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Celiac.com 02/14/2022 - Prior studies have found links between the gut microbiome and COVID-19, along with other diseases. However, a new study by investigators at the Chinese University of Hong Kong offers the first published data specifically linking gut health to COVID's long-term effects. The research team assessed 106 patients with COVID-19 from February to August 2020, at three different hospitals, and compared their results against a group of patients recruited in 2019, who did not have COVID. Patients had mostly mild to moderate Covid severity. At 3 months, nearly ninety of the COVID patients had post–acute COVID-19 syndrome (PACS), which researchers defined as at least one persistent, otherwise unexplained symptom 4 weeks after testing negative for Covid. After six months, more than eighty patients still had PACS, with the main complaints being anxiety, fatigue, poor memory, hair loss, and difficulty sleeping. Stool sample analysis of PACS patients showed sharply lower bacteria diversity and abundance at six months, compared with with control subjects, and those without PACS. In patients with PACS, at both baseline and follow-up, nearly thirty bacteria species were reduced, while nearly fifteen were increased. Patients with COVID but not PACS showed just 25 changes to bacteria species at hospital intake, and all of those patients normalized by 6 months. The team linked patient respiratory symptoms at 6 months to higher levels of opportunistic pathogens such as Streptococcus anginosus and S. vestibularis. They also tied neuropsychiatric symptoms and fatigue to nosocomial pathogens, which are linked to opportunistic infections, such as Clostridium innocuum and Actinomyces naeslundii (P < .05). Bacteria that produce the beneficial fatty acid butyrate were substantially reduced in patients with hair loss. They also found that specific bacteria, including Bifidobacterium pseudocatenulatum and Faecalibacterium prausnitzii, showed the greatest inverse correlations with PACS at 6 months.. "Particular gut microbial profiles may indicate heightened susceptibility," said Dr Siew Ng, MBBS, PhD, associate director at the university's Center for Gut Microbiota Research. "Although the findings were drawn from patients with earlier strains of the COVID-19 virus, the findings still apply to new variants, including Omicron, since these pose the same problem of persistent disruption of the immune system," Ng adds. Dr Ng's group is currently carrying out trials to assess how long COVID might be prevented, and antibodies boosted, by modulating the microbiome after vaccination in high-risk people. "To our knowledge, this is the first study to show that altered gut microbiome composition is strongly associated with persistent symptoms in patients with COVID-19 up to 6 months after clearance of SARS-CoV-2 virus," said Dr Ng. Meanwhile, Eugene Chang, MD, professor of medicine at the University of Chicago, who has studied the gut microbiome and gastrointestinal disease, cautions that the study is "too preliminary" to lead to any clinical changes. Dr. Chang notes that the observations merely identify the microbes present, not their actual effects. Stay tuned for more on this and related stories about celiac disease and Covid. Read more in Medscape Medical News

Celiac.com 08/04/2021 - Dietary restriction of fermentable carbohydrates (a low-FODMAP diet) is getting a good deal of attention as a potential method for reducing symptoms in patients with irritable bowel syndrome (IBS), particularly in combination with a gluten-free diet. Several studies have associated IBS with dysbiosis in the gut microbiota. Additionally, a few studies have reported inflammation in the gastrointestinal (GI) system of adults with IBS. A team of researchers recently set out to investigate the effects of a low FODMAP-gluten free diet (LF-GFD) on clinical symptoms, intestinal microbiota diversity, and fecal calprotectin (FC) level in Iranian patients with IBS. The research team included Kaveh Naseri, Hossein Dabiri, Mohammad Rostami‑Nejad, Abbas Yadegar, Hamidreza Houri, Meysam Olfatifar, Amir Sadeghi, Saeede Saadati, Carolina Ciacci, Paola Iovino, and Mohammad Reza Zali. They are variously affiliated with the Celiac Disease Department, Gastroenterology and Liver Diseases; the Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and the Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Shahid Arabi Ave., Yemen St., Velenjak, Tehran, Iran. In their clinical trial study, the team put 42 IBS patients, with Rome IV criteria, on a low-FODMAP, gluten-free diet for 6 weeks and assessed symptoms using the IBS symptom severity scoring (IBS-SSS), and collected and analyzed fecal samples by quantitative 16 S rRNA PCR assay at baseline, and after the gluten-free diet. They compared gut microbiota diversity at baseline and after 6 weeks of dietary intervention, and analyzed all fecal calprotectin using the ELISA method. Thirty patients, ranging in age from about 25 to 49 years old, completed the six-week diet. After the diet, they showed substantially reduced IBS-SSS overall, compared to the baseline scores. The team noted significant microbial differences in fecal samples taken before and after the dietary period. They found a significant increase in Bacteroidetes, and a decrease in the ratio of Firmicutes to Bacteroidetes (F/B) after the dietary intervention, and also noted decreased FC values. The team's results suggest that IBS patients on a low FODMAP-gluten-free diet show marked reduction in IBS symptom severity, along with reduced FC level after normalization of gut microbiota. The team advocates for more rigorous trials to better assess long-term efficacy and safety of a a low FODMAP-gluten free diet for personalized nutrition in IBS. Read more in BMC Gastroenterol (2021) 21:292

Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease. The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up. The researchers profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease. Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp. Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp. The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis. Source: Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6

Celiac.com 10/12/2020 - Researchers have recently begun to understand that gut bacteria play a critical role in keeping people healthy. They are also beginning to understand that our poop offers an excellent glimpse into our gut health. We know that the gut microbiota of children begin to change when they get celiac disease. Low levels of certain gut bacteria correspond with higher rates of celiac disease. We also know that gut microbiomes of children with a high genetic risk for type 1 diabetes are significantly different than those of children with low genetic risk. Moreover, changing gut microbiota could protect against celiac disease. However, there's much to learn about exactly which bacteria is beneficial and which bacteria is harmful, and what the best balance of bacteria may be to help optimize our health. We do understand that one bacteria strain, bifidobacterium infantis, is beneficial to gut health. To learn more, a group of researchers conducted a study to see if they could introduce an important species of good bacteria, known as bifidobacterium infantis, into the guts of babies with deficient levels. When they did so, they found that the stool pH became much more acidic, which is a more normal gut condition. This led the team to hypothesize that lower stool pH could reflect a healthier gut, with more optimal levels of beneficial microbes. To investigate their hypothesis, the team analyzed the pH of infant stool by looking at studies from 1926 to 2017. They found that infant stool pH has risen from 5.0 to 6.5 over the last hundred years or so, meaning that is has become less acidic and more basic over the years. This is a major difference, as the pH scale runs from 0 to 14.0, with 7.0 being neutral. That change could reflect a decrease in bifidobacterium, and a reduction in gut health during that time. Normally, healthy mothers pass bifidobacterium and many other strains of gut bacteria to their babies via their breast milk. The researchers think that the reduction in bifidobacterium in infants may reflect reduced gut health in mothers doing that time. According to researcher Bethany Henrick, of Evolve BioSystems, a biomedical company in Davis, California, and her co-author Jennifer Smilowitz, a nutritional biologist at the University of California, Davis, bifidobacterium is important, because it binds exclusively to human milk oligosaccharides, which are sugars found only in breast milk. Oligosaccharides provides food bifidobacterium needs to grow and reproduce. Healthy levels of bifidobacterium in the gut help to keep bad bacteria from growing in the gut. About 80% of the cells that make up our immune systems are in our guts. "There's this intimate connection between the gut microbiome and our immune system," says Henrick. If bifidobacterium levels are low, bad bacteria can flourish. Higher levels of bad gut bacteria could tax the immune system, and promote allergies and certain autoimmune diseases. Women can promote gut health by eating a diet high in fiber, such as whole grains, nuts, seeds, legumes, fruits, and vegetables. Prior studies have shown that gut bacteria is influenced by three things: How often a baby gets antibiotics, whether they are breastfed, and whether they were delivered naturally, or via cesarean section. The researchers encourage doctors and new mothers to work to promote a healthy gut microbiome in their babies by limiting antibiotics and cesarean sections, and to breastfeed, when possible. By learning more about the role of gut bacteria and a healthy gut biome in the development of celiac disease can help us to better understand the origins of the disease, as well as how we might be able to reduce it in the future. Stay tuned for more on the role of gut bacteria in celiac disease, and related news. Read more at Pediatr Res. 2019; 86(6): 749–757.

