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Category: human microbiome

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Further reasons to be cautious of using antibiotics, and more support for finding beneficial bacteria and other microbes to outcompete the "bad" microbes. I especially liked the last paragraph that stressed for a healthy microbiota (microbial community):"Instead of trying to kill the "bad" bacteria causing an illness, a healthy and functioning microbiota may be able to outcompete the unwanted microbes and improve immune function." From Medical Xpress:

Unwanted impact of antibiotics broader, more complex than previously known

Researchers at Oregon State University have discovered that antibiotics have an impact on the microorganisms that live in an animal's gut that's more broad and complex than previously known. The findings help to better explain some of the damage these medications can do, and set the stage for new ways to study and offset those impacts.

Researchers have known for some time that antibiotics can have unwanted side effects, especially in disrupting the natural and beneficial microbiota of the gastrointestinal system. But the new study helps explain in much more detail why that is happening, and also suggests that powerful, long-term antibiotic use can have even more far-reaching effects. Scientists now suspect that antibiotic use, and especially overuse, can have unwanted effects on everything from the immune system to glucose metabolism, food absorption, obesity, stress and behavior.

The issues are rising in importance, since 40 percent of all adults and 70 percent of all children take one or more antibiotics every year, not to mention their use in billions of food animals. Although when used properly antibiotics can help treat life-threatening bacterial infections, more than 10 percent of people who receive the medications can suffer from adverse side effects.

This research used a "cocktail" of four antibiotics frequently given to laboratory animals, and studied the impacts."Prior to this most people thought antibiotics only depleted microbiota and diminished several important immune functions that take place in the gut," Morgun said. "Actually that's only about one-third of the picture. They also kill intestinal epithelium. Destruction of the intestinal epithelium is important because this is the site of nutrient absorption, part of our immune system and it has other biological functions that play a role in human health."

The research also found that antibiotics and antibiotic-resistant microbes caused significant changes in mitochondrial function, which in turn can lead to more epithelial cell death....Mitochondria plays a major role in cell signaling, growth and energy production, and for good health they need to function properly.

Morgun and Schulzhenko's research group also found that one of the genes affected by antibiotic treatment is critical to the communication between the host and microbe. "When the host microbe communication system gets out of balance it can lead to a chain of seemingly unrelated problems," Morgun said. Digestive dysfunction is near the top of the list, with antibiotic use linked to such issues as diarrhea and ulcerative colitis. But new research is also finding links to obesity, food absorption, depression, immune function, sepsis, allergies and asthma.

Healthy microbiota may also be another way to address growing problems with antibiotic resistance, Morgun said. Instead of trying to kill the "bad" bacteria causing an illness, a healthy and functioning microbiota may be able to outcompete the unwanted microbes and improve immune function.

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This is very interesting, and raises all sorts of possibilities for microbial transplants. While it's looking at only one person, this seems to be evidence that microbes are involved with our weight and manipulating them may result in weight gain or loss. From Science Daily:

Rapid and unexpected weight gain after fecal transplant

A woman successfully treated for a recurrent Clostridium difficile infection with stool from an overweight donor rapidly gained weight herself afterwards, becoming obese, according to a case report published in the new journal Open Forum Infectious Diseases.

Fecal microbiota transplant (FMT) is a promising treatment for relapsing C. difficile infections, a common cause of antibiotic-related diarrhea that in severe cases may be life-threatening. The case suggests that clinicians should avoid selecting stool donors who are overweight. The report also raises questions about the role of gut bacteria in metabolism and health.

At the time of the woman's fecal transplant in 2011, her weight was stable at 136 pounds, and her Body Mass Index (BMI) was 26. Then 32 years old, she had always been of normal weight. The transplant used donor stool from the woman's overweight but otherwise healthy teenage daughter, administered via colonoscopy, to restore a healthy balance of bacteria in the woman's gut, curing her C. difficile infection.

Sixteen months later, the woman weighed 170 pounds, and her BMI was 33, meeting medical criteria for obesity. The weight gain persisted despite a medically supervised liquid protein diet and exercise program. Continuing efforts to diet and exercise did not lower her weight: Three years after the transplant, she weighed 177 pounds with a BMI of 34.5, and she remains obese today.

"We're questioning whether there was something in the fecal transplant, whether some of those 'good' bacteria we transferred may have had an impact on her metabolism in a negative way," said Colleen R. Kelly, MD, of the Warren Alpert Medical School of Brown University, who wrote the case report with Neha Alang, MD, of Newport Hospital in Rhode Island. Such a link between bacteria in the gastrointestinal tract and weight is supported by previously published animal studies, where transfer of gut bacteria from obese to normal-weight mice can lead to a marked increase in fat. In light of the case and the animal data, the authors recommend selecting stool donors who are not overweight for fecal transplants.

Importantly, the FMT was not the only possible cause of the woman's weight gain. In addition to treatment for C. difficile, she had also been treated with several antibiotics for Helicobacter pylori infection. Other possible contributing factors in the woman's weight gain include the resolution of her C. difficile infection, genetic factors, aging, and stress related to illness. However, as noted above, she had never been overweight before.

