- The Secret To Treating Autoimmune Disease May Lie In The Gut
- Autoimmune Disease: Why Is My Immune System Attacking Itself?
- The Link Between Autoimmune Disease and Women
- The Role of Infection and Disease
- The Damage Theory
- Genetic Risk
- A Lactobacillus strain worsens symptoms of autoimmune disease
- Commensal bacteria exacerbate lupus-related symptoms and mortality
- Bacteria enriched in lupus models are transferable
- A special dietary starch modulates L. reuteri growth and improves autoimmune symptoms
- Could targeting gut bacteria prevent autoimmunity?
- Gut Health & Seasonal Allergies | Prebiotin™ | Improve your Gut Health
- Is my asthma an allergy?
- How to diagnose asthma in young children
- A new approach to treating your seasonal allergies and asthma
- How does our gut health affect allergies and asthma?
- How to heal your gut dysfunction with prebiotics and probiotics
- Leaky gut: What is it, and what does it mean for you?
- Probiotics and Arthritis
- Become a Member
- Make a Honor or Memorial Gift
- Tell us what matters most to you. Change the future of arthritis
- How are you changing the future?
- More About Partnerships
- Gut Bacteria May Hold Key to Treating Autoimmune Disease
- Gut bacteria are sensitive to salt: Link to autoimmune disease and hypertension
The Secret To Treating Autoimmune Disease May Lie In The Gut
An estimated 50 million Americans ― that’s 20 percent of the general population ― suffer from autoimmune diseases lupus, multiple sclerosis and rheumatoid arthritis, and many experts say that number is rising at an alarming rate.
Autoimmunity occurs when the immune system begins attacking the body’s healthy tissue as if it were an outside invader, leading to chronic inflammation. We still don’t know much about what causes the immune system to go haywire, or how to effectively treat it.
But new research suggests that the gut microbiome ― the community of trillions of “good” and “bad” bacteria living in the body’s intestinal tract ― could play a larger role than scientists have realized.
Alterations in gut bacteria are one cause of the runaway inflammation characteristic of autoimmune conditions, according to a study slated for publication in the January issue of the Journal of Experimental Medicine.
Scientists already knew that the gut microbiome and the immune system are closely intertwined and constantly engaged in dynamic interaction. But new studies this one continue to reveal more intricate connections between these two key systems of the body, including the ways that dysfunctions in both systems can contribute to autoimmunity.
“Beneficial gut bacteria promotes immune homeostasis, which means that resident gut bacteria have beneficial nutritional effects and the effect of reducing autoimmunity and inflammation,” Dr. Yuying Liu, an associate professor of pediatrics and gastroenterology at the University of Texas and the study’s lead author, told The Huffington Post.
In an experiment on mice, Liu and her colleague Dr. J.
Marc Rhoads showed that increasing levels of a particular strain of healthy bacteria (also known as a probiotic) could “reset” the microbial community in the gut, thereby reducing inflammation.
These “good” bacteria are a beneficial strain of the Lactobacillus family, other strains of which can be found in commercial probiotic supplements and fermented foods yogurt and kefir.
Here’s how it works: The body contains “regulatory T cells.” Their job is to maintain balance within the immune system and prevent immune cells from getting so confused they accidentally attack the body’s own cells. Defective T reg cells cause chronic inflammation and autoimmune disease by altering the type of bacteria living in the gut, reducing levels of certain healthy bacteria.
But mice that were given healthy Lactobacillus bacteria had their microbial community go back to normal and saw reduced inflammation.
“Probiotics and probiotic-modulated microbiota … may represent a potential avenue for combatting autoimmune diseases mediated by T reg dysfunction,” Liu said.
The study revealed further links between gut bacteria and autoimmune disease, beyond T cell activity. Mice that carried a mutant version of a particular gene showed changes in gut bacteria ― specifically, lower levels of bacteria from the genus Lactobacillus ― at roughly the same time that they began exhibiting autoimmune symptoms, the researchers found.
These findings add weight to the idea that dietary and lifestyle interventions may be a powerful way to treat autoimmune diseases ― conditions for which conventional treatments are often ineffective and come with many side effects.
The beneficial effects of probiotics on the immune system may be one reason why (anecdotally, at least) autoimmune conditions seem particularly responsive to dietary changes as a form of complementary treatment.
In fact, many functional and integrative medicine doctors prescribe nutrition-based protocols to treat patients with autoimmune disease.
Liu agreed that these kinds of treatments had potential, although more research is needed to understand how they affect the immune system.
“We know that gut microbiota are altered by stress, antibiotics, high-fat diet, and a ‘overly clean environment,’” Liu said. “It is reasonable to postulate that lifestyle interventions could help to prevent or treat autoimmune diseases.”
