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Massive Study Yields Exciting Findings about Gut Health and the Microbiome

Gut health could be the biggest trend in the health field right now. Everywhere I turn people are discussing the importance of their gut health and how it is linked to their overall health, as well as the benefits of probiotics. And, for good reason: a growing body of research shows that what happens in our gut expands well beyond the gut.

Now new research shows that the health of your gut is significantly influenced by what you eat. A new study assessed 15096 fecal samples provided by 11336 people, published in the journal of the American Society for Microbiology, found some exciting facts about gut health and the microbiome, which is the total of all the microbes in a living being.

We each have a microbiome and no two microbiomes are alike, although there can be some similarities between them. The microbiome is a sort of microbial fingerprint. And, thanks to the new research, we have greater insight into the effect of diet on our microbiome. Here are some of the findings from this exciting study:

1) Plant-based diets produce the most diverse microbiomes. Diverse microbiomes seem to confer health benefits. Consider people who struggle to lose weight: earlier research in the journal Beneficial Microbes shows that they tend to have less diverse strains of beneficial bacteria and a lower ratio of beneficial microbes to harmful ones.

2) Eating more than 30 types of plant foods weekly yields the most diverse microbiome. In other words, it’s important to eat a plant-based diet but also one that has tremendous diversity. So, expand your horizons when it comes to trying new vegetables, fruits, nuts, seeds and grains. Your microbiome will thank you. And, who knows? You might even discover a new favorite food.

3) There is a lower incidence of bacterial resistance in those who eat the greatest variety of plant foods weekly. This is great news since more and more varieties of harmful bacteria like E. coli and MRSA are, not only becoming more prevalent, they are also becoming resistant to the typical drug treatment: antibiotics. This is an astounding discovery on its own. We tend to assume that all of a certain variety of bacteria have the same level of potency against humans, but the research shows that people who eat a large variety of plant-based foods are less likely to be host to these disease-causing, resistant bacteria. People who ate more than 30 types of plant foods weekly had less resistance to antibiotics.

4) The gut bacteria of people suffering from mental health issues, including: post-traumatic stress disorder (PTSD), schizophrenia, depression or bipolar disorder were more similar to others suffering from mental disorders than to those who do not suffer from mental disorders. While the scientists conducting the study did not draw any conclusions, there may be a possible connection between gut health and mental health. Certainly other research suggests that is indeed the case. Research in the Journal of Physiological Anthropology found a link between gut bacteria and increased activity in brain pathways that improve brain health and reduce depression risk.

microbiome

How can you reap the benefits of this exciting research?

There are endless ways to boost the variety of plant-based foods you consume, but the following ones should help you get started:

  1.    Start by replacing meat in your diet with plant-based options. Start with Meatless Mondays but don’t hesitate to go meatless the rest of the week as well
  2.    The next time you pass by that odd-looking fruit or vegetable in the produce section of your grocery store, add it to your cart. It’s easy enough to find recipes for lesser-known foods using a quick Internet search. And, most importantly, add the food to your diet.
  3.    Instead of just snacking on almonds or another nut, branch out to try Brazil nuts, cashews, hazelnuts, pecans, pistachios, etc. Choose raw, unsalted varieties.
  4.    Rather than just add a can of kidney beans to your soup, stew, or chili, opt for bean varieties you are less familiar with. That could include: chickpeas, lentils, pinto beans, Romano beans, black beans, navy beans, etc.
  5.    The next time a snack attack strikes, choose a piece of fruit or a bowl of mixed berries.
  6.    When you have a craving for salty foods, choose traditionally-fermented pickles, pickled green beans, pickled beets or other foods with live cultures. Not only will you be getting a wider variety and a greater quantity of plant-based foods, you’ll also help expand the beneficial microbes you consume. Be sure to choose pickled foods that state “live cultures” or “unpasteurized” on the label.

 

Dr. Michelle Schoffro Cook, PhD, DNM is the publisher of the free e-newsletter World’s Healthiest News, the Cultured Cook, co-founder of BestPlaceinCanada, and an international best-selling and 20-time published book author whose works include: The Cultured Cook: Delicious Fermented Foods with Probiotics to Knock Out Inflammation, Boost Gut Health, Lose Weight & Extend Your Life.