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Now we are finally finding out about all the microbes we encounter when go through New York City's subway system: touching handrails, turnstiles, and just sitting on benches. This study looked at the microbial communities of NYC's subway system. From the Wall Street Journal:

Big Data and Bacteria: Mapping the New York Subway’s DNA

Aboard a No. 6 local train in Manhattan, Weill Cornell researcher Christopher Mason patiently rubbed a nylon swab back and forth along a metal handrail, collecting DNA in an effort to identify the bacteria in the New York City subway. In 18 months of scouring the entire system, he has found germs that can cause bubonic plague uptown, meningitis in midtown, stomach trouble in the financial district and antibiotic-resistant infections throughout the boroughs.

The big-data project, the first genetic profile of a metropolitan transit system, is in many ways “a mirror of the people themselves who ride the subway,” said Dr. Mason, a geneticist at the Weill Cornell Medical College... By documenting the miniature wildlife, microbiologists hope to discover new ways to track disease outbreaks—including contagious diseases like Ebola or measles—detect bioterrorism attacks and combat the growing antibiotic resistance among microbes, which causes about 1.7 million hospital infections every year.“We know next to nothing about the ecology of urban environments,” said evolutionary biologist Jonathan Eisen at the University of California at Davis. “How will we know if there is something abnormal if we don’t know what normal is?”

Dr. Mason and his research team gathered DNA from turnstiles, ticket kiosks, railings and benches in a transit system shared by 5.5 million riders every day. They sequenced the genetic material they found at the subway’s 466 open stations—more than 10 billion fragments of biochemical code—and sorted it by supercomputer. They compared the results to genetic databases of known bacteria, viruses and other life-forms to identify these all-but-invisible fellow travelers.

In the process, they uncovered how commuters seed the city subways every day with bacteria from the food they eat, the pets or plants they keep, and their shoes, trash, sneezes and unwashed hands. The team detected signs of 15,152 types of life-forms. Almost half of the DNA belonged to bacteria—most of them harmless; the scientists said the levels of bacteria they detected pose no public-health problem. Data from the PathoMap Project, as Dr. Mason calls it, was published online in the journal Cell Systems on Thursday.

As more and more scientists probe urban microbiology, they are also hoping to find ways to foster beneficial bacteria through building design and to learn how to eliminate construction practices that create living conditions for the germs that make people ill.

This emerging field reflects the growing awareness that the human body swarms with bacteria. Typically, every person is home to about a hundred trillion microbial cells bearing five million different genes, totaling about 5 pounds of micro-organisms per person. Indeed, microbes in and on the body outnumber human cells about 10 to one. The body’s collection of microbes, called the microbiome, influences health in ways that researchers are only beginning to understand. 

Broadly speaking, city living leaves its mark on people. That includes the sorts of microbes that collect inside them. A recent comparison of urban and rural residents in Russia found that city dwellers had different sets of stomach microbes than people in the countryside. Every person trails a distinctive collection of microbes, by shedding about 1.5 million microscopic skin cells every hour. Bacteria from a person’s body can colonize a hotel room in less than six hours, scientists at the U.S. Department of Energy’s Argonne National Laboratory in Illinois recently discovered.

Depending on the material involved, some surfaces can have thousands of different types of bacteria while others may have only a few hundred, researchers monitoring the new Chicago hospital found. Pathogens responsible for common infections, such as the strep germs that cause an estimated 700 million infections world-wide every year, can survive for months on a dry surface, researchers in Germany reported in September in the journal BMC Infectious Diseases.

The New York subway study quickly hit the current limits of science. Most microbes have never been isolated or studied. Only a few thousand creatures of any sort have ever had their entire set of genes analyzed, so identifications of DNA sequences through online computer comparisons can be inaccurate. All told, the biodiversity of the subway isn’t as rich as normal soil. The dirt in Central Park contains 167,000 types of micro-organisms—about 11 times the number of species in the transit system... But a deep breath of subway air contains about as many free-floating bacteria as fresh air at street level, researchers at the University of Colorado Boulder reported last year in the journal Applied and Environmental Microbiology.

No two subway stations were exactly the same, said Weill Cornell project leader Ebrahim Afshinnekoo, who helped analyze the data.The greatest subway biodiversity was found at the Myrtle-Willoughby Avenue stop for the G train in Bedford-Stuyvesant, Brooklyn, where 95 unique bacteria groups were detected....Among the DNA of higher organisms, the researchers found across the system that genetic material from beetles and flies was the most prevalent—the cockroach genome hasn’t been sequenced yet so that DNA wasn’t identified... Human DNA ranked fourth.

So far, scientists have identified 562 species of bacteria, most of them benign or low risk. At least 67 of those species can make people sick. Even these infectious bacteria were all detected at such low levels that they were unlikely to cause illness in a healthy person...Among the pathogenic and infectious bacteria, the Cornell researchers identified DNA related to strep infections at 66 stations and urinary tract infections at 192 stations. They found E. coli at 56 stations and other bacteria related to food poisoning at 215 stations.

