A reader forward the announcement to me. Unfortunately, the trial is limited  for C.Diff

Criteria:

• Are 18 years of age or older
• Are experiencing recurrent Clostridium difficile infection (C. diff or CDI)
• Have responded to CDI antibiotic therapy for the most recent CDI episode
• Do not have a history or diagnosis of inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS)

As with many trials, you must be in an appropriate location.

Outside of the trial (i.e. with a cooperative physician):

Pricing: Each recommended dose of 30 capsules plus a safety test capsule costs $635. OpenBiome’s standard shipping charges and policies apply. [src]

I have been very busy with the http://microbiomeprescription.azurewebsites.net and have not had time to do my usual review (I have several partial drafts waiting which I will try to get finished soon).

• “The results indicate a total of seven single or multiple-strain formulations favoring the probiotic treatment group, with the strain Lactobacillus rhamnosus GG being the most effective [relative risk ratio of probiotic versus placebo 0.30 (95% CI 0.16–0.5) ]. ” i.e. 30% of patients do better.[Src]
• “probiotic strain Bifidobacterium breve B-3 may help reduce body fat levels in healthy pre-obese adults” [src] i.e. not proven
• ” clinical trials on probiotics for depression and anxiety have been heterogeneous in terms of dosing, probiotic strain selection and length of treatment”[src]
• “Fructophilic Lactic Acid Bacteria, a Unique Group of Fructose-Fermenting Microbes<https://aem.asm.org/content/84/19/e01290-18?etoc>
  Fructophilic lactic acid bacteria (FLAB) ” [src]
• ” the authors develop a low-cost, paper-based synthetic biology platform that allows species-specific quantification of bacterial mRNAs and clinically relevant host biomarkers.” [src]
• ” the primary gallate-decarboxylating microbial phyla in the intestinal microbiota were Firmicutes (74.6%), Proteobacteria (17.6%), and Actinobacteria (7.8%). These reads corresponded to 53 genera, i.e., 47% of the bacterial genera detected previously in these samples. Among these genera, Anaerostipes and Klebsiella accounted for the majority of reads (40%)…no gallate decarboxylase homologs were identified from representatives of Bacteroidetes. .” [src]
• ” key findings from studies that investigate the impact and benefits of HMOs, with a focus on 2’-fucosyllactose (2’-FL), the most abundant HMO found in human milk.”[src]
• An 85 gram (g) serving of white mushrooms may be enough to trigger a prebiotic, gut health-boosting action that could lower the risk of Type 2 diabetes [src]
• Physical activity and the affect on maternal and fetal gut microbiome<http://blog.dnagenotek.com/microbiome/physical-activity-and-the-affect-on-maternal-and-fetal-gut-microbiome>
• The Complete Guide to the Science of the Microbiome<https://endpoints.elysiumhealth.com/microbiome-explainer-e345658db2c>
• FMT
  • “‘Good bacteria’ found in infant faeces could form the basis of a probiotic supplement that could help lower disease risk as researchers point to babies’ good health and absence of age-related diseases as good starting points.”[src] Baby faeces for FMT?????
  • “Twenty-one subjects were analyzed, with a median age of 12 years, of whom 57% and 28% demonstrated clinical response at 1 and 6 months post-FMT, respectively. ” [src]  In other words. FMT have poor odds of persisting.
  • Could an East Bay startup’s ‘poop pill’ reset your pet’s gut? [src]
  • The brave new world of DIY faecal transplant – BBC News<https://www.bbc.com/news/magazine-27503660>
• Disease and
  • “Patients with Parkinson’s disease (PD) often have non-motor symptoms related to gastrointestinal (GI) dysfunction, such as constipation and delayed gastric emptying, which manifest prior to the motor symptoms of PD.. Increasing evidence indicates that changes in the composition of the gut microbiota may be related to the pathogenesis of PD” [src]
  • Acne vulgaris was first proposed to have a gastrointestinal mechanism in 1930 by dermatologists Stokes and Pillsbury,  [src]
  • Antibiotics as Instigators of Microbial Dysbiosis: Implications for Asthma and Allergy [src]
  • Oral microbiome disparity linked to pneumonia amongst elderly:  [src]
  • Genetic risk, dysbiosis, and treatment stratification using host genome and gut microbiome in inflammatory bowel disease<https://www.nature.com/articles/ctg201758>
• Probiotics — Good or Bad?
  • News<https://www.bbc.com/news/magazine-27503660>
  • No BBC, probiotics are not ‘quite useless'<https://www.nutraingredients-usa.com/Article/2018/09/07/No-BBC-probiotics-are-not-quite-useless#.W5Kq-17WKmI.linkedin>
  • ” But, again, probiotic treatment appeared to slow the return to baseline and extend the timeframe of dysbiosis, the researchers reported.” [src]
  • “Cryptosporidiosis, a leading etiology of infant diarrhea, is caused by apicomplexan parasites classified in the genus Cryptosporidium….mice treated with probiotic developed a more severe infection. ” [src]
• DNA – inherited microbiome
  • “In Goodrich et al. (2014), we increased the power to detect heritable microbiota with a 16S rRNA gene-based analysis of 416 twin pairs. As observed for the Missouri twin studies, the UniFrac distances for MZ twins were slightly less than for DZ twins, but due to the greater sample size, the difference reached statistical significance. Importantly, the greater number of subjects allowed us to identify taxa with significant heritabilities. Among common taxa (those found in at least 50% of samples), the most heritable was the family Christensenellaceae (phylum Firmicutes), ” [src]
  • Human Genetics Shape the Gut Microbiome – ScienceDirect<https://www.sciencedirect.com/science/article/pii/S0092867414012410>

