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What can the amazing beneficial bacteria Lactobacilus sakei treat? We know it can treat sinusitis (sinus infections) - based on the original Abreu et al (2012) research, personal experiences, and feedback from hundreds of people since I started this site in 2013. Can it treat bronchitis? Earaches? How about skin infections? L. sakei dominates over and inhibits growth of pathogenic bacteria, including Staphylococcus aureus. Instead of using antibiotics - what else could L. sakei be used for?

I've been hearing interesting stories from people - a number of people have found that it (kimchi, sauerkraut with garlic, or a L. sakei product such as Lanto Sinus) works to treat coughs (bronchitis), or prevents upper respiratory infections from developing into serious sinus infections, gets rid of fungal balls in the sinuses, treats earaches, and even treats small skin infections. People have been using the various products in creative ways - all self-experimentation!

The experiences of some people contacting me, as well as family members (including myself) - is that it treated bronchitis and coughs for which they would have taken antibiotics in the past - by swishing L. sakei powder (such as Lanto Sinus) in the mouth (but not in the nose). For example, one person reported that she occasionally gets bronchitis, but never sinusitis - and she successfully used Lanto Sinus to treat the bronchitis by swishing it in the mouth. The first two days she used it 2 x per day, and after that once per day until she felt better, but not totally well - and when she stopped the bronchitis (cough, phlegm) came back. So she used the L. sakei again until she felt totally healthy - and this time the cough stayed away. Since I personally know this person (we take walks together) I was able to observe her progress - cough & phlegm, then improvement, then backwards slide, and then total health when she used the product again. Hmmm... Definitely wasn't an imaginary effect or wishful thinking (placebo effect).

Not wanting to dab kimchi juice in the nostrils (the usual way to use kimchi) some gargled with kimchi juice and also swished it in the mouth and then didn't eat or drink for a while - but I don't know how the results compare to the usual kimchi method. One person dabbed kimchi juice in the ear for an earache and thought it helped (see Sinusitis Success Stories). For skin infections some individuals mixed L. sakei with a little water and applied to infection - this has been reported for both frozen Bactoferm F-RM-52 and refrigerated Lanto Sinus. But at any rate, the reports from people of various ways to use a L. sakei product are interesting. Just remember - this is all self-experimentation - which means results can be positive, negative, or no effect. And please be cautious!

For ways people use the various Lactobacillus sakei products to treat sinus infections (both chronic sinusitis and acute sinusitis) see the Sinusitis Treatment Summary page. The Best Probiotic For Sinus Infections gives an in-depth look at the different L. sakei products and results.

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Today's topic: sinusitis success stories. For those suffering from chronic sinusitis or frequent sinus infections it sounds incredible, doesn't it? For more than 5 years I've posted about the probiotic Lactobacillus sakei and how it can successfully treat sinusitis - both chronic sinusitis and  acute sinusitis (sinus infections). Back in January 2013 I read a study by Abreu et al (2012) that the sinus microbiome (microbial community) in people with chronic sinusitis was imbalanced and that this beneficial bacteria could be a possible treatment. I had suffered from chronic sinusitis for years, so of course I went searching for Lactobacillus sakei. It wasn’t in any probiotics at the time, but I did find it in kimchi. Through experimentation I (and my family) successfully treated our sinusitis by dabbing and smearing a little of the kimchi juice in the nostrils once or twice a day. It felt miraculous!

By the end of 2013 I started this blog to get the word out about Lactobacillus sakei, and to also hear the experiences of others. (See results post) In the last 5 years I have heard from hundreds of people, including lots of sinusitis success stories with Lactobacillus sakei – especially using kimchi, sauerkraut made with garlic, sausage starter cultures such as Bactoferm F-RM-52, and recently with the sinusitis probiotic Lanto Sinus, which was introduced in 2018. When a Lactobacillus sakei product works as a sinusitis treatment for a person it feels absolutely wonderful and amazing. Sinus health after years of suffering! Unfortunately, it appears that Lactobacillus sakei may not work for everyone - only trying it determines if it works and how well.

The following are excerpts of some of the sinusitis success stories that people have reported - almost all are from comments after posts on this site, and a few from emails to me. Sometimes we need to hear successful treatment stories, especially if we’ve been struggling with sinusitis for a long time. Just keep in mind that these are stories of people experimenting on their own - how they used Lactobacillus sakei varies and their experiences vary. (See Sinusitis Treatment Summary for methods). Note that in Feb. 2019 the Lacto Sinus name was changed to Lanto Sinus in order to get a trademark - but the product remains exactly the same.