 

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Published on 2 Comments on Two Years (and Counting) Without Sinusitis

It is now 104 weeks being free of chronic sinusitis and off all antibiotics! Two full years since I started my easy do-it-yourself sinusitis treatment! And my sinuses feel great! I would never ever have thought such a thing was possible several years ago. Thanks to the probiotic (beneficial bacteria) Lactobacillus sakei I got my life back. Yes, I know I'm gushing...

After reading the original ground-breaking research on sinusitis done by Abreu et al (2012), it led to finding and trying L. sakei as a sinusitis treatment. Of course, there is an entire community of microbes that live in healthy sinuses (the sinus microbiome), but L. sakei seems to be a key one for sinus health. As you may have guessed, the name of this web-site Lacto Bacto is in homage to the bacteria Lactobacillus sakei.

Thank you all who have written to me  - whether publicly or privately. Please keep writing because it is adding to the sinusitis treatment knowledge base. I will keep posting updates.

I will be trying to find more sources of L. sakei this year and also look for other microbes that help treat sinusitis. And the foods or products that they're in. As of today, my family (all 4 members) have successfully used live kimchi and even sausage starter culture (both containing L. sakei) to treat both acute and chronic sinusitis these past 2 years. Based on our experiences and those of others, finding live L. sakei in kimchi (not all brands have L. sakei in it) and other products can be tricky, but when the product has live L. sakei in it - the results are absolutely great! We have also learned that L.sakei products should be used sparingly - only as needed.

[NOTE: Since then I've posted a number of posts with sinusitis treatment information. The updated (November 2018) The Best Probiotic For Sinus Infections has products and sources of L. sakei. The Sinusitis Treatment Summary page has treatment methods. And news about a Lactobacillus sakei product which I really like - Lacto Sinus. One can also click on SINUSITIS under CATEGORIES to see more posts, such as "Which Kimchi is Best for Sinusitis Treatment: Vegan or Seafood?"]

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Another study that shows that differences in the gut microbiota appear early in life, and appear to be based on length of gestation (pregnancy) and type of delivery (vaginal vs C-section). From Science Daily:

Birth method, gestation duration may alter infants' gut microbiota

Environmental factors like mode of delivery and duration of gestation may affect how infants' gut bacteria mature, and that rate could help predict later body fat, international researchers have found.

Among a group of 75 infants, those who were vaginally delivered and had a longer gestation before birth tended to more quickly develop a more mature gut microbiota, and had typical body fat at 18 months. By contract, babies who were delivered via Caesarean section and had shorter gestations took longer to acquire a more mature gut microbiota and had lower body fat at 18 months.

"It seems like the early environment, for instance mode of delivery, mode of feeding, the duration of gestation and living environment may be influencing the rate at which babies acquire their gut microbiota," said senior study author Joanna Holbrook, a senior principal investigator at the Singapore Institute for Clinical Sciences, "and that in turn has an association with how babies grow and put on body fat."

At birth, human infants start accumulating intestinal microbiota until a relatively stable state is reached, Holbrook said. The rate at which babies acquire gut microbiota is believed to have a considerable impact on later health outcomes.

For the study, Holbrook and colleagues used a laboratory technique called 16s rRNA sequencing to analyze stool samples that had been collected from 75 infants participating in the GUSTO (Growing Up in Singapore Toward Healthy Outcomes) study, which includes members of the three main ethnic groups in Singapore: Chinese, Indian and Malay. The samples were taken when the infants were three days old, three weeks old, three months old and six months old. 

Their work found that the samples could be classified into three distinct clusters based on when infants' gut microbiota matured. Of 17 infants who had a more mature, six month-like microbiota profile high in the bacteria Bifidobacterium and Collinsella by day three, 16 were delivered vaginally. Other babies took up to six months to reach that stage.

Most infants acquired a similar microbiota by the age of six months. Infants that acquired a profile high in Bifidobacterium and Collinsella at an earlier age had typical body fat at age 18 months, while those that acquired this profile later had relatively low body fat.

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An amazing breakthrough for those suffering from peanut allergies. The bacteria Lactobacillus rhamnosus is added to some yogurts and kefir, but in smaller amounts.From The Telegraph:

Fatal peanut allergies could be cured by probiotic bacteria, say Australian doctors

A strain of probiotic bacteria could offer a cure for potentially fatal peanut allergies, according to scientists in Australia. The breakthrough followed a trial in which a group of children were given increasing amounts of peanut flour, along with a probiotic called Lactobacillus rhamnosus, over an 18-month period. About 80 per cent of the children who had peanut allergies were subsequently able to tolerate peanuts.

Mimi Tang, the lead researcher, said the families involved believed the treatment had "changed their lives". "These findings provide the vital first step towards developing a cure for peanut allergy and possibly for all food allergies," she told Melbourne's Herald Sun.

