Drug interactions Archives

Healthy Bugs Prevent Depression and Gut Distress

Children’s Health, Drug interactions / By Staff Writer

This month I am discussing some new, exciting research on the effect of probiotics on the gut-brain axis(1). Before proceeding, I think it is best to explain the relationship between the intestines and the brain.

We have all experienced the effect of this axis. Most of us have been in a situation where we become very anxious about an upcoming event – making a presentation, taking an exam – and, as a result, developed a terrible gut pain or “knot.”

As quickly as the pain surfaced, it similarly eases when the stressful event resolves. When this happens, we don’t develop an ulcer or any other structural intestinal problem. So what physically happened to cause this pain?

The brain releases chemicals that travel through the blood stream (or nerves) to the gut. The major nerves between the brain and intestines are called the vagus and the sympathetic nerves. The “knot” commonly experienced during stressful events is a result of the nerve endings releasing chemicals that cause spasms of the intestines and activation of the intestinal pain fibers.

Now, let’s get really geeky to explain how this happens in more detail. The gut-brain axis consists of:

(1) Vagus and sympathetic nerves that send messages to:

Stimulate or inhibit stomach and intestinal secretions
Increase or decrease stomach and intestinal motility
Enhance or decrease appetite
Transmit pain sensation from the gut to the brain
Alter our mood …positively or negatively

2) Hormones secreted by the brain and gut that stimulate or suppress the hunger and satiety centers in the brain affecting dietary intake. It is very common for people to attribute weight loss to stress. Their appetite seems to have just “disappeared.”

What really happened was that the emotional stress sent hormones and nerve signals to the intestines causing the following:

Disruption of the healthy intestinal balance of the bacteria.
Multiplication of the unhealthy bacteria, causing intestinal inflammation.
Release of chemicals by the inflamed intestines, stimulating the satiety center in the brain – resulting in loss of appetite.
Once the stress is resolved, both the healthy bacteria and appetite will return.

Be Happy…Take a Probiotic!

With this brief background, we will explore more clearly how intestinal bacteria can be impacted by stress and how probiotic bacteria can improve our mood. It is a two way street.

A research article published this month in the prestigious medical journal Proceedings of the National Academy of the Sciences discusses how probiotic bacteria may lessen anxiety and depression and help to maintain a positive attitude(3).

The point of the study was to determine how bacteria dwelling in the gut can effect the brain, and thereby influence mood and behavior. Since there are special neurotransmitters in the brain that impact mood, the researchers sought to evaluate whether these receptors could be modified by probiotics.

The researchers split their rodent subjects into two groups. One lot was fed a special broth containing Lactobacillus rhamnosus. The other group was fed an ordinary diet not fortified with microbes.

The mice were subjected to a battery of tests that measured their emotional state. The results indicated that the mice fed Lactobacillus performed more activities in a maze which indicated confidence and less anxiety. They were able swim in a container farther indicating a more positive mood.

Direct measurements of the animals’ brains supported the behavioral results. Levels of cortisone, a stress hormone, were significantly lower in the bacteria-fed mice than they were in the control group.

In addition, the number of neurotransmitter receptors was higher in the mood altering portion of the brain. Stimulation of these receptors results in sensations of relaxation and euphoria.

Finally, to prove that the vagus nerve is responsible for transmitting signals from the gut to the brain, the study was done again. But in the second study, the vagus nerve was severed in both groups of mice. The results of the repeat study revealed that the behavior in the two groups of mice was the same. The probiotic fed mice didn’t demonstrate the same activities which had been associated with confidence, less anxiety and a more positive mood. The damaged vagus nerve couldn’t transmit the benefits of the probiotics to the brain.

At this point you may say “well that is very interesting but we are not mice. Are there studies in humans that also show similar results?”

A recent study in the British Journal of Nutrition(4) assessed whether a daily dose of a Lactobacillus and Bifidobacterium probiotic taken for 30 days could influence the psychological impact of everyday life events in normal human volunteers.

By using standardized psychological tests, the scores of the probiotic treated group had lower values for depression, anger-hostility and physical complaints.

