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Probiotics, Leaky Gut and Autoimmune Diseases

I am hopeful you all had a wonderful holiday season and will enjoy a healthy and successful New Year.

January is the month in which we make resolutions to exercise, eat healthy and maybe lose a few of those unwanted pounds.

This month’s newsletter discusses another reason why you should consider adding EndoMune to your list of healthy things to do.

Leaky Gut Makes Way for Harmful Toxins

I want to begin 2012 by sharing with you an important probiotic benefit that I haven’t previously mentioned. The term “leaky gut” has been around for a long time. It has been used more in the alternative medicine sector to explain a variety of health issues(2).

Conventional medicine now recognizes the importance of a healthy intestinal barrier against toxins and harmful intestinal organisms. When there is a breakdown in this barrier, the disorder is decsribed as “increased intestinal permeability”(3) – or, in other words, leaky gut.

In the November issue of the medical journal, Clinical Reviews in Allergy and Immunology, Dr. Alessio Fasano (Director of the University of Maryland Center for Celiac Research) published an article on “Leaky Gut and Autoimmune Diseases”(4).

As a pediatric gastroenterologist and research scientist, he has developed a theory on how a leaky gut can contribute to autoimmune disorders such as:

  • Celiac disease
  • Inflammatory bowel disease
  • Type 1 diabetes
  • Multiple sclerosis
  • Rheumatoid arthritis

Evolution of a Healthy Intestinal Barrier

As man evolved, it was critical to develop a mechanism that would allow humans to coexist with intestinal organisms like bacteria and parasites. Some of the organisms were beneficial but others could invade and cause serious infections and death.

Fortunately, the intestinal lining cells acts as an effective barrier between the internal and external environment. From a physical standpoint, the lining is similar to a brick wall. The bricks are the intestinal cells and the mortar is the “tight junction” between the cells. The tight junction is made up of secreted proteins that make the lining impermeable to some of the gut contents. The healthy intestinal bacteria – like those in probiotics – help maintain the intestinal barrier by stimulating the production of tight junction proteins.

One of the major proteins in the tight junction is called zonulin. “Zonulin works like the traffic conductor or the gatekeeper of our body’s tissues. Zonulin opens the spaces between cells allowing some substances to pass through while keeping harmful bacteria and toxins out(5),” explains Dr. Fasano. “It has a major effect on intestinal permeability.

Zonulin: A Contributor to Autoimmune Diseases

Studies suggest that increased levels of zonulin are a contributing factor to the development of autoimmune diseases. Zonulin weakens the other proteins making up the tight junction resulting in increased intestinal permeability.

In individuals with a genetic predisposition to autoimmune disorders, a leaky gut exposes their immune cells to proteins in bacteria, viruses and other environmental agents. They then develop antibodies which cross react to their own cells resulting in a variety of autoimmune diseases.

Dr. Fasano performed a clinical trial in patients with celiac disease. This disorder is due to an immune reaction against gluten proteins in grains. The studies found that when individuals with a genetic predisposition to celiac disease were challenged with gluten, there was a 70% increase in intestinal permeability and an increase in zonulin. By giving a drug that blocks the activity of zonulin, however, there was no increase in permeability when exposed to gluten. Additionally, the patients didn’t develop diarrhea or symptoms associated with celiac disease.

When the healthy intestinal balance is disturbed by such diverse things as repeated antibiotic exposure, stress or alcohol misuse, the harmful bacteria are then able to penetrate the tight junctions and invade the wall of the intestines. The result is increased permeability and immune inflammation.

There are a number of studies on how probiotic bacteria stimulate the production of tight junction proteins and prevent increased intestinal permeability(6,7,8).

This is a very exciting time in intestinal permeability research and understanding how to lessen the risk of developing an autoimmune disease.

I am amazed how intestinal bacteria and specifically probiotic bacteria have such an impact on our overall health!

Take Home Message

If you or any of your family members suffer with an autoimmune disorder, check with your doctor about the benefits of taking a probiotic like EndoMune.

Eat healthy, exercise, take EndoMune and live well!

Best Wishes,
Dr. Hoberman

References

(1) Developmental biology of gut-probiotic interaction Ravi Mangal Patel, Patricia W Lin Gut Microbes. 2010 May-Jun; 1(3): 186–195. Published online 2010 May 26. doi:

(2) A brief evidence-based review of two gastrointestinal illnesses: irritable bowel and leaky gut syndromes. Kiefer D, Ali-Akbarian L. Altern Ther Health Med. 2004 May-Jun; 10(3):22-30; quiz 31, 92.

(3) Intestinal permeability, leaky gut, and intestinal disorders. Hollander D. Curr Gastroenterol Rep. 1999 Oct; 1(5):410-6.

(4) Leaky Gut and Autoimmune Diseases. Fasano A.Clin Rev Allergy Immunol. 2011 Nov 23.

(5) Physiological, Pathological, and Therapeutic Implications of Zonulin-Mediated Intestinal Barrier Modulation : Living Life on the Edge of the WallAlessio Fasano Am J Pathol. 2008 November; 173(5): 1243–1252

(6) Therapeutic manipulation of the enteric microflora in inflammatory bowel diseases: antibiotics, probiotics, and prebiotics.Sartor RB Gastroenterology. 2004 May ;126(6):1620

(7) VSL#3 probiotics regulate the intestinal epithelial barrier in vivo and in vitro via the p38 and ERK signaling pathways.Dai C, Zhao DH, Jiang M.Int J Mol Med. 2012 Feb;29(2):202-8. doi: 10.3892/ijmm.2011.839. Epub 2011 Nov 15.

(8) Molecular regulation of the intestinal epithelial barrier: implication in human diseases.Liu Z, Shi C, Yang J, Zhang P, Ma Y, Wang F, Qin H.Front Biosci. 2011 Jun 1;17:2903-9. Review.

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