J. October 2017
So glad I found this site! Have been struggling with chronic sinus and gut issues go over 20 years after several rounds of antibiotics.
Immediately after reading thru this I put a dab of Kimchi juice up each nostril (had some on hand, as I eat a lot of fermented veggies). I could tell almost immediately that something was happening. Almost felt as if there was a duel going on in my sinuses between the kimchi probiotics and the nasties in my sinuses. Had some stuffiness and stiff neck but went to bed and slept great last night and woke up this morning with clearer sinuses and feeling better!

Jo. October 2015
Through the years I've tried everything for sinus infections and nothing but antibiotics helped. When I read about kimchi helping I tried that too. To my utter delight and relief, Sunja's white kimchi worked a miracle! I bought another 3 jars and keep it in the refrigerator for the next bout.

M. November 2018
I had great success in treating my chronic sinusitis with Lacto Sinus.
I’ve had sinus problems for 2 decades and tried all sorts of medicines and treatments, but nothing helped. Every single sore throat and every cold, no matter how minor, led to full-blown sinusitis and having to take antibiotics for weeks. I was always in fear of getting sick. And even when I was “healthy” I really wasn’t, I always had some symptoms. I would frequently wake up with a sore throat and with thick phlegm dripping down my throat.
I was desperate when I tried Lacto Sinus and was thrilled to see improvement within a day! I used it daily for over a week, then every other day for about 2 more weeks. And then I stopped because I didn’t need it anymore.
Getting my life and health back feels like a miracle! I don’t dread getting a cold or virus anymore – I just use some Lacto Sinus again if I get some sinus symptoms. I will always keep a bottle in my refrigerator.

T. January 2017  ...continue reading "Sinusitis Success Stories"

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Probiotics are the future of sinusitis treatment. Research found that a probiotic (beneficial bacteria) that is lacking in those with chronic sinusitis and which successfully treats sinusitis is Lactobacillus sakei. This article is the full summary of what has been learned over the past 6 years: the best L. sakei  products (such as kimchi and Lanto Sinus - which can treat even the worst recurring sinus infections), results of people trying various L. sakei products, ways to use the products, and other possible probiotics for sinusitis and sinus health.

Back in 2012, a study by Abreu et al suggested Lactobacillus sakei as a possible treatment for sinusitis. In the past 6 years those conclusions have been supported by the experiences of hundreds of people contacting me, and my family's experiences with L. sakei products. It really is the best sinusitis treatment for most people!  When Lactobacillus sakei works as a treatment - it can seem miraculous as sinusitis symptoms gradually disappear or greatly improve. Many times within days! Unfortunately it doesn't work for everyone - for a minority there seems to be no effect, and it is not clear why. It also doesn't treat seasonal allergies or allergy symptoms. (See Treatment Summary page for different ways to use products.) Lactobacillus sakei works best when it is used only when needed, when there are sinus symptoms.

Sinusitis research in the last decade has found 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) in chronic sinusitis -  with a depletion of some bacterial species, and an increase in "abundance" of other species.

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.

BACKGROUND STORY: Six years ago there were no probiotics containing L. sakei. None. So instead members of my family experimented using a very easy kimchi sinusitis treatment (basically dabbing and smearing kimchi at certain stages of fermentation into the nostrils like a very messy eater) and found that it cured  chronic sinusitis of many years within several weeks. Obviously it contained L. sakei. It felt miraculous, especially because it was so easy to do. (See Sinusitis Treatment Story page for our background story).

After 6 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. The last few years we've needed to do this far less (and more minimally - usually only a few days) than the first year because every year we have improved – fewer colds and viruses, and an improved sinus microbiome. 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 6 years. We do not use cortisone or antihistamine nasal sprays either.

WHEN A TREATMENT WORKS: Many of you have contacted me to report your own progress with various sinusitis treatments. Thank you! People used terms such as "miraculous", "transformative", and "fabulous" when they had positive results with a product containing L. sakei. 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  or there is major improvement - frequently within a few days. Symptoms that go away include 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 very cautious. Best results are to use L. sakei only when needed.)

OVERALL RESULTSThe 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 from the USA, Canada, Europe, Australia, New Zealand, Japan, 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.

Those same chronic sinusitis sufferers also reported that the same treatments also worked to treat acute sinusitis. It seems that after colds, etc. they (including myself) may develop acute sinusitis again and need re-treatment (apparently the L. sakei frequently doesn't stay or colonize in the sinuses from earlier treatments). However, the sinuses do continue improving over time so our experience has been that fewer and more minimal treatments (perhaps only a few days) are needed over the years. Another very small group reported that other probiotic strains helped (but it is not always clear whether they also tried a L. sakei product), and 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.