The authors concluded that the beneficial effects of the probitotics may be explained by competitive exclusion of harmful gut bacteria and a decrease in inflammatory signals via the vagus nerve to the brain!

Take Home Message

If you are feeling a little “blue” or just want to feel positive about life, consider taking a beneficial probiotic like EndoMune. The best part of these studies is that there were no adverse effects of probiotics – no need for a black box!

Read about the latest research on the gut-brain axis in 2025 on this blog.

References

(1) Gut-brain axis. Romijn JA, Corssmit EP, Havekes LM, Pijl H. Curr Opin Clin Nutr Metab Care. 2008 Jul;11(4):518-21.

(2) The new link between gut-brain axis and neuropsychiatric disorders. Fetissov SO, Déchelotte P.Curr Opin Clin Nutr Metab Care. 2011 Sep;14(5):477-82.

(3) Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Bravo JA, Forsythe P, Chew MV, Escaravage E, Savignac HM, Dinan TG, Bienenstock J, Cryan JF.Proc Natl Acad Sci U S A. 2011 Sep 20;108(38):16050-5.

(4) Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. Messaoudi M, Lalonde R, Violle N, Javelot H, Desor D, Nejdi A, Bisson JF, Rougeot C, Pichelin M, Cazaubiel M, Cazaubiel JM. Br J Nutr. 2011 Mar;105(5):755-64.

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Probiotics in the News

Children’s Health, Drug interactions / By Staff Writer

I receive daily emails from a number of sources about new developments in medicine, particularly in the areas of gastroenterology and probiotics.

There are two interesting articles I would like to briefly discuss this month:

Benefits of Lactobacillus probiotic bacteria against gas-producing E. Coli found in colicky infants⁽¹⁾
Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults⁽³⁾

Benefits of Probiotic Bacteria for Colicky Infants

The first report details the research that has been underway to determine how probiotics can lessen the problem of “Infantile Colic.” This is a condition in which a healthy baby shows periods of intense, unexplained fussing/crying lasting more than 3 hours a day, for more than 3 days a week over a duration of three or more continuous weeks. Parents have sleepless nights and stressful days trying to calm their baby. The pediatricians used to recommend trying simethicone drops, which works no better than tap water.

The exact cause of infantile colic is unknown, but a number of reports have associated colic to changes in the bacterial balance in a baby’s intestine.

A study published in the journal Pediatrics in 2007⁽²⁾ reported on the benefits of taking a probiotic. In the study, 83 colicky babies were divided into two groups: 41 were given a Lactobacillus probiotic and 42 babies received simethicone. The results were astounding:

After one week, babies treated with the probiotic had close to 20% less crying time

By 4 weeks, probiotic treated babies had 74% less crying
Overall, there was a 95% positive response to the Lactobacillus probiotic drops in colicky infants.

To better understand how probiotics lessen infantile colic, this study was performed to evaluated the interaction between Lactobacillus probiotics and gas-forming coliforms that were isolated from stools of colicky infants. The results showed that several strains of Lactobacillus produced antibiotics against six different species of gas-forming coliforms.

The authors concluded:

There was a greater presence of of coliform bacteria in colicky infants, and
Certain Lactobacillus probiotic bacteria can improve colicky symptoms by reducing the ability of coliform bacteria to colonize the gut.

Probiotics for Prevention of Antibiotic-Associated Diarrhea, C. Difficile

This report published in the American Academy of Nurse Practioners reviewed all the relevant studies on probiotic efficacy for preventing diarrhea and colitis due to taking antibiotics.

I have written several newsletters on how antibiotics can upset the healthy balance of the intestinal bacteria, resulting in mild diarrhea or life-threatening clostridia difficile colitis. There are a 100 trillion bacteria in the gastrointestinal tract. Generally, 85% or more are healthy beneficial bacteria that help in digestion and immunity.

Antibiotics prescribed for an infection like sinusitis or bronchitis can destroy the healthy intestinal bacteria and result in problems with diarrhea. A particular bacteria called Clostridia difficile can multiply when the healthy bacteria are destroyed.

