Tuesday, November 8, 2011

0 Two Notable Antibiotic Articles - Long-term Effects & Alternatives

H. pylori: Friend or foe?
Answer: It depends...
I know some of you reading along may have already seen this, but I think it bears mentioning again and also bears mentioning for those who may not have seen it: The New York Times recently published an article on the long-term effects of antibiotic usage, "In Some Cases, Even Bad Bacteria May Be Good".

After reading the above link, I found it fascinating and disturbing that antibiotics not only could contribute to obesity - the hypothesis originally being test driven by the writer - but that antibiotic use could also lead to allergies, inflammatory bowel disease, asthma, and gastroesophageal reflux. These are conditions which are not only common in Lyme disease patients, but in the general population as well.

Among the astonishing findings in this article:
  • Eradicating H. pylori infections entirely leads to the inability of ghrelin (a hunger hormone secreted in the stomach) to decrease in the stomach, thus leaving the brain to think it's always time to eat more. Therefore, lack of infection = eating more = weight gain.
  • Researchers found that the ratios of various bacteria in the guts of obese mice and obese humans were significantly different from those of lean controls, suggesting that altering the stomach’s microbial balance with antibiotics might put patients at risk for gaining weight. H. pylori is not the only culprit for change.
  • Less H. pylori in someone's system is associated with a greater risk of not only asthma but gastric reflux disease as well.
  • The human body contains a very complex bacterial ecosystem which we don't know anywhere near as much about as we should. Knowing about it is important in understanding the cause for disease and how to prevent it.
  • It's not just antibiotics that are changing the human microbiota - many aspects of modern life, including diet, smaller families, more hygienic practices and improved public sanitation, are affecting our bacterial communities.
The research cited contains sobering news and adds to the realization that as much as antibiotics have brought deadly infections under control and saved lives, they can have negative side effects and possibly more longer term consequences than at first realized.

All this said, I have been an advocate of antibiotic usage to treat Lyme disease - especially in its early stage and with a clear case of neuroborreliosis - because antibiotics have been tested and used in clinical trials for many years for their effectiveness. It's  important in the case of neuroborreliosis to ensure that treatment can pass the blood-brain barrier, and so far antibiotics have been tested which are demonstrated to have this property.

So I still stand by the use of antibiotics for their effectiveness and documented record for helping patients everywhere. However,  I am aware that in the future, antibiotics may not work as well as they once did due to antibiotic resistance, and this knowledge of longer term effects concerns me as well. Alternatives will need to be found that are safe and effective.

What sort of treatment could be available other than antimicrobial herbs?

The answer may be as close as your local wallaby.

Okay, well, for most people reading this, wallabies are hardly local to them - unless you are one of my Australian readers or you have a decent zoo nearby.

Last month, Byte Size Biology blog published an entry on the innate immune system and research on cathelicidins, specifically those peptides found within marsupials - including wallabies - which can fight off infection.

A baby kangaroo (joey) or wallaby is born in its fetal stage and must travel across its mother's abdomen and into a pouch to complete development. This can expose the fragile fetus to all sorts of germs, so what protects it? While the joey has adaptive immunity which is quite undeveloped, it can produce some killer all-purpose peptides he can use against microbes.

The same class of peptides are produced in Kanga’s milk. (Think of the idea as being similar to colostrum in cows, perhaps?) Collectively they are known as cathelicidins. Only about 30 amino acids long, these highly charged molecules kill both gram-positive and gram-negative bacteria.

Preliminary studies were conducted on the use of cathelicidins as antibiotics. The author of Byte Size Biology wrote:
"They used cathelicidins from wallaby and platypus to kill human pathogens: P. aeruginosa, K. pneumoniae and A. baumanii, including antibiotic resistant strains. Cathelicidins were much more effective than, well, antibiotics against those bacteria. Also, cathelicidins did not kill human red blood cells, which makes them a potential drug. Of course, immune reaction against cathelicidins as a foreign still needs to be checked, among many, many other things, but the whole idea of looking at marsupials is that, as mammals, they may be able to supply us with clues on how to synthesize a cathelicidin to be used as a drug in humans."
More research is needed, obviously, but this may be one option to antibiotics sitting in your medicine cabinet of the future.

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