THREE MAIN PRODUCT CATEGORIES: Currently there are 3 main categories of products containing live Lactobacillus sakei, and which people have reported success in treating sinusitis: kimchi (and some sauerkraut), refrigerated products (e.g. Lanto Sinus), 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 (without naming brands), while others named brands that helped them. And 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 (medium spicy cucumber kimchi and mild white kimchi), Sinto Gourmet brand kimchiMama-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), Mother-in-law's KimchiOzuke Kimchi (in Colorado), in the United Kingdom the brand Mr Kimchi, and in Australia Kehoe's Kitchen white kimchi. I'm sure some (many?) other brands also contain L. sakei.

(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 or phlegmy 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 - Sauerkraut has worked for some people if it is 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 high-quality refrigerated L. sakei product specifically meant for the sinuses and treatment of sinusitis is sold by Lanto Health. The kimchi derived Lactobacillus sakei product called Lanto Sinus is meant to be used when needed. Lanto Sinus  is sold as a dietary supplement, holds up well in the refrigerator, is effective, reliable, and easy to use. This 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 2 years (self-experimentation!).    ...continue reading "The Best Probiotic For Sinus Infections"

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Big announcement today! The high quality product Lanto Sinus, which contains the probiotic Lactobacillus sakei specifically for sinus support (for sinusitis symptoms), is now available. This product contains an excellent strain of Lactobacillus sakei that is kimchi derived. Lactobacillus sakei is the one probiotic (beneficial bacteria) that has successfully treated sinusitis (both chronic sinusitis and acute sinusitis) of many people, including all members of my family. It has been an amazing journey - and since using Lactobacillus sakei our sinuses feel great, and we have not had to use antibiotics in 6+ years! A win-win.

More than 6 years ago I read research about the sinus microbiome (microbial community), and how chronic sinusitis sufferers lack the keystone bacteria Lactobacillus sakei that successfully treats sinusitis. There were no probiotics with L. sakei available back then. None. But we (my family) were able to successfully treat chronic sinusitis with live kimchi, which can contain Lactobacillus sakei (see Sinusitis Treatment Story). Kimchi is a wonderful product, but... with kimchi you never know if you're getting L. sakei, and even then it dies off rapidly. We went on to experiment with other products for years, with none of them ideal. So it is great that finally, after all these years, a product like Lanto Sinus is now available.

Nice things about Lanto Sinus are that the Lactobacillus sakei strain is kimchi derived (an excellent strain!), the product holds up well, it is in powder form, easy to use, and it only needs to be refrigerated. (That's right, it's meant to be refrigerated, and not frozen.) Since it also holds up well for a time without refrigeration, it also ships well. After all, L. sakei lives and multiplies in our body at about 98.6 degrees Fahrenheit. [Please note: Even though it is shipped with an ice pack, shorter shipping (1 or 2 day shipping) in hot summer months is always preferable. Keep in mind that USPS delivers to mailboxes while UPS typically delivers packages to the door.]

Lanto Sinus is sold by Lanto Health, and shipped from the NJ/NY metro area. Lanto Sinus is a high quality product that is produced with Good Manufacturing Practices, and is lab tested and verified.

It feels gentle, yet it is strong. It is being sold as a probiotic dietary supplement. It comes in powder form with directions stating to mix with a little bottled water or take it dry, and swallow - after all, it is a dietary supplement. Lanto Sinus comes with a little spoon for ease of use. The product is meant to be used when needed for sinus support - that is, when there are some sinusitis symptoms.

I want to mention that I have been a consultant to the company, and have been testing and using the product for over 2 years. As usual, I self-experimented various ways to see what works best for me - but of course, only using it when needed (for example, if I start to slide into sinusitis after a cold). After 6 years of self-experimentation in various ways my sinus microbiome has improved, so at this point I only need to use a little bit for successful results. What works for me is swishing a little of the dry powder in the mouth, then swallow it, and not drinking or eating for a least 30 minutes after that (to let it travel to the sinuses). Yes, I like the product a lot!

By the way, the advice to use only when needed - should be applied to any probiotic  supplement that is used as a sinusitis treatment or for sinus support. And as I describe in The One Probiotic That Treats Sinusitis - based on my family's experiences and many people contacting me - most people are helped by Lactobacillus sakei, but not all. Unfortunately there is no way to know if L. sakei will treat a person's sinusitis unless it is tried. This is because everyone's sinus microbiome (microbial community) is different - and so how one reacts to different probiotics can vary. By the way, L. sakei does not appear to treat allergies or allergy symptoms.

Finally, I want to point out that currently all probiotics in the United States are sold as dietary supplements and not as treatments. The FDA (Food and Drug Administration) at this time does not allow any medical treatment claims for any probiotic sold. Using a probiotic dietary supplement in ways other than label directions is SELF-EXPERIMENTATION. [See Sinusitis Treatment Summary page for self-experimentation details - the different ways people use L. sakei products.]

[FEB. 2019 UPDATE: Lanto Sinus was originally called Lacto Sinus. On February 3, 2019 the company changed the name to Lanto Sinus in order to get a trademark. It is the exact same product - the only change is the name. This post has been updated to reflect the name change.