C difficile produces toxins that cause a severe colitis. Unfortunately, this bacteria is becoming more common in hospitals and other health care facilities. As a result, the risk of developing colitis and diarrhea has increased. In 2006, it was reported that patients with C difficile colitis stayed in the hospital 3.6 days longer and the additional hospital costs averaged $3,669 per patient day.⁽⁴⁾ A conservative estimate of the cost of this disease in the United States was $3.2 billion annually.⁽⁵⁾

This report was to determine if giving probiotics to patients receiving antibiotics would lessen the risk of developing antibiotic-associated diarrhea and C difficile-associated disease.

The meta-analysis found that the administration of probiotics led to a statistically significant relative risk reduction. Compared to patients given a placebo, the patients receiving probiotics had a:

44% reduction for antibiotic-associated diarrhea
71% reduction for C difficile-associated disease

The authors concluded that administering probiotics concurrently with antibiotics in hospitalized patients could potentially lessen the healthcare spending, morbidity and mortality due to the gastrointestinal complications related to the use of antibiotics.

Articles like these two indicate the amount of research that is going on to determine the health benefits of probiotics. Since I started researching the importance of the healthy intestinal bacteria and probiotics in 2005, the amount of new scientific information published annually is amazing.

(1) Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants.Savino F, Cordisco L, Tarasco V, Locatelli E, Di Gioia D, Oggero R, Matteuzzi D. BMC Microbiol. 2011 Jun 30;11(1):157.

(2)Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Savino F, Pelle E, Palumeri E, Oggero R, Miniero R. Pediatrics. 2007 Jan;119(1):e124-30.

(3) Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults-A meta-analysis.Avadhani A, Miley H.J Am Acad Nurse Pract. 2011 Jun;23(6):269-74

(4) Health care costs and mortality associated with nosocomial diarrhea due to Clostridium difficile.Kyne L, Hamel MB, Polavaram R, Kelly CP. Clin Infect Dis. 2002 Feb 1;34(3):346-53. Epub 2001 Dec 17.

(5) Strategies to prevent clostridium difficile infections in acute care hospitals. Dubberke ER, Gerding DN, Classen D, Arias KM, Podgorny K, Anderson DJ, Burstin H, Calfee DP, Coffin SE, Fraser V, Griffin FA, Gross P, Kaye KS, Klompas M, Lo E, Marschall J, Mermel LA, Nicolle L, Pegues DA, Perl TM, Saint S, Salgado CD, Weinstein RA, Wise R, Yokoe DS. Infect Control Hosp Epidemiol. 2008 Oct;29 Suppl 1:S81-92

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Yale Workshop on Probiotics Presents New Research

Drug interactions, Probiotics / By Staff Writer

I just returned from the 3rd Yale Workshop on “Advances in Probiotic Use” and am pleased to report there is a large amount of active research in the area of the intestinal bacteria. Namely, research is examining how bacteria impact human health and disease.

Among various findings, researchers presented new information about how probiotic bacteria can modulate the intestinal immune system. They have discovered how probiotic bacteria interact with the intestinal lining cells to improve the inflammatory conditions that occur due to infection colitis and ulcerative colitis.

In addition, there were a number of discussions about how the healthy intestinal bacteria can break down or ferment indigestible dietary starches. The breakdown products (short chain fatty acids) enhance the intestinal function, improve intestinal motility and lessen the risk of colon cancer. This is called a symbiotic relationship – mutually beneficial for the human host and the bacteria.

The conclusions from the various presentations are that probiotics can:

Lessen irritable bowel syndrome symptoms
Shorten the duration of infectious diarrhea in children
Aid in the prevention of antibiotic-associated diarrhea
Aid in the management of ulcerative colitis
Aid in the prevention of childhood allergies like eczema

Transplantation Therapy to Improve Bacteria Balance

An infection with a bacterium called Clostridia difficile can cause life-threatening colitis. The infection occurs when the healthy intestinal bacteria are reduced as a result of taking an antibiotic for something like a sinus infection.

There are special antibiotics that can destroy the Clostridia difficile infection. Unfortunately, there is a tendency for the infection to recur multiple times in the same person despite taking appropriate antibiotics to kill the Clostridia difficile organisms.

