Skip to content

Published on

Last year a small study by Abreu et al raised the exciting possibility that the sinus microbiome (the microbial community in our sinuses) being seriously out of whack could be behind chronic sinusitis. Which some day could result in sinusitis treatment being the restoration of beneficial microorganisms that should be there, perhaps with a nasal spray. From Science Daily, September 12, 2012:

Sinusitis Linked to Microbial Diversity

A common bacteria ever-present on the human skin and previously considered harmless, may, in fact, be the culprit behind chronic sinusitis, a painful, recurring swelling of the sinuses that strikes more than one in ten Americans each year, according to a study by scientists at the University of California, San Francisco.

The team reports this week in the journal Science Translational Medicine that sinusitis may be linked to the loss of normal microbial diversity within the sinuses following an infection and the subsequent colonization of the sinuses by the culprit bacterium, which is called Corynebacterium tuberculostearicum.

In their study, the researchers compared the microbial communities in samples from the sinuses of 10 patients with sinusitis and from 10 healthy people, and showed that the sinusitis patients lacked a slew of bacteria that were present in the healthy individuals. The patients also had large increases in the amount of Corynebacterium tuberculostearicum in their sinuses, which are located in the forehead, cheeks and eyes.

The team also identified a common bacterium found within the sinuses of healthy people called Lactobacillus sakei that seems to help the body naturally ward off sinusitis. In laboratory experiments, inoculating mice with this one bacterium defended them against the condition. 

"Presumably these are sinus-protective species," said Susan Lynch, PhD, an associate professor of medicine and director of the Colitis and Crohn's Disease Microbiome Research Core at UCSF. What it all suggests, she added, is that the sinuses are home to a diverse "microbiome" that includes protective bacteria. These "microbial shields" are lost during chronic sinusitis, she said, and restoring the natural microbial ecology may be a way of mitigating this common condition.

Though the sinuses' underlying purpose is still unclear, they are all too familiar to American doctors and their patients because of what happens when the thin tissues lining them become inflamed, as occurs in chronic sinusitis -- one of the most common reasons why people go to the doctor in the United States. There are about 30 million cases each year, and the cost to the healthcare system is an estimated $2.4 billion dollars annually.

The pain of sinusitis can last for months. Doctors typically prescribe bacteria-killing antibiotics and, in more severe and long-lasting cases, conduct sinus surgeries. However, said Andrew Goldberg, MSCE, MD, the director of rhinology and sinus surgery at UCSF and a co-author on the paper, "the premise for our understanding of chronic sinusitis and therapeutic treatment appears to be wrong, and a different therapeutic strategy seems appropriate."

Published on

There is a new procedure in which microbiota (the microbes) from a healthy individual are introduced into the gastrointestinal system of a diseased individual via a fecal transplant.  The purpose of the fecal transplant is to replace good bacteria which has been suppressed or killed (usually by antibiotics) , and which has caused bad bacteria, such as Clostridium difficile, to overpopulate the gut. This is having amazing success rates.  It has been used the most for Clostridium difficile (C. difficile) infections, which sickens about half a million Americans annually. This infection can be so debilitating and so resistant to all antibiotics that about 14,000 Americans die each year from it. Even though not that many have been done, fecal transplants are gaining in popularity (some even being done by do-it-yourselfers using fecal enemas at home) because fecal transplants can have a 95 to 98% success rate.                      

New research is starting to see if the fecal transplant can be made even easier (via a "poop pill"), and also if fecal transplants will work for Inflammatory Bowel Diseases (IBD). This would mean the future treatment possibility of transplanting microbiota from healthy individuals to individuals sick with IBD. From the October 4, 2013 Science Daily:  

 Fecal Transplant Pill Knocks out Recurrent C. Diff Infection

C. diff infection can occur after people take antibiotics, wiping out the good bacteria in the gastrointestinal (GI) system, allowing C. diff to flourish and leading to severe diarrhea. In some patients, infection continues to recur despite standard treatment with antibiotics. For patients trapped in that cycle, doctors have transplanted feces from healthy donors into their GI system to rebalance the bacteria and stop infections from recurring.

University of Calgary researchers reported a 100 percent success rate -- none of the 27 patients who took the tablet-sized pills had a recurrence of C. diff, even though all of them previously had had at least four bouts of the infection. Patients ingested between 24 and 34 capsules containing fecal bacteria, often donated by family members.

