Tuesday, January 25, 2022

Can Heart Transplant Patients Take Probiotics

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Dysbiosis And Renal Fibrosis

Can PROBIOTICS prevent HEART FAILURE?

In a recent study on transplant patients, Modena et al.42 collected urinary samples from 25 patients after kidney transplantation. All of these patients developed interstitial fibrosis/tubular atrophy at 6 months after transplantation at kidney biopsy. Patients were compared with 23 kidney transplant recipients who did not develop IF/TA. Patients with IF/TA had a decreased number of Lactobacillus and Streptococcus genera. The authors concluded that modification of the urinary microbiota could develop IF/TA by altering the host immune response.

Mr Bacteria Please Eat Some Uremic Toxins

Give me some of that uremic-toxin eating bacteria! you say. Yes, that is possible! Let me tell you what that really means as far as what you do. Also consider that we are not just concerned about a strain of bacteria but also must always consider overall gut health because of how it impacts inflammation.

Gut health and kidney disease is not just about uremic toxins. Theres a lot more. There hasnt been one huge study, perfectly randomized, placebo-controlled study that shows the relationship between gut health and CKD progression. But theres been plenty of smaller studies focusing on correcting gut bacterial balance with reported findings of delaying kidney progression, reducing inflammation, and improving iron status .

There is also some interesting data showing that probiotics may help improve the health, strength, and overall condition of the gut barrier . The gut barrier is an absolutely essential point to understand when looking at the connection between gut health and inflammation.

The gut barrier is pretty important since it houses 70% or so of our immune system . It also is supposed to be a semi-permeable barrier meaning it lets some little things through and some big things out . If the gut barrier becomes more permeable, aka leaky, then unwelcome things pass into the blood that shouldnt.

When your guts epithelial tight junctions start to loosen up, some ugly things that should stay in your gut and be metabolized by bacteria begin toenter the bloodstream.

A Gut Check For Heart Failure Patients

Date:
European Society of Cardiology
Summary:
Heart failure patients who consume more dietary fiber tend to have healthier gut bacteria, which is associated with reduced risk of death or need of a heart transplant.

Heart failure patients who consume more dietary fibre tend to have healthier gut bacteria, which is associated with reduced risk of death or need of a heart transplant. The fibre study was presented today at Heart Failure 2019, a scientific congress of the European Society of Cardiology .

“Our gut microbiota is composed of trillions of microorganisms that have the potential to affect our health,” said study author Dr Cristiane Mayerhofer, of Oslo University Hospital, Norway. “Previous research has reported reduced biodiversity of microbes in the gut of patients with heart failure patients. Today we show for the first time that this is related to low fibre intake.”

The study also linked meat intake to higher levels of trimethylamine-N-oxide in patients with heart failure. Prior research has shown that increased TMAO levels are associated with a greater risk of cardiovascular events, and that gut microbes play a role in its formation.

“We show an important pathway that connects diet, microbial activity, and cardiovascular disease,” said Dr Mayerhofer. “It would be prudent for patients with heart failure to limit their meat intake to two to three times a week.”

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Management Of Vzv Disease: Bmt Patients

Primary infection with VZV causes chickenpox whereas reactivation of latent virus causes shingles . Chickenpox has a high mortality in immunocompromised patients but is fortunately rare in BMT recipients. Before the use of passive vaccination and acyclovir prophylaxis varicella occurred in 25% of children during the first 6 months after BMT.

Herpes zoster, on the other hand, is frequently seen as a relatively late complication after BMT, occurring within the first 210 months after BMT . Before the use of prophylaxis, about one-third of both autologous and allogeneic adult BMT patients experienced either localized or disseminated herpes zoster within the first year., Skin and visceral dissemination occur in 25% and 15%, respectively, of cases of herpes zoster in such patients: the mortality of this form of disease approaches 30%. Cutaneous dissemination of herpes zoster usually precedes visceral dissemination. Contralateral hemiparesis is also a recognized complication of ophthalmic herpes zoster.

