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Archive for the ‘Infection’ Category

Biofilm And Bacterial Resistance To Antibiotics When Starved

Saturday, November 19th, 2011

 

Dr. Dao Nguyen, now at McGill University, trained in the University of Washington lab of Dr. Pradeep Singh, a lung specialist who studies bacterial biofilm infections.

“A chief cause of the resistance of biofilms is that bacteria on the outside of the clusters have the first shot at the nutrients that diffuse in,” said Pradeep Singh, associate professor of medicine and microbiology at the University of Washington.

“This produces starvation of the bacteria inside clusters, and severe resistance to (their) killing,” added the senior study author, the journal Science reports.

“Bacteria become starved when they exhaust nutrient supplies in the (infected) body, or if they live clustered together in groups known as biofilms,” said study co-author Dao Nguyen, assistant professor of medicine at Montreal’s McGill University.

Preventing pathogenic bacteria from sensing nutrient starvation may present a new therapeutic approach to increasing antibiotic efficacy and preventing drug resistance, researchers claim. A team led by McGill University investigators has found that blocking an active mechanism used by bacteria to respond to starvation by slowing their growth significantly reduces the natural tolerance to antibiotics that infectious organisms develop when nutrient supplies become low.

The investigators work is reported in Science in a paper titled “Active Starvation Responses Mediate Antibiotic Tolerance in Biofilms and Nutrient-Limited Bacteria.” Pradeep K. Singh, Ph.D., Dao Nguyen, Ph.D., and colleagues

Abstract:

Bacteria become highly tolerant to antibiotics when nutrients are limited. The inactivity of antibiotic targets caused by starvation-induced growth arrest is thought to be a key mechanism producing tolerance. Here we show that the antibiotic tolerance of nutrient-limited and biofilm Pseudomonas aeruginosa is mediated by active responses to starvation, rather than by the passive effects of growth arrest. The protective mechanism is controlled by the starvation-signaling stringent response (SR), and our experiments link SR-mediated tolerance to reduced levels of oxidant stress in bacterial cells. Furthermore, inactivating this protective mechanism sensitized biofilms by several orders of magnitude to four different classes of antibiotics and markedly enhanced the efficacy of antibiotic treatment in experimental infections.

You can read all of my biofilm posts here

The Cycle of Inflammation – From Stressors to Disease

Sunday, October 31st, 2010

If after reading this post you have questions regarding alternative medicine, integrative medicine, chiropractic, weight-loss, diabetes or pre-diabetes prevention, nutritional supplementation or how to become a new patient, please feel free to contact our office. Advanced Healing Center of Orange County, the practice of Dr. Marcus Ettinger BSc, DC. Phone: 714-639-4360, E-mail: info@advancedhealing.com, Mail: 630 South Glassell Street #103. Orange, CA 92866.

The below cycle of inflammation (also known as an inflammatory cascade) is one of the most profound contributors to ill health and disease we face. Once set in motion, this inflammatory cycle will feed itself and becomes harder to suppress. 75% of the patients I see are in my practice because of the effects inflammation is having on their body. 100% of these effects are a direct result of not following (step 6) at the bottom of the page. The easiest way to avoid disease and ill health is to remove as many stressors (step 1) out of your life.Step 1. Over-exposure or excessive physical, emotional and/or chemical stress’, leading to the activation of  a potent modulator of the inflammatory cycle.

Stressors: Radiation; oxidative stress; physical injury, bacterial endotoxin or lipopolysaccharide (LPS) from food-borne bacteria (E. coli and Salmonella); “Leaky Gut Syndrome”; food and environmental allergens; viral infections; excessive consumption of simple sugars (sucrose); consumption of corn oil; arachidonic acid metabolites such as PGE2; nutrient poor, processed food diet; insufficient Omega 3 fatty acids (ALA, EPA, DHA), insufficient GLA and Vitamin D deficiency.

Step 2. Activation of NF-κB

NF-κB is widely used by eukaryotic (cells that contain a nucleus) cells as a regulator of genes that control cell proliferation and cell survival (anti-apoptotic). Blocking NF-κB can cause tumor cells to stop proliferating, to die, or to become more sensitive to the action of anti-tumor agents.

NF-κB also controls many genes involved in inflammation (cytokines [signaling molecules used extensively in intercellular communication], cell adhesion molecules and the pro-inflammatory enzymes: inducible nitric oxide synthase (iNOS,) cyclo-oxygenase (COX) and lipoxygenase (LPOX). NF-κB is found to be chronically active in many inflammatory diseases, such as inflammatory bowel disease, arthritis, sepsis, gastritis, asthma, neurodegenerative diseases, and cardiovascular disease.