The randomised trial, involving a group of about 30 children, was conducted by Murdoch Childrens Research Institute in Melbourne. The children, aged one to ten, were given small amounts of peanut flour, gradually building up to two grams, or the equivalent of six or seven nuts.They were also given daily doses of Lactobacillus rhamnosus, which is found in yoghurt but was given in quantities equivalent to the amount found in 44 pounds of yoghurt.

Following the treatment, about 80 per cent of the children were able to tolerate four grams of peanut protein, equivalent to about 14 peanuts. Typically, about four per cent of children would have overcome their peanut allergy during this time.

Rates of peanut allergies have dramatically increased in the past two decades, particularly in developed countries. For most sufferers, the condition is lifelong.

A link to the press release from the Murdoch Childrens Research Institute (their researchers are doing the research), has more:

Oral Therapy Could Provide Treatment For Peanut Allergies

Over 60 peanut allergic children in the study were either given a dose of a probiotic, Lactobacillus rhamnosus, together with peanut protein in increasing amounts, or a placebo over 18 months to assess whether children would become tolerant to peanut.

The probiotic was a fixed daily dose, while the peanut oral immunotherapy was a daily dose of peanut protein starting at very low doses followed by a dose increase every two weeks until the maintenance dose (2 grams peanut protein) was reached. At the end of the treatment, the child's ability to tolerate peanut was assessed by a peanut challenge performed two to five weeks after stopping treatment.

23 of 28 (82.1%) probiotic treated children and one of 28 (3.6%) placebo-treated children were able to include peanut in their diet at the end of the trial. The likelihood of success was high - if nine children were given probiotic and peanut therapy, seven would benefit.

The need for a curative treatment is greatest for peanut allergy since this is usually lifelong, and is the most common cause of fatality due to food induced anaphylaxis. Further research is now required to confirm whether patients can still tolerate peanut years after the study has finished.

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This is very exciting research if it holds up. Basically a bacterial cause for urologic chronic pelvic pain syndrome (UCPPS), also known as non-bacterial chronic prostatitis, means that it is really a urinary tract infection. Bacteria were found that can only be found with state of the art genome sequencing, and NOT with ordinary cultures. From American Microbiome Institute:

Bacteria may be responsible for chronic prostatitis

Some people suffer from an enigmatic diagnosis known as ), also known as non-bacterial chronic prostatitis.  UCPPS’s symptoms are rather similar to urinary tract infections (UTI’s), with a conspicuous lack of a bacterial cause.  In order to diagnose UCPPS doctors must do a bacterial culture of the urine, and if no bacteria grow then the UCPPS diagnosis may be given. 

While many believe that this disease may be caused by stress or hormone imbalances, a team of researchers from across the U.S. and Canada investigated if there was a bacterial cause.  As we know, much of the microbiome is unculturable, and can only be identified through genome sequencing.  These researchers hypothesized that bacteria are the true cause of UCPPS, and that UCPPS is similar to UTI, only the bacteria are unculturable, and so basic hospital screens for the bacteria fail to identify them.  The scientists recently published the results of their study in The Journal of Urology.

The researchers did genome analyses on 110 urine samples from male patients suffering from UCPPS and 115 urine samples from normal males with no UCPPS diagnosis.  The results showed that both the groups had approximately 75 bacteria in their urine, all of which would unlikely have cultured in normal hospital assays.  When they compared the types of bacteria between the groups they noticed that Burkholderia cenocepacia was highly abundant in patients with UCPPS but not the control group.  Interestingly, this species had been previously identified as a possible urologic pathogen.

The study had a number of limitations, and the authors admit as much.  For example, it is unclear their sampling procedures would adequately identify any bacteria causing biofilms, and they limited the study to bacteria so fungi and viruses went untested.  Still, it is compelling evidence for a bacterial cause to a disease that had previously been thought to not have a bacterial origin.  These findings really speak to what prominent microbiome scientist, and member of the AMI’s scientific advisory board, Rob Knight recently said in an interview with NPR:  “When you consider the number of diseases where, just over the last five years, it went from being crazy to think the microbes were involved to now being crazy to think the microbes aren't involved, it's amazing how rapidly the evidence has been accumulating.”

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After my January 9, 2015 post I was asked more about the microbial differences in babies who had been born by cesarean vs vaginal deliveries. What could be done about this? Should this be of concern when C-section rates in some places are approaching 50% of all births?

Well, some researchers are concerned, including Dr. Dominguez-Bello, who is doing ground-breaking research in this area. She is doing a long-term study in which babies born by cesarean section are immediately swabbed with a gauze cloth laced with the mother's vaginal fluids and resident microbes. Several (but not all) articles that I looked at said that the gauze is a "saline-soaked gauze".

Summary of the method:1) Incubate gauze in mother's vagina for 1 hour 2) Extract gauze before C-section  3) Expose newborn to the vaginal gauze (Mouth first, then face, then rest of body). If for some medical reason they don’t (and there is a C-section), then this is a restoring intervention.