Autoimmune Disease: Why Is My Immune System Attacking Itself?
Autoimmune disease affects 23.5 million Americans, and nearly 80 percent of those are women. If you’re one of the millions of women affected by this group of diseases, which includes lupus, rheumatoid arthritis and thyroid disease, you may be wondering why your immune system is attacking itself.
Ana-Maria Orbai, M.D., M.H.S., is a rheumatologist at the Johns Hopkins Arthritis Center. Rheumatologists specialize in diagnosing and treating musculoskeletal diseases and autoimmune conditions (rheumatic disease). Orbai explains several theories researchers have about what might cause autoimmune disease, including infection, tissue damage and genetics.
The Link Between Autoimmune Disease and Women
Doctors aren’t sure why autoimmune disease happens in the first place or why women are affected more than men. One theory is that higher levels of hormones in women, especially during the childbearing years, could make women more susceptible to autoimmune diseases.
However, Orbai notes that this idea has not yet been proven — there are many factors that affect autoimmunity, both genetic and environmental. Researchers cannot definitively explain why women develop these diseases more than men do.
The Role of Infection and Disease
On a basic level, autoimmune disease occurs because the body’s natural defenses — the immune system — attack the body’s own healthy tissue. Researchers have several ideas about why this happens.
When the body senses danger from a virus or infection, the immune system kicks into gear and attacks it. This is called an immune response. Sometimes, healthy cells and tissues are caught up in this response, resulting in autoimmune disease.
Many scientists believe this is what causes rheumatoid arthritis, a type of autoimmune disease that attacks the joints. It’s also common that after having strep throat, people develop psoriasis, an autoimmune condition that causes patches of thick, scaly skin.
Other types of autoimmune disease may come from the body trying to fight specifically against cancer cells. Orbai points to scleroderma, a disease that causes thickening of the skin and connective tissues.
“The thought is that when the immune system gets rid of the cancer, there is a leftover inflammatory response because of that fight,” she says.
Johns Hopkins researchers studied patients who developed both scleroderma and cancer to try to clarify this relationship.
The Damage Theory
Scientists think injury may play a role in some types of autoimmune disease such as psoriatic arthritis, a condition that affects the joints of some people with psoriasis.
Research has shown that in parts of the body subjected to high stress, an autoimmune response happens after damage to tendons, which attach muscle to bone. For example, a runner’s heel is an area where the muscle is constantly pulling on the bone to create movement.
“This repeated stress can expose tissue that shouldn’t normally be in contact with blood cells,” says Orbai. “When that tissue gets exposed, it’s a small wound. Blood cells try to heal it, but an abnormal immune response causes inflammation of the joints and tendons.”
Orbai is quick to point out that while there is some data to support them, scientists have not proven that these are causes of autoimmune disease.
It’s clear that genetics play a role in autoimmune disease, but researchers still don’t fully understand how. For example, having a family member with lupus or multiple sclerosis (MS) raises your risk of getting these diseases. Some families have multiple members affected by different autoimmune diseases. However, genetics alone isn’t enough to cause autoimmune disease.
“We know that genes are important, but they aren’t everything,” Orbai says. “You can have family members with lupus or MS and never get them yourself. You can even test positive for lupus-specific DNA and still not have the disease.”
It’s possible that autoimmune disease occurs the immune system’s ability to handle stress. Orbai says that this is an area of intense research. “When does the stress on your body exceed your immune system’s ability to handle it? If we knew this, it could be the key to preventing autoimmune disease before it develops.”
A Lactobacillus strain worsens symptoms of autoimmune disease
A commensal Lactobacillus strain worsens the symptoms of the autoimmune disease systemic lupus erythematosus by triggering the host’s immune system, a study in mice has found. Daniel Zegarra-Ruiz and his colleagues at Yale University School of Medicine in New Haven reported these findings in the journal Cell Host & Microbe.
Western diets are characterized by low amounts of fiber and high amounts of fat, which alter the gut microbiota make-up. Changes in the microbiota composition have been linked to several autoimmune diseases, but whether diet influences autoimmunity through gut bacteria remains unclear.
To address this question, the researchers looked at mouse models of lupus and identified specific bacterial species that were linked to lupus development.
Commensal bacteria exacerbate lupus-related symptoms and mortality
The team first induced lupus in genetically prone mice, then suppressed the gut microbiota using broad-spectrum antibiotics or growing the rodents under germ-free conditions.
In both situations, mice lived longer and showed fewer symptoms of autoimmune disease such as decreased levels of the inflammatory molecule type I IFN in the spleen and blood as well as reduced blood disorders and kidney injury.