Read the The Best Probiotic For Sinus Infections - results from many people using Lactobacillus sakei and other probiotic sinusitis treatments.]

And on a final note, some other news about L. sakei: According to several studies, when taken orally (swallowed) Lactobacillus sakei appears to be beneficial in certain skin conditions such as atopic eczema-dermatitis syndrome and atopic dermatitis. Another study found that patients with ischemic strokes had decreased numbers of Lactobacillus sakei in the gut (as compared to healthy individuals).  It's an interesting microbe!

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It's official. This month is 5 whole years being free of chronic sinusitis and off all antibiotics! Yes, that's correct - 5 whole years for all 4 family members, and our sinuses feel great!

Back in February 2013 - first I, and then the rest of my family, started using easy do-it-yourself sinusitis treatments containing the probiotic (beneficial bacteria) Lactobacillus sakei. Now we only treat with a L. sakei  product when occasionally needed - and it still works great. In fact, the best way to use Lactobacillus sakei is to use only when there are sinusitis symptoms, and not when feeling well. The whole process still feels miraculous.

After reading the original ground-breaking research on sinusitis done by Abreu et al (2012), it led to me trying L. sakei as a sinusitis treatment. Of course, there is an entire community of microbes (bacteria, fungi, viruses) that live in healthy sinuses - the sinus microbiome - but L. sakei seems to be a key one for sinus health. Since that original 2012 study, other studies have also found that in people with chronic sinusitis, the sinus microbial community is out of whack (dysbiosis). 

The one thing different this past year is that our sinus microbial community (sinus microbiome) seems better. If we need to treat (for example, after a virus that goes into sinusitis, or when sliding toward sinusitis for whatever reason), then all four of us noticed that we need to use much less of a product than in the past. Incredibly little. So it seems that our sinus microbial community has definitely improved over time.

The post The One Probiotic That Treats Sinusitis (originally posted January 2015 and with many updates since then) contains information using my family's experiences (lots of self-experimentation!) and all the information that people have given me over the years. Thanks everyone! The post has a list of brands and products with L. sakei, treatment results, as well as information about some other promising probiotics (beneficial bacteria).

Thank you all who have contacted me  - whether publicly or privately. Please keep writing and tell me what has worked or hasn't worked for you as a sinusitis treatment. If you find another bacteria or microbe or product that works for you - please let me know. It all adds to the sinusitis treatment knowledge base. I will keep posting updates. 

(NOTE: I wrote our background story - Sinusitis Treatment Story back in December 2013, there is a  Sinusitis Treatment Summary page with the various treatment methods quickly discussed, and the latest information on The Best Probiotic For Sinus Infections. One can also click on SINUSITIS under CATEGORIES to see more posts about what is going on in the world of sinusitis research.)

It's now 4 years being free of chronic sinusitis and off all antibiotics! Four amazing years since I (and then the rest of my family) started using easy do-it-yourself sinusitis treatments containing the probiotic (beneficial bacteria) Lactobacillus sakei. My sinuses feel great! And yes, it still feels miraculous.

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 (bacteria, fungi, viruses) that live in healthy sinuses - the sinus microbiome - but L. sakei seems to be a key one for sinus health.

I just updated the post The One Probiotic That Treats Sinusitis (originally posted January 2015) using my family's experiences (lots of self-experimentation!) and all the information that people have sent me. The post has a list of brands and products with L. sakei, treatment results, as well as information about some other promising probiotics (beneficial bacteria). Thank you so much!

Thank you all who have written to me  - whether publicly or privately. Please keep writing and tell me what has worked or hasn't worked for you as a sinusitis treatment. If you find another bacteria or microbe or product that works for you - please let me know. It all adds to the sinusitis treatment knowledge base. I will keep posting updates. 

(NOTE: I wrote our background story - Sinusitis Treatment Story back in December 2013, there is also an updated  Sinusitis Treatment Summary page with the various treatment methods quickly discussed, and latest information on everything: The Best Probiotic For Sinus Infections. One can also click on SINUSITIS under CATEGORIES to see more posts about what is going on in the world of sinusitis research.)

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People assume that taking probiotics results in the beneficial probiotic bacteria colonizing and living in the gut (or sinuses when using L. sakei). It is common to hear the phrase "take probiotics to repopulate the gut" or "improve the gut microbes". The human gut microbiota (human gut microbiome) refers to all the microbes that reside inside the gut (hundreds of species). Probiotics are live bacteria, that when taken or administered, result in a health benefit. But what does the evidence say?