Note that Dr. Dominguez-Bello always first checks to make sure the mother is HIV-negative and strep-B negative, and showing no signs of a STD. The basic premise is that babies should have crossed the mother's birth canal to be "seeded" with the mother's microbes, but if for some medical reason they don’t (and there is a C-section), then this is a (somewhat) restoring intervention.

From Feb. 2014 New York Academy of Sciences: Hats Off to Bacteria!

Why are bacteria in the body? What do we, and the bacteria, gain from this arrangement? And who's in charge? "There is a dialogue," Dominguez-Bello said, "sometimes a fight, sometimes a good dialogue. We have evolved with them. The first form of life on Earth was bacteria. Whatever came after had to deal with bacteria, cope with bacteria, associate with bacteria ...  ...continue reading "Can Missing Birth Canal Bacteria Be Restored to Cesarean Birth Babies?"

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Published on 252 Comments on The One Probiotic That Treats Sinusitis

[Please go to updated June 2022 version of this post.]

(Oct. 2018) Probiotics and sinusitis treatment go hand in hand. In the last few years researchers found that one probiotic (beneficial bacteria) that chronic sinusitis sufferers lack and that treats and cures sinusitis is Lactobacillus sakei.  And for many, major improvement may take only days!

The researchers Abreu et al found in their 2012 study that not only do sinusitis sufferers lack L. sakei, they have too much of some other bacteria, and they also don't have the bacteria diversity in their sinuses that healthy people without sinusitis have. In other words, the sinus microbiome (microbial community) is out of whack (dysbiosis). A number of studies since then also found that there is a depletion of some bacterial species, and an increase in "abundance" of other species in those with chronic sinusitis.

Luckily Lactobacillus sakei is found in some foods (such as some brands of live fermented kimchi), some sausage starter cultures (such as B-2), and recently in some probiotic supplements (e.g. Lanto Sinus). One reason it is used in sausage starter cultures is because L. sakei dominates over and inhibits growth of pathogenic bacteria, including Staphylococcus aureus. This post discusses these L. sakei products and other possible probiotic treatments for sinusitis.

Treating sinusitis with beneficial bacteria (rather than with antibiotics, corticosteroid nasal sprays, and surgery) is the future in sinusitis treatment.

BACKGROUND STORY: More than 5 years ago there were no probiotics containing L. sakei. None. So I experimented using a very easy kimchi sinusitis treatment (basically dabbing and smearing kimchi at certain stages of fermentation into my nostrils like a very messy eater) and found that it cured my chronic sinusitis of many years within two weeks. Obviously it contained L. sakei. Then the rest of my family also tried the kimchi treatment and were also quickly cured of chronic sinusitis! It felt miraculous, especially because it was so easy to do.

After 5 years we still feel great! Generally we only need to treat again with a product containing Lactobacillus sakei (we've been using refrigerated Lanto Sinus) after a virus which goes into sinusitis, or if for some other reason we feel like we're sliding into sinusitis. We've improved every year so need to do it less and more minimally.

Because we no longer have chronic sinusitis and can easily treat sinusitis if it occurs with L. sakei, we have NOT taken antibiotics or any other bacteria killing spray or product (such as xylitol) for over 5 years. We do not use cortisone or antihistamine nasal sprays either.

WHEN A TREATMENT WORKS: A number of you have contacted me to report your own progress with various sinusitis treatments. People used terms such as "miraculous", "transformative", and "fabulous" when they had positive results with a product containing L. sakei  -  and many with major improvement happening within a few days. I’ve also heard from a few people of some other beneficial bacteria species that may treat sinusitis.

When a treatment works, then all sinusitis symptoms go away  --sometimes within days, sometimes longer. This includes post nasal drip, sinus headaches, "clogged ears", bad breath, and sinusitis-related coughs. Even tonsil stones! (Please note that trying such products to treat sinusitis is self-experimentation - effects can be positive or negative. One should always be cautious.)

OVERALL RESULTS: The majority of people contacting me with results reported positive results (chronic sinusitis greatly improved or totally gone) from some form of L. sakei treatment. Successes have been reported to me from the USA, Canada, Europe, Australia, New Zealand, and Africa. But since it's from self-experimentation and not a clinical trial, then I don't know the actual percentage of positive results.

Some of the people reporting success have had multiple operations, some currently have deviated septums, some with nasal polyps, and all have had long-standing chronic sinusitis, some for decades. Interestingly,  Lactobacillus sakei works best when it is used only when needed, when there are sinus symptoms. Don't use when feeling healthy.

Those same chronic sinusitis sufferers also reported that the same treatments also worked to treat acute sinusitis or sinus infections. It seems that after colds or viruses may develop acute sinusitis again and need re-treatment (apparently the L. sakei frequently doesn't stay in the sinuses from earlier treatments). However, the sinuses do continue improving over time so fewer and more minimal treatments are needed over the years.

Another very small group reported that other probiotic strains helped, and a minority of people reported that nothing has helped and there could be a variety of reasons for this (see below). Some people reported that one product helped, but not another - whether kimchi or a L. sakei product. It also became clear that L. sakei does not treat seasonal allergies or allergy symptoms.