To identify bacteria driving lupus manifestations, the researchers collected fecal samples from lupus-prone mice and sequenced the bacterial DNA.
Compared to wild-type mice, lupus-prone mice had an altered gut microbiota, which included bacterial species such as L. reuteri, Desulfovibrio, and Rikenellaceae.
These mice also had an impaired gut epithelium that allowed Lactobacillus spp., and L. reuteri in particular, to leak into the blood. L.
reuteri increased over time in the feces of lupus-prone mice as their disease progressed.
The researchers also found increased levels of L. reuteri in the feces of lupus patients compared to healthy people.
Bacteria enriched in lupus models are transferable
When lupus-prone mice were housed together with wild-type mice, the majority of bacterial species enriched in lupus-prone mice, including L. reuteri, were transferred to wild-type mice. Cohousing also increased gut leakiness in wild-type mice.
What’s more, the researchers observed increased gut leakiness and autoimmune symptoms such as an abnormal enlargement of the liver and spleen, worsened kidney disease and high levels of type I IFN in rodents that received the gut microbiota of lupus-prone mice.
Similar effects, as well as the worsening of lupus-related symptoms, occurred when wild-type mice were fed L. reuteri, but not when they were fed an unrelated gut bacterial species.
A special dietary starch modulates L. reuteri growth and improves autoimmune symptoms
To assess the role of diet in modulating bacteria in lupus-prone mice, the team fed them food enriched with resistant starch, a type of fiber that resists digestion and is fermented by gut bacteria.
Resistant starch decreased the amount of L. reuteri found in the feces and in the gut of mice fed with resistant starch.
Resistant starch also tightened the gut epithelial barrier and reduced gut leakiness and L. reuteri translocation to the blood.
Over time, resistant starch reduced lupus-related mortality and decreased the levels of inflammatory molecules in the spleen and gut.
The researchers discovered that L. reuteri growth was inhibited by short-chain fatty acids, in particular butyrate, which are the main metabolites of resistant starch fermentation by the gut microbiota.
In conclusion, these data suggest that a dietary intervention is sufficient to prevent the development of lupus- disease, whose symptoms are exacerbated by the commensal L. reuteri strain. The findings could inform clinical approaches to restrain bacteria that contribute to autoimmune diseases.
Could targeting gut bacteria prevent autoimmunity?
The findings of a new study might hold promise for the future of treating chronic autoimmune conditions such as systemic lupus and autoimmune liver disease, according to its authors.
Share on PinterestResearchers suggest that targeting a specific gut bacterium could help to prevent autoimmune disease.
In the study, researchers from Yale University in New Haven, CT, discovered that bacteria in the small intestine can travel to other organs and induce an autoimmune response.
Importantly, the team also found that this reaction can be treated by targeting the bacteria with an antibiotic or vaccine.
The study results were recently published in the journal Science.
In autoimmune diseases, the immune system mistakingly attacks healthy cells and tissues. Some of the most common autoimmune diseases include type 1 diabetes, lupus, and celiac disease.
According to the National Institutes of Health (NIH), around 23.5 million people in the United States are affected by autoimmune diseases.
A variety of autoimmune conditions have been linked to bacteria in the gut. Using a mouse model, the Yale team specifically looked at a bacterium called Enterococcus gallinarum, which can travel beyond the gut to the spleen, lymph nodes, and liver.
The team found that E. gallinarum provoked an autoimmune response in the mice when it traveled beyond the gut.
The researchers were able to replicate this mechanism using cultured human liver cells, and they also found E. gallinarum to be present in the livers of people who have autoimmune disease.
By administering an antibiotic or vaccine to target E. gallinarum, the scientists then found that it was possible to suppress the autoimmune reaction in the mice and prevent the bacterium from growing.
“When we blocked the pathway leading to inflammation,” says senior study author Martin Kriegel, “we could reverse the effect of this bug on autoimmunity.”
“The vaccine against E. gallinarum was a specific approach, as vaccinations against other bacteria we investigated did not prevent mortality and autoimmunity.”
Kriegel adds that the team plans to further study the biological mechanisms that are associated with E. gallinarum and the implications that they might have for systemic lupus and autoimmune liver disease.
The new study complements previous studies that have uncovered a link between gut bacteria and autoimmune diseases.
Studies in mice, for example, have found that the colonization of the gut by some bacteria can lay the groundwork for the development of autoimmune disorders in the future.
These bacteria can cause changes in the tissue of the gut, resulting in the production of antibodies that attack cells in conditions such as systemic lupus.
Previously, Medical News Today covered a study that suggested that altering gut bacteria might help to alleviate lupus symptoms.
