communicable disease. Many were in their fifties. By the time I left medicine everyone was six inches taller, lived 10 years longer and by and large stayed fit and well until old age.

 

[Violeta]

Is that actually true, or is it just society's recognition of those as actual diseases rather than just "complaints". I assume that the number of official diagnoses of ADHD steeply rose after that term was coined, but that doesn't mean that the number of people who had attention problems rose faster than general population growth.

Micro/nanoparticles of synthetic products gets news coverage, as do new noxious chemicals, but the natural world has been producing micro/nanoparticles since it formed. Do dust mites and houseflies not produce nanoparticles? Do plants and fungi not produce new noxious chemicals during their ongoing battle against attackers? I'm certainly not saying that none of the products developed in the last 60 years might be causing new health problems, but humans evolved dealing with new chemicals and particles, although at a much slower rate than today.

I can't find data going back 60 years, but here's some data from the 2000's.

Noncommunicable disease deaths in the Americas have risen 43% since 2000, PAHO report shows

Washington, D.C., July 2, 2025 (PAHO)– Deaths from noncommunicable diseases (NCDs), such as heart disease, cancer, and diabetes, have surged by 43% in the Americas since 2000, reaching 6 million in 2021, according to the Pan American Health Organization’s (PAHO) NCDs at a Glance 2025 report...

www.paho.org

The increasing trend of Non-Communicable Diseases among young adults may invite multiple public health challenges in the future​

https://www.medrxiv.org/content/10.1101/2024.07.30.24311217v1.full

 

[neophyte32]

Not that I am aware of.
Actually it is quite obviously the opposite since people are living much longer.
When I trained as a doctor I was responsible for about 50 people in bed dying of chronic non-communicable disease. Many were in their fifties. By the time I left medicine everyone was six inches taller, lived 10 years longer and by and large stayed fit and well until old age.

With us, you reconnect with the tender days of your youth as a doctor. The circle is complete.

 

[Violeta]

Non-communicable diseases in the world over the past century: a secondary data analysis​

• 

Frontiers | Non-communicable diseases in the world over the past century: a secondary data analysis

We visualized the change in the top 10 non-communicable diseases (NCDs) in the recent century by the World Health Organization (WHO) regions.The data were ex...

www.frontiersin.org

"Globally, NCDs are increasing each year, accounting for approximately 60% of all causes of death annually."

"Almost all NCDs have increased in recent years;"

 

[Jonathan Edwards]

"Almost all NCDs have increased in recent years;"

I think that just shows that if you search the net you will find something that confirms any statement - in this case a paper from someone in Iran with a personal take.

People are living longer - even since Covid life expectancy has gone back to increasing in most countries. In the last twenty years there was a huge increase in deaths due to drug addiction especially in the USA. Obesity is also making diabetes much more common, nut people are still much healthier and living longer than they were in 1970. Non-communicable diseases is a pretty odd category anyway. Communicable diseases stopped being the major problem in the West nearly a century ago. And TB is now increasing again.

The original statement in the paper has no meaningfu basis as far as I can see. There is nothing to suggest that drug abuse and obseisty are due to epithelial problems. They are due to ingesting drugs and sugar.

 

[Violeta]

People are living longer

Whether or not people are living longer isn't the same as whether there is an increase in noncommunicable diseases.

One piece of data would be increase in number of people with MS.

"Over the past 30 years, the prevalence of MS has increased globally by an average of 26% and has more than doubled in some countries since 1990. “In 2021, there were 1.89 million (uncertainty interval: 1.688 to 2.113) people in the world living with MS."

 

[Jonathan Edwards]

Whether or not people are living longer isn't the same as whether there is an increase in noncommunicable diseases.

But the statement was made specifically in the context of increased deaths.

Lots of conditions are diagnosed more. for various reasons and because peopoe live longer.
Sorry, but if you were an intern looking after people crippled and dying in middle age in the 1970s (mostly from smoking which is anon-communicable disease) you would see how laughable all this is.

 

[Violeta]

A steep increase in the prevalence of many chronic noncommunicable diseases occurred during the last 60 years

This thread is about increase in prevalence of chronic noncommunicable diseases, not about length of life.

"Conclusion:

In recent years, nearly all NCDs have shown an increase, yet mortality rates have declined across all regions. Lifestyle can be a major cause of this increase, but advancements in health and medical services, such as screening and treatment, have played a crucial role in improving survival rates."

Frontiers | Non-communicable diseases in the world over the past century: a secondary data analysis

We visualized the change in the top 10 non-communicable diseases (NCDs) in the recent century by the World Health Organization (WHO) regions.The data were ex...

www.frontiersin.org

 

[Jonathan Edwards]

In recent years, nearly all NCDs have shown an increase

But this is just wrong. I suspect there is a statistical artifact here. The commonest diseases now may well have become commoner and those may be the ones focused on. But there are lots of non-communicable diseases that have gone away.

Perhaps the key question is whether or not people are more sick more of the time at the same age from non-communicable disease. I cannot believe that. Just looking at people in the street and on buses fifty years ago lots of them were disabled by disease. They were about six inches shorter than they are now.

There will always be people writing articles tryint o persuade us of their pet theories. If the theories were new it might be fun but they are always decades old - the same tired old stories supported by threadbare evidence. The theories that have turned out right now have routine tests that back them up in routine medical care. Epithelial barrier tests have been around forever and never proved any use as far as I know.