A reader forwarded me a lab result from InVitaLab Medizindiagnostik and I have encoded as a new Lab on the site.

The report section on the microbiome is shown below

The Entry Form

As usual, I have tried to follow the sequence and do the best matches when things are fuzzy. In some case, like for E. Coli Rauhform, there was no match so it was omitted.

http://microbiomeprescription.com/labs/definition?key=C

Bottom Line

If you have a Lab result that is not a match for the existing ones, please send me a PDF of the results and I will add it. To see the current list of clinical labs supported visit:
http://microbiomeprescription.com/Labs

Also, I am working on the ability for user to save these lab reports so you can return and get updated suggestions as the database of modifiers grows.

This is a review of recent studies recorded on PubMed. The focus is on new information – so studies reporting prior information will rarely be mentioned. Cases are now being reported from Nepal to New York City proper.

• Microbiological features distinguishing Lyme disease and relapsing fever spirochetes.[2018]
  • “The recent proposal of splitting the genus Borrelia into two genera in the newly formed family of Borreliaceae, i. e. Borrelia and Borreliella “
• Lyme Disease in 2018: What Is New (and What Is Not).
  • 
• Cost-effectiveness of a potential anti-tick vaccine with combined protection against Lyme borreliosis and tick-borne encephalitis in Slovenia[2018].
  • “A wholesale price for a vaccine shot of €9.13 would lead to cost savings followed by health gains for the vaccination strategy.”
  • Omics and bioinformatics applied to vaccine development against Borrelia.[2018]
  • Design of a Lyme Disease Vaccine as an Active Learning Approach in a Novel Interdisciplinary Graduate-Level Course.[2017]
• The Persistent Lyme Disease: “True Chronic Lyme Disease” rather than “Post-treatment Lyme Disease Syndrome”[2018].
  • “A meta-analysis of test accuracy reported a sensitivity of only 59.5%, varying from 30.6%–86.2%.[5] Antibiotic testing is necessary to reach Lyme disease final diagnosis, namely in patients presenting with negative tests and a suggestive clinical presentation.”
  • “A new approach with antibiotics was initiated: ceftriaxone (2 g/day for 1 month) followed by doxycycline (200 mg twice a day) associated with hydroxychloroquine 200 (once a day). Two months later, after a quick improvement, the patient exhibited no symptoms. “
• Identifying vancomycin as an effective antibiotic for killing Borrelia burgdorferi[2018].
  • “doxycycline, a standard of care for uncomplicated acute infection, did not clear the pathogen. By contrast, both ceftriaxone and vancomycin cleared the infection.”
• Infectious Mononucleosis and Lyme Disease as Confounding Diagnoses: A Report of 2 Cases [2018].
  • “Significant cross-reactivity is known to occur between Lyme and EBV serologic assays complicating the diagnosis. “
  • Comment: i.e. you may have EBV and get a positive Lyme results. With CFS reactivation of prior EBV infection being well known – Telling CFS from Lyme lack any reliable tests.
• Metabolites of prostaglandin synthases as potential biomarkers of Lyme disease severity and symptom resolution[2018].
  • “subjects with Lyme meningitis, Lyme arthritis (LA) and antibiotic-refractory LA had increased levels of an array of PGs and lipid mediators (e.g., LTB_4, 8-isoPGF_2α, and phospholipases A₂ activity). ‘
  • Identification of Urine Metabolites as Biomarkers of Early Lyme Disease [2018].
    • “Linear discriminant analyses demonstrated that individual metabolic biosignatures can correctly discriminate ELD from the other patient groups with accuracies of 71 to 100%. “

