Antibiotics – Unintended Consequences; Microbiota and Immunity Suffer

Your gastrointestinal tract is home to complex microbial populations, which, collectively, are referred to as the microbiota. The relation between the microbiota and you – the host is meant to be symbiotic, with you providing a warm moist physical niche and suitable food to intestinal bacteria and then if all works well you in turn gain benefit from the enhancement of resistance to infection and the improved facilitation of the absorption of ingested food [1],[2]

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Antibiotic Exposure in Infancy Linked to Food Allergies

Long implicated in numerous adverse events linked to intestinal immunity and associated mucosal tolerance a recent presentation at the American Academy of Allergy Asthma &Immunology annual meeting has shown a credible causation link between antibiotics and allergy.[1]

In their retrospective case–control study, presented as a late-breaking abstract at the meeting, Dr. Love and colleagues found an almost 2-fold increase in food allergy in children exposed to 3 or more courses of antibiotics between the ages of 7 and 12 months.

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Antibiotics and IBD in Childhood

Inflammatory Bowel Disease such as Ulcerative Colitis and Crohn’s blight people’s lives and restrict their functionality. The formative years of our lives represents the time when microbiological partnerships are being formed to provide lifelong co-dependence on each other. The role of the microbiota in immune tolerance in the gut and elsewhere is increasingly understood but is still an area rich for investigation.

In this study of Danish children a nationwide cohort study was conducted of all Danish singleton children born from 1995 to 2003 (N=577,627) with individual-level information on filled antibiotic prescriptions, IBD and potential confounding variables.[1] Using Poisson regression, rate ratios (RRs) of IBD were calculated according to antibiotic use. Antibiotic use was classified according to time since use, type, number of courses used and age at use.

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Antibiotics; How Do They Work?

Nutritional orientated practitioners are well aware of the potentially damaging effects of inappropriate prescribing of antibiotics, not simply in terms of increasing resistance but also because even a single treatment can alter the microbial ecology in the gut for months without relevant interventions.

Antiobiotics have undoubtedly been a fantastic intervention, the discovery of the sulfa drugs in the 1930 s and the subsequent development of penicillin during World War II ushered in a new era in the treatment of infectious diseases. Infections that were common causes of death and disease in the pre-antibiotic era – rheumatic fever, syphilis, cellulitis and bacterial pneumonia – became treatable, and over the next 20 years most of the classes of antibiotics that find clinical use today were discovered and changed medicine in a profound way.[i]

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Is There A Rural/Urban Gradient In The Prevalence Of Eczema? A Systematic Review And What Can Be Done About It?

One in 10 schoolchildren in the western world suffers from eczema and even developing nations have also seen an increasing trend in the last few decades. There are many proposals to explain the increased incidence, one area of relevance is the environmental impact. Falling under the often misused ‘hygeine hypothesis’ title it has been proposed that there is a reflective difference in the gradient between rural and urban children. Implying the environmental impact on the developing immune system of children is different and therefore less protective in the urban setting.

This concept has now been studied in a recent article in the British Journal of Dermatology.[1] By conducting a Medline and Embase data base review studies that compared the incidence between the two environments were reviewed. Some 26 papers were assessed with 19 demonstrating a higher risk for eczema in an urbanised area, of these 11 were regarded as being statistically significant. A further 6 studies showed a lower risk of eczema in an urbanised area, of which just 1 was statistically significant.

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A Bacteria Triggers Arthritis.

The gut microbiomes of humans and mice are broadly similar which is helpful as this paper has used the mouse model to explain how a resident bacteria in the gut can induce arthritis. In both hosts human and mouse upwards of ∼1000 different microbial species from ∼10 different divisions colonise the gastrointestinal tract, but just two bacterial divisions—the Bacteroidetes and Firmicutes—and one member of the Archaea appear to dominate, together accounting for ∼98% of the 16S rRNA sequences obtained from this site.[1] 16SrRNA is a laboratory method for analysing bacterial and provides species-specific signature sequences useful for bacterial identification but is not routinely used in diagnostic settings yet.

