Microbiome

The microbiome is the collection of all microorganisms, bacteria, fungi and viruses. Well, we used to think about the bacteria that colonized humans as bad. We always thought of them as pathogens, and we wanted to try to destroy them and thought that was the real benefit of antibiotics. But...

In 2007, the National Institutes of Health launched a massive five-year consortium to map our microbial complexity. The agency’s Human Microbiome Project created a base line portrait of a healthy human microbiome. This project, and numerous other studies that followed, showed us that Homo sapiens are essentially symbiotic organisms and that the microbiome is an integral component of human biology, with a major role in health and well-being. Also, today we know that we host over 100 trillion of bacteria, mostly in our gut, mouth and skin. And we have only 10 trillion human cells, so microbiome cells outnumber human cells ten to one. The number of genes in all the microbes in one person’s microbiome is 200 times the number of genes in the human genome. (1)

Gut Microbiome and Autoimmunity

Keeping a delicate balance in the immune system by eliminating invading pathogens, while still maintaining self-tolerance to avoid autoimmunity, is critical for the body’s health. The gut microbiota that resides in the gastrointestinal tract provides essential health benefits to its host, particularly by regulating immune homeostasis. Moreover, it has recently become obvious that alterations of these gut microbial communities can cause immune dysregulation, leading to autoimmune disorders (2)

Kids

In a recent study researchers showed that early-life antibiotic exposures, cesarean section, and formula feeding disrupt microbiome establishment and adversely affect health later in life. 

• The study points that antibiotics delayed kids microbiome development and suppressed Clostridiales, including Lachnospiraceae. 
• The maternal vaginal microbiota provides newborns with a greater variety of colonizing microorganisms responsible for boosting and preparing the immune system. Infants born vaginally presented a greater concentration of Bacteroides, Bifidobacteria, and Lactobacillus in the first days of life and more significant microbial variability in the following weeks. The microbiome of infants born via C-section is similar to the maternal skin and the hospital setting and less diverse, mainly composed of Staphylococcus, Streptococcus, and Clostridium.
• Formula-feeding was associated with age-dependent diversity deviations. Unlike formula, human milk contains an incredible array of microorganisms. These likely contribute to the seeding of the infant gastrointestinal microbiome, thereby influencing infant immune and metabolic development and later-life health.

These findings illustrate the complexity of early-life microbiome development, and microbiota disturbances with antibiotic use, cesarean section, and formula feeding that may contribute to obesity, asthma, and other disorders. (3) (4) (5)

Brain-Gut Axis

If you’ve ever “gone with your gut” to make a decision or felt “butterflies in your stomach” when nervous, you’re likely getting signals from an unexpected source: your second brain. Hidden in the walls of the digestive system, this “brain in your gut” is revolutionizing medicine’s understanding of the links between digestion, mood, health and even the way you think. 

The interaction of the central nervous system (CNS) and gut signaling pathways includes chemical, neural immune and endocrine routes. Alteration or dysbiosis in the gut microbiota leads to different gastrointestinal tract disorders that ultimately impact host physiology because of the abnormal microbial metabolites that stimulate and trigger different physiologic reactions in the host body. Intestinal dysbiosis leads to a change in the bidirectional relationship between the CNS and GM, which is linked to the pathogenesis of neurodevelopmental and neurological disorders. Increasing preclinical and clinical studies/evidence indicate that gut microbes are a possible susceptibility factor for the progression of neurological disorders, including Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS) and autism spectrum disorder (ASD).(7)

Healthy Microbiome

What it means for our microbiome to be healthy will look different from person to person, but it can be categorized in two main ways: how we take care of our gut health physically, including exercise and the food we eat, and mentally/emotionally, such as managing stress and anxiety and engaging in healthy lifestyle behaviors.