THREE MAIN PRODUCT CATEGORIES: The main categories of products containing live Lactobacillus sakei are:: kimchi (and some sauerkraut), refrigerated products, and frozen products. Note that at this time the FDA does not allow any probiotics to be sold as a medical treatment – they can only be sold as a supplement.

Using the following products to treat sinusitis is self-experimentation (results are unknown and can vary). Always be cautious when testing a new product. (See Sinusitis Treament Summary page for treatment methods.)

KIMCHI - Many people report that kimchi helped them. One person reported a homemade kimchi worked great (he was finally symptom free after 8 years). A few have even mentioned that kimchi has helped sinusitis with fungal problems.

Kimchi brands that people reported helping their chronic sinusitis: Sunja's Kimchi (mild white kimchi and medium spicy cucumber kimchi), Sinto Gourmet brand kimchi, Mama-O's Premium Kimchi, the white Napa kimchi and cabbage kimchi made by Choi's Kimchi Company (in Portland, Oregon), Farmhouse Culture Kimchi (in California), Ozuke Kimchi (in Colorado), Mother-in-law's Kimchi, in the United Kingdom the brand Mr Kimchi, and in Australia Kehoe's Kitchen white kimchi.

(Not all kimchi brands or types of kimchi within brands contain L. sakei - finding one that has it is due to self-experimentation. The kimchi must be live, and not pasteurized. We found that kimchi may contain L. sakei from about day 14 (or earlier) to about 2 to 2 1/2 months (from the day it's made).

When the kimchi contained L. sakei we felt the same or started feeling better within one or 2 days. If we felt more mucusy over the next 2 days, or the acute sinusitis kept getting worse, than it did not contain L. sakei.) Some researchers feel that it's the garlic in kimchi that encourages L. sakei growth.

SAUERKRAUT - Some people improved with sauerkraut made with garlic. Some researchers feel that it's the garlic in kimchi that encourages L. sakei growth, and sauerkraut typically doesn't contain garlic.

REFRIGERATED LACTOBACILLUS SAKEI PRODUCTS  – A refrigerated L. sakei product specifically meant for the sinuses is now available. The company Lanto Health has introduced a kimchi derived Lactobacillus sakei product called Lanto Sinus - to be used when needed (when there are symptoms). Lanto Sinus  is sold as a dietary supplement, holds up well in the refrigerator, is effective, quick-acting, and easy to use. This high-quality product ships well because it holds up for a while (days) without refrigeration.

People have reported success using it mixed with bottled water (dabbing, smearing, spooning a little in nostrils), or swishing it dry in the mouth. I’ve been a consultant with Lanto Health on this product and have been testing and using this product successfully for over a year (self-experimentation!).

FROZEN LACTOBACILLUS SAKEI PRODUCTS  – The main L. sakei products available in many countries throughout the world are various frozen sausage starter cultures. All L. sakei products needing to be kept frozen are generally reliable and effective for sinusitis treatment. They should only be used when needed. But negatives with all frozen L. sakei products are that they must be kept frozen, they don’t hold up well once the package is opened, and they can easily die off during shipping.

Sausage starter cultures include BACTOFERM F-RM-52 (many countries, made by Chr. Hansen), PRIMAL SK NATUR 50 (Europe, made by Van Hees), and BITEC LS-25 (Europe, made by Frusarum). These starter cultures contain 2 types of bacteria (L. sakei and Staphylococcus carnosus) – little is known about S. carnosus, but it is considered non-pathogenic, and no one has reported negative effects from it. B-2, which is only L. sakei (made by Chr Hansen), is available in New Zealand and some EU countries. The starter culture BACTOFERM  SM 160 (L. sakei, Staphylococcus carnosus and Debaryomyces hansenii) has also been used successfully for chronic sinusitis. But one should be very cautious because while the third bacteria is considered non-pathogenic, is common in food products, is used commercially to make B12 - it is a yeast species (fungi).

Most use a frozen product by dabbing/smearing or spooning a little of the mixture (L. sakei and bottled water) into the nostrils. Sometimes a side effect on the day the product is used is a dry mouth and throat (and they can be very dry when overused - so it's important to use only a little in a treatment). The person who used the nasal aspirator reported a temporary decrease in her sense of smell.

[NOTE: I personally have overuse concerns (too strong a dose) with using L. sakei in a neti pot or nasal syringe, and so have never used any L. sakei product that way. My personal view: let the little suckers travel up to the sinuses on their own. And they do. And I always start first with the most cautious way to see if that works.]

SOME L.SAKEI ISSUES: I still think of L. sakei as fairly fragile – for example, it is killed off by antibiotics, by oxygen, and it only lives a limited amount of time at room temperature. [For ex.: the culture Bactoferm F-RM-52 package says that it dies off in less than 2 weeks at room temperature - therefore store in freezer.] On the other hand, many different Lactobacillus strains live and multiply in our bodies at 98.6 degrees Fahrenheit - so L. sakei can handle warm temperatures just fine for a while.