----------------------------------------------------------------------------------------

There is even the site The Power of Poop  which calls itself a "patient information resource dedicated to promoting safe accessible Fecal Microbiota Transplant (FMT) and to raising awareness of the role of the human microbiome in digestive illness."    http://thepowerofpoop.com

Published on

In case you missed it, Michael Pollan wrote an article about the human microbiome (the community of microbes that live within us) that was published May 15, 2013. Much of the article was about how the modern western diet may not be good for the human microbiome and how we can eat for better gut health. From the NY Times:

Some of My Best Friends Are Germs 

 As part of a new citizen-science initiative called the American Gut project, the lab sequenced my microbiome — that is, the genes not of “me,” exactly, but of the several hundred microbial species with whom I share this body. These bacteria, which number around 100 trillion, are living (and dying) right now on the surface of my skin, on my tongue and deep in the coils of my intestines, where the largest contingent of them will be found, a pound or two of microbes together forming a vast, largely uncharted interior wilderness that scientists are just beginning to map.

Few of the scientists I interviewed had much doubt that the Western diet was altering our gut microbiome in troubling ways. Some, like Blaser, are concerned about the antimicrobials we’re ingesting with our meals; others with the sterility of processed food. Most agreed that the lack of fiber in the Western diet was deleterious to the microbiome, and still others voiced concerns about the additives in processed foods, few of which have ever been studied for their specific effects on the microbiota.

So I gave up asking scientists for recommendations and began asking them instead how, in light of what they’ve learned about the microbiome, they have changed their own diets and lifestyles. Most of them have made changes. They were slower to take, or give their children, antibiotics. (I should emphasize that in no way is this an argument for the rejection of antibiotics when they are medically called for.) Some spoke of relaxing the sanitary regime in their homes, encouraging their children to play outside in the dirt and with animals — deliberately increasing their exposure to the great patina. Many researchers told me they had eliminated or cut back on processed foods, either because of its lack of fiber or out of concern about additives. In general they seemed to place less faith in probiotics (which few of them used) than in prebiotics — foods likely to encourage the growth of “good bacteria” already present. Several, including Justin Sonnenburg, said they had added fermented foods to their diet: yogurt, kimchi, sauerkraut. These foods can contain large numbers of probiotic bacteria, like L. plantarum and bifidobacteria, and while most probiotic bacteria don’t appear to take up permanent residence in the gut, there is evidence that they might leave their mark on the community, sometimes by changing the gene expression of the permanent residents — in effect turning on or off metabolic pathways within the cell — and sometimes by stimulating or calming the immune response.

...something a gastroenterologist at the University of Pittsburgh told me. “The big problem with the Western diet,” Stephen O’Keefe said, “is that it doesn’t feed the gut, only the upper G I. All the food has been processed to be readily absorbed, leaving nothing for the lower G I. But it turns out that one of the keys to health is fermentation in the large intestine.” And the key to feeding the fermentation in the large intestine is giving it lots of plants with their various types of fiber, including resistant starch (found in bananas, oats, beans); soluble fiber (in onions and other root vegetables, nuts); and insoluble fiber (in whole grains, especially bran, and avocados).

With our diet of swiftly absorbed sugars and fats, we’re eating for one and depriving the trillion of the food they like best: complex carbohydrates and fermentable plant fibers. The byproduct of fermentation is the short-chain fatty acids that nourish the gut barrier and help prevent inflammation. And there are studies suggesting that simply adding plants to a fast-food diet will mitigate its inflammatory effect.

...I began to see how you might begin to shop and cook with the microbiome in mind, the better to feed the fermentation in our guts. The less a food is processed, the more of it that gets safely through the gastrointestinal tract and into the eager clutches of the microbiota. Al dente pasta, for example, feeds the bugs better than soft pasta does; steel-cut oats better than rolled; raw or lightly cooked vegetables offer the bugs more to chomp on than overcooked, etc. This is at once a very old and a very new way of thinking about food: it suggests that all calories are not created equal and that the structure of a food and how it is prepared may matter as much as its nutrient composition.