Step 3. Cytokines, cell adhesion molecules and the pro-inflammatory enzymes are produced.

*Interleukin-6 (IL-6) → C-Reactive Protein (CRP)
Cyclooxygenase-2 → Prostaglandin-E2 (PGE2) and Thromboxanes
Interleukin-1 (IL-1) → Collagenase-3 (MMP-13)
Lipoxygenase → Leukotrienes
Inducible Nitric Oxide Synthase (iNOS) → Nitric Oxide (NO)
Tissue Necrosis Factor (TNFα)
*Cell Adhesion Molecules (CAMs)

Step 4. Health conditions created by prolonged exposure to the above chemicals.

  • Pain
  • Inflammation (edema, swelling)
  • Asthma and Hypersensitivity to Potential Allergens
  • Cardiovascular disease
  • Thrombosis (blood clots)
  • Insulin resistance
  • Autoimmune disease (Hashimoto’s, Lupus…)
  • Rheumatoid disease
  • Neurodegeneration (Alzheimer’s disease, Parkinson’s disease)
  • Cancer

Step 5. IL-1, PGE2, reactive oxygen species and oxidative stress, TNFα and CRP created because of the above health conditions, facilitate the continued activation of NF-κB.

Step 6. In order to break the above inflammatory cycle, stressors need to be removed,  severely reduced or reversed. One of the easiest steps that can be taken is to eliminate table sugar, vegetable oil and hydrogenated fats out of the diet and add in Omega 3 fatty acids, in the form of fish and flax seed oil. Next, is to reduce animal protein (red meat) consumption to 6 ounces per day and add-in nutrient dense foods like: vegetables, fruits, nuts, seeds and beans. Increasing antioxidants and anti-inflammatory nutrients is a cost effective measure that will pay dividends in the form of less sickness, disease and an increased life-span. Here are a few of my favorite nutrients that support  anti-inflammatory processes: molecularly distilled fish oil, natural vitamin C, chlorella, vitamin E, selenium, NAC, resveratrol, grape seed extract and curcumin. Here are a few of my favorite antioxidant rich (anti-inflammatory) fruits and vegetables: red bell pepper, tomato, cilantro, spinach, red cabbage, onion, garlic, strawberries, blueberries and red raspberries. Lastly, engaging in mild-moderate exercise (3 days/week), taking a broad-spectrum, enteric-coated probiotic and 4,000 – 10,000 IU’s of vitamin D3 per day, will round-out any  anti-inflammatory protocol.

Step 7. Proactive diagnostic blood tests to determine the presence and level of inflammation within the body, as well as tests that will determine risk for development of cardiovascular disease (heart attack) or cerebrovascular disease (stroke). Any of these tests can be ordered by calling our office 714-639-4360

  • C-Reactive Protein (CRP) – High Sensitive (Cardiac)
  • Homocysteine
  • Fibrinogen
  • Hemoglobin A1C
  • IL-6 – Interleukin – 6
  • Sed Rate (ESR)
  • Lipid Panel
  • D,25 Hydroxycalciferol – Vitamin D

*Atherosclerosis is strongly considered to be a low-grade inflammatory response of the arterial wall to a variety of stimuli in all aspects of coronary syndromes, from the pathogenesis of atherosclerosis to plaque rupture and myocardial cell death. In each of these steps, infiltration of cardiovascular tissue by inflammatory cells is evident and is regulated by a number of cytokines (IL-6 and CRP) and cell adhesion molecules.  Maseri A. N Engl J Med. 1997;336:1014-1016

Antiviral and Antibacterial Actions of Monolaurin and Lauric Acid

Monday, August 16th, 2010

If after reading this post you have questions regarding alternative medicine, integrative medicine, chiropractic, weight-loss, diabetes or pre-diabetes prevention, nutritional supplementation or how to become a new patient, please feel free to contact our office. Advanced Healing Center of Orange County, the practice of Dr. Marcus Ettinger BSc, DC. Phone: 714-639-4360, E-mail: info@advancedhealing.com, Mail: 630 South Glassell Street #103. Orange, CA 92866.

Monolaurin - Monolauroylglycerin - Glycerol monolaurate

Lauric acid is a 12-carbon medium chain fatty acid (MCFA) found naturally in human breast milk (6.2% of total fat) and coconut oil (47.5% by weight). Lauric acid was originally discovered when microbiologists studied human breast milk to determine the protective (anti-viral and anti-bacterial) substances which protected infants from microbial infections. Other fatty acids were also found to have antimicrobial actions but lauric acid was found to be the most active.