First, it is important to realize that currently supplements and foods contain only a small variety of probiotic species, with some Lactobacillus and Bifidobacterium species among the most common. But they are not the most common bacteria found in the gut. And very important bacteria such as Faecalibacterium prausnitzii (a reduction of which is associated with a number of diseases) are not available at all in supplements. One problem is the F. prausnitzii are "oxygen sensitive" and they die within minutes upon exposure to air, a big problem when trying to produce supplements.

The evidence from the last 4 years  of L. sakei use for sinusitis treatment is that for some reason, the L. sakei is not sticking around and colonizing in the sinuses. My family's experiences and the experience of other people contacting me is that every time a person becomes sick with a cold or sore throat, it once again results in sinusitis, and then another treatment with a L. sakei product is needed to treat the sinusitis. And of course this has been a surprise and a big disappointment.

The same appears to be true for probiotics (whether added to a food or in a supplement) that are taken for other reasons, including intestinal health. Study after study, and a review article, finds that the beneficial bacteria do not colonize in the gut even if there are health benefits from the probiotics. That is, there may be definite health benefits from the bacteria, but within days of stopping the probiotic (whether in a food or a supplement) it is no longer found in the gut. Researchers know this because they can see what bacteria are in the gut by analyzing (using modern genetic sequencing tests) what is in the fecal matter (the stool).

However, the one exception to all of the above is a fecal microbiota transplant (FMT) - which is transfer of fecal matter from one person to another. There the transplanted microbes of the donor do colonize the recipient's gut, referred to as "engraftment of microbes". Some researchers found that viruses in the fecal matter helped with the engraftment. So it looks like more than just some bacterial strains are involved. Another thing to remember is that study after study finds that dietary changes result in microbial changes in the gut, and these changes can occur very quickly.

From Gut Microbiota News Watch: Learning what happens between a probiotic input and a health output

What scientists know is that probiotics in healthy individuals are associated with a number of benefits. Meta-analyses of randomized, controlled trials show that probiotics help prevent upper respiratory tract infections, urinary tract infections, allergy, and cardiovascular disease risk in adults. But between the input and the output, what happens? A common assumption is that probiotics work by influencing the gut microbe community, leading to an increase in the diversity of bacterial species in the gut ecosystem and measurable excretion in the stool.

But this theory doesn’t seem to be true, according to a recently published systematic review by Kristensen and colleagues in Genome Medicine. Authors of the review analyzed seven studies and found no evidence that probiotics have the ability to change fecal microbiota composition. So even though individuals in the different studies were ingesting live bacterial species, the bacteria didn’t stick around to increase the diversity of the gut fecal microbiota.

Do probiotics alter the fecal composition of healthy adults? The answer seems to be no,” says Dr. Mary Ellen Sanders, Executive Science Officer for the International Scientific Association for Probiotics and Prebiotics (ISAPP)....Dr. Dan Merenstein, Research Division Director and Associate Professor of Family Medicine at Georgetown University Medical Center in Washington, DC (USA), agrees. “Initially when probiotics were studied, some people expected to see permanent colonization. We now realize that is unlikely to occur,” he says. “This study shows that the probiotics tested to date do not result in overarching bacterial community structure changes in healthy subjects. But clinical effects are clearly demonstrated for probiotics, and likely some are mediated by microbiome changes.

At issue, then, is not what probiotics do for healthy individuals, but exactly how they work: the so-called ‘mechanism’. Sanders, who described some alternative mechanisms in her BMC Medicine commentary about the Kristensen review, points out a logical error in news stories worldwide that covered the article: the assumption that if probiotics fail to change the microbiota composition, they fail to have any health effects. Sanders emphasizes that probiotics might work in many possible ways. “Probiotics may act through changing the function of the resident microbes, not their composition. They may interact with host immune cells,” she says. “They may inhibit opportunistic pathogens that are not dominant members of the microbiota. They may promote microbiota stability… .” 

After writing about Lactobacillus sakei in the sinuses for several years (present in healthy sinuses, absent or less in those with chronic sinusitis, and also a treatment for chronic sinusitis), I wondered whether L. sakei is found anywhere else in the body. Today I read a study (conducted in Japan) about gut microbes and strokes and there it was - the presence of L. sakei in the gut. Specifically, a study found that people who have ischemic strokes tend to have lower amounts ("depletion") of L. sakei in the gut than healthy people, even though it was detected in 80% of both groups.

The study found that in people with ischemic strokes there was evidence for the gut microbes being out of whack (dysbiosis), as well as more inflammation, and more of certain bacteria species (Atopobium cluster and Lactobacillus ruminis), and depletion of L. sakei bacteria. The researchers took samples of stool (fecal samples) from each person of both groups (ischemic stroke group and healthy group) and analyzed the stool with modern tests (genetic sequencing) to see whether 22 groups of bacteria were in it. (Note that there are normally hundreds of species of bacteria living in a healthy person's gut, as well as viruses, fungi, etc.).