Published on

Within the past few years there has been an explosion in human microbiome research - looking at the community of microorganisms that live in and on human beings. Within the body of a healthy adult, microbial cells are estimated to outnumber human cells ten to one! This community of microorganisms remains largely unstudied, and so their influence on human development, diseases, immunity, and health are almost entirely unknown.  Some of the latest research looks at the microbiomes of healthy people and those with diseases, seeing how they differ, and from that looking at possible treatments using bacteria.  This is a whole different mind-set from the one we've had for decades that viewed all bacteria as bad (pathogens) and needing to be eliminated. 

An introduction to this emerging area of human microbiome research was written by Gina Kolata in the NY Times, June 13, 2013:  

In Good Health? Thank Your 100 Trillion Bacteria

For years, bacteria have had a bad name. They are the cause of infections, of diseases. They are something to be scrubbed away, things to be avoided. But now researchers have taken a detailed look at another set of bacteria that may play even bigger roles in health and disease: the 100 trillion good bacteria that live in or on the human body.

No one really knew much about them. They are essential for human life, needed to digest food, to synthesize certain vitamins, to form a barricade against disease-causing bacteria. But what do they look like in healthy people, and how much do they vary from person to person?

In a new five-year federal endeavor, the Human Microbiome Project, which has been compared to the Human Genome Project, 200 scientists at 80 institutions sequenced the genetic material of bacteria taken from nearly 250 healthy people. They discovered more strains than they had ever imagined — as many as a thousand bacterial strains on each person. And each person’s collection of microbes, the microbiome, was different from the next person’s. To the scientists’ surprise, they also found genetic signatures of disease-causing bacteria lurking in everyone’s microbiome. But instead of making people ill, or even infectious, these disease-causing microbes simply live peacefully among their neighbors.

"Until recently, Dr. Bassler added, the bacteria in the microbiome were thought to be just “passive riders.” They were barely studied, microbiologists explained, because it was hard to know much about them. 

The work also helps establish criteria for a healthy microbiome, which can help in studies of how antibiotics perturb a person’s microbiome and how long it takes the microbiome to recover.

In recent years, as investigators began to probe the microbiome in small studies, they began to appreciate its importance. Not only do the bacteria help keep people healthy, but they also are thought to help explain why individuals react differently to various drugs and why some are susceptible to certain infectious diseases while others are impervious. When they go awry they are thought to contribute to chronic diseases and conditions like irritable bowel syndrome, asthma, even, possibly, obesity.

"The microbiome starts to grow at birth, said Lita Proctor, program director for the Human Microbiome Project. As babies pass through the birth canal, they pick up bacteria from the mother’s vaginal microbiome.

Babies born by Caesarean section, Dr. Proctor added, start out with different microbiomes, but it is not yet known whether their microbiomes remain different after they mature.In adults, the body carries two to five pounds of bacteria, even though these cells are minuscule — one-tenth to one-hundredth the size of a human cell. The gut, in particular, is stuffed with them.

“The gut is not jam-packed with food; it is jam-packed with microbes,” Dr. Proctor said. “Half of your stool is not leftover food. It is microbial biomass.” But bacteria multiply so quickly that they replenish their numbers as fast as they are excreted.

Including the microbiome as part of an individual is, some researchers said, a new way to look at human beings. The next step, he said, is to better understand how the microbiome affects health and disease and to try to improve health by deliberately altering the microbiome. But, Dr. Relman said, “we are scratching at the surface now.”

-----------------------------------------------------

FOR THOSE WHO WOULD LIKE TO SEE A VIDEO ON THIS TOPIC, this TED talk given by Dr. Jonathan Eisen  is an excellent introduction to the human microbiome and how we should view ourselves as being covered in a microbial cloud.  And that this microbial community within and on us should be viewed as an organ, and thus should be treated carefully and with respect.

Who are “Me, Myself and Us?”

2012Jonathan Eisen

Published on

 It seems like every day numerous new science and health articles are published. I have always enjoyed going to various sites and looking for articles that I actually think are significant and could help us understand the world around us, or what we should be concerned with, or even how to live a good and healthy life. For years I have been sending out articles to friends and family and finally decided to, what the heck, send them out to everybody else by posting them on a web-site.

I have always been interested in the interplay between our environment and health. There is still so very much that is unknown. And then there are new exciting areas of research using new technologies that make us rethink what we thought we knew, and how to treat diseases and live a healthy life.

I've decided to start by posting some articles that were published earlier this year because they lay out the groundwork for a lot of new exciting research. Stuff that we didn't know about or understand back when learning basic biology in school.