The study, published in the journal Applied and Environmental Microbiology, showed that species of Lactobacillus in the gut of a lupus mouse model were linked to a reduction of lupus symptoms, while the Lachnospiraceae bacteria were associated with worsening symptoms of lupus.
“The use of probiotics, prebiotics, and antibiotics,” said Husen Zhang, first author of that study, “has the potential to alter microbiota dysbiosis, which in turn could improve lupus symptoms.”
Gut Health & Seasonal Allergies | Prebiotin™ | Improve your Gut Health
by Prebiotin Team
Seasonal allergies and related asthma can really ruin your day.
Red, itchy watery eyes, sneezing, ear pain, a runny nose, coughing, wheezing, labored breathing, and fatigue can all be a major barrier to enjoying your life—or even functioning effectively in any setting, from work to family time.
You take medications that may help a little, use an inhaler, or avoid the outdoors all together, with plenty of time to wonder why your body is reacting so severely, while people around you don’t even have a sniffle.
Essentially, an allergy is the result of your immune system overreacting. Your immune system is designed to protect you from viruses and bacteria that can make you sick, but sometimes it gets tricked into going on the offensive for no reason at all.
Seasonal allergies are caused by the body’s immune system having an overly aggressive response to pollen, ragweed, grass, and other harmless substances in the environment. When the immune system sees these substances as a threat, it releases chemicals that cause the inflammation linked to your troublesome allergy symptoms, from common hay fever symptoms to seasonal asthma.
Most of us are able to diagnose seasonal allergies fairly easily. Everyone recognizes the stuffy nose and weeping eyes that get better if we move indoors away from allergen sources. If we have difficulty breathing, it may be time to go to the doctor who can confirm a seasonal allergy or asthma diagnosis and eliminate other conditions.
Seasonal allergies are the 6th leading cause of chronic illness in the U.S., with an annual cost in excess of $18 billion. Hay fever alone affects 7.
8% of the adult population in the United States, according to the American Academy of Allergy Asthma & Immunology. Additionally, 9% of children reported hay fever symptoms in the past 12 months.
Of the 26 million people who have asthma, about 60% have allergic asthma, the most common type.
Most people believe that allergies are a lifelong condition, but that’s not necessarily true. It’s quite possible to suddenly struggle with allergies or asthma as an adult, even if you had no symptoms before. Additionally, many children who suffer from seasonal allergies and asthma will eventually outgrow their condition.
Developing allergies later in lifeAccording Harvard Men’s Health Watch newsletter, seasonal allergies can affect almost anyone and at any time of life. The newsletter quotes Dr. Mariana Castells, of the Department of Allergy, Rheumatology, and Immunology at Harvard-affiliated Brigham and Women’s Hospital: “Even if you have never suffered from allergies — or used to when you were much younger but not anymore — there is a good chance you will become more sensitive to pollen as you reach your 60s and 70s, although it’s not clear why.”
Is my asthma an allergy?
For some people, an allergy to pollen or pet dander, for example, may trigger more severe symptoms that affect the lungs and make it harder to breathe. These symptoms are often a sign of allergic asthma. For example, you may experience:
- chest tightness
- problems breathing
- shortness of breath
In severe cases, allergic asthma, as well as nonallergic asthma, can be life threatening. Make sure you know what triggers these symptoms so you can avoid exposure or be prepared with appropriate medications or an inhaler.
I thought I was having a heart attack!“Everything was blooming, and mother nature was at her most beautiful in the rural part of PA I call home. Since I’ve never had allergies, spring is my favorite time of year for long walks to enjoy the springtime display. Until last year. I started noticing I had difficulty catching my breath and found it difficult to walk as my breathing became more labored.
Eventually, I became concerned enough to visit my family physician. As a baby boomer, I never considered developing an allergy at this stage of life, and instead worried about a possible heart attack.
My doctor sent me to the emergency room where I stayed overnight and underwent a battery of cardiac function tests. My heart was fine.
Only during a follow-up appointment a few weeks later did I learn that I had probably developed allergy related asthma.
By then, the height of the pollen season was over, and I was breathing normally again, at least until the hospital bills started arriving.– G. Amersbach, Prebiotin science writer.
How to diagnose asthma in young children
Young children under 5 are especially hard to diagnose with any kind of asthma because they are too young for breathing tests, according to the Mayo Clinic.
While symptoms may be similar to those in adults, the doctor will ask the parents a series of detailed questions, from how often the child is experiencing symptoms, the duration, nighttime issues, and response to seasonal changes, among others, to eliminate other possible childhood conditions.
If the child’s symptoms are severe—he or she is gasping for breath, breathing so hard the abdomen is sucked to the ribs, or has trouble speaking because of restricted breath—parents must seek emergency treatment where the child may receive blood tests, a chest x-ray, or allergy tests. In moderate or severe cases, the child may be placed on daily medications, with directions on how to avoid possible triggers.