So once again it looks like L. sakei may be beneficial bacteria, even in the gut. The researchers were careful to point out that they couldn't say that certain bacteria caused the strokes - just that there was an association. And what diet is associated with lower levels of inflammation in the body? Once again - a diet with lots of fruits, vegetables, whole grains, nuts, seeds, and legumes (think Mediterranean style diet). You want to feed the beneficial bacteria in the gut. Excerpts from a research article by Yamashiro et al in PLoS One:

Gut dysbiosis is associated with metabolism and systemic inflammation in patients with ischemic stroke

The role of metabolic diseases in ischemic stroke has become a primary concern in both research and clinical practice. Increasing evidence suggests that dysbiosis is associated with metabolic diseases. The aim of this study was to investigate whether the gut microbiota, as well as concentrations of organic acids, the major products of dietary fiber fermentation by the gut microbiota, are altered in patients with ischemic stroke, and to examine the association between these changes and host metabolism and inflammation. We analyzed the composition of the fecal gut microbiota and the concentrations of fecal organic acids in 41 ischemic stroke patients and 40 control subjects via 16S and 23S rRNA-targeted quantitative reverse transcription (qRT)-PCR and high-performance liquid chromatography analyses..... Although only the bacterial counts of Lactobacillus ruminis were significantly higher in stroke patients compared to controls, multivariable analysis showed that ischemic stroke was independently associated with increased bacterial counts of Atopobium cluster and Lactobacillus ruminis, and decreased numbers of Lactobacillus sakei subgroup, independent of age, hypertension, and type 2 diabetes....Together, our findings suggest that gut dysbiosis in patients with ischemic stroke is associated with host metabolism and inflammation.   ...continue reading "Gut Bacteria Associated With Strokes"

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As you may have noticed, I write about the beneficial bacteria Lactobacillus sakei a lot. This is because it has turned out to be a great treatment for both chronic and acute sinusitis for my family and others (see post The One Probiotic That Treats Sinusitis). We originally found it in kimchi (it occurs in the kimchi during normal fermentation), but not all kimchi brands. Kimchi is a mix of vegetables (including typically cabbage) and seasonings, which is then fermented for days or weeks before it is eaten.

Why is L. sakei found in some kimchi, but not all? Which vegetable or spice is needed or important for encouraging L. sakei growth? It turns out it is not the cabbage - which is why L. sakei is not found in sauerkraut. A recent study looking at several kimchi samples found that garlic seems to be important for the development of various Lactobacillus bacteria, of which L. sakei is one. The results mean that raw garlic has very low levels of L. sakei, and it multiplies during kimchi fermentation. Note that as fermentation progresses, the bacterial species composition in the kimchi changes (this is called ecological succession). Korean studies (here and here) have consistently found L. sakei in many brands of kimchi (especially from about day 14 to about 2 or 2 1/2 months of fermentation), but not all kimchi brands or recipes. L.sakei, of which there are many strains, is so beneficial because it "outcompetes other spoilage- or disease-causing microorganisms" and so prevents them from growing (see post).

Excerpts are from the blog site Microbial Menagerie: MICROBES AT WORK IN YOUR KIMCHI

Cabbage is chopped up into large pieces and soaked in salt water allowing the water to draw out from the cabbage. Other seasonings such as spices, herbs and aromatics are prepared. Ginger, onion, garlic, and chili pepper are commonly used. The seasonings and cabbage are mixed together. Now the kimchi is ready to ferment. The mixture is packed down in a glass container and covered with the brining liquid if needed. The kimchi sits at room temperature for 1-2 days for fermentation to take place....Kimchi does not use a starter culture, but is still able to ferment. Then where do the fermentation microbes come from?

Phylogenetic analysis based on 16S rRNA sequencing indicates that the kimchi microbiome is dominated by lactic acid bacteria (LAB) of the genus Leuconostoc, Lactobacillus, and Weissella. Kimchi relies on the native microbes of the ingredients. That is, the microbes naturally found on the ingredients. Because of this, there may be wide variations in the taste and texture of the final kimchi product depending on the source of the ingredients. In fact, a research group from Chung-Ang University acquired the same ingredients from different markets and sampled the bacterial communities within each of the ingredients. The group found a wide variability in the same ingredient when it was bought from different markets. Surprisingly, the cabbage was not the primary source of LAB. Instead, Lactic acid bacteria was found in high abundance in the garlic samples

Note that Lactobacillus sakei is an example of a lactic acid bacteria. More study details from  the Journal of Food Science: Source Tracking and Succession of Kimchi Lactic Acid Bacteria during Fermentation.