In an attempt to treat Clostridia difficile, a new innovative form of therapy was also discussed. The therapy involves the transplantation of stool from healthy individuals into patients as a means to re-establish a healthy intestinal bacterial balance.

There have been a few published case reports dating back to 1958 of transplanting healthy stool into patients who had recurrent Clostridia infections, and the results were very promising. Larger trials of infusing suspensions of healthy stool into ill patients have been recently done. The results have shown a cure rate of more than 90% within two days!!

This presentation was very thought provoking. To have this type of cure rate certainly indicates the importance of the healthy intestinal bacteria. The procedure is aesthetically unpleasing, but the alternative is to give the healthy bacteria in capsule form – accomplished when probiotics are prescribed.

Take Home Message

All of the presentations at the Yale Workshop provide further evidence of the importance of a healthy balance of intestinal bacteria. In addition, the studies confirm that probiotic bacteria have many beneficial benefits in helping to improve and maintain normal intestinal immune and digestive functions.

Please consider taking a high quality probiotic like EndoMune if you are going to take antibiotics or if you are struggling with ongoing GI symptoms despite medical evaluation.

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Antibiotics Assist with Ear Infections

Children’s Health, Drug interactions, Women’s Health / By Staff Writer

The debate over whether or not to prescribe antibiotics to treat infections continues. This time, research evidence has been presented supporting antibiotics for the treatment of ear infections in children.

Recent research from the Children’s Hospital of Pittsburgh and the University of Turku in Finland both found positive results for children that had been prescribed Augmentin, versus children treated with a placebo.

As allergy season continues to heat up, the temptation to prescribe antibiotics will grow as well. What’s important to remember, though, is that antibiotics do not discriminate with regard to bacteria. Yes, the bacteria causing the infection are attacked, but so are the good bacteria that keep your lower intestines in check. This is often why many people who take antibiotics experience gastrointestinal ailments such as diarrhea.

If you are taking an antibiotic, it is advisable to take also take a probiotic. This will help to replenish the good bacteria that are being attacked by the antibiotic. In essence, you are helping to protect yourself against the unwanted digestive side effects that are often accompanied by antibiotics.

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Probiotics to Treat IBD?

Drug interactions, Healthy Aging / By Staff Writer

An article in the February 2010 issue of Journal of Medical Microbiology explores the potential of various bacteria strains to address the causes of Irritable Bowel Disease (IBD). Certain types of bacteria produce compounds that can reduce inflammation of the intestinal lining.

Nearly six months ago I wrote an article addressing the potential of bacteria within probiotics to address the issues associated with IBD. In that article I explained:

Here are the five top reasons to consider probiotics in individuals with IBD ^(3,5,6).

Probiotics adhere to the intestinal lining cells and competitively inhibit the harmful bacteria from taking up residence.
Probiotics suppress immune mediated inflammation by producing cytokines that inhibit the inflammatory process.
Probiotics produce antimicrobial products that inhibit the survival of harmful bacteria.
Probiotics enhance the intestinal lining cells health by tightening the junction between intestinal lining, thereby inhibiting the invasion by the harmful bacteria.
Probiotics have been shown to inhibit immune cells responses, which would result in further inflammation.

Researchers are now trying to identity which strains are the most effective for surviving within the intestinal tract of individuals with IBD, given their unique circumstances and depleted supply of functional bacteria.

To read more about this study, visit the Medical News Today article:
http://www.medicalnewstoday.com/articles/176550.php

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Are Bugs in the Gut Good for Your Skin

Diet, Drug interactions, Probiotics / By Staff Writer

Over the years, I have reviewed many of the diverse health benefits of probiotics, and the list keeps getting longer.

Probiotics have been shown to lessen the risk of:

Irritable Bowel Syndrome symptoms
Infectious diarrhea
Antibiotic related diarrhea
Vaginal yeast infections
Recurrent female urinary tract infections
Cold and flu illness symptoms in children
Allergy related disorders like eczema
Colon cancer

Most of the benefits of probiotics are related to their direct effects in the intestines, but there are extra-intestinal benefits.

