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Lucy Mailing Article
Mesalamine (and Select Probiotics) Keep Candida at Bay During Antibiotics by Supporting Gut Hypoxia
Background
- Healthy Colon Environment
- Low-oxygen environment critical for gut health.
- Clostridia bacteria produce butyrate, maintaining low oxygen levels.
- Impact of Antibiotics
- Antibiotics deplete Clostridia, reducing gut butyrate levels.
- Depletion causes a shift in gut epithelial cell metabolism.
- Metabolic changes increase oxygen, lactate, and nitrate in the gut, disrupting microbiome balance (dysbiosis).
- Role of PPAR-gamma Pathway
- Activation of PPAR-gamma in gut epithelial cells reverses dysbiosis.
- Promotes butyrate metabolism and oxygen utilization.
- Mesalamine (5-ASA) is a known PPAR-gamma activator.
Recent Findings by Baumler Lab
- Mesalamine’s Role in Preventing Candida Overgrowth
- Study shows mesalamine helps prevent Candida albicans overgrowth post-antibiotics by maintaining gut hypoxia.
- Antibiotics increase gut oxygen levels, leading to susceptibility to C. albicans.
- Mesalamine restores gut hypoxia, preventing C. albicans overgrowth.
- Significance of Candida Overgrowth
- Broad-spectrum antibiotics increase the risk of Candida overgrowth.
- Antifungals used to prevent this can negatively impact beneficial fungi.
New Insights on Probiotics
- E. coli Nissle 1917
- Probiotic E. coli Nissle 1917 found to prevent Candida overgrowth by consuming oxygen, making the gut less favorable for Candida growth.
- Unlike Clostridia, which produce butyrate, E. coli Nissle 1917 directly reduces gut oxygen levels.
- Suggests potential use alongside mesalamine and butyrate for protecting gut health post-antibiotics.
- Cautions with E. coli Nissle 1917
- Uncertainty about the broader implications of high amounts of E. coli Nissle 1917 during/post-antibiotic treatment.
- Potential risks include occupying too large a niche in the gut and delaying the return of other beneficial bacteria.
Exploring Alternative Probiotics
- Saccharomyces boulardii as a Safer Alternative
- S. boulardii may offer a safer alternative to other probiotics post-antibiotics.
- Increases PPAR-gamma expression and utilizes oxygen, supporting gut recovery.
- Produces acetate in oxygen-rich conditions, aiding ecosystem recovery.
- Research Gaps
- Need for robust studies on post-antibiotic microbiome recovery with and without S. boulardii.
Takeaways
- Optimal Strategy During and After Antibiotics
- Combination of butyrate, S. boulardii, and mesalamine may support a healthy gut, particularly for those at high risk of Candida infection.
- Future research needed to confirm findings and determine optimal dosing and timing.