UC Chronicity and biofilms

[mf15]

Can anyone see a connection here.

Bacteria and there biofilms should not physically touch our colon mucosa.

Why no medical cure. The medical community are not targeting the cause.


What's the cause. Persistent biofilm on the mucosa.

Not saying this is the initial cause, but why there is no medical cure.

Biofilms on top of or in the outer mucus, are where they should be.



Ok so what is going on.




appendix:

If you look at the first set of pictures and read their comments, the biofilm decrease from proximal to the

distal part of the colon.

Descending colon no apparent biofilm.


http://sciences.surgery.duke.edu/files/BillSection1SecondInsert.pdf


Antibiotics. Even with antibiotics the biofilm is still there, and when your done the bacteria bounce back, many fold.

http://www.charite.de/arbmkl/publikationen/2008bact_bio_suppression.pdf



You can see in these pictures that when treated with 5-asa the bacteria are suppressed but the mucosal biofilm is still there, but the immune system is functional. The bacteria are suppressed,so the inflammation is lowered,perhaps also somewhat immune modulating effect where the immune system calms down.



Now look at Azathioprine, the immune system is suppressed and the bacteria in the mucosa associated biofilm are quite active,but you have calmed down the inflammation.



Bottom line. Whether 5-asa, antibiotics or immune suppression,or all at once the biofilm is still there.

You can obtain remission, one way or another, but the cause of chronic UC is still present.



http://onlinelibrary.wiley.com/doi/10.1002/ibd.20003/pdf




Read the last sentence, confirms what I see just by looking at the pictures.

http://www.ncbi.nlm.nih.gov/pubmed/16000463


Last sentence.

Both 5-ASA and antibiotics suppress but do not eliminate the adherent biofilm.





Old Mike

 

[xeridea]

Biofilms, and more specifically, quorum sensing, is a problem, not just in the gut but also places like the lung. I think they're working on the problem because it often underlies antibiotic resistance.

 

[7vNH]

Mike, Thanks for those links and your commentary. I see that antibiotics very signjficantly reduce the microbes in the large intestine biofilm. Have you found any papers about antibiotics' use in UC that suggest a "weakened" biofilm would be advantageous for an FMT recipient?

 

[mf15]

Nothing specific,but believe it to be a good idea, along with colon washout/lavage.
As you see with the antibiotics the biofilm is still there, and if they are stopped there is a large rebound of bacteria in the biofilm.

I am also starting to believe that FMT is not the ultimate probiotic, what might be better is mucosal associated bacteria, stool bacteria is not the same as what lives on top of or in the outer mucus layer.

We have just had another failure of FMT,on healingwell where I usually hang out.
Old Mike
http://www.healingwell.com/community/default.aspx?f=38&m=3239531

 

[7vNH]

As you see with the antibiotics the biofilm is still there, and if they are stopped there is a large rebound of bacteria in the biofilm.

Yeah, I saw that, but discounted the rebound if the transplanted microbiome was infused at around the time when the antibiotic level was going away. In other words, I thought that the introduced microbes would "fill the gap" left as the antibiotics retreated. Are you suggesting that even in the presence of a new healthy microbiome that there would still be a rebound of old/bad guys in the biofilm layer?

 

[mf15]

Not talking about a biofilm on the outer mucus or in the outer mucus.
This is a adherent biofilm that is attached to the mucosa, in the pictures.
Simply replacing one mucosal biofilm with a new one from FTM will not work IMO.
The biofilm has to go somehow,the mucus barrier needs to regenerate and protect the mucosa from any new biofilm/bacteria invasion. FMT supplies nice fresh bacteria that cant wait to invade into the mucosa. Along with this we have to hope that there is not also a innate immune system defect,which allowed this to happen in the first place.
The antibiotics only suppress the activity of the bacteria in the biofilm, the biofilm is not removed by the antibiotics,unless perhaps your lucky.

There are also probiotic bacteria that can disrupt biofilms, also suspect there are bacteria in FMT that do the same. Don't pretend to know how FMT really works, but perhaps timeing,which bacteria and where they go is important.

Also and probably most important, the biofilm is secondary to an impaired mucus barrier, which probably entails quite a bit.

Same thing going on with chronic sinusitis, they have to operate and get the biofilm.
Old Mike