By: Michelle Schoffro Cook May 31, 2018
 Follow Michelle at @mschoffrocook
 
source: www.care2.com
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Three Things to Boost Your Immune Health

Are you trying to get through flu season without catching a cold or getting sick? Make sure to follow these three habits as part of your immune boosting care kit:

1. Eat well

Having a well-balanced antioxidant rich diet is the most effective immune-boosting nutrition strategy. Carbohydrates, lean protein and healthy fats are great to fill up on immune boosting nutrients like vitamin C, D, iron, zinc and magnesium.

Consider adding at least two to three antioxidant rich foods at each meal. These can be citrus fruits, whole grains, nuts/seeds, and dark coloured vegetables such as spinach or peppers.

The body’s immune cells feed on carbohydrates, and with the natural drop in blood sugar that occurs during exercise, having good pre- and post-training nutrition is key to keeping your immune system fuelled. Aim to have a snack before and after your training. If you’re running for longer than an hour, consider having a gel or sport drink.

2. Love friendly bacteria

Friendly bacteria in your gut or “probiotics” have been shown to have a positive effect on immune health. Before heading to buy a probiotic supplement, try to first increase probiotic intake through the diet.

Many foods are naturally high in probiotics such as yogurt, aged cheeses, Kefir, Kombucha, miso, tempeh and kimchi. Aim to have two to three probiotic rich foods per day to populate your gut friendly bacteria.

3. Spice up your diet

Many herbs and spices like ginger, turmeric, mint and cinnamon have anti-inflammatory and antibacterial properties contributing to a healthy immune system. Aim to include herbs and spices daily, for example add cinnamon to peanut butter toast, smoothie or an oatmeal bowl.

Choose fresh ginger, as it is best consumed uncooked, and grate into soups. Add turmeric to curry stews or make homemade spiced roasted nuts. Try adding fresh mint leaves to your salad or infusing the leaves to make tea.

The list is endless, get creative and spice up your diet.

by Melissa Kazan MSc, RD,  SportMedBC’s registered dietitian and sport nutritionist 
February 4, 2018


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The Type of Probiotic That May Reverse Depression

The probiotic buffered the body against the damaging effects of stress.

Depression has been reversed in mice by feeding them probiotic bacteria, new research reports.

Lactobacillus is a type of ‘good’ bacteria found in yogurt, among other foods.

The role of the gut microbiome — the bacteria which live in our gut — has become a focus of research interest recently.

Dr Alban Gaultier, who led the study, said:

“The big hope for this kind of research is that we won’t need to bother with complex drugs and side effects when we can just play with the microbiome.
It would be magical just to change your diet, to change the bacteria you take, and fix your health — and your mood.”

The scientists found that when mice in the study were put under stress, the bacteria in their gut changed.

The main change was a reduction in Lactobacillus, which was linked to depressed behaviour in the mice.

Feeding them Lactobacillus almost completely stopped their depressive behaviours.

pickles

The researchers found a mechanism for how this change in the gut led to depression (it is through a metabolite called kynurenine).

First author, Ms Ioana Marin said:

“This is the most consistent change we’ve seen across different experiments and different settings we call microbiome profiles.
This is a consistent change.
We see Lactobacillus levels correlate directly with the behavior of these mice.”

The researchers plan to continue investigating kynurenine’s role in depression, Ms Marin said:

“There has been some work in humans and quite a bit in animal models talking about how this metabolite, kynurenine, can influence behavior.
It’s something produced with inflammation that we know is connected with depression.
But the question still remains: How?
How does this molecule affect the brain?
What are the processes?
This is the road we want to take.”

The study was published in the journal Scientific Reports (Marin et al., 2017).
MARCH 15, 2017
source: PsyBlog


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Is Chronic Mouthwash Use Endangering Your Beneficial Bacteria?

New study out of the journal Nitric Oxide links mouthwash use to diabetes.

It sounds like one of those spurious correlations that show up whenever you sift through large piles of data, such as the supposed link between cheese consumption and death from bedsheet strangulation.