For example, the probiotic bacteria can stimulate the intestinal immune cells to release substances into the blood stream that will then strengthen the immune cell functions in the upper respiratory tract. The result is to lessen the flu and cold symptoms of cough, runny nose and fever.

So how does taking a probiotic orally have a benefit for our skin? It has to do with modifying the reactions of the immune cells in the skin.

Numerous recent human clinical trials involving the immune system have found that probiotic supplementation might be useful in the management of skin allergies like eczema and dry skin ^(1,2,3).

Protective Function of Probiotics

There are several recent studies that have demonstrated that UV exposure induces dramatic changes in the skin’s immune functions^(4,5), and how probiotics may be protective.

Part of the aging process of the skin is related to our frequent exposure to UV radiation, which causes inflammation. The result is damage to skin collagen and cell DNA. We all know that repeated sun exposure increases the risk for wrinkles and skin cancer.

To determine if probiotics could modify the skin’s immune reaction to UV exposure, 54 volunteers were randomized in two groups (27 each group) taking a placebo or a probiotic for 8 weeks before UV exposure⁽⁶⁾. Biopsies of the skin were taken to determine the effects of the probiotic versus the placebo on the immune reaction of the skin.

The results found that the probiotic could modulate the immune reaction and lessen the inflammatory damage. The authors of the study concluded that probiotics may “represent a new strategy for photoprotection.”

There are even studies looking at a topical cream containing probiotics. A recent clinical trial demonstrated that the bacterial extracts of cultured probiotics regulated skin reactivity and dryness in healthy female volunteers⁽⁷⁾. So far these are clinical studies; there are no commercial preparations available.

The point is, though, that there is very exciting new research into how the intestinal bacteria can affect our overall health…even the skin!

I am often asked if it is worthwhile taking a probiotic daily. Several years ago I said to take them only if you have some intestinal problems, or if you are taking an antibiotic. Today, I truly believe probiotics should be considered a daily healthy supplement.

Take Home Message

If you are going on an outdoor outing, make sure you use sunscreen and take a good probiotic like EndoMune.

Eat healthy, exercise and live well!
Dr. Hoberman

(1) Probiotics and down-regulation of the allergic response. Kalliomäki MA, Isolauri E.Immunol Allergy Clin North Am. 2004 Nov;24(4):739-52

(2) The development of gut immune responses and gut microbiota: effects of probiotics in prevention and treatment of allergic disease.Rautava S, Isolauri E Curr Issues Intest Microbiol. 2002 Mar;3(1):15-22.

(3) Probiotics during the first 7 years of life: a cumulative risk reduction of eczema in a randomized, placebo-controlled trial.Kalliomäki M, Salminen S, Poussa T, Isolauri E.J Allergy Clin Immunol. 2007 Apr;119(4):1019-21. Epub 2007 Feb 7.

(4) Sunlight and skin cancer: lessons from the immune system.Ullrich SE. Mol Carcinog. 2007 Aug;46(8):629-33. Review

(5) Alterations in human epidermal Langerhans cells by ultraviolet radiation: quantitativeand morphological study.Seité S, Zucchi H, Moyal D, Tison S, Compan D, Christiaens F, Gueniche A, Fourtanier A.Br J Dermatol. 2003 Feb;148(2):291-9

(6) Probiotics for photoprotection.Guéniche A, Philippe D, Bastien P, Blum S, Buyukpamukcu E, Castiel-Higounenc I.Dermatoendocrinol. 2009 Sep;1(5):275-9

(7) Bifidobacterium longum lysate, a new ingredient for reactive skin.
Guéniche A, Bastien P, Ovigne JM, Kermici M, Courchay G, Chevalier V, Breton L, Castiel-Higounenc I.Exp Dermatol. 2010 Aug;19(8):e1-8

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Probiotics Provide Insurance Against Salmonella

Diet, Drug interactions, Healthy Aging / By Staff Writer

What do peanut butter, pistachios, cantaloupes, and eggs have in common? They have all been recent sources of Salmonella food borne illnesses in humans.

Since we are in the middle of a nationwide outbreak of a Salmonella infection due to contaminated eggs, I thought it would be of interest to discuss the benefits of probiotics against Salmonella infections.