This study aimed at evaluating raw materials as potential lactic acid bacteria (LAB) sources for kimchi fermentation and investigating LAB successions during fermentation. The bacterial abundances and communities of five different sets of raw materials were investigated using plate-counting and pyrosequencing. LAB were found to be highly abundant in all garlic samples, suggesting that garlic may be a major LAB source for kimchi fermentation. LAB were observed in three and two out of five ginger and leek samples, respectively, indicating that they can also be potential important LAB sources. LAB were identified in only one cabbage sample with low abundance, suggesting that cabbage may not be an important LAB source.

Bacterial successions during fermentation in the five kimchi samples were investigated by community analysis using pyrosequencing. LAB communities in initial kimchi were similar to the combined LAB communities of individual raw materials, suggesting that kimchi LAB were derived from their raw materials. LAB community analyses showed that species in the genera Leuconostoc, Lactobacillus, and Weissella were key players in kimchi fermentation, but their successions during fermentation varied with the species, indicating that members of the key genera may have different acid tolerance or growth competitiveness depending on their respective species.

Although W. koreensis, Leu. mesenteroides, and Lb. sakei were not detected in the raw materials of kimchi samples D and E (indicating their very low abundances in raw materials), they were found to be predominant during the late fermentation period. Several previous studies have also reported that W. koreensis, Leu. mesenteroides, and L. sakei are the predominant kimchi LAB during fermentation (Jeong and others 2013a, 2013b; Jung and others 2011, 2012, 2013a, 2014). 

An interesting study that compared bacterial communities between healthy children and those that have a history of acute sinusitis (but not chronic sinusitis). The study specifically looked at the nasopharyngeal (NP)  microbiome (community of microbes) over the course of one year in the 2 groups of children, who were between the ages of 4 and 7. Nasopharyngeal pertains to the nose or nasal cavity and pharynx. They used modern methods of genetic analysis to test for bacterial species - and found a total of 951 species among the 47 children, of which 308 species had some "depletion" among those children with a history of sinusitis, and one species was increased in "abundance".

NP samples from children with a prior history of acute sinusitis were characterized by significant depletion of bacterial species, including those in the Akkermansia, Faecalibacterium prausnitzii, Clostridium, Lactobacillus, Prevotella, and Streptococcus species. But there was a siignificant increase "in relative abundance" in the bacterial species Moraxella nonliquefaciens. Once again, a study shows bacterial communities to be "out of whack" in those who've had sinusitis - this time in children. And the diminished diversity was linked to more frequent upper respiratory illnesses. The researchers mention the "possibility that the manipulation of the airway microbiota" could help prevent childhood respiratory diseases. Research by C.A. Santee et al from the Microbiome journal at BioMed Central:

Nasopharyngeal microbiota composition of children is related to the frequency of upper respiratory infection and acute sinusitis

Upper respiratory infections (URI) and their complications are a major healthcare burden for pediatric populations. Although the microbiology of the nasopharynx is an important determinant of the complications of URI, little is known of the nasopharyngeal (NP) microbiota of children, the factors that affect its composition, and its precise relationship with URI.

Healthy children (n = 47) aged 49–84 months from a prospective cohort study based in Wisconsin, USA, were examined. Demographic and clinical data and NP swab samples were obtained from participants upon entry to the study. All NP samples were profiled for bacterial microbiota using a phylogenetic microarray, and these data were related to demographic characteristics and upper respiratory health outcomes. The composition of the NP bacterial community of children was significantly related prior to the history of acute sinusitisHistory of acute sinusitis was associated with significant depletion in relative abundance of taxa including Faecalibacterium prausnitzii and Akkermansia spp. and enrichment of Moraxella nonliquefaciens. Enrichment of M. nonliquefaciens was also a characteristic of baseline NP samples of children who subsequently developed acute sinusitis over the 1-year study period. Time to develop URI was significantly positively correlated with NP diversity, and children who experienced more frequent URIs exhibited significantly diminished NP microbiota diversity (P ≤ 0.05). 

These preliminary data suggest that previous history of acute sinusitis influences the composition of the NP microbiota, characterized by a depletion in relative abundance of specific taxa. Diminished diversity was associated with more frequent URIs

....These observations indicate that the composition of the pediatric upper airway represents a critical factor that may either potentiate or protect against infection by respiratory pathogens. They also indicate that the interplay between the bacterial microbiota and respiratory pathogens associated with upper airway infection is important to consider.Both bacteria and viruses can influence each other’s pathogenicity [8] and a number of interactions between specific viruses and bacterial species have been reported in the airways [910]. For example, human rhinovirus infection was found to significantly increase the binding of Staphylococcus aureus, S. pneumoniae, or H. influenzae to primary human nasal epithelial cells [11]....