But the results of a new epidemiological study linking mouthwash use and diabetes risk are – to all appearances, at least – a real effect, with fascinating implications for our understanding of the complex links between health, athletic performance and the trillions of bacterial cells that inhabit our bodies. A cleaner mouth, it turns out, isn’t always better.

The new study, which appears in the December issue of the journal Nitric Oxide, analyzes data from a longitudinal study of 945 adults in Puerto Rico who were followed over a period of three years. Just less than half of the participants reported using mouthwash regularly, and those who gargled at least twice a day were roughly 50-per-cent more likely to develop prediabetes or diabetes than those who used it less frequently or not at all.

“Most over-the-counter mouthwashes contain antibacterial ingredients,” explains Dr. Kaumudi Joshipura, an epidemiologist at the University of Puerto Rico and Harvard University who led the study, “which could destroy or inhibit oral microbes, some of which may be beneficial for metabolic health.”

This is an idea that’s already familiar to elite endurance athletes. Over the past decade, beet juice has emerged as a powerful and ubiquitous performance enhancer, because it enables muscles to consume less oxygen during exercise. The key component of beet juice is nitrate, which is converted by bacteria in the mouth to nitrite, which is in turn converted to nitric oxide, a powerful signalling molecule with wide-ranging beneficial effects in the body.

Earlier studies had already shown that mouthwash, by killing the bacteria that convert nitrate to nitrite, breaks this chain reaction and negates the immediate performance benefits of beet juice. It also wipes out acute gains in blood pressure and insulin sensitivity. But the new Puerto Rican study is the first to extend these findings to chronic health effects measured outside the laboratory. Since nitric oxide plays a role in determining how muscles use glucose, Joshipura hypothesizes that it is loss of oral bacteria that convert nitrate to nitrite that leads to higher diabetes risk in heavy mouthwash users.

It’s tempting, then, to wonder how we can nurture the “good” nitrate-converting bacteria while suppressing the “bad” oral bacteria that contribute to gum disease, bad breath and tooth decay. But it’s not that simple, says Dr. Anni Vanhatalo, an exercise physiology researcher at the University of Exeter in Britain who studies dietary nitrate but wasn’t involved in the new study.

“It’s about a balance,” she says. “We have around 700 species of bacteria in our mouths, most or all of which have the potential to be pathogenic in large numbers. In that sense there are no ‘good’ or ‘bad’ bacteria.”

That’s similar to our emerging understanding of the complexity of gut bacteria, where greater diversity, rather than any particular superbug, is associated with better health. And chronic mouthwash use, Vanhatalo says, can be likened to the effect of antibiotics on gut bacteria. “Few would contemplate going on antibiotics permanently,” she says, “while more than 20 per cent of Americans use mouthwash daily.”

Where is the ideal balance? Vanhatalo suggests that brushing your teeth with toothpaste twice a day is about right. Joshipura notes that the people in her study who reported using mouthwash just once a day didn’t have any elevated risk of prediabetes or diabetes, but adds that further evidence is needed to make recommendations.

“People with specific oral conditions may need to use mouthwash as prescribed, usually for short duration,” Joshipura says. “However, we are concerned that mouthwash is often used routinely long-term in the absence of specific oral needs, without awareness of potential long-term effects.”

Finally, if all this sounds a little gloomy, it’s worth concluding on a more positive note. The negative effects of blocking nitrate conversion are, in a way, a reminder of all the benefits you can get from nitrate-rich foods – in addition to beets, leafy greens like arugula and spinach are very high in nitrates, as are rhubarb and celery – if you don’t block them.


Alex Hutchinson’s new book, Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance, will be published in February. Follow him on Twitter @sweatscience.

ALEX HUTCHINSON        SPECIAL TO THE GLOBE AND MAIL       JANUARY 14, 2018


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Lactic Acid Bacteria Can Protect Against Influenza A Virus

Lactic acid bacteria, commonly used as probiotics to improve digestive health, can offer protection against different subtypes of influenza A virus, resulting in reduced weight loss after virus infection and lower amounts of virus replication in the lungs, according to a study led by Georgia State University.