A new approach to treating your seasonal allergies and asthma
The simple approach to avoiding pollen and other seasonal allergies is to just stay inside. You may also rely on a combination of antihistamines and decongestants to help with symptoms.
However, these medications often have unwelcome side effects such as drowsiness. They’re also a temporary fix that do nothing to treat the underlying problem.
And finally, most of us enjoy spring time and resent viewing Mother Nature at her most showy through the window.
If your seasonal allergies are driving you crazy, consider looking into the relationship between your gut health and allergy symptoms. It sounds counterintuitive to turn to your digestive system for a solution to your allergies and allergic asthma, but growing evidence supports this approach to seasonal allergy relief.
The human microbiome is a collection of bacteria, viruses, fungi, and other microbes that live in your gut and on other areas of your body.
The average person carries trillions of microbes in their gut, including more than 1,000 different species of bacteria. These bacteria help us digest our food and play a crucial role in immune system function.
It is believed that up to 80% of the entire immune system makes its home in our gut!
Babies start to develop their unique microbiome right after birth and get many beneficial bacteria from the mother through the birth canal and through breast feeding. The infant’s interaction with other family members and even pets also continues to shape the microbiome—as do antibiotic treatments.
Researchers find even early in life, the composition of the gut microbiome can be an indicator if the child is at risk for a wide range of illnesses, including allergies and asthma.
In a 2018 study with 792,130 children, researchers found the risk of developing an allergic disease was significantly increased in those who had received antibiotics or medications to suppress acid during the first 6 months of life.
Adults with allergies also have a different gut microbiome than those without allergies, according to a study of 1,879 adults released by the National Institutes of Health.
This study found that a lack of diversity in the gut microbiota was associated with all types of allergies, especially seasonal and/or nut allergies. They had reduced Clostridiales and increased Bacteroidales bacteria colonies in their gut microbiota.
It might be strange to think that a lack of certain bacteria in your gut is the cause of your sneezing and itchy eyes and even asthma symptoms, but this is actually good news. If you take steps to heal your gut, you’re ly to see a noticeable improvement in your allergy symptoms.
How does our gut health affect allergies and asthma?
Too clean for our own good: While a cleaner environment with improved public sanitation has had obvious health benefits, we may have become too clean for our own good.
According to the hygiene hypothesis, the increasing use of antibacterial soaps, hand sanitizers, and powerful germ-killing cleaning products create a more “hygienic” environment and change the microbiota in the gut (where 80% of the immune system is housed).
As our immune systems are no longer challenged, we are more prone to environmental allergens.
Leaky gut syndrome: Another reason we may develop allergies is leaky gut syndrome, or increased intestinal permeability. A poor diet, with too many processed foods, sugary sweets, and alcohol, may cause the intestinal wall to become weak and unable to block food particles, germs, and toxins from entering the bloodstream.
This can lead to systemic inflammation which has been associated with many chronic diseases, from inflammatory bowel disease and rheumatoid arthritis, to asthma and allergies. Reducing stress, exercise, and a healthy diet rich in prebiotic fiber can help to repair intestinal permeability.
Histamine intolerance: A histamine intolerance is another reason we may have allergic symptoms, even when no allergens are present.
If we can’t tolerate foods high in histamines ( cured meat, aged cheese, alcohol, an canned or smoked fish, for example), the histamines may build up and produce an allergic response that mimics hay fever.
A doctor can test for this condition and may ask you to avoid foods high in histamines to see if allergy symptoms get better.
Is the pollen allergy season getting longer? Blame climate change.Scientists and physicians are documenting that as temperatures rise, the pollen allergy season is getting longer and more intense each year. In a March 2019 article in The Lancet Planetary Health, the authors note that the ongoing increase in temperature extremes might already be contributing to a longer pollen season across the northern hemisphere. They write that their study “highlights an important link between ongoing global warming and public health—one that could be exacerbated as temperatures continue to increase.”
How to heal your gut dysfunction with prebiotics and probiotics
In order to heal gut dysfunction, prebiotics and/or probiotics can help. A prebiotic is non-digestible fiber found in foods bananas, asparagus, onions and garlic, Jerusalem artichoke, the skin of apples, chicory root, beans, and dandelion greens. Prebiotic fiber goes through the small intestine undigested and is fermented when it reaches the large colon.
This fermentation process feeds the “good” bacteria colonies (including probiotic bacteria). With more beneficial bacteria in our digestive systems (also called the gut), we feel better and have reduced disease risk.