Subclinical viraemia and clinical episodes of herpes zoster provide in vivo re-exposure to VZV antigens and help the recovery of virus-specific cytotoxic T-cell function. A recent study of varicella vaccine has shown that BMT recipients immunized with an inactivated varicella vaccine showed early reconstitution of immunity.

Treatment

In the rare case of herpes zoster where the virus is resistant to acyclovir, foscarnet has been shown to be effective.

Recommendations.

Prophylaxis

Sibo Small Intestinal Bacterial Overgrowth

Are probiotics safe for renal transplant patients?

A SIBO diagnosis means that there are bacteria growing in your small intestine, where theyre not supposed to be! If you take probiotics with this condition, you will feel worse. You will be more bloated, have more discomfort and pain, and possibly even feel quite sick. Here is an article posted on the NIH website about it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099351/

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How L Reuteri Reduces Cholesterol Levels

The key to success for L. reuteri is in its ability to produce an enzyme called bile salt hydrolase. This enzyme makescholesterol less absorbable so that instead of being absorbed into the bloodstream, it becomes trapped in the gut, then later excreted in fecal matter.21

Like all fats, cholesterol in its free state cannot dissolve in water and is not easily absorbed on its own. This creates a problem because cholesterolboth LDL and HDLis beneficial for the body and is necessary for functions such as forming cell membranes and creating hormones.

In order to make cholesterol more absorbable, liver cells produce free bile acids, which are then bonded to the amino acids glycine and taurine and secreted into the intestines.22 Conjugated bile acids are more water-soluble than free bile acids, meaning they are better able to assist with the absorption of cholesterol.15

The problem is that when too much cholesterol is available, either from excess dietary consumption or excess release from the liver into the small intestine, the reabsorption of cholesterol causes the body to maintain blood cholesterol levels higher than necessary, raising cardiovascular disease risk.23-27

Other Lactobacillus Research

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Management Of Herpes Simplex Disease: Bmt Patients

Symptomatic HSV infections occur in the first weeks after BMT during the period of leucopenia, when mucosal damage is maximal as a consequence of the radiotherapy and chemotherapy used for conditioning. Oral ulceration, often painful and necrotic and lasting for several weeks, is the most common clinical manifestation and results from reactivation of long-standing latent infection in the trigeminal ganglion. Peri-oral lesions often spread into the mouth and may give rise to oesophagitis and pneumonia by direct spread from the oral cavity: HSV pneumonitis occurred in 2% of BMT recipients before effective antiviral therapy was introduced. Only rarely does infection become disseminated to produce HSV hepatitis. Persons previously infected with HSV in the sacral ganglia are also at risk of reactivation to produce genital ulceration. Mucocutaneous recurrences of HSV occurring later after BMT, even though there may still be some cellular immunodeficiency, are usually less severe.

Treatment

Both oral and iv acyclovir is very effective in reducing the duration of viral shedding and time to healing of mucocutaneous lesions in BMT recipients. There are no placebo-controlled trials of iv acyclovir in HSV infections of visceral organs but there is a good deal of anecdotal evidence of benefit. Oral acyclovir is likely to be useful in patients with oral, oesophageal or genital lesions but for severe localized or disseminated disease in BMT patients, iv acyclovir is more suitable.

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What Is A Valuable Type Of Probiotics

At present, there are many different types of microbiological bacteria each one has the separate effects. To determine the impact of microbial strains, treatment and clinical examination practically are necessary. Great probiotics need to meet the following criteria:

Firstly, the effectiveness of probiotics depends on the type of bacteria inside them. Bacterial strains that were selected and developed from useful microorganisms in the human body have been studied and tested clinically. Some bacterial groups were recommended by World Health Organization to use like yeast strains of the Saccharomycetaceae, Lactobacillus, Bacillus.

A study sponsored by Nation Center for Complementary and Integrative Health revealed that Lactobacillus strains were safe for over 65-year-old healthy inhabitants.

Secondly, the content of bacterial strain must have a minimum of 107 CFU/gr. According to WHO, to get the most efficient effects, the bacterial content must reach from 107 to 1010 CFU/gr. If the microbiological level is out of this range, their ability to survive and grow in the digestive tract will not be high, leading to lower their effects and even be ineffective.