Influenza virus can cause severe respiratory disease in humans. Although vaccines for seasonal influenza viruses are readily available, influenza virus infections cause three to five million life-threatening illnesses and 250,000 to 500,000 deaths worldwide during epidemics. Pandemic outbreaks and air transmission can rapidly cause severe disease and claim many more human lives worldwide. This occurs because current vaccines are effective only when vaccine strains and circulating influenza viruses are well matched.

Influenza A virus, which infects humans, birds and pigs, has many different subtypes based on hemagglutinin (HA) and neuraminidase (NA) proteins on the surface of the virus. There are 18 different HA and 11 different NA subtype molecules identified, which indicates numerous HA and NA influenza virus combinations. As a result, it’s important to find ways to provide broad protection against influenza viruses, regardless of the virus strain.

Fermented vegetables and dairy products contain a variety of lactic acid bacteria, which have a number of health benefits in addition to being used as probiotics. Studies have found some lactic acid bacteria strains provide partial protection against bacterial infectious diseases, such as Streptococcus pneumoniae, as well as cold and influenza viruses.

This study investigated the antiviral protective effects of a heat-killed strain of lactic acid bacteria, Lactobacillus casei DK128 (DK128), a promising probiotic isolated from fermented vegetables, on influenza viruses.

Mice pretreated with DK128 intranasally and infected with influenza A virus showed a variety of immune responses that are correlated with protection against influenza virus, including an increase in the alveolar macrophage cells in the lungs and airways, early induction of virus specific antibodies and reduced levels of pro-inflammatory cytokines and innate immune cells. The mice also developed immunity against secondary influenza virus infection by other virus subtypes. The findings are published in the journal Scientific Reports.

“We found that pretreating the mice with heat-killed Lactobacillus casei DK128 bacteria made them resistant to lethal primary and secondary influenza A virus infection and protected them against weight loss and mortality,” said Dr. Sang-Moo Kang, lead author of the study and professor in the Institute for Biomedical Sciences at Georgia State. “Our results are highly significant because mice pretreated with DK128 had 100 percent survival and prevention of weight loss. This strain of lactic acid bacteria also equipped mice with cross-protective immunity against secondary lethal infection with influenza virus. Protection against influenza virus infection was not specific to a particular strain of influenza.

“Our study provides evidence that heat-killed lactic acid bacteria could potentially be administered via a nasal spray as a prophylactic drug against non-specific influenza virus infections.”

The researchers pretreated mice intranasally with heat-killed DK128 and then infected them with a lethal dose of influenza A virus, subtype H3N2 or H1N1. Mice pretreated with a low dose of DK128 showed 10 to 12 percent weight loss, but survived the lethal infection of H3N2 or H1N1 virus. In contrast, mice pretreated with a higher dose of heat-killed DK128 did not show weight loss. Control mice, which were not pretreated with DK128, showed severe weight loss by days eight and nine of the infection and all of these mice died.

Mice that received heat-killed lactic acid bacteria (DK128) prior to infection had about 18 times less influenza virus in their lungs compared to control mice.

Next, the researchers tested protection against secondary influenza virus infection by infecting pretreated mice with a different influenza A subtype from their primary virus infection. For the secondary virus infection, mice were exposed to H1N1 or rgH5N1.

The study’s results suggest that pretreatment with lactic acid bacteria, specifically DK128, equips mice with the capacity to have protective immunity against a broad range of primary and secondary influenza A virus infections.

Co-authors of the study include Drs. Yu-Jin Jung, Young-Tae Lee, Vu Le Ngo, Eun-Ju Ko and Ki-Hye Kim of the Institute for Biomedical Sciences at Georgia State; Drs. Young-Hee Cho, Sung-Moon Hong, Cheol-Hyun Kim of Dankook University; Drs. Ji-Hun Jang and Joon-Suk Oh of Tobico Inc.; Dr. Min-Kyung Park of Chungwoon University and Dr. Jun Sun of the University of Illinois at Chicago.

The study is funded by the National Institute of Allergy and Infectious Diseases and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health and the United States Department of Defense.