Probiotics provide your body with an extra dose of the “good” bacteria that live in your digestive system and help keep you healthy. Yogurt is the most common food source of probiotics, since it contains beneficial bacteria lactobacillus or bifidobacteria. Fermented foods such as kefir, sourdough bread, sauerkraut, miso soup, and Gouda cheese also have probiotics.
Prebiotic and probiotic supplements may be useful if you don’t eat enough prebiotic and probiotic-rich foods to help heal your gut and promote seasonal allergy relief.
Prebiotin® Prebiotic Fiber is an ideal supplement to add prebiotic fiber to your diet.
It has been shown to help grow beneficial bacteria in the gut, which can boost immunity as well as promote intestinal health.
Seasonal allergy sufferers in search of natural relief for their symptoms will find Prebiotin is the most medically researched prebiotic supplement on the market today. Prebiotin is the only full-spectrum prebiotic containing both inulin and oligofructose to treat the entire bowel wall and reduce leaky gut syndrome.
Many of us already suffer from seasonal allergies and asthma. With climate change, even more of us will develop symptoms.
Whether you are miserable with weepy eyes, stuffy nose, or labored breathing or want to boost your immune system to ward off future allergy symptoms, the best step is to keep your gut microbiome as healthy as possible.
As you add more prebiotic fiber Prebiotin to your diet, exercise, and find ways to decrease stress, you may be able to enjoy nature again, hopefully without a glass barrier!
Photo by Fancycrave on Unsplash
- American Academy of Allergy Asthma & Immunology. Allergy Statistics. Updated 2019. Accessed April 30, 2019.
- American Academy of Allergy Asthma and Immunology. Allergic Asthma Definition. 2019. Accessed April 30, 2019.
- American Academy of Allergy Asthma and Immunology. Views of Allergy Specialists on the Health Effects of Climate Change. Key Findings: Membership Survey of the American Academy of Allergy, Asthma & Immunology. December 2015. Accessed April 30, 2019.
- American College of Academy of Allergy, Asthma, and Immunology. Allergy Facts. Allergist. Updated 1/9/18. Accessed April 30, 2019.
- American College of Allergy, Asthma, and Immunology. The year 2040: Double the pollen, double the allergy suffering? ScienceDaily. 9 November 2012. Retrieved May 5, 2019 from www.sciencedaily.com/releases/2012/11/121109083736.htm.
- Corbett, Adrian. “7 Huge Reasons to Avoid Processed Foods,” Gut Geek (blog), July 22, 2018, https://gutgeek.com/10-2/ .
- Farshchi MK, Azad FJ, Salari R, et al. A Viewpoint on the Leaky Gut Syndrome to Treat Allergic Asthma: A Novel Opinion. J Evid Based Complementary Altern Med. 2017 Jul; 22(3): 378–380. Published online 2016 Dec 22. doi: 10.1177/2156587216682169.
Leaky gut: What is it, and what does it mean for you?
Before the medical community had better understanding of the mechanisms that cause disease, doctors believed certain ailments could originate from imbalances in the stomach. This was called hypochondriasis. (In Ancient Greek, hypochondrium refers to the upper part of the abdomen, the region between the breastbone and the navel.
) This concept was rejected as science evolved and, for example, we could look under a microscope and see bacteria, parasites, and viruses. The meaning of the term changed, and for many years, doctors used the word “hypochondriac” to describe a person who has a persistent, often inexplicable fear of having a serious medical illness.
But what if this ancient concept of illnesses originating in the gut actually holds some truth? Could some of the chronic diseases our society faces today actually be associated with a dysfunctional gastrointestinal system?
The expression “leaky gut” is getting a lot of attention in medical blogs and social media lately, but don’t be surprised if your doctor does not recognize this term.
Leaky gut, also called increased intestinal permeability, is somewhat new and most of the research occurs in basic sciences.
However, there is growing interest to develop medications that may be used in patients to combat the effects of this problem.
What exactly is leaky gut?
Inside our bellies, we have an extensive intestinal lining covering more than 4,000 square feet of surface area. When working properly, it forms a tight barrier that controls what gets absorbed into the bloodstream.
An unhealthy gut lining may have large cracks or holes, allowing partially digested food, toxins, and bugs to penetrate the tissues beneath it. This may trigger inflammation and changes in the gut flora (normal bacteria) that could lead to problems within the digestive tract and beyond.
The research world is booming today with studies showing that modifications in the intestinal bacteria and inflammation may play a role in the development of several common chronic diseases.
Who gets a leaky gut (and why)?
We all have some degree of leaky gut, as this barrier is not completely impenetrable (and isn’t supposed to be!). Some of us may have a genetic predisposition and may be more sensitive to changes in the digestive system, but our DNA is not the only one to blame.