If you are feeling paranoid about what to eat, you may feel safer taking EndoMune after reading this newsletter.

There are a number of reasons why probiotics may prevent or shorten the duration of a bout of infectious diarrhea like Salmonella.

Probiotics^(1,2,3):

Secrete bacteriocins (proteins that can kill harmful invading bacteria)
Produce products like lactic acid and hydrogen peroxide that inhibit infectious bacteria
Stimulate the intestinal immune system to release antibodies and inflammatory cells to destroy the hostile bacteria
Carpet the intestinal lining to prevent the harmful bacteria from attaching and invading the intestinal lining cells

With the knowledge that probiotics can have a beneficial effect against infectious bacteria, researchers have done several types of investigations.The following are studies where probiotics have been shown to be helpful:

Acute Infectious Diarrhea

A number of controlled trials⁽¹⁾ have compared probiotics versus placebo when treating children and adults with acute infectious diarrhea, including Salmonella. The general finding was that probiotic could reduce the duration and severity of the illness. The diarrheal illnesses were shortened, on average, 1-2 days in the individuals who were taking a probiotic.

Traveler’s Diarrhea

The cause of traveler’s diarrhea is exposure to food and water that has been contaminated with fecal matter due to poor sanitary and public health conditions. The organisms that cause the diarrhea are bacteria, viruses and parasites. Studies have found that bacteria like E. coli, Shigella, Salmonella and Campylobacter account for 80% of the episodes. There have been a number of published controlled trials giving travelers either probiotics or placebos. A review⁽⁵⁾ of 12 well done clinical trials found that probiotics were safe and generally effective in preventing traveler’s diarrhea. Compared to the travelers receiving a placebo, the probiotic travelers had about 25-50% fewer bouts of diarrhea.

Experiemental Studies

Several recent research studies have investigated how probiotics inhibit Salmonella. One study⁽⁶⁾incubated either Salmonella alone or the combination of probiotics and Salmonella on cultures of human colon cells. The immune reactions in the intestinal cells that were exposed to the probiotic with the Salmonella were much greater than that seen in the cells in contact with only the Salmonella. The study showed that the probiotics could stimulate the release of protective immune reactions against the Salmonella bacteria.

In another study⁽⁷⁾, one group of mice were fed probiotics for seven days before being challenged with Salmonella. The other group did not receive the probiotic. The survival rate was greater and the infection milder in the group receiving the probiotics. Studies of the intestinal fluid found much higher levels of antibodies against the Salmonella bacteria. Again, this would indicate that the probiotics stimulate the intestinal immune system to fight harmful intestinal bacteria.

Take Home Message

Be careful about the eggs you consume and make sure you cook them thoroughly. Avoid the runny eggs like poached eggs or eggs that are served sunny-side up. Eggs Benedict with hollandaise sauce is probably not a good idea, at least for now. You may want to consider a bowl of oatmeal until all the bad eggs are recalled.

If you are still concerned about exposure to Salmonella, consider taking a high quality probiotic like EndoMune.

Eat healthy, exercise and live well!
Dr. Hoberman

(1) Guidance for substantiating the evidence for beneficial effects of probiotics: prevention and management of infections by probiotics.Wolvers D, Antoine JM, Myllyluoma E, Schrezenmeir J, Szajewska H, Rijkers GT.J Nutr. 2010 Mar;140⁽³⁾:

(2) Probiotics have clinical, microbiologic, and immunologic efficacy in acute infectious diarrhea.Chen CC, Kong MS, Lai MW, Chao HC, Chang KW, Chen SY, Huang YC, Chiu CH, Li WC, Lin PY, Chen CJ, Li TY.Pediatr Infect Dis J. 2010 Feb;29⁽²⁾:135-8.

