Role of Microflora in CFS / FM / IBS

A few years ago, a section on the gut for CFS and its bacteria would have been just a sentence and not a chapter. The involvement of the gut would likely be a description of poor absorption of nutrients only. Recent studies have suggested that the gut’s bacteria or microfloras may play a major, possibly dominant role, in CFS. Microbiota has a role in immune regulation, and changes in gut microbiota may be the basis for an increased incidence of autoimmune diseases and asthma in developed countries[663]. microfloras do impact stress response.

A 2010 study alters the relationship between microfloras and disease greatly. The study found that metabolic profiles based on bacterial structural components and metabolites are disease-specific. In other words, the pathogens determine different microfloras mixtures. The mixture is almost a fingerprint for the pathogen! Each microfloras produces different mixtures of amino acids, inflammatory chemicals, etc. Some specific microfloras convert food more efficiently than others and thus have been associated with obesity[665] [666]. Other microfloras impact the respiratory immune system and appear to be seeded by the birth process (quasi-inherited). Fecal transplants are most successful when the donor is a blood relative.

Of special interest to CFS patients, is the association of microfloras changes with sleep disorders, as well as behavioral changes in IBS. 92% of CFS patients in one study had IBS. We are not talking about minor changes of microfloras, but large shifts in microfloras populations.

Each person has a unique microfloral signature

We should note that we are talking about a lot of different types and species of bacteria. A total of 947 Bacteroides and 745 Clostridium strains were isolated from 67 healthy and 94 anti-microbial treated children in one study. For each family, over a thousand strains may be seen. Eliminating the harmful ones and encouraging the helpful ones is a task for researchers for decades to come. Shift of strains percentage in a species may be a significant factor that has only been lightly explored. There are more than a 1000 species that commonly live in and on the healthy human body. Each person harbors around 150 species, mostly in the gut (Nature, Volume 464, p. 56,18 March 2010). This unique profile is being investigated as equivalent (or better) than a fingerprint (New Scientist, Volume 215, no. 2875, p. 36, 28 Jul 2012). Identical twins who can rarely be distinguished by DNA are easily distinguished by the use of skin bacteria. A very old Dr.Who episode, used as a story-device, a scanner that determined who was the last person holding an object. This was science fiction then; today it has been demonstrated that a skin bacteria fingerprint will remain, and be detected for up to two weeks on computer mice, keyboards, and tables (Proceeding of the National Academy of Science, Volume 107 p. 6477).

CFS microfloras

Our current knowledge on CFS microfloras is limited, but there are many shifts of families of microfloras from those seen in controls.

  • High Enterobacter species (240%)
  • High Fungi
  • High Gram positive D/L lactate producing bacteria
  • High Klebsiella/Enterobacter
  • High Streptococcus
  • Low Escherichia coli[698](50% less) in 62% of CFS Patients
  • Low Bacteroides species in 25% of CFS Patients
  • Low Bifidobacterium species (30%)
  • Low Lactobacillus species.

This was done from a sample of CFS patients, and these individuals are expected to have different shifts depending on their pathogens (and their genes). This simple model explains the wide variety of laboratory manifestations and symptoms seen in CFS. The pathogens, microfloras, and genes determine the clinical manifestations.

Microfloras encourages pathogens

The triggering event for CFS may be changes of the microfloras that ended up activating pathogens altering microfloras further. Consider a change of microfloras that decreases lysine and increases arginine production: this combination is known to reactivate some herpes viruses. Over production of trypsin reactivates influenza viruses. microfloras and pathogens are a two way street. Pathogens alter microfloras; microfloras reactivates pathogens.

A second route arises from a surprising finding about the high incidence of viral RNA found in stomach samples compared to controls. The viral RNA becomes incorporated with your native microfloras, producing harmful mutations.

Probiotics can be deadly

Probiotics are not a zero risk treatment, contrary to popular belief.

“There is an urgent need to better define their appropriate clinical use, especially as probiotics are not always benign. There are many reports of probiotics causing infections, and in particular there is an increased risk of invasive infection in patients with in dwelling intravenous noeters. Probiotic use can even turn deadly: in one clinical trial examining probiotics for pancreatitis, the trial had to be stopped early because the probiotic group actually fared much worse. There were 24 deaths in the probiotic group and 9 in the control group, and 9 cases of bowel ischemia reported in the probiotic group, whereas none were seen in the control group. The results of this trial provide a good illustration of how we still do not entirely understand the complex mechanisms of action of probiotics, and of the urgent need to better determine the scientific basis for their function. This clinical trial used rigorously-tested probiotics, so it is not difficult to imagine the additional potential dangers lurking in probiotics of inadequately controlled quality. Fortunately, probiotic use is generally safe and it shows much promise for clinical efficacy in many gastrointestinal disorders, but we still have a long way to go. Ongoing research in this area, and a better understanding of host-microbial interactions through ongoing research on the human microbiome, will undoubtedly lead to further advances in this important field of Gl research”.

Elaine O. Petrof, Probiotics and Gastrointestinal Disease: Clinical Evidence and Basic Science

Probiotics can also cause inflammation for some conditions.

In my next post I will look at the probiotics that have been documented to help these conditions. Stay tune!

(c) 2012 Ken Lassesen