• Secondary dementia due to Lyme neuroborreliosis.[2018]
• Cognitive Decline in Post-treatment Lyme Disease Syndrome. [2018]
• Neuropsychiatric Lyme Borreliosis: An Overview with a Focus on a Specialty Psychiatrist’s Clinical Practice[2018].
  • “usually presenting with significant comorbidity which may include developmental disorders, autism spectrum disorders, schizoaffective disorders, bipolar disorder, depression, anxiety disorders (panic disorder, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, intrusive symptoms), eating disorders, decreased libido, sleep disorders, addiction, opioid addiction, cognitive impairments, dementia, seizure disorders, suicide, violence, anhedonia, depersonalization, dissociative episodes, derealization and other impairments. “
  • Aggressiveness, violence, homicidality, homicide, and Lyme disease.[2018]
  • Risk Factors for Clinician-Diagnosed Lyme Arthritis, Facial Palsy, Carditis, and Meningitis in Patients From High-Incidence States.[2017]
• Ophthalmological findings in neuroborreliosis – a prospective study performed in western Sweden.[2018]
  • “Facial palsy with palpebral diastasis was a common finding. Onset of diplopia and/or sixth nerve affection may be a first sign of neuroborreliosis. Number of ophthalmological findings was correlated with the CSF antibody titre”
  • Outcome of facial palsy from Lyme disease in prospectively followed patients who had received corticosteroids [2018].
• The Emergence of a Forgotten Entity: Dermatomyositis-like Presentation of Lyme Disease in Rural Wisconsin.[2018]

This is a review of recent studies recorded on PubMed. The focus is on new information – so studies reporting prior information will rarely be mentioned.

• The effects of warm water immersion on blood pressure, heart rate and heart rate variability in people with chronic fatigue syndrome[2018].
  • Temporary relief.
  • “Chronic fatigue syndrome (CFS) is a central sensitisation syndrome with abnormalities in autonomic regulation of blood pressure (BP), heart rate (HR) and heart rate variability (HRV).”
  • Cerebral blood flow and heart rate variability predict fatigue severity in patients with chronic fatigue syndrome. [2018]
• Dry eye syndrome and the subsequent risk of chronic fatigue syndrome-a prospective population-based study in Taiwan.
  • 2x greater risk of CFS
• Chronic fatigue syndrome patients have alterations in their oral microbiome composition and function.
  • “CFS patients had a higher relative abundance of Fusobacteria compared with healthy controls. Further, the genera Leptotrichia, Prevotella, and Fusobacterium were enriched and Haemophilus, Veillonella, and Porphyromonas were depleted in CFS patients compared to healthy controls. “
• Open-label pilot for treatment targeting gut dysbiosis in myalgic encephalomyelitis/chronic fatigue syndrome: neuropsychological symptoms and sex comparisons [2018].
  • “Results support the notion that specific microorganisms interact with some ME/CFS symptoms and offer promise for the therapeutic potential of targeting gut dysbiosis in this population. Streptococcus spp. are not the primary or sole producers of D-lactate. Further investigation of lactate concentrations are needed to elucidate any role of D-lactate in this population”
  • 400 mg of erythromycin twice daily
• Visual Aspects of Reading Performance in Myalgic Encephalomyelitis (ME)[2018].
  • “vision-related reading difficulty belongs to a class of measureable symptoms for ME/CFS patients.”
• The expression signature of very long non-coding RNA in myalgic encephalomyelitis/chronic fatigue syndrome [2018].
  • “LncRNAs NTT, MIAT and EmX2OS levels were found to be significantly elevated in ME/CFS patients as compared with healthy controls. Furthermore, NTT and EmX2OS levels increased with disease severity. “
• Multidisciplinary rehabilitation treatment is not effective for myalgic encephalomyelitis/chronic fatigue syndrome: A review of the FatiGo trial[2018].
• Cognitive-behavioural therapy for chronic fatigue syndrome: neither efficacious nor safe[2018].
• Higher Prevalence of “Low T3 Syndrome” in Patients With Chronic Fatigue Syndrome: A Case-Control Study[2018].
• Differentiating Multiple Sclerosis from Myalgic Encephalomyelitis and Chronic Fatigue Syndrome [2017].
  • “Those individuals with ME or CFS reported significantly more functional limitations and significantly more severe symptoms than those with MS.”

Bottom Line

It was nice reading of success addressing the lactic acid aspect of CFS with antibiotics (erythromycin – a macrolide) on patients with high streptococcus count. It was the coming together of multiple threads — if you want to understand better or get a better background, see these posts:

• Approaches to D-Lactic Acidosis

• Staphylococcus aureus –  the CFS maintainer?

• Why Jadin’s Antibiotics Protocol usually work — Pasteur Institute got the solution right and the explanation wrong?