(3) Clinical evidence for immunomodulatory effects of probiotic bacteria.
Ruemmele FM, Bier D, Marteau P, Rechkemmer G, Bourdet-Sicard R, Walker WA, Goulet O.J Pediatr Gastroenterol Nutr. 2009 Feb;48⁽²⁾:126-41. Review

(4) Probiotics for treating infectious diarrhoea(Cochrane Review). Reviewers: Allen, Stephen J; Okoko, B; Martinez, Elizabeth G; Gregorio, Germana V; Dans, Leonila F. Review Group: Cochrane Infectious Diseases Group; Cochrane Database of Systematic Reviews; Edited/Substantively amended: 11 November 2008; Edited (no change to conclusions) this issue

(5)McFarland LV: Meta-analysis of probiotics for the prevention of traveler’s diarrhea. Travel Med Infect Dis. 2007;2:97-105

(6) Microbial products from probiotic bacteria inhibit Salmonella enteritidis 857-induced IL-8 synthesis in Caco-2 cells.Malago JJ, Nemeth E, Koninkx JF, Tooten PC, Fajdiga S, van Dijk JE.Folia Microbiol (Praha). 2010 Jul;55⁽⁴⁾:401-8. Epub 2010 Aug 3

(7) Anti-infective mechanisms induced by a probiotic Lactobacillus strain against Salmonella enterica serovar Typhimurium infection.de LeBlanc Ade M, Castillo NA, Perdigon G.Int J Food Microbiol. 2010 Apr 15;138⁽³⁾:223-31. Epub 2010 Feb 1.

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Gut Microbes: From Bugs to Drugs

Children’s Health, Drug interactions / By Staff Writer

Spring has finally arrived! With the new season, it’s time to start thinking about how you can add new healthy habits to your daily routine.

This last month I read a very interesting article⁽¹⁾ by Dr. Fergus Shanahan – the chairman of the Department of Medicine/Director of Alimentary Pharmabiotic Centre, University College Cork in Ireland. His research interest is in the area of the intestinal immune system and the way in which intestinal bacteria interact with the intestinal immunity.

The title of the article is: “Gut Microbes: From Bugs to Drugs.”

Dr. Shanahan starts by pointing out how the scientific community had been misled for decades with their efforts to determine the cause of stomach ulcers. In the 1970s, discoveries revealed that peptic ulcer is an infectious disease caused by the bacteria Helicobacter pylori⁽²⁾. Instead of the standard practice of operating on the stomach to reduce the acid production or by giving medications to lessen acid output, peptic ulcers are now cured with antibiotics!

Recently, discoveries revealed that cervical cancer is caused by a virus, and now there is a vaccine to prevent this cancer⁽³⁾ as well.

The point is that the solutions to a number of chronic human diseases will come as we gain a better understanding about how the bacteria and viruses in our environment interact with the cells in our body.

For example, new research on the cause of Crohn’s disease has discovered a genetic mutation in affected individuals⁽⁴⁾. This mutation causes the intestinal immune cells to produce an excessive immune response to normal intestinal bacteria. This inappropriate reaction results in the development of inflammatory bowel disease.

Recent studies using probiotic bacteria, like those in EndoMune, have discovered how these bacteria can down regulate the immune response that occurs in Crohn’s disease.

Segments of intestines that have been surgically removed from patients with Crohn’s disease have been cultured with certain Probiotic bacteria. These bacteria release messenger proteins that inhibit the immune mediated inflammation in the lining to the intestinal segment⁽⁵⁾.

The goal would be to develop a strain of bacteria or isolate the messenger protein that could then be used as a safe, essentially natural therapy for Crohn’s disease.

Dr. Shanahan suggests that studying how our diet, intestinal immune cells and intestinal bacteria interact can potentially lead to new drug therapies for intestinal disorders like irritable bowel disease, inflammatory bowel disease and even colon cancer.

The Implication for Future Cures

Dr. Shanahan believes that the future pharmalogic cures for intestinal disorders will come from studies on how to manipulate our intestinal bacteria with diet and probiotics. He uses the term, pharmabiotics, to refer to “any material with a potential health benefit that can be mined from the host-microbe-dietary interactions.”

An example of a pharmabiotic is ‘bacteriocin’ which is a protein produced by certain strains of bacteria that acts as an antibiotic. One strain of Streptococcus produces a bacterocin that suppresses the bacteria in the mouth that causes halitosis or bad breath.