Celiac.com 05/14/2018 - An imbalance or defect in gut bacteria function may be a major cause of hair loss and pattern baldness. Pattern baldness (alopecia areata) affects approximately 1.7 per cent of the population and we still don’t know precisely what causes it. In addition to promoting a healthy digestive tract, our gut bacteria play an important function in our overall health. Recent experiments with antibiotics and bacteria-free mice reveal how a single a single gut bacteria, Lactobacillus murinus, could cause pattern baldness by triggering deficiencies in biotin. Biotin, vitamin B7, is a crucial vitamin. Biotin deficiency can lead to skin disease and hair loss. Some bacteria in our gut produces biotin, while other bacteria breaks down and consumes biotin. Biotin deficiency is most often seen in patients with serious conditions, such as celiac disease, but it can also be common among pregnant women. Previous research has shown that bacteria-free mice that lack biotin in their diet, develop mild hair loss (alopecia). Could an imbalance or defect in gut bacteria function be a major cause of hair loss and pattern baldness? To determine if the underlying cause of hairless might be an imbalance of our gut bacteria, a team of Japanese scientists conducted experiments with antibiotics and bacteria-free mice to see if variations gut bacteria might cause pattern baldness by influencing biotin levels. The team first fed laboratory mice a diet with and without biotin, but saw no impact on hair loss. They then repeated the experiment, but this time they also gave the mice a long course of antibiotics to destroy the balance of bacteria in their gut. The laboratory mice on a biotin-free diet coupled with antibiotics saw an increase in a particular gut bacteria that corresponded to patten hair loss, as was previously shown in bacteria-free mice. By studying what had happened in the gut bacteria of these mice, the scientists discovered that a particular type of lactic acid bacteria, Lactobacillus murinus, had expanded after the antibiotic treatment. When the team fed bacteria-free mice with Lactobacillus murinus, they saw that the hair loss became even worse and the mice became almost entirely bald. Further tests followed, in which regular mice and bacteria-free mice received a regular diet with normal levels of biotin, but added Lactobacillus murinus. These mice showed no hair loss at all. Direct injections of biotin also stopped hair loss; although the team did concede that skin bacteria could also play a role. The discovery that gut bacteria and diet to influence hair loss creates new avenues for treating baldness and hair loss simply by adjusting gut microbiota. It’s possible that probiotic dietary supplements can be used to influence gut bacteria, and prevent the biotin-eating bacteria now known to cause hair loss. Stay tuned for news on the role of gut bacteria in hair loss, and on any new treatment approaches to hair loss and alopecia that may result. Their results appear in the scientific journal Cell Reports.

Celiac.com 04/25/2018 - A team of Yale University researchers discovered that bacteria in the small intestine can travel to other organs and trigger an autoimmune response. In this case, they looked at Enterococcus gallinarum, which can travel beyond the gut to the spleen, lymph nodes, and liver. The research could be helpful for treating type 1 diabetes, lupus, and celiac disease. In autoimmune diseases, such as type 1 diabetes, lupus, and celiac disease, the body’s immune system mistakenly attacks healthy cells and tissues. Autoimmune disease affects nearly 24 million people in the United States. In their study, a team of Yale University researchers discovered that bacteria in the small intestine can travel to other organs and trigger an autoimmune response. In this case, they looked at Enterococcus gallinarum, which can travel beyond the gut to the spleen, lymph nodes, and liver. They found that E. gallinarum triggered an autoimmune response in the mice when it traveled beyond the gut. They also found that the response can be countered by using antibiotics or vaccines to suppress the autoimmune reaction and prevent the bacterium from growing. The researchers were able to duplicate this mechanism using cultured human liver cells, and they also found the bacteria E. gallinarum in the livers of people with autoimmune disease. The team found that administering an antibiotic or vaccine to target E. gallinarum suppressed the autoimmune reaction in the mice and prevented the bacterium from growing. "When we blocked the pathway leading to inflammation," says senior study author Martin Kriegel, "we could reverse the effect of this bug on autoimmunity." Team research team plans to further investigate the biological mechanisms that are associated with E. gallinarum, along with the potential implications for systemic lupus and autoimmune liver disease. This study indicates that gut bacteria may be the key to treating chronic autoimmune conditions such as systemic lupus and autoimmune liver disease. Numerous autoimmune conditions have been linked to gut bacteria. Read the full study in Science.