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Month: December 2022

Gut-Brain Axis

Gut-Brain Axis

Up until recently, scientists had minimal understanding of how our GI tract and brain are connected.  Until this new research I naively figured the only connection was my tummy telling my brain when I was hungry.  As it turns out there is a very strong bidirectional interplay between the brain and the GI tract and a major fulcrum is the gut microbiome.  The ENS (enteric (GI) nervous system) interacts with the intestinal membrane and its immune cells.  Changes in the membrane and immune cells are mediated by local hormones and neuroactive molecules.  These, in turn, affect the local nerves which send messages to the brain.  And the brain sends messages back. 

The importance of these connections has led to better understanding of both GI problems and neurologic disorders.   For instance, these is mounting evidence that altered GI microbiome plays a role in anxiety, depression, OCD behavior, autism, Parkinson’s disease, Alzheimer’s disease, and others.  On the other side of the equation is greater understanding of how the brain contributes to irritable bowel syndrome and inflammatory bowel disease. 

The ENS is often referred to as the second brain because of its size (100 million neurons and 400 million glial cells), its complexity and the similarity of neurotransmitters with the central nervous system (CNS).

One mechanism whereby the gut microbiome can contribute to neurologic disorders is via these neurotransmitters.  For instance, some “bad” gut flora lead to low levels of amino valeric acid and taurine, both of which are essential to making to making the neurotransmitter called GABA.  Patients with OCD and autism have low levels of GABA. 

On the other side of the equation, proper brain signaling to the ENS is important for producing a protein essential to a healthy intact epithelial barrier in the intestines: GDNF (glial derived neurotrophic factor).  Reduced barrier function is one of the main flaws that causes inflammatory bowel disease.  So, if the patient is suffering from stress, the brain in turn sends “distress” signals to the gut with the resultant worsening symptoms. 

Germ free mice have been the surrogate for humans in researching modifications in gut flora.  Since these specialized mice are germ sterile, researchers can establish any gut flora desired and measure its outcome.  These experiments are remarkable in that by establishing a “bad” flora researchers can make young, playful and social mice become withdrawn, and “depressed” and can also create mice who exhibit Parkinsonian movements and mice who suffer memory loss.

As exciting as this research is there are as yet no proven clinical applications for humans. 

Hypnotherapy for IBS

Hypnotherapy for IBS

Scientists at Monash University in Melbourne, Australia have developed a hypnotherapy-based computer app to help people with IBS (irritable bowel syndrome). 

The program called Nerva guides users through a ten-minute hypnotherapy session every day for six weeks.  The neural therapy is designed to correct the disordered signaling from brain to gut.  Patients who complete the six-week program report a reduction in symptom severity from 67 (on a scale of 100) to 39.  Adding a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet has additional benefit. 

Alpha Fold

Alpha Fold

An AI called Alpha Fold developed by London based company Deep Mind is a computer-based program trained to predict protein shapes by recognizing patterns in structures already solved by years of tedious experimental work using electron microscopes and other methods.  So far, it has predicted 400,000 protein structures including most of known human proteins. 

Now you might ask: “OK, what is the big deal and why is this in your newsletter?”  Well as it turns out many biologic processes work based on the shape of molecules.  For instance, as the Corona virus has mutated over the past three years its 3-dimensional structure has changed dramatically.  This is one reason that the original vaccines and the original nasal swab tests have become less efficient as doing their jobs; prevention and recognition. 

Another example is insulin allergy.  Years ago, the only available insulin for diabetics was from beef or swine.  Insulin allergy was fairly common back then.  But once the “human insulin” was developed (which uses a human gene transferred into test tube bacteria) it was mistakenly thought that there would no longer be insulin allergy.  Beef insulin has a four amino acid difference from human insulin.  Pig insulin has a three amino acid difference.  But “human insulin” from tissue culture has an identical amino acid sequence; however, the 3-D structure produced by the bacteria is different than that produced by the human pancreas. 

In some cases, this 3-D difference can lead to the development of allergy. The other foible that can occur is the development of anti-insulin antibodies which lead to insulin resistance.  Again, the antibodies are in response to the 3-D structural difference from nascent insulin. 

The efficiency and therefore the benefit of many medications is related to how well they fit into cellular receptors in the body.  This too comes down to 3-D structure.  Long story short, this new research has the potential to revolutionize medicine.  

House Plant Police

House Plant Police

Researchers at the University of Washington have developed a “souped-up” house plant to “police” indoor pollutants. 

Indoor air pollution is a reality.  A myriad of chemicals from cooking to cleaning materials to increasing outdoor pollutants can adversely affect human health. 

Benzene and Formaldehyde are known carcinogens and certain states have strict rules limiting their use (notably California and Minnesota). 

It has been known that indoor plants can remove these pollutants but their impact is very minor.  The scientists in Seattle modified the common house plant pothos by adding a rabbit gene for an enzyme that breaks down pollutants.  These “souped-up” golden pothos have a remarkable ability to remove and detoxify pollutants. 

In Canada, Oirgen Air is selling the new pothos plants and in the US Neoplants will begin sales this month. NASA scientists are conducting experiments with these plants to help reduce pollutants in the re-circulated air in the orbiting space station. 

Dear Dr. K- 

Dear Dr. K- 

I recently read that monkey pox vaccine can be given ID.  Is that true?

Yes, it is true.  In fact, early research indicates that it is the preferred route of administration in terms of getting the best immunologic protection. 

At this point the only other vaccines approved for ID (intradermal) dosing are the flu vaccines and the polio vaccine.  The advantages of ID vaccination are several.  It can generate an immune response as good or better than an intramuscular vaccine but with as little as one fifth the dose.  Owing to its superficial administration it avoids the rare risk of nerve, blood vessel or muscle injury that can occur with IM dosing.  The Gates Foundation has spent 5 billion dollars to help eradicate global polio and have used the dosing efficiency to great advantage.