Faecal Transplant (FT) and IBD

I have explored the role of appropriate transplantation in the resolution of MRSA infection that fails to resolve with antibiotic therapy, and have intimated that other conditions of the bowel and linked tissues may also benefit. The model is: that loss of mucosal tolerance underlies the pathology of inflammatory bowel disease and is also linked to irritable bowel syndrome. These altered states of function reflect a combination of environmental, genetic and emotional events that coalesce into a wide range of conditions.

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Dendritic Cells Aid Intestinal Homeostasis and Disease

Inside our gastrointestinal tract live a family of specialised cells, co-dependent on bacteria and nutrients to send a calming message to the mucosal tissues. They have a number of variations in their make up but they are vital in their role as diplomats, passing sensitive information across the borders to provide a long term peaceful mission and maintain oral tolerance. Essentially they induce either protective immunity to infectious agents or tolerance to innocuous antigens, including food and commensal bacteria. This recent article out in the Journal of Clinical Investigation explores the current understanding of how these cells contribute to health and illness.[1]

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Vegas, Pregnancy, Immunity and Allergy Prevention!

The saying is ‘what happens in Vegas stays in Vegas’, or if you are English ‘what happens in Blackpool….’ but the same cannot be said about what happens in utero, as increasing evidence supports the understanding that the maternal nutritional environment and early feeding affects the health of the foetus beyond infancy and into adulthood.[1],[2] An article in Nature’s Mucosal Immunology this month explores some of the key events in foetal and neonatal immune management.[3] It stimulated a revisit to the area of what to consider for parents to be and mums of young children when they ask ‘is there anything I can do to prevent or reduce the risk of allergy or atopy in my child’.

The first moments, weeks and months of life can determine the health outcomes of an individual over the duration of their lifetime and this knowledge represents a significant choice for prospective parents. Fortunately the remarkable adaptability of the immune and central nervous system means that there are numerous opportunities in the early years of life to positively influence health outcomes even if the early stages were less than optimal.

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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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Fat – I’m Not To Blame Its My Bugs!

A trial to see if the ingestion of a probiotic bacterium enriched drink might have a beneficial impact on central obesity was funded by Snow Brand Milk Products company in Japan and the results were published in the European Journal of Clinical Nutrition this June 2010. [i]

Whilst it may seem a stretch that bacteria can influence our body mass, (I have written a previous review) it is an area of growing interest and investigation as bacteria have previously been implicated in the metabolic storage of fat. Studies in mice have shown up to 30% greater fat storage in mice with gastrointestinal colonies of commensals rather than their skinnier counterparts operating with sterile guts.

One proposal for this is that certain bacteria (Bacteroides Thetaiotaomicron is one likely contender) are able to manipulate energy to be stored in adipocytes through a pathway that involves microbial regulation of the intestinal epithelial expression of fasting-induced adipocyte protein (Fiaf), a circulating inhibitor of lipoprotein lipase (LPL).[ii]

The microbiota can then, based on this and other studies be viewed as a metabolic “organ” exquisitely tuned to our physiology and performing functions that we have not had to evolve on our own.

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What Do Bacteria Do To Our Immune System?

The germ theory that has so modernised medicine and driven us, the western world living human to regard all bugs as bad has been undergoing a dramatic rethink over the last few years. Firstly the recognition that your body is teeming with bacteria, providing a warm residence to approximately 10 times as many bacterial cells as human cells. Our mutual inhabitants live on skin, in the respiratory tract and throughout the digestive tract. Your digestive tract alone is home to between 1,000 and 40,000 bacterial species depending on your choice of journal.

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Can Bacteria Make You Smarter?

The potential cognitive gains linked to the role of gastrointestinal bacteria continues to attract international interest. The scientific community are becoming entranced with the notion that our bacterial exposure affects not only the local tissues, but also others including the brain.

Exposure to specific bacteria in the environment, already believed to have antidepressant qualities, could increase learning behaviour.  Mice fed live cultures of Mycobacterium vaccae were able to learn and complete a maze twice as fast as control mice were the key comments delivered at the 110th General Meeting of the American Society for Microbiology last week.

Mycobacterium vaccae is a natural soil bacterium which people likely ingest or breath in when they spend time in nature,” says Dorothy Matthews of The Sage Colleges in Troy, New York, who conducted the research with her colleague Susan Jenks.

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Leaky Gut & Food Reactivity – What’s the Mechanism?

Michael Ash looks at leaky gut with a contemporary approach to investigation, relevance and restoration. It is quite clear that in order to extract nutrients and other sentinel information carrying agents the barrier that divides the contents of the gastric lumen from the host must be permeable. The question that has interested clinicians for many years is – when is it too permeable and what does that mean in terms of health and illness.

A paper in the March edition of Mucosal Immunology explores this concept in some detail and delivers some much needed information and potential direction in terms of dietary management and risk.[1]

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Could a ‘Bacterial Thali’ Resolve Inflammation? – A Novel Strategy

Michael Ash BSc(Hons) DO, ND, DipION reviews the possibility that strategically selected foods and food concentrates represent a valid therapy for inflammatory illnesses.

There is substantive interest in the potential translation from bench to bedside of simple safe strategies to modify the adverse effects of inflammation. Approaching from a preventative and restorative angle the numbers of papers being published on the role of orally ingested bacteria (probiotics) and in this article – the herb Tumeric (active ingredient of which is curcumin) is presenting increasingly supportive evidence for their reasonable and safe clinical use.

Modern analytical techniques are helping to reveal novel opportunities for inflammation control in the gut and the systemic tissues in new ways that even a few years ago would have been thought of as very alternative!

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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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