Story Source:
Materials provided by Georgia State University. Note: Content may be edited for style and length.   December 13, 2017

Journal Reference:
Yu-Jin Jung, Young-Tae Lee, Vu Le Ngo, Young-Hee Cho, Eun-Ju Ko, Sung-Moon Hong, Ki-Hye Kim, Ji-Hun Jang, Joon-Suk Oh, Min-Kyung Park, Cheol-Hyun Kim, Jun Sun, Sang-Moo Kang. Heat-killed Lactobacillus casei confers broad protection against influenza A virus primary infection and develops heterosubtypic immunity against future secondary infection. Scientific Reports, 2017; 7 (1) DOI: 10.1038/s41598-017-17487-8


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Is Strep Linked to Scary Kids’ Behavior Disorder?

When Garrett Pohlman was diagnosed with strep throat in 2007, his illness didn’t respond to antibiotics. Then the strange behaviors began.

Diana Pohlman says her son, who was 7 years old at the time, had been easygoing up to that point. But he developed severe obsessive compulsive disorder (OCD) symptoms overnight. He became paranoid – worrying about things like radiation from the TV and light switches. He had tics and anorexia and started having frequent episodes of rage.

“He was not anyone I recognized. He was a completely different child,” she says. “It was a nightmare. At first I thought maybe he had been molested. Then I thought he had a brain tumor.

“He became so delusional he would climb on the roof thinking it was the front door. He would jump in front of cars and out of moving cars, and he had self-harm fantasies. He was afraid to leave the house. We had to pick him up and wrap him in a sheet to get him out of the house. At the age of 7,” Pohlman says.

 

He was not anyone I recognized.
He was a completely different child.
Diana Pohlman

The search for answers was long and expensive. After many months, the family found their way to a psychiatrist who knew about a disorder called pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, or PANDAS, a condition she says several specialists didn’t know about. That led to medical treatment that included long-term antibiotics, having his tonsils and adenoids removed, and eventually two rounds of immunoglobulin, or IVIG treatments.

Recovery was slow, but after 2 years, by the age of 9, Pohlman says the severe symptoms stopped. For another 2 years, he had what she calls mild and manageable symptoms that eventually dissipated.

But rather than move on from PANDAS, the boy’s mother decided she needed to help other parents trying to figure out these mysterious symptoms. She founded the nonprofit PANDAS Network in 2009 to raise awareness, support families, and push for more research to better understand how to diagnose and treat the condition.

“When I realized doctors didn’t understand it, I thought I better not quit working on this because how will anyone else ever get help,” Pohlman explains. “It is abysmal. It has been shocking how misinformed doctors are about the term ‘PANDAS.’ ”

Little is known about how or why the syndrome happens, and not all doctors believe there is a connection. The American Academy of Pediatrics does not recognize a link between strep and the syndrome.

“You will not find consensus from pediatric infectious disease doctors that PANDAS even exists, much less what to do about it and how to manage the patients,” says Meg Fisher, MD, a pediatrician and infectious disease specialist at Unterberg Children’s Hospital at Monmouth Medical Center in Long Branch, NJ. “We still haven’t had the definitive article or study or demonstration to really get some solid clinical evidence behind this. My problem is, even if you believe in the syndrome, it’s totally unclear what you should do to help those patients. All of the information is anecdotal.”

What Is PANDAS/PANS?

Susan E. Swedo, MD, at the National Institute of Mental Health (NIMH), first identified PANDAS in the 1990s after she reported on a link between the fast onset of OCD and group A streptococcus, more commonly known as strep.

You will not find consensus from pediatric infectious disease doctors that PANDAS even exists, much less what to do about it and how to manage the patients.
Meg Fisher, MD, Unterberg Children’s Hospital, Monmouth Medical Center

PANDAS happens when strep triggers a misdirected immune response that causes inflammation in a child’s brain. Pediatric acute-onset neuropsychiatric syndrome, or PANS, is a larger umbrella term that has to do with cases with a trigger other than strep, including infections like walking pneumonia or the flu.

Both disorders appear in childhood, typically between the ages of 3 and 12. While blood tests may help identify infections, there are no lab tests or other indicators for PANDAS or PANS.