Taking care of your gut health through food and lifestyle could look like eating a varied and colorful diet that can provide adequate amounts of vitamins and minerals as well as fiber, probiotics, and prebiotics, as well as incorporating some of the practices below:

• Moving your body regularly through exercise that works for you
• Staying hydrated
• Managing stress and anxiety, whether through meditation, breathwork, or meeting with a mental health professional regularly
• Creating an environment that supports your well-being, including nurturing positive relationships and a safe and healthy home
• Refraining from excessive alcohol consumption and smoking

What Should I Eat To Get Better

American College of Rheumatology recommends Mediterranean Diet as the best one for patients with Rheumatoid Arthritis, and other popular diets are Anti-Inflammatory, Vegetarian, Carnivore, Keto, Paleo, Plant Paradox, Wahls Protocol etc. All of these diets work for some as they impose time restricted eating, which means you can eat only certain number of meals each day, and they limit intake of junk foods like sugary drinks, packaged foods, snacks with added sugar, and grains.
At St. Pete Arthritis & Rheumatology we believe that there is no 'one-size fits all' when it comes to diet and nutrition, but generally, we recommend the natural, healthy animal and vegetable foods that people ate and grew robust on in centuries past, and avoid modern ultra-processed foods, specially those with added sugar. Examples of good food choices are:

• wild-caught fish and grass-fed meats
• fermented foods (kimchi, sauerkraut, pickles, yogurt, kefir)
• pasture raised eggs
• healthy oils (coconut oil, olive oil, butter) 
• green leafy vegetables, peas, artichokes, asparagus
• olives
• honey
• some nuts 
• avocado
• seasonal local fruits 
• herbal teas (green tea) 
• basil, turmeric, oregano, ginger
• filtered or spring water
• etc.

At St. Pete Arthritis & Rheumatology, we have expert physicians who are all sympathetic, educated, and skilled. If you are considering consulting a rheumatologist, call us today at 727-290-1444 or book online. 

(1)   Your Microbes and You, The Good, Bad and Ugly - NIH Press Release November 2012 https://newsinhealth.nih.gov/2012/11/your-microbes-you

(2)  Wu HJ, Wu E. The role of gut microbiota in immune homeostasis and autoimmunity. Gut Microbes. 2012 Jan-Feb;3(1):4-14. doi: 10.4161/gmic.19320. Epub 2012 Jan 1. PMID: 22356853; PMCID: PMC3337124. 

(3) Bokulich NA, Chung J, Battaglia T, Henderson N, Jay M, Li H, D Lieber A, Wu F, Perez-Perez GI, Chen Y, Schweizer W, Zheng X, Contreras M, Dominguez-Bello MG, Blaser MJ. Antibiotics, birth mode, and diet shape microbiome maturation during early life. Sci Transl Med. 2016 Jun 15;8(343):343ra82. doi: 10.1126/scitranslmed.aad7121. PMID: 27306664; PMCID: PMC5308924. 

(4)  Coelho GDP, Ayres LFA, Barreto DS, Henriques BD, Prado MRMC, Passos CMD. Acquisition of microbiota according to the type of birth: an integrative review. Rev Lat Am Enfermagem. 2021 Jul 19;29:e3446. doi: 10.1590/1518.8345.4466.3446. PMID: 34287544; PMCID: PMC8294792. 

(5)  Stinson LF, Sindi ASM, Cheema AS, Lai CT, Mühlhäusler BS, Wlodek ME, Payne MS, Geddes DT. The human milk microbiome: who, what, when, where, why, and how? Nutr Rev. 2021 Apr 7;79(5):529-543. doi: 10.1093/nutrit/nuaa029. PMID: 32443154. 

(6)  Hou, K., Wu, ZX., Chen, XY. et al. Microbiota in health and diseases. Sig Transduct Target Ther 7, 135 (2022). 

(7)  Front. Neurosci., 04 August 2023 Sec. Gut-Brain Axis Volume 17 - 2023 | https://doi.org/10.3389/fnins.2023.1225875