The esterification of lauric acid, that naturally occurs in our body, yields an amazing compound known as monolaurin (glycerol monolaurate). Monolaurin is a non-ionic surfactant¹, which possesses an even greater anti-viral and anti-bacterial activity than its precursor, lauric acid. Monolaurin, when given orally, at therapeutic doses between 2,500 – 4,500 mg/day is generally well tolerated, with loose bowels as the only negative concern. Monolaurin has been studied at medical research centers, including the Center for Disease Control (CDC), because of its high antimicrobial (anti-viral, anti-bacterial, anti-fungal, anti-yeast and anti-protozoal) activity. These studies have provided information about the anti-viral and anti-bacterial mechanisms of monolaurin. Monolaurin was found to be effective against certain Lipid Coated Bacteria (LCBs) and Lipid Coated Viruses (LCVs) – enveloped DNA and RNA viruses.

¹Surfactant: Surfactants are compounds that lower the surface tension of a liquid, allowing easier spreading, and lowering of the interfacial tension between two liquids, or between a liquid and a solid. Surfactants may act as: detergents, wetting agents, emulsifiers, foaming agents, and dispersants.

Lipid Coated Virus

HIV-1, Influenza virus, paramyxoviruses, rubeola virus, bronchitis virus, and the herpes family of viruses (Epstein-Barr, cytomegalo, zoster, vericella-zoster and herpes type I and II). Sadly, monolaurin had no effect on diseases caused by non-enveloped viruses such as polio virus, coxsackie virus, encephalomyocarditis virus, rhinovirus, and rotaviruses.

 

Lipid Coated Bacteria

Helicobacter pylori (H. pylori),  Staphylococcus aureus and Streptococcus agalactiae.

The anti-viral and anti-bacterial action attributed to monolaurin is that of solubilizing the lipids and phospholipids in the protective envelope of these particular infective agents causing the disintegration of the lipid envelope. Recent publications have shown that monolaurin and lauric acid inhibit the replication of viruses by interrupting the communication and binding of virus to host cells and thus preventing the uncoating of viruses necessary for replication and infection. Other studies have shown that monolaurin is able to remove all measurable infectivity by directly disintegrating the protective bacterial and viral lipid envelop. Binding of monolaurin to the viral envelop also makes the virus more susceptible to degradation by host defenses, heat, or ultraviolet light.

Microorganisms Inactivated by Monolaurin

Ecological Formulas Monolaurin (600 mg’s – 90 caps) $34.00 or Lauricidin® The Original Monolaurin 227gr $40.00 Call to Purchase 714-639-4360

Quorum Sensing and Biofilm

Sunday, December 13th, 2009

What is Quorum Sensing and how do bacteria talk to each other?

The discovery that bacteria are able to communicate with each other changed our general perception of many single, simple organisms inhabiting our world. Instead of language, bacteria use signaling molecules which are released into the environment. As well as releasing the signaling molecules, bacteria are also able to measure the number (concentration) of the molecules within a population. Nowadays we use the term ‘Quorum Sensing’ (QS) to describe the phenomenon whereby the accumulation of signaling molecules enable a single cell to sense the number of bacteria (cell density). In the natural environment, there are many different bacteria living together which use various classes of signaling molecules. As they employ different languages they cannot necessarily talk to all other bacteria. Today, several quorum sensing systems are intensively studied in various organisms such as marine bacteria and several pathogenic bacteria.

Quorum Sensing & Biofilm Formation

Quorum Sensing & Biofilm Formation

Why do bacteria talk to each other?

(QS) enables bacteria to co-ordinate their behavior. As environmental conditions often change rapidly, bacteria need to respond quickly in order to survive. These responses include adaptation to availability of nutrients, defense against other microorganisms (biofilm formation) which may compete for the same nutrients and the avoidance of toxic compounds (biofilm formation) potentially dangerous for the bacteria. It is very important for pathogenic bacteria during infection of a host (e.g. humans, other animals or plants) to co-ordinate their virulence in order to escape the immune response of the host in order to be able to establish a successful infection. The University of Nottingham Quorum Sensing Research Group

From Dr. Ettinger’s Biofilm Protocol for Lyme and Gut Pathogens: Pathogenic bacteria known to reside in biofilms include: Borrelia burgdorferi, Escherichia coli, Candida albicans, Clostridium difficile, Clostridium perfringens, Helicobacter pylori, Klebsiella pneumoniae, Legionella pneumophila, Listeria monocytogenes, Pseudomonas aeruginosa, Salmonella typhimurium, Staphylococcus aureus, Staphylococcus epidermidis, and Vibrio cholerae. The number of human diseases shown to be associated with biofilms is expanding and includes chronic bacterial prostatitis, chronic rhinosinusitis, cystic fibrosis pneumonia, infective endocarditis, periodontitis, recurrent otitis media, and virtually all device and implant related infections. Strong evidence is also beginning to emerge for an etiologic role of pathogenic mucosal biofilms in gastrointestinal diseases, such as Irritable Bowel Disorders: Crohn’s disease and ulcerative colitis.