Doctors diagnose the syndrome when children suddenly get severe OCD or eat a lot less food, along with at least two of the following symptoms: anxiety, depression, irritability or aggression, behavioral regression, ADD- or ADHD-like symptoms affecting schoolwork, sensory or motor problems, troubled sleep, and frequent urination.

The PANDAS Network says in some cases, the emotional symptoms can weaken children and make them homebound. Other children are OK at school but fall apart at home. The NIMH describes the start of symptoms as “dramatic,” happening “overnight and out of the blue.”

“The consensus of scientists and clinicians is that it needs to be sudden and severe,” says Margo Thienemann, MD, co-director of the PANS program at Stanford University Medical Center in California. “Sudden can be overnight. Some people can say exactly what time it started or that it happened over a couple of days. But they all say this isn’t their child anymore. Even if they don’t believe someone can be possessed, it feels that way. What happened? Why are they doing these things? Why can’t they stop?”

Swedo estimates that it impacts about 1% of elementary school-aged children and is likely under-diagnosed. The PANDAS Network estimates 1 in 200 children have it. Thienemann says her program at Stanford has seen more than 250 patients since it started in 2012. But she says that since their staff is small, they have to narrow down who gets in. One year, they turned away 1,000 patients because they couldn’t handle any more.

Thienemann says this is why they have helped write guidelines to allow health care providers to identify and treat these children. “It takes a multidisciplinary team to manage. A psychiatrist, pediatrician, or rheumatologist can’t do it alone. You need all these different vantage points to diagnose and coordinate care,” she says.

There are now PANS centers in California and Arizona, and some doctors around the country treat the disorder.

The NIMH says research suggests IVIG can ease symptoms and may be used in severe PANDAS cases, but it warns it has many side effects — including nausea, vomiting, headaches, and dizziness — and there is a chance of infection with this sort of procedure. Parents say it is also expensive and often not covered by insurance.

Some families say they also see improvement when they have their children’s tonsils and adenoids removed, although no studies show that works.

streptococcus pneumonia bacteria

Controversy

Not all in the medical community agree that strep or other infections can trigger these kinds of behaviors. There is also much debate about whether treatments are effective.

While the American Academy of Pediatrics does not recognize a link between strep and PANDAS, a March 2017 article in AAP News, sent to the group’s 66,000 pediatrician members, discusses the disorders and the controversy around them. While it’s not the group’s official policy, the article says pediatricians should consider PANS anytime a child “has an abrupt behavior change with obsessive thoughts,” and it points them to material that shows them how to diagnose it.

Fisher says it’s complicated for pediatricians, since there is no evidence that taking out tonsils and adenoids is helpful or that antibiotics work. She says many pediatricians worry that young patients will become resistant to antibiotics if you prescribe them long-term, and many have concerns about IVIG side effects.

“I understand the parents’ frustration, because finding a physician for these patients is very difficult. There are a lot of doctors who are, quote unquote, PANDAS specialists, but there is nothing that is evidence-based about what they are doing,” she says. “Our goal is first do no harm, and it is hard to know how best to help these patients. It is a very frustrating thing. I wish someone would come up with some solutions.”

Thienemann says most parents who find their way to her program are frantic because they can’t get help anywhere else. “Part of that desperation is nobody would listen to them. People say my pediatrician won’t do anything, and my child is trying to jump out of moving cars or a window. They can’t get out of the house, can’t sleep, are urinating on themselves, and have severe separation anxiety,” she says.

 

There is something medically wrong. There isn’t a finger to be pointed. There are questions to be asked and answered.
Ali Claypoole

Parents say it is obvious something isn’t right.

“I thought she had schizophrenia or severe mental illness,” says Kelly, a mother in Maryland who asked that we not use her last name to protect the privacy of her 7-year-old daughter, Maggie, who has PANDAS. “It was rapid-onset OCD, and then we were spending our entire life trying to keep her from jumping out of cars, hurting herself, biting us, and losing her mind.”

“There is something medically wrong. There isn’t a finger to be pointed. There are questions to be asked and answered,” adds Ali Claypoole, whose son, now 9 years old, first showed PANDAS symptoms at the age of 6. “Our world is turned upside down, and from where I am, it’s almost like parents are more informed than the doctors. I find the civilian community is much more understanding, interested, and willing to learn about this than the medical community. It makes me mad.”