A total of 951 taxa were identified in baseline NP microbiota of participants (n = 47) in our cohort. These bacterial communities were variably composed of members of the Rickenellaceae, Lachnospiraceae, Verrucomicrobiaceae, Pseudomonadaceae, and Moraxellaceae as well as multiple unclassified members of the phylum Proteobacteria. .... Our study used independent NP samples collected from individual participants over a 12-month study period that spanned all four seasons. Season of sample collection also demonstrated a relationship with bacterial beta-diversity.

Compared with children who had no history of acute sinusitis (n = 33), those with a past history of acute sinusitis (n = 14) did not exhibit differences in α-diversity indices, suggesting that differences in microbiota characterizing these groups may be due to the enrichment or depletion of a subset of taxa within these bacterial communities. A total of 309 taxa (representing 101 genera) exhibited significant differences in relative abundance between children with and without a history of acute sinusitis. NP samples from children with a prior history of acute sinusitis were characterized by significant depletion of 308 of the 309 taxa, including those represented by Akkermansia, Faecalibacterium prausnitzii, Clostridium, Lactobacillus, Prevotella, and Streptococcus species. The only taxon that exhibited a significant increase in relative abundance in these subjects was represented by Moraxella nonliquefaciens. 

Children who experienced at least one URI (n = 17) within 60 days of collection of the baseline sample had significantly lower phylogenetic diversity compared to those who had no URIs within that time frame (n = 23). Time to development of URI, defined as the number of days between the collection of the baseline sample and the first incidence of URI (a value of 365 days was assigned to those children who did not experience a URI during the year of monitoring), was also significantly correlated with phylogenetic diversity .... Hence, these data indicate that diminished diversity of the NP microbiota is a precursor to URI in these children.  

In addition to Moraxella, a Corynebacterium was enriched in relative abundance in the NP microbiota of children who experienced acute sinusitis subsequent to baseline sample collection during the study period. ... However, Abreu et al. previously found Corynebacterium tuberculostearicum to be significantly enriched in the maxillary sinuses of adults with chronic rhinosinusitis compared to healthy control subjects [17]. The authors subsequently confirmed the ability of C. tuberculostearicum to induce acute sinusitis in the context of an antimicrobial-depleted murine model of sinus infection. Moreover co-installation of Lactobacillus sakei (one of a number of taxa acutely depleted in relative abundance among chronic rhinosinusitis patients) protected animals against C. tuberculostearicum infection [17]. Our pediatric data exhibits similarity with these murine studies, in that six members of the Lactobacillus genus were among those taxa most significantly depleted in relative abundance in the NP bacterial communities of children who developed sinusitis during our study. Five of these same taxa were also depleted in relative abundance in the NP microbial communities of children with a prior history of sinusitis. 

In addition to Lactobacillus, many other bacterial taxa including Akkermansia, Faecalibacterium prausnitzii, Clostridium, Prevotella, and Streptococcus species were depleted in relative abundance among children with a prior history of acute sinusitis. Though traditionally associated with gut microbiota, anaerobic bacterial species can exist in biofilms in the upper respiratory tract [18] and Akkermansia  and Faecalibacterium have previously been detected in the nasopharynx of children [1920]. While its role in the airway is unknown, gastrointestinal Akkermansia muciniphilia metabolizes mucin and has been shown to activate immune homeostasis, increasing host expression of antimicrobial peptides such as RegIIIγand improving barrier function via an increase in 2-oleoylgylcercerol [212223]. However, whether such mechanisms play a role at the airway mucosal surface remains to be determined. 

Mechanisms by which Lactobacillus and other bacterial species depleted in the NP microbiota of sinusitis patients may prevent the development of disease include competitive exclusion of pathogenic species. A previous murine study indicated that intra-nasal inoculation of mice with L. fermentum decreased S. pneumoniae burden throughout the respiratory tract and increased the number of activated macrophages in the lung and lymphocytes in the tracheal lamina propria [24]. Hence, it is plausible that the absence of NP genera with known competitive exclusion and immunomodulatory capabilities leads to pathogen expansion and associated clinical manifestations of upper airway infection. 

....We do show that a history of sinusitis, its pathophysiology or treatment, may shape the NP microbiota—which may inform future studies and their design. Additionally, though we recognize that the composition of the microbiota in the upper airways is likely highly influenced by antibiotic administration .... The pervasive effects of antimicrobials on the human microbiota are well-described [2627], and it is likely that lifetime antibiotic use plays an important role in shaping the baseline NP microbial community

The composition of the NP microbiota in healthy children between 49 and 84 months of age is associated with past and subsequent history of acute sinusitis and frequency of URI. Widespread bacterial taxon depletion and enrichment of M. liquefaciens and C. tuberculostearicum are associated with upper airway infection and the development of acute sinusitis. Collectively, these findings provide evidence of close connections between microbial colonization of the airways and susceptibility to upper respiratory illnesses in early childhood and raise the possibility that the manipulation of the airway microbiota could be applied to the prevention of childhood respiratory illnesses.