Stress and Our Body – An Integrative Medicine Approach

Friday, December 11th, 2009

Excessive negative stress has become, over the last 25 years, as much a part of our daily lives as eating and sleeping. Excessive negative stress can be physical (chronic illness, lack of exercise, over-exercising, etc.), emotional (losing a job, winning the lottery, etc.), or chemical (bad diet, drugs, medicines, alcohol, pesticides, etc.).

Excessive negative stress is most likely to be the initial predisposing factor in the cause and prolongation of a disease or illness. Again, the greater the exposure and duration to these negative stressors the greater the susceptibility to acute or chronic illness or body dysfunction.

It is also important to note that not all stress is bad or has negative effects on our bodies. Some types of stress are actually beneficial for us and can increase our immune function, overall strength, emotional well being and longevity. The most beneficial form of stress is exercise, especially swimming and weight training. This type of stress can, in moderation, even negate some of the excessive negative stress’ we face.

stress_and_our_body_1When our bodies are exposed to any form of negative stress our organ systems innately responds with what is known as the “fight-flight response”. During this stress induced response, many different and potentially damaging physiological reactions occur. During the initial phase, which can last for seconds to years, digestion and absorption of nutrients are greatly reduced; body tissues begin to break down; the immune system is suppressed; our heart begins to overload and the aging process is significantly accelerated. These are but a sampling of what does occur.

Individuals who are exposed to excessive negative stress may also develop a condition known as adrenal exhaustion. This condition occurs when the adrenal glands work beyond their normal capacity thus eventually shutting down (no more Cortisol, a hormone, being produced). Adrenal exhaustion presents with symptoms similar to those found in patients with chronic fatigue syndrome (CFS), hypothyroidism, fibromyalgia and hypoglycemia (see table 1).

Table 1

Tiredness Weakness
Depression, Anxiety 1
Headache
Muscle or Joint Pain Heart Palpitations
Hives, Rash, Eczema 1 2 3
Bowel Disorders
Weak Nails Fatigue
Chronic Illness
Irritability, Moodiness
Water Retention Weight Gain
Dizziness, Vertigo Arthritis
Salt Craving Allergies

An integrative medicine approach for the treatment of adrenal exhaustion or the effects excessive negative stress are identical. First, it’s crucial to reduce or eliminate as many negative stressors (individual stress factors) as possible.

Second, get plenty of rest, at least 8 hours, starting before midnight; engage in regular, but not excessive, exercise; greatly reduce your carbohydrates intake (bread, sweets, pasta, corn and potatoes); increase protein intake; increase fibrous vegetable intake; drink eight glasses of filtered water daily, and perform deep breathing exercises every morning and evening.

Third, nutritional and/or pharmacological support. To determine pharmacological support we must first determine thyroid and adrenal function via blood tests (thyroid panel including both thyroid antibodies and rT3), and (DHEA, cortisol and progesterone) levels. Nutritional support can be in the form of DHEA and/or Pregnenolone (10 – 50 mg daily) and/or glycerrhizin (25 – 100 mg daily – preferably in the morning). These two supplements safely support proper adrenal hormone levels. DMG (vitamin B15) and Siberian Ginseng have both been shown in Russian clinical studies to help regulate the hypothalamus, pituitary, adrenal axis. Pantothenic acid (vitamin B5) is the initial precursor, along with our LDL cholesterol to our adrenal hormones, whole C complex (Ester-C w/bioflavonoids) is an antioxidant for the adrenal and the highest concentration of vitamin C out side of the spinal chord and brain is found in the adrenal; and potassium are essential for proper adrenal gland function. Adrenal glandular preparations (Whole Desiccated Adrenal (short-term), Drenamin and Drenatrophin PMG) from Standard Process Inc. will also help to support the adrenal glands. These are but a few options that I have used to support the stress response of the body.

Additionally, antioxidants and supportive products like: CoQ10, glutathione, NAC, vitamin E, bioflavonoids, alpha lipoic acid, SAMe, Gabatone (Apex Energetics), L-tryptophan, magnesium and MSM, will also help reduce the overall oxidative burden placed on the body by the excessive negative stress.

With the above knowledge the road to well being and health is now a much shorter one.


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