Hijacking the Gut-Lung Axis to Treat COVID-19
The stomach and intestines are the immune system’s primary headquarters.
THREE things you need to know this week.
There is low Bifidobacterium in patients with severe COVID-19
There is a gut-lung axis and you need to know about it
Low antibody response corresponded to inadequate levels of the bacteria
Neuro Athletes,
Happy Tuesday! I hope you have had a powerful start to the week as have I.
Let me ask you something… What do the trillions of friendly bacteria, fungi and other microorganisms that live in your gut have to do with your chances of developing severe COVID-19 symptoms? As it turns out, more than you might think.
Last week I was fortunate enough to speak with Dr Sabine Hazan - a gastroenterologist with over 22 years of experience in clinical trials- about her research in the area of COFVID-19 and gut-health. It was mind blowing! When the COVID-19 outbreak began, Hazan decided to use her resources to seek a remedy. "We found 4 unique variants in eight patients very quickly and 33 mutations across all patients. We began trials to see if was possible that some people might respond to simple treatments or avoid the infection altogether."
I don’t think many are aware of the relationship between the gut and lung so in this newsletter we will go through it all along with the relationship between the gut and COVID-19!
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Primer:
Probiotics are living microorganisms that have been shown to have positive effects on immune response in man with some bacteria; some strains of Bifidobacteria, for example, possess especially potent immune modulating effects. These bacteria have the potential to ameliorate the 'cytokine storm' through a differential effect on pro- and anti-inflammatory cytokines. In the management of COVID-19 and other coronovirus-mediated illnesses, probiotic bacteria also have the potential to enhance vaccine efficacy.
So you could say that probiotics boost the immune system, enhance the mucosal barrier function and inhibit bacterial adherence and invasion capacity in the intestinal epithelium.
Let’s keep going…
Gut-Lung Axis:
Gastrointestinal and respiratory tract diseases often occur together. There are many overlapping pathologies, leading to the concept of the ‘gut–lung axis’ in which stimulation on one side triggers a response on the other side. This axis appears to be implicated in infections involving severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).
Disturbances in gut microbiota composition, is associated with a reduced capacity to mount adequate local and systemic immune responses. This gut dysbiosis (the term microbiologists use to describe an unwell or out-of-whack microbiome) in humans has been linked to inflammatory conditions in the gastrointestinal tract itself, but also in the airways, such as in asthma and chronic obstructive pulmonary disease (COPD).
Low Bifidobacterium in patients with severe COVID-19
There are trillions of bacteria on and in your body, and they’re extremely important for your health. One of the most important types is called Bifidobacteria - these species are probiotics ("good" bacteria). The types, numbers, diversity, and proportions of these bacteria vary from person to person. While some species reliably populate the guts of healthy people and are therefore regarded as “good” or helpful, other types tend to be more numerous in the guts of those who are unwell. The presence of unhealthy bacteria is also associated with barrier problems in the lining of the intestines — a condition known as leaky gut.
Its turning point in medicine came when French pediatrician, Dr. Henry Tissier, with the use of anaerobic culture, discovered the Bifidobacterium bacteria in 1899. He observed that Bifidobacterium were present abundantly in the intestinal flora of healthy infants, while it was scarce in infants suffering from diarrhea. In one of his clinical trials, pure cultures of Bifidobacterium obtained from healthy infants were administered to children with diarrhea, who gradually recovered as their gut flora were restored.
With extensive research conducted on Bifidobacterium, this bacteria is known to produce beneficial compounds such as vitamins B and K, short-chain fatty acids (known for their anti-inflammatory properties) and lactate (balances the gut pH to create a friendly environment for good bacteria to thrive). At present, Bifidobacterium is one of the most widely used probiotics in the world, which are found in fermented foods like yogurt, kefir and sauerkraut.
Dysbiosis may allow the novel coronavirus to penetrate the gut’s lining, called the epithelium. In fact, low counts of Bifidobacteria have been linked to COVID-19. In severe cases, the virus may even pass through the gut’s epithelial barrier and into the bloodstream, where it can then travel to the brain and other internal organs, wreaking havoc.