Note that the L. sakei in any product can also die off during shipping if it takes too long, it’s too hot (e.g. inside hot postal vehicles in extreme heat), or some other reason. Thus we order 2 day shipping (if possible) and hope for the best. (Note: Consider overnight shipping during 100+degree Fahrenheit heat waves. Also, USPS delivers to mailboxes, while UPS typically delivers to the door.)

WHY DOESN'T L. SAKEI WORK FOR SOME PEOPLE? Some possibilities to explain why some people trying various L. sakei products has not resulted in their sinusitis improving is that perhaps some other "keystone species" (a very important microbial species for a normal healthy community) besides L. sakei is  missing in their sinus microbiomes. Or perhaps they have microbes that the L.sakei bacteria cannot overcome.

It is unclear whether the results are different if there are also nasal polyps. Researchers now suspect that those with nasal polyps also have a problem with "primary inflammation". We (modern medicine) know so little about the normal healthy sinus microbiome that there are many unanswered questions.

PROBLEM WITH A PRODUCT SUDDENLY NOT WORKING, OR OVERUSE - Several people reported that a kimchi brand or L. sakei product that originally worked for them suddenly stopped working or not as well, but usually it had been the only product used for a while. There may be a feeling of "imbalance" or on rare occasion some symptoms (e.g. more mucus, sore throat). We think this might be an issue of "too much of certain microbes".

Then we (family members) have found that immediately switching to another product (e.g., from one brand or type of kimchi to another), or from a L. sakei product to kimchi, or swishing an opened capsule (the dry powder) of multi-strain probiotics, or refrigerated L.sakei in the mouth (this last if switching from kimchi)  has corrected the situation for us. (Finding what works is self-experimentation, and varies from time to time.). And weeks later, we can use the original product once again. This is also why we only use a product when needed.

BOTTOM LINE: When feeling good or healthy, stop using the L. sakei product. Use L. sakei products sparingly - only as needed (e.g. when developing sinusitis). Using less is better than more over time – probably due to sinus microbial communities improving over the years. L. sakei seems to be necessary for sinusitis treatment for most people (a keystone bacteria), but there are also other important microbes in the sinuses - a whole community.

OTHER PROBIOTICS MAY OR MAY NOT HAVE BENEFICIAL EFFECTS - Rarely some people have reported that multi- strain probiotics (but they did not contain L. sakei) treated their sinusitis. They mixed the powder in the capsules with water and smeared or dabbed the mixture in the nose, or even used it in a saline rinse (this last was rare). Different brands containing different mixtures of bacteria (Lactobacillus and Bifidobacterium) have been mentioned - but all were refrigerated probiotics - so nothing stands out.

On the other hand, other people (including my family members) reported trying various multi-strain probiotics containing various Lactobacillus and Bifidobacterium species in the nostrils and found it did not help sinusitis. However, we found that when we feel a little “imbalanced” – perhaps a cough or mucusy – then swishing the dry powder from one capsule in the mouth and then swallowing it - frequently results in some improvement (perhaps with a cough).

I have concerns with products that also contain titanium dioxide – this is because it may be in nanoparticle form, and recent studies have raised concerns that the nanoparticles can travel to other organs in the body, and are also inflammatory. So read the ingredients!

STILL UNKNOWN: Some multi-strain probiotics now contain L. sakei, but may be problematic if they don’t need refrigeration (e.g. Multi-strain Probiotic by Innovix Labs). L. sakei products typically die after a few weeks without refrigeration, and die when exposed to oxygen (anaerobic).  So...while the L. sakei may be alive when the product is produced, is it alive weeks or months later at room temperature?

Also, will a multi-strain probiotic containing both L. sakei and S. salivarius K12 (such as Pro-Kids ENT by Hyperbiotics) help or make things worse for those with sinusitis?  S. salivarius K12 has caused problems for some people (scroll down to "Problems With BLIS K12?").

NO EVIDENCE FOR JUST SWALLOWING PROBIOTIC SUPPLEMENTS: Evidence (my family, people writing in, research) so far has been that only directly dabbing/applying probiotics in the nose, or even swishing probiotics in the mouth may help treat sinusitis. I have not found any studies finding that just swallowing a probiotic pill has helped sinusitis (including a 2009 study looking at swallowing L. rhamnosus tablets 2 times daily for 4 weeks).

PROMISING PHAGE THERAPY - Some researchers in the USA and Australia are currently testing phage therapy to see if it could be used as a treatment for chronic sinusitis. A bacteriophage is a virus that infects bacteria, and the name literally means "bacteria eater". Phage therapy is the therapeutic use of bacteriophages to treat bacterial infections. See the June 3, 2016 post Phage Therapy May Help Sinusitis Sufferers for more information.

The authors of one study I posted said that they had found evidence for people having "virus-like particles" in their sinuses, which they thought were bacteriophages.