Modern life may actually be the main driver of gut inflammation. There is emerging evidence that the standard American diet, which is low in fiber and high in sugar and saturated fats, may initiate this process.
Heavy alcohol use and stress also seem to disrupt this balance.
We already know that increased intestinal permeability plays a role in certain gastrointestinal conditions such as celiac disease, Crohn’s disease, and irritable bowel syndrome. The biggest question is whether or not a leaky gut may cause problems elsewhere in the body.
Some studies show that leaky gut may be associated with other autoimmune diseases (lupus, type 1 diabetes, multiple sclerosis), chronic fatigue syndrome, fibromyalgia, arthritis, allergies, asthma, acne, obesity, and even mental illness.
However, we do not yet have clinical studies in humans showing such a cause and effect.
A path toward a healthier gut
Although it is unusual to hear the term “increased intestinal permeability” in most doctors’ offices, alternative and integrative medicine practitioners have worked on gut healing as an initial step to treat chronic diseases for decades. Other cultures around the world often recommend specific diets to make people feel better.
Even in the United States, it is common to see people changing their diets after getting sick. A common initial step some practitioners take is to remove foods that can be inflammatory and could promote changes in the gut flora. Among the most common are alcohol, processed foods, certain medications, and any foods that may cause allergies or sensitivities.
In my practice, I often see patients improve significantly when they start eating a healthier diet.
Controversy still exists on whether leaky gut causes the development of diseases outside the gastrointestinal tract in humans.
However, it is always a good idea to eat a nutritious, unprocessed diet that includes foods that help quell inflammation (and avoids foods known to trigger inflammation), which may, at least in theory, help to rebuild the gut lining and bring more balance to the gut flora. This recipe could make you feel better, without any side effects. It is definitely worth a try.
Leaky Gut As a Danger Signal for Autoimmune Diseases. Frontiers in Immunology, May 2017.
The intestinal epithelial barrier: a therapeutic target? Nature Reviews Gastroenterology & Hepatology, November 2016.
Probiotics and Arthritis
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Gut Bacteria May Hold Key to Treating Autoimmune Disease
Foxp3-mutant mice suffer inflammatory damage in their lung tissue (left), but this is prevented by treatment with the bacterium Lactobacillus reuteri (right). Courtesy of He, et al., 2017
Defects in the body’s regulatory T cells (T reg cells) cause inflammation and autoimmune disease by altering the type of bacteria living in the gut, researchers from The University of Texas Health Science Center at Houston have discovered.
The study, “Resetting microbiota by Lactobacillus reuteri inhibits T reg deficiency-induced autoimmunity via adenosine A2A receptors,” which will be published online December 19 in the Journal of Experimental Medicine, suggests that replacing the missing gut bacteria, or restoring a key metabolite called inosine, could help treat children with a rare and often fatal autoimmune disease called IPEX syndrome.
T reg cells suppress the immune system and prevent it from attacking the body’s own tissues by mistake. Defects in T reg cells therefore lead to various types of autoimmune disease.
Mutations in the transcription factor Foxp3, for example, disrupt T reg function and cause IPEX syndrome. This inherited autoimmune disorder is characterized by a variety of inflammatory conditions including eczema, type I diabetes, and severe enteropathy.
Without a stem cell transplant from a suitable donor, IPEX syndrome patients usually die before the age of two.
Autoimmune diseases can also be caused by changes in the gut microbiome, the population of bacteria that reside within the gastrointestinal tract. In the study, the team led by Yuying Liu and J.
Marc Rhoads at the University of Texas Health Science Center at Houston McGovern Medical School find that mice carrying a mutant version of the Foxp3 gene show changes in their gut microbiome at around the same time that they develop autoimmune symptoms. In particular, the mice have lower levels of bacteria from the genus Lactobacillus.
The researchers discovered that by feeding the mice with Lactobacillus reuteri, they could “reset” the gut bacterial community and reduce the levels of inflammation, significantly extending the animals’ survival.
Bacteria can secrete metabolic molecules that have large effects on their hosts. The levels of a metabolite called inosine were reduced in mice lacking Foxp3 but were restored to normal after resetting the gut microbiome with L. reuteri.
The researchers found that, by binding to cell surface proteins called adenosine A2A receptors, inosine inhibits the production of Th1 and Th2 cells. These pro-inflammatory T cell types are elevated in Foxp3-deficient mice, but their numbers are diminished by treatment with either L.
reuteri or inosine itself, reducing inflammation and extending the animals’ life span.
“Our findings suggest that probiotic L. reuteri, inosine, or other A2A receptor agonists could be used therapeutically to control T cell–mediated autoimmunity,” says Yuying Liu.