In the management of COVID-19 and other coronovirus-mediated illnesses, probiotic bacteria also have the potential to enhance vaccine efficacy.
Can You Get the Virus Through the Gut?
By now, it is no surprise that cells with ACE2 and TMPRSS2 receptors are prime targets of the novel coronavirus, SARS-CoV-2. The same viral target ACE-2 receptor that's found in the lung, also exists in the gut, along the oesophagus the small intestine and the colon. So yes, there's a possibility that we can actually get the virus through the gut, and similarly we can detect a viral RNA in stool and there's even been a few reports of scientists, being able to isolate live virus inside poop.
The Study Design and Results:
Hazan compared gut microbiome diversity and composition in SARS-CoV-2 polymerase chain reaction (PCR)-confirmed positive patients whose symptoms ranged from asymptomatic to severe versus PCR-negative exposed controls.
“Everything we put in our mouths has consequences”- Dr Sabine Hazan, Renowned Gastroenterologist and CEO of ProgenaBiome
What This Means for You
Prior to the vaccine breakthrough, the best advice I learned about surviving this pandemic (aside from social distancing and mask wearing) was to strengthen my immune system by getting sufficient sleep, exercising daily and taking enough vitamin D (around 1000 IU per day, as I was not getting much sunlight from being indoors most of the time). Knowing that the gut microbiome may influence disease outcomes, it is essential to eat healthy as well.
In order to achieve a balanced gut microbiome, here are some dietary tips you may consider adopting:
Probiotics — supplements or fermented foods containing live bacteria that are beneficial for your gut and protects you from inflammation; these include: yoghurt, cheese, kimchi, miso, sauerkraut, kombucha, tempeh, kefir, etc.
Increase your fiber intake with prebiotics — the beneficial bacteria (and probiotics) in your gut feed on prebiotics to thrive. Prebiotics are non-digestible carbohydrates rich in fiber, often found in plant-based foods like: wheat, whole grains, mushrooms, rye, barley, legumes, garlic, onions, apples, bananas, carrots, etc.
Reduce your sugar intake — studies have shown that the small intestine is unable to absorb excess sugars; once they make their way into the colon, this facilitates the growth of harmful bacteria while inhibiting the growth of beneficial bacteria, resulting in gut dysbiosis.
Avoid processed foods — these foods are often high in fat, which has been shown to increase the levels of harmful endotoxin-producing bacteria in the gut flora, contributing to intestinal inflammation.
Avoid using painkillers frequently — specifically NSAIDs (non-steroidal anti-inflammatory drugs), which are observed to alter one’s gut microbiome with chronic use and may adversely irritate your gut lining.
Refrain from taking antibiotics unnecessarily — antibiotics kill bacteria, this includes the good ones residing in your gut, inducing dysbiosis and antibiotic resistance. Only take them as prescribed by your doctor.
The gut microbiome is fascinating, with much room for discovery thanks to the leaps and bounds of technology, from its breakthrough of culturing anaerobes in 1944 to genome sequencing and present-day metagenome-assembled genomes. Although the gut microbiome is by no means a magic bullet, knowing more about it will establish its role in diseases, as well as prompt future conceptions of effective treatment modalities.
That’s it for this week! I really hope you enjoyed this newsletter, if you did please feel free to comment or share this along to someone who you think could benefit.
Until next time,
Louisa x
This Week On The Neuro Experience Podcast
Sabina Hazan is a gastroenterologist with over 22 years of experience in clinical trials and is the Founder and CEO at both Ventura Clinical Trials and Malibu Specialty Center.
In this episode you will learn:
1. The link between the gut microbiome and COVID-19
2. Controversy around clinical trials - FDA regulations
3. Bifidobacteria
4. How the immune system is linked to the gut
5. What is Dysbiosis and how can we correct a leaky gut
6. Sabine touches on the history of the gut microbiome
7. Gut health Myths- what diet to eat for a healthy gut
8. Testing for gut microbiome
9. Tools and protocols to help keep your gut healthy and in peak form
The visually inclined can watch it all go down on Youtube. And as always, the podcast streams wild and free on apple Podcasts and Spotify.
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