Evidence map›Paper›PMID 24154724›Full record

ReviewProceedings of the National Academy of Sciences of the United States of America2013

Regulation of the immune system by biodiversity from the natural environment: an ecosystem service essential to health.

Graham A Rook

Open access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Proceedings of the National Academy of Sciences of the United States of America, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 253 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
253citing papers in PubMed, 9 pooled it
25.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

253 citing papers in PubMed, 9 syntheses or guidelines pooled it, 735 citations in OpenAlex.

  1. Pooled it
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  5. Green Space and Health in Mainland China: A Systematic Review.International journal of environmental research and public health · 2021
    Pooled it
  6. Nature Exposure and Its Effects on Immune System Functioning: A Systematic Review.International journal of environmental research and public health · 2021
    Pooled it
  7. Pooled it
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  13. Review
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  18. [Gut microbiota and allergic diseases].Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026
    Review
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  20. Review

193 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author at 1 institution in 1 country.

Graham A RookCentre for Clinical Microbiology, Department of Infection, and the National Institute for Health Research and University College London Hospitals Biomedical Research Centre, University College London, London NW3 2PF, United Kingdom.
National Institute for Health Research · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Epidemiological studies suggest that living close to the natural environment is associated with long-term health benefits including reduced death rates, reduced cardiovascular disease, and reduced psychiatric problems. This is often attributed to psychological mechanisms, boosted by exercise, social interactions, and sunlight. Compared with urban environments, exposure to green spaces does indeed trigger rapid psychological, physiological, and endocrinological effects. However, there is little evidence that these rapid transient effects cause long-term health benefits or even that they are a specific property of natural environments. Meanwhile, the illnesses that are increasing in high-income countries are associated with failing immunoregulation and poorly regulated inflammatory responses, manifested as chronically raised C-reactive protein and proinflammatory cytokines. This failure of immunoregulation is partly attributable to a lack of exposure to organisms ("Old Friends") from mankind's evolutionary past that needed to be tolerated and therefore evolved roles in driving immunoregulatory mechanisms. Some Old Friends (such as helminths and infections picked up at birth that established carrier states) are almost eliminated from the urban environment. This increases our dependence on Old Friends derived from our mothers, other people, animals, and the environment. It is suggested that the requirement for microbial input from the environment to drive immunoregulation is a major component of the beneficial effect of green space, and a neglected ecosystem service that is essential for our well-being. This insight will allow green spaces to be designed to optimize health benefits and will provide impetus from health systems for the preservation of ecosystem biodiversity.

Indexed as

BiodiversityEnvironmentHygiene HypothesisAdaptive ImmunityHumansMicrobiota

Identifiers

PMID24154724
PMCPMC3831972
OpenAlexW2051692047

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.