Antibiotics Probiotics And Prebiotics

Probiotics Prevent Heart Disease

To prevent or treat complications and ameliorate the imbalanced gut microbiota after allogeneic transplantation, gut microbial intervention methods are used. Antibiotics, probiotics and prebiotics are most often used. Promising and encouraging results have been obtained . However, the role of intestinal decontamination in allogeneic transplantation is still controversial.

Table 2 The results of different gut microbial intervention methods

Probiotic administration is also useful in ameliorating gut microbial dysbiosis after SBT. Compared with non-treated hosts, small bowel histological injuries were significantly ameliorated and BT was reduced in rats with 6 days of probiotics treatment after SBT . Similarly, in mice with an allogeneic stem cell transplantation, modifying the intestinal microbiota using the probiotic microorganism Lactobacillus rhamnosus resulted in a reduced translocation of enteric bacteria to the mesenteric lymph nodes, reduced acute GVHD and improved survival .

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Difference In Gender Ethnicity And Age

As we all know, the composition of the intestinal microbiota differs from person to person , and might be dependent on gender and ethnicity as well.

Ageing may be a potential risk factor that influence the human gut microbiota. Recently, a surprising study conducted by Arya and his co-workers demonstrated that ageing is associated with a reduction in the beneficial commensal microbes. Reduction of beneficial muciniphola, prausnitzii, lactobacilli and bifidobacteria and an increase of staphylococci, clostridia, streptococci and enerobacteria were found in ageing rodents gut microbiota. Those results were same with OToole and Claesson conclusions, a significantly reduction of Lactobacillus and Faecalibacterium and the increase of Eubacteriaceae family and Oscillibacter and Alistipes genera was found in the gut microbiota of frailty elderly people. Those results conclude that ageing is probably associated with the gut microbiota.

Moreover, ethnic also have an important influence to gut microbiota. Yazici and his co-workers found that race-dependent association of sulfidogenic bacteria with colorectal cancer. They used 16S rDNA sequence to confirm that sulfidogenic bacteria was associated with colorectal cancer, and examine the microbiota of African Americans and non-Hispanic whites. To their surprise, they found that African Americans harboured a great abundance of sulfidogenic bacteria compared with non-Hispanic whites regardless of disease status.

Gut Microbiota Complications And The Immune System

As discussed above, gut microbial dysbiosis and complications after transplantation coexist. However, the role of a host immune system in the correlation between gut microbial dysbiosis and complications is rarely studied. Similar to pathogens, gut microbes express microbial-associated molecular patterns such as lipopolysaccharides that can be sensed by specialized receptors on various cells, including immune and gut endothelial cells, to communicate with the immune system. There are a variety of pattern recognition receptors . The most studied ones are Toll-like receptors and NOD-like receptors . Intracellular adaptors are indispensable in transferring PRR signaling information and MyD88 is the most studied one, which is a molecule downstream of all TLRs except TLR3. After being exposed to MAMPs, PRR signaling in cells can promote the expression of major histocompatibility complex and costimulatory molecules, particularly on antigen-presenting cells and some endothelial cells . As a result, cytokines such as tumor necrosis factor , type I interferons , interleukin-1 and IL-6 are produced.

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Choosing A Probiotic For Heart Health

Natren offers a range of probiotics so that you can pick the one that best fit your needs.

If you are new to probiotics, we recommend starting with Healthy Trinity as the best probiotic for your heart health. Healthy Trinity is a good choice because it provides a 3 in 1 supplement that takes the guesswork out of choosing the best probiotic for you.

For those who want to customize their probiotic routine, we recommend you learn more about:

  • Megadophilus which is step 1 in our 3-step system, and focuses on the small intestine where the majority of digestion takes place.
  • Bifido Factor which is step 2 is our 3-step system, and focuses on the large intestine.
  • Digesta-Lac which is the final step in our 3-step system, and gives support through the whole digestive process.
  • Natrens line of probiotics are appropriate for men, women, and children including those who feel like theyre at their peak health and want to stay that way, as well as those looking to take steps to improve their health. You can learn more about us, our products, and our commitment to your health at natren.com

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    How Probiotics Might Be Bad For You

    Can probiotics improve our health?