Their analysis revealed that despite the enormous species variation in the gut a single species of bacteria that lives here is able to trigger a cascade of immune responses that can ultimately result in the development of arthritis.[2] Gut-residing bacteria can also play a role in disorders of the immune system, especially autoimmune disorders in which the body attacks its own cells. The gut microbiota is now known to shape intestinal immune responses during health and disease with systemic effects.

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Antibiotics Can Cause Gut Related Diseases

Michael Ash BSc (Hons), DO, ND FDipION reviews the current understanding of the role of antibiotics in the initiation of gut associated inflammation and local and systemic health problems, and briefly explores some strategies to prevent and manage this.

What is perhaps the greatest medicinal discovery in the last 100 years has a sting in its tail, the tremendous success in managing bacterial infection has encouraged over and inappropriate use of antibiotics, the problems of which have been well documented. This review explores the developing comprehension that even a single day of antibiotic use has consequences that may produce transient and long term effects that compromise the health and well being of the patient and their bacterial co-habitants.

Sir Alexander Fleming discovered the antibiotic substance penicillin in 1928 and was awarded a co share in the Nobel Prize in Medicine in 1945.

It was a discovery that would change the course of history. The active ingredient in that mould, which Fleming named penicillin, turned out to be an infection-fighting agent of enormous potency. When it was finally recognised for what it was—the most efficacious life-saving drug in the world—penicillin would alter forever the treatment of bacterial infections. By the middle of the century, Fleming’s discovery had spawned a huge pharmaceutical industry, churning out synthetic penicillin’s that would conquer some of mankind’s most ancient scourges, including syphilis, gangrene and tuberculosis. (Time Magazine April 1999)

However, as the combined benefits of decent engineering for sanitation, prevention via vaccination and bacterial infection control through antibiotics have contributed to life extension, they have also produced microbe and human disturbances. The incidence of immune mediated disorders is continuing to increase and the gastrointestinal tract is continuing to gain traction as a site of significant origination.[1],[2]

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IBS Relief and Probiotics – They do Work

Probiotics are widely consumed and the widespread advertising is often not really justified by the evidence. Many products were never studied as such and some companies use studies performed with other (and different) products for advertising.

In the March edition of GUT a systematic review on the randomised control trials (RCT) undertaken so far suggests that many are of good quality.[1], they determine that meta-analysis is impossible due to the various strains, phenotypes and genome vary greatly.[2] As a consequence and as stressed by the FAO/WHO joint report the benefits of one probiotic ‘cannot be extrapolated to other probiotic strains without experimentation.[3] However there tend to be properties consistent with different groups, from which strain specific organisms may be extracted.

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Gut Bacteria May Make You Fat

Obesity: A consequence of adverse inflammation & microbial disruption?

By Michael Ash BSc(Hons) DO, ND, FDipION

Published in CAM 2005

Overweight and obesity are serious, chronic medical condition associated with a wide range of debilitating and life threatening and economically burdensome conditions. The recent and extensive increases in obesity among Europeans are eroding many recent health gains.

Paradoxically the economically wealthier communities of the world continue to over consume food and food products, whilst other nation communities still suffer from food deprivation and starvation, due in the main to drought, floods, ‘acts of God’, corruption and conflict. Approximately 9.5% of the global burden of disease is currently attributable to being underweight,[1] whilst there are now hundreds of millions of people (>500) in developed and developing countries that are overweight or obese. This condition of excessive weight is now so common that it is rapidly replacing malnutrition and infectious diseases as the most significant cause of ill health[2]. An escalating global epidemic of overweight and obesity – “globesity” – is taking over many parts of the world.

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Dysbiosis – What Have We Learned?

Michael Ash BSc(Hons) DO, ND, FDipION reviews some of the last 12 months of published research.

The human body has some 10 trillion human cells—but 10 times that number of microbial cells. So what happens when such an important part of our bodies goes missing or never develops?

Plus what can we do to limit any adverse consequences linked to microbial disruption – referred to as dysbiosis?[1]

Further, do probiotics—dietary supplements containing potentially beneficial microbes actually support appropriate immune responses?

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