Going Forward

More research is now being done.

In a 2017 large-scale study of key parts of the PANDAS theory, researchers looked at 17 years of data out of Denmark and found that young patients with a positive strep test had higher chances of having of mental disorders, especially OCD and tic disorders, compared with those without a positive strep test. Non-strep throat infections also carried a higher chance of these types of mental disorders in children, although it was less – perhaps pointing to the chance that other infections can trigger the symptoms.

It is really the brain inflammation  
that is central to this disease.
Dritan Agalliu, PhD, Columbia University Medical Center

In 2016,  Dritan Agalliu, PhD, an assistant professor in the Department of Neurology at Columbia University Medical Center in New York City, published a study showing that immune cells produced in the nose after multiple strep infections appear to be the culprit for the disease. These cells enter the brain via the nerves that are responsible for the sense of smell, and they damage the blood vessels and synapses in the brain.

Agalliu says this research helped explain a crucial step in the disease: how antibodies that the body makes to attack strep or other infections cross the blood/brain barrier in these children and attack parts of their brain by mistake; similar to what happens in other autoimmune diseases of the brain, like multiple sclerosis.

The NIHM recently awarded Agalliu nearly $2 million to keep studying the disorder. He says it should be called post-streptococcal basal ganglia encephalitis, or inflammation of the brain. He’s also doing research funded by a private donor, looking at genetic chances of having the disorders to understand why a small number of children who get multiple strep infections are prone to get the disease.

“It is really the brain inflammation that is central to this disease. If we think about PANDAS/PANS this way, it will relieve a lot of controversy and make therapies more acceptable for patients,” Agalliu says. “I am hoping with our next publication, we can alleviate any potential question that this is an autoimmune disease.”

There’s also increasing interest in looking at PANDAS as a type of Sydenham chorea, defined by abnormal movements, OCD, mood swings, and other emotional symptoms that follow strep infection.

The NIMH now has a group for PANDAS and PANS. The PANDAS Network is working to make information about the disorders part of continuing medical education for pediatricians, and a working group has created handouts to educate school personnel nationwide to help children with these disorders get back to their classrooms.

So will children outgrow PANDAS? Like most other things associated with this disorder, there is no consensus.

Doctors who focus on the disorders say when patients can get to them, improvement is possible. “If we get people as early as possible, maybe even at the onset of illness, I think we do a good job of being able to tamp down inflammation and help them a lot and maybe get them all the way better,” Thienemann says. “If someone has been dealing with it for 10 years, I think they may develop ongoing autoimmune problems and there may be damage to their brain. Recovery might not be as complete, but I think we can still help them.”

Three years after he first showed symptoms, Claypoole’s son had a full remission at the age of 9 after IVIG treatments. But after a few months, he got strep again and the PANDAS symptoms returned, but they were less severe. Kelly’s daughter Maggie has seen her symptoms subside for a while, only to return. Her doctors prescribe antibiotics and anti-inflammatories after each new episode. She takes both medications daily for months on end. She has also had two rounds of IVIG. “Every time we do an intervention, the baseline gets better, but it doesn’t end the problem. She is not symptom-free,” Kelly says.

Pohlman says her son, now 17, is a straight-A student who plays football and the cello and is applying to college. He is symptom-free.

“Once I understood that Garrett’s brain was on fire from an infectious illness, I barely could believe his body would have the capacity for a full recovery,” she says. “Could he have the normal life I had expected for my child? So I look at him now in amazement.”

 

By Jennifer Clopton       Nov. 10, 2017     WebMD Article Reviewed by Hansa D. Bhargava, MD on November 10, 2017