Another bacteriocin that belongs to the family called ‘thuricin’ acts as a strong antibiotic against a bacteria called Clostridia difficle. This bacteria can cause life threatening colitis. The hope is that this chemical can be developed as a drug to use against Clostridia difficle as this dangerous bacteria is becoming resistant to the currently available antibiotics.

Research in the area of probiotics has produced a number of very interesting and potentially new therapeutic options for dealing with some chronic human illnesses.

As Dr. Shanahan titled his paper, the idea is to find “drugs from bugs.”

Reading this article provides new understanding how ongoing research is identifying the biologic benefits of probiotics. I am amazed how often someone tells me that EndoMune has made such a difference in his/her life!

Take Home Message

Probiotics can suppress harmful bacteria and down regulate intestinal inflammation. Consider EndoMune Advanced for adults or EndoMune Kids for children to help improve gastrointestinal function and ease intestinal symptoms.

Eat healthy, exercise and live well!
Dr. Lawrence Hoberman

(1) Gut microbes: from bugs to drugs.Shanahan F. Am J Gastroenterol. 2010 Feb;105(2):275-9. Epub 2010 Jan 12

(2) Helicobacter pylori’s unconventional role in health and disease. Dorer MS, Talarico S, Salama NR.PLoS Pathog. 2009 Oct;5(10):e1000544. Epub 2009 Oct 26

(3) HPV vaccination: the beginning of the end of cervical cancer? – A Review.Lepique AP et al. Mem Inst Oswaldo Cruz. (2009)

(4) The genetic basis of inflammatory bowel disease.Cooney R, Jewell D.Dig Dis. 2009;27(4):428-42. Epub 2009 Nov 4.

(5) Lactobacillus casei downregulates commensals’ inflammatory signals in Crohn’s disease mucosa.Llopis M, Antolin M, Carol M, Borruel N, Casellas F, Martinez C, Espín-Basany E, Guarner F, Malagelada JR.Inflamm Bowel Dis. 2009 Feb;15(2):275-83.

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IBS Sufferers Not at Greater Risk for Colon Cancer

Disease, Drug interactions, Probiotics / By Staff Writer

Some very reassuring news was just released from a recent research study. The study, published in the American Journal of Gastroenterology found Irritable Bowel Syndrome (IBS) patients to be at no greater risk than healthy patients for polyps, colon cancer or inflammatory bowel disease.

According to the article:

This research shows that it is unnecessary to order colonoscopies for patients with IBS, unless they show alarming symptoms like unexplained weight loss or anaemia, bleeding from the GI tract, or have a family history of colon cancer, inflammatory bowel disease, or celiac disease, says Dr. Chey.

If you’re interested in reading the article in its entirety on DocGuide.com, visit:
http://www.docguide.com/news/content.nsf/news/852576140048867C852576E20000C862

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C Difficile on the Rise Again

Disease, Drug interactions / By Staff Writer

In the past, I’ve written about the potential complications of the infection, Clostridium Difficile. Typically, the incidence of C. Diff. Minus Colitis is within hospitals amongst patients. The intensity and severity of cases outside the hospital seems to be increasing, however:

“Recent reports have shown increasing incidence and severity of infection, especially in the older population,” Dr. Darrell Pardi, a Mayo Clinic gastroenterologist and senior author of a study on the situation, said in a Mayo news release. “Our study examines why the cases are on the rise and who is getting the infection.”

C. difficile is a bacterium that can reside in our intestines and generally will not cause harm because the normal, healthy bacteria in our in gut will suppress its growth. The problem arises when we take an antibiotic. The use of antibiotics for illnesses such as respiratory and urinary infections doesn’t only destroy the infection itself, but also the good bacteria within the intestines. Once the good bugs are out of the way, the hostile C. difficile can multiply and take over the intestines.

The C. difficile bacteria produce toxins that damage the lining of the colon and cause diarrhea or even severe colitis. The infection can be life threatening, especially in elderly patients with other health issues. The frequency of having to surgically remove an inflamed colon has become an increasing occurrence.

In the meantime, be aware of this significant, potentially serious side effect of taking an antibiotic. You may want to consider taking a probiotic like EndoMune if an antibiotic is prescribed.

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