SNOT TRANSPLANTS IN THE FUTURE? – Currently a “snot transplant” study from healthy persons to sinusitis sufferers is going on in Europe to see if it works as a sinusitis treatment. This possibility may work great, but researchers have the same concerns as with fecal microbial transplants (stool transplant) for the gut. For example, are diseases also being transplanted?

PROBLEMS WITH BLIS K12 ? - Some people (and family members) tried the probiotic BLIS K12 bacteria (also known as Streptococcus salivarius BLIS K12), but found it brought on sinusitis-type symptoms. Scientific research finds it to be an immune booster and it lowers the incidence of upper respiratory infections. But not for us - from the first tablet (ate it by slowly dissolving it in the mouth) there were problems - feeling phlegmy and yellow mucus.

Several persons reported similar negative effects with PRO-dental tablets, which also contains BLIS K12. The message here is clear: these specific bacteria did not react well with our sinus and oral bacterial communities. Remember, whenever one introduces new bacteria into the human organism, there can be positive or negative effects.

PLEASE WRITE!  I would really like to hear how you are treating and curing your sinusitis, especially chronic sinusitis. Or even what hasn't worked. It all adds to the knowledge base. Write to me privately, or can comment after any post.

(Note that most comments are after this post, the SINUSITIS TREATMENT SUMMARY page, the CONTACT page, and other sinusitis posts - see category SINUSITIS).

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Nice write-up of how what happens from the type of birth (vaginal vs cesarean) affects the baby's microbiome (community of microbes). Remember, it is very complicated and much is still unknown. (UPDATE: see January 16, 2015 post discussing research by Dr. Dominguez-Bello who is conducting a study in which babies born via C-section are immediately swabbed with their mother's vaginal secretions; these babies will then be followed for years). From Gastroenterology and Endoscopy News:

Delivery Mode Alters Newborn’s First Bacterial Exposure

 A baby’s first exposure to bacteria varies by the method of delivery, researchers have found. These differences could have health implications later in life, according to an emerging body of evidence that suggests gut bacteria may be important to the development of a healthy immune system (Arrieta MC et al.Front Immunol 2014;5:427). For example, evidence shows that alterations in gut bacteria early in life may increase the incidence of allergies later on (Bendiks M, Kopp MV. Curr Allergy Asthma Rep 2013;13:487-494).

In the new study, presented at the 2014 annual meeting of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, a group at the University of Colorado School of Medicine, in Aurora, compared oropharyngeal aspirates taken from 12 infants born by cesarean delivery and 11 born vaginally, and their bacterial content by sequencing the bacterial genes in the samples (abstract 7). Samples taken from the mothers’ vaginal and rectal areas, and samples of the infants’ stool, were also analyzed for bacterial genes.

Bacteria in aspirates from newborns delivered vaginally were more similar to the bacteria found in samples from their mothers than the aspirates from infants born by cesarean delivery, the investigators found. Infants born vaginally had higher numbers of firmicutes (62.6% vs. 30.1%; P=0.0013), particularly lactobacilli typically found in the vagina.

Aspirates from infants born by cesarean delivery, in contrast, had higher levels of Actinobacteria (20.1% vs. 3.8%; P=0.045), which are found on the skin. Stool samples from vaginally delivered newborns also had greater numbers of Bacteroidetes than stool samples from infants born by cesarean delivery. This difference persisted through six weeks of life, the researchers said.

David Brumbaugh, MD, assistant professor of pediatrics at the University of Colorado School of Medicine, in Aurora, said the finding of fewer Bacteroidetes in cesarean newborns is potentially alarming. Studies of mice raised in sterile conditions have shown that exposure to a specific type of Bacteroidetes, Bacteroides fragilis, suppresses the animals’ inflammatory response (Mazmanian SK et al. Nature 2008;453:620-625), he said. 

“The fact that this bacteria never gets established early in life [in babies born by cesarean delivery] is concerning,” he said. Some studies have suggested that infants born by cesarean delivery may be at greater risk for developing conditions such as asthma, type 1 diabetes and celiac disease (Cho CE, Norman M. Am J Obstet Gynecol 2013;208:249-254). But not all studies have supported such risks; other studies suggest that genetic factors or the reason for the cesarean delivery itself may contribute to disease later in the child’s life (Almqvist C et al.Clin Exp Allergy 2012;42:1369-1376).

Jean-Eric Ghia, PhD, assistant professor of immunology and internal medicine at the University of Manitoba, in Winnipeg, Canada, said the findings add to a body of evidence suggesting that gut bacterial colonization is affected by mode of delivery, and these altered gut bacteria might contribute to immune system–related disease later in life (Neu J, Rushing J.Clin Perinatol 2011;38:321-331). “The first colonization of the gut happens when the baby comes out,” he said. But he noted that long-term studies are needed to assess the effect of these gut differences on health in the long term. He noted that a multitude of exposures before and after birth can also influence gut biota (Munyaka PM et al. Front Pediatr. doi:10.3389/fped.2014.00109 [published online October 9, 2014]). “It’s really, really complicated,” he said.