Sources
Ali Claypoole, Maryland.
Kelly, Maryland. (Requested not using last name)
Dritan Agalliu, PhD, Columbia University Medical Center, New York City.
Meg Fisher, MD, Unterberg Children’s Hospital at Monmouth Medical Center, Long Branch, NJ.
Diana Pohlman, executive director, PANDAS Network, Stanford, CA.
Patricia Rice Doran, EdD, associate professor, Department of Special Education, Towson University, Maryland.
Margo Thienemann, MD, Stanford University School of Medicine, Stanford, CA.
AAP News: “PANDAS/PANS treatments, awareness evolve, but some experts skeptical.”
American Academy of Pediatrics Red Book: “Group A Streptococcal Infections.”
National Institute of Mental Health: “PANDAS, Questions and Answers.”
National Institute of Mental Health: “Guidelines published for treating PANS/PANDAS.”
PANDASNetwork.org: “What is PANS?” “What is PANDAS?” Symptoms,” “Statistics,” “Our Mission.”
K. Chang, Journal of Child and Adolescent Psychopharmacology, Feb. 1, 2015.
R. Kurlan, Pediatrics, June 2008.
S Orlovska, JAMA Psychiatry, July 1, 2017.
K.A. Williams, Brain Research, August 18, 2015.
T Dileepan, The Journal of Clinical Investigation, January 4, 2016.

source: WebMD 


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Gut Bacteria ‘Boost’ Cancer Therapy

Bacteria living in the murky depths of the digestive system seem to influence whether tumours shrink during cancer therapy, say French and US researchers.

They tested the microbiome – the collection of microscopic species that live in us – in cancer patients.
Two studies, in the journal Science, linked specific species and the overall diversity of the microbiome to the effectiveness of immunotherapy drugs.

Experts said the results were fascinating and held a lot of promise.

Our bodies are home to trillions of micro-organisms and the relationship between “us” and “them” goes far beyond infectious diseases.

The microbiome is involved in digestion, protection from infection and regulating the immune system.

  • Gut bugs ‘help prevent allergies’
  • Parkinson’s disease ‘may start in gut’

Both studies were on patients receiving immunotherapy, which boosts the body’s own defences to fight tumours.

It does not work in every patient, but in some cases it can clear even terminal cancer.

Survival

One study, at the Gustave Roussy Cancer Campus in Paris, looked at 249 patients with lung or kidney cancer.

They showed those who had taken antibiotics, such as for dental infection, damaged their microbiome and were more likely to see tumours grow while on immunotherapy.

One species of bacteria in particular, Akkermansia muciniphila, was in 69% of patients that did respond compared with just a third of those who did not.

Boosting levels of A. muciniphila in mice seemed to also boost their response to immunotherapy.
Meanwhile, at the University of Texas MD Anderson Cancer Center, 112 patients with advanced melanoma had their microbiome analysed.

Those that responded to therapy tended to have a richer, more diverse microbiome than those that did not.

And they had different bacteria too. High levels of Faecalibacterium and Clostridiales appeared to be beneficial, while Bacteroidales species were bad news in the study.

‘Game-changing’

Tissues samples showed there were more cancer-killing immune cells in the tumour of people with the beneficial bacteria.

The team then performed a trans-poo-sion, a transplant of faecal matter, from people to mice with melanoma.

Mice given bacteria from patients with the “good” mix of bacteria had slower-growing tumours than mice given “bad” bacteria.

Dr Jennifer Wargo, from Texas, told the BBC: “If you disrupt a patient’s microbiome you may impair their ability to respond to cancer treatment.”
She is planning clinical trials aimed at altering the microbiome in tandem with cancer treatment.
She said: “Our hypothesis is if we change to a more favourable microbiome, you just may be able to make patients respond better.
“The microbiome is game-changing, not just cancer but for overall health, it’s definitely going to be a major player.”

Promising

Mark Fielder, president of the Society for Applied Microbiology and professor of medical biology at Kingston University, said the study showed the importance of understanding the micro-organisms that call our bodies home.

He told the BBC: “It’s really interesting and holds a lot of promise, we need to do more work but there are exciting glimmers here in treating some difficult diseases.
“Some claim the microbiome is the answer to everything, I don’t think that’s the case.
“But once we understand more, it could be that microbiome manipulation is important in changing people’s health.”

Dr Emma Smith from Cancer Research UK, said: “It’s fascinating.

“One of the big challenges for using immunotherapies to treat cancer is understanding which patients will respond, and this research is a step towards helping doctors to identify these people.”

By James Gallagher    Health and science correspondent, BBC News    3 November 2017 
 
source: www.bbc.com