Source: Rockefeller University Press
Gut bacteria are sensitive to salt: Link to autoimmune disease and hypertension
Common salt reduces the number of certain lactic acid bacteria in the gut of mice and humans according to a study published in Nature by Berlin's Max Delbrück Center and Charité. This has an impact on immune cells which are partly responsible for autoimmune diseases and hypertension. Probiotics ameliorate the symptoms of disease in mice.
We eat salt every day, sometimes more, sometimes less, but often too much.
“But so far, nobody had studied how salt affects the bacteria in the gut,” says head of the study Professor Dominik Müller of the Berlin Experimental and Clinical Research Center (ECRC) and the Berlin Institute of Health (BIH), both of which are joint institutions within the Max Delbrück Center for Molecular Medicine and the Charité — Universitätsmedizin Berlin.
Lactobacilli offset the harmful effects of salt
Too much salt in food can encourage hypertension and might even have a negative impact on the course of autoimmune diseases multiple sclerosis (MS).
Now Müller and his team have demonstrated that excess salt decimates the lactobacilli in the gut while blood pressure rises and the number of Th17 helper cells is increased.
These immune cells are associated with hypertension and autoimmune diseases MS.
When the animals were given probiotic lactobacilli in addition to the high-salt diet, however, the frequency of TH17 helper cells decreased once again and blood pressure dropped. The probiotics also alleviated the clinical symptoms of experimental autoimmune encephalomyelitis, a disease model for MS.
The researchers thus identified the microbiome as an important factor in diseases affected by salt. The lead author and ECRC scientist Dr Nicola Wilck says, “Gut bacteria influence the host organism, and the immune system is also very active in the gut.”
Müller and Wilck worked together with an interdisciplinary research team including Professor Ralf Linker from FAU Nürnberg-Erlangen, scientists from Massachusetts Institute of Technology (MIT) in Boston, USA, from the European Molecular Biology Laboratory (EMBL), Heidelberg, the University of Regensburg and the Vlaams Instituut voor Biotechnologie (VIB) in Hasselt, Belgium. The German Centre for Cardiovascular Research (DZHK) also supported the study.
Pilot study with human test subjects
Apart from the experiments on mice, the researchers also investigated the bacterial community in the digestive tract of twelve healthy men who were given six extra grams of salt every day for a fortnight.
As the test subjects otherwise maintained their usual eating habits, they thus roughly doubled their daily intake of salt. Here, too, the lactobacilli responded sensitively. Most of them were no longer detectable after 14 days of increased salt intake.
At the same time, scientists discovered that the probands' blood pressure rose and the number of Th17 helper cells in the blood increased.
Pathbreaking discoveries for therapy
The role played by bacteria in the most diverse diseases is becoming an ever more important focus of research. Just how the organism interacts with gut flora is, however, still largely unknown. “Our study goes beyond just describing the changes caused by salt.
We want to consider interrelated processes,” says Müller. But so far, they have not managed to completely elucidate the precise interactions, he explains. “We can't exclude the possibility that there are other salt-sensitive bacteria that are just as important.
The new findings have not actually confirmed the therapeutic effect of lactobacilli which are found in fermented food such as sauerkraut, yogurt and cheese.
Neuroimmunologist Professor Ralf Linker notes, “Multiple sclerosis may be one of the salt-sensitive diseases which we might be able to treat in the future with individually-tailored probiotics as add-on to standard immune therapies.” Lactobacillus probiotics of this kind have therapeutic potential.
This will soon all be examined at ECRC, says Wilck. “We are planning a blood pressure study with human subjects: double blind with a larger number of participants of both genders and placebo controlled.” After that, they can start thinking about the therapeutic application of probiotics.
- Nicola Wilck, Mariana G. Matus, Sean M. Kearney, Scott W. Olesen, Kristoffer Forslund, Hendrik Bartolomaeus, Stefanie Haase, Anja Mähler, András Balogh, Lajos Markó, Olga Vvedenskaya, Friedrich H. Kleiner, Dmitry Tsvetkov, Lars Klug, Paul I. Costea, Shinichi Sunagawa, Lisa Maier, Natalia Rakova, Valentin Schatz, Patrick Neubert, Christian Frätzer, Alexander Krannich, Maik Gollasch, Diana A. Grohme, Beatriz F. Côrte-Real, Roman G. Gerlach, Marijana Basic, Athanasios Typas, Chuan Wu, Jens M. Titze, Jonathan Jantsch, Michael Boschmann, Ralf Dechend, Markus Kleinewietfeld, Stefan Kempa, Peer Bork, Ralf A. Linker, Eric J. Alm, Dominik N. Müller. Salt-responsive gut commensal modulates TH17 axis and disease. Nature, 2017; DOI: 10.1038/nature24628