    Because these good bacteria already exist in the body, theyâre considered safe for most people. But there are some things to consider.

    They can trigger an allergic reaction. They might cause mild stomach problems, especially the first few days you start taking them. You might have stomach upset, gas, diarrhea, or bloating. Those symptoms usually go away after your body gets used to them.

    If you have an immune system problem or another serious health condition, you may have a greater chance of issues. Some reports have linked probiotics to serious infections and other side effects. The people most likely to have trouble are those with immune system problems, people whoâve had surgery, and others who are critically ill. Donât take probiotics if you have any of those issues.

    Always talk to your pediatrician before giving probiotic supplements to your child. If youâre pregnant or nursing, you should also talk to your doctor before you try one.

    Most probiotics in the U.S. are sold as dietary supplements. That means the companies that make them donât have to test their products and show that they work or that they are safe. More research is needed to confirm that probiotics are safe and effective.

    Ask your doctor which probiotics are the right ones for you. Be sure to stop taking them if you have any problems.

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    How Probiotics Support A Healthy Heart

    More than 2000 years ago, Hippocrates said all disease begins in the gut. But only now are we beginning to understand how the gastrointestinal system mediates many functions and is therefore central to health and disease. Apart from the ever-increasing incidence of digestive disorders, an unhealthy gut and an imbalance in gut bacteria can contribute to a wide range of diseases, including heart disease.

    How are our gut bacteria relevant to heart health? People with reduced microbial diversity in the gut are at a higher risk of cardiovascular disease . A recent study showed that heart failure patients who eat more fibre have healthier balance of gut bacteria, which has been linked to reduced risk of death and need for a heart transplant.

    So its clear that one of the most natural ways to support heart health includes optimising our gut bacteria through diet and using the right probiotics that have been researched for their heart health-promoting properties.

    Specific Foods And Drinks To Avoid To Help Reduce Your Risk Of Food Borne Infections

    The attached list of foods should be avoided by all transplant patients to minimize the risk of Listeria or Salmonella infection.

    Types of food to avoidAlternative choices
    Unpasteurised milk such as milk sold on local farms

    Pasteurised milk, tinned milks, UHT, dried milk

    Yoghurts

    Unpasteurised yoghurts

    Yoghurt which is described on the label as bio or probiotic or bio drinks or supplements such as Yakult, Actimel

    Pasteurised yoghurts

    Any yoghurt that does not describe itself as bio or probiotic including live, plain, Greek and fruit yoghurts

    Cheeses

    Blue-veined and soft mould-ripened cheeses such as Brie, Camembert, Dolcelatte, Roquefort, Feta, Cambozola, Stilton, Danish blue

    Soft sheep and goats cheesesSoft cheeses made with unpasteurised milk for example feta

    Hard cheeses such as Cheddar,

    Red Leicester and Edam

    Processed cheese, for example Philadelphia, Dairylea, Kraft, Cottage cheese

    EggsRaw eggs or undercooked eggs

    Dishes containing raw egg, such as homemade mayonnaise, mousse hollandaise sauce, egg nog

    Hard boiled eggs,

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    What Type And Dose Of Probiotic Is Best For Infants

    Most of the infant studies used an infant formula fortified with category 1 probiotics. The exact strains varied from study to study. Dosages varied between studies as well, but 10 billion CFU per day appears a good general starting point. Talk to your pediatrician before choosing a probiotic for your child.

    Probiotic Species
    L. paracasei and B. lactis

    Management Of Cmv Disease: Liver And Renal Transplantation

    Experience a Heart Transplant in 360°

    Recently published clinical trials suggest that symptomatic CMV infection in liver and renal transplantation may be preventable. However, efforts taken to prevent CMV disease should be commensurate with the magnitude of the clinical problem. Suggested strategies for CMV prevention should be subjected to careful costbenefit analysis and the results or interpretation of such analyses may differ between transplant units. For example, a strategy might be deemed appropriate for liver recipients in one transplant centre, but may be inappropriate for renal recipients at another centre.

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