How to maintain a healthy balanced of microflora?

How to maintain a healthy balanced of microflora?

Although most of the time we think of bacteria as a cause of infection or developing certain diseases, there are actually billions of beneficial bacteria present in the human body. In fact, human body is in an interdependent relationship with microbes. Different parts of the body such as skin, digestive tract, respiratory system, eyes, ears, and reproductive system each has a unique microbial profile. Healthy body is consists of a range of microorganisms including bacteria, viruses, fungi and eukaryotes. These microorganisms are recognized as essential to our health.

Micobiome is originally referred to the genes of these microorganisms and microbiota is referred to the different microbial species. However, nowadays these terms are used interchangeably, including both species and their genetic material.

Studies suggest that the number of microbial cells to be at least equal to the number of human body's cells. Human microflora consists of the 10–100 trillion symbiotic microbial cells in each person. Human gut microbiome consists of the largest quantity and diversity, including over 1,000 different bacterial species across individuals and it makes up 2-4 pounds of the body weight. There are about 5 million of only gut microbial genes which is significantly greater than all human's 22,000 protein-encoding genes.

New scientific studies provide vast information on how the microbiome interacts with our cells influencing our health, how it is shaped, maintained and could be used to prevent and treat disease. Since 2008, The Human Microbiome Project has begun working to identify microbial groups and their variations in healthy humans, starting with the gastrointestinal tract, respiratory tract vaginal tract, skin, and oral cavity. Main goal of this project is to gather data to determine that how changes in microbial patterns may contribute to disease and how to restore healthy microbial balance. Recent advancements in gene sequencing techniques has helped to speed up our ever increasing knowledge about the microbiome.


What are the functions of microflora?

Human gut microflora produce enzymes to help with digesting certain food categories that our digestive enzymes alone could not digest. The population of these microbes adapt to the food groups that are mainly consumed. Diet high in animal protein alters the population of the gut flora to include more of those bacteria which are able break down protein. Often metabolites of these digested proteins are harmful to the digestive tract and are known to increase risks of diseases such as colon cancer.

Intestinal microflora metabolizes and activates many plant polyphenols and other phytochemicals which are important to our health. For instance, certain intestinal bacteria are found to be able to modify lignans and isoflavones into active compounds which are related to a better female hormone signaling.

Gut flora through fermentation metabolise the dietary fiber to short chain fatty acids which is used as a source of energy for the intestinal cells and play an important role to regulate immune system, reduce inflammation, prevent infections, can impact on cholesterol levels, and improve absorption of minerals such as calcium.

These beneficial bacteria help to produce B vitamins , vitamin K, and amino acids such as tryptophan. Amino acid tryptophan the is utilized by the body to produce compounds which have an important role in the immune and nervous systems. About 90% of the serotonin is made in the gastrointestinal tract from tryptophan.

Gut flora also may produce other neurotransmitters, such as acetylcholine, norepinephrine, dopamine, and gamma-aminobutyric acid (GABA) which impact on modulating stress response, influencing brain function and mood.

Intestinal flora are important in metabolizing some medications. Micro flora can help to improve body's tolerance to certain medications and improve their bioavailability. Gut microbes help process and detoxify harmful environmental toxins such as carcinogens.

Other important role of the micro flora is to prevent infections by limiting the over growth of the harmful microorganisms. These friendly bacteria provide this benefit via different mechanisms, such as maintaining the PH level, producing anti microbial compounds, calling up the local immune system, competing for food source, preventing the attachments of the harmful bacteria at the site.

Microflora help regulating the immune system . In this way most of our body is impacted by their function. Micro flora influence the immune system development, immune responses, and could help to improve health conditions associated with poor immune health such as, allergies and chronic inflammation which is found in conditions like rheumatoid arthritis, inflammatory bowel disease, dermatitis, and many more. Also, relation between the intestinal micro flora and immune system is important for renewal and repair of the intestinal lining.

Intestinal microflora in particular is found to greatly impact our metabolism. Research has shown that altered intestinal micro flora profile in infancy can indicate the risk of developing obesity and other metabolic conditions. Some factors such as maternal antibiotic or breastfeeding have been shown to impact the infant microbiome. Imbalanced Intestinal microbial profile is often observed in conditions such as obesity, fatty liver (none alcoholic), and type 2 diabetes. Adapting a high fiber diet and weight loss is shown to improve the intestinal microbiome and metabolism; while, high fat and animal protein based diet is found to disrupt micro flora health.

The sleep and intestinal micro flora are also found to be related. In an animal studies, interruptions in circadian rhythms by creating conditions of jet lag or night-shift work, caused change in the normal turnover of the micro flora and caused metabolic disturbances. Other evidence suggests that this may be a two way relationship, further explaining that imbalanced micro flora can affect circadian signaling, which alters biological rhythms and metabolism.


How is the human microflora formed?

Human microflora and the immune system start shaping during infancy, and factors such as the type of diet, genetic , and geography, childhood sickness, use of antibiotics, contact with other people, and even animals and pets, all could have a lifelong impact on forming a balanced microflora and immune health. Bifidobacterium bacteria, along with Lactobacillus species, are the main micro flora of the infant gut, where they help with development of a healthy microbiome and immune system. Microbiome transmission from the mother to the newborn is shown to be also important for the newborn's brain development. Maternal stress during pregnancy, may alter mother's microbiome and its transmission to the infant.

Mother's milk contains certain prebiotics (oligosaccharides) which further supports the growth of Bifidobacterium species, as well as healthy development and function of the intestinal mucus lining and the immune system.

The infant gut microbiome gradually changes in the first two to four years of life, and becomes more stable and similar to the adults microbiome. Healthy Micro Flora in general resists against changes of its environment, and returns to the previous state later; however, it is susceptible to certain factors and its recovery varies between individuals. For instance, antibiotics and changes in eating habits are well known to cause a rapid modification in micro flora and the ability to recover to the primary microbial balance differs from person to person.

Other contributors factors to cause change in microbiome are including; hormonal cycles, hormonal treatments, travel, illness, and aging.


What is Dysbiosis and how would it affect our health?

Dysbiosis is also known as dysbacteriosis. Dysbiosis is referred to as the microbial imbalance or its improper adaptation inside or on the body. Dysbiosis, for instance, can occur on the skin, in the gastrointestinal tract, and vaginal canal. Dysbiosis is often seen in the digestive system, especially in conditions known as small intestine bacterial overgrowth (SIBO) or small intestine fungal overgrowth (SIFO). Dysbiosis could be explained as a shift in the microbial balance away from a healthy pattern.

A healthy microflora is very diverse and generally resilient to physiological stress or changes; while, dysbiotic conditions are associated with lower number of beneficial species and higher number of potentially disease-causing species.

Intestinal dysbiosis is found to increase the risk of immune disturbances and inflammation on the inside and outside of the digestive tract. Dysbiosis has been linked to a number of chronic diseases and conditions such as; allergies, asthma, autoimmune flare ups, cardiovascular conditions, diabetes, IBD, IBS, colitis, cancer, obesity, vaginal infections, chronic fatigue syndrome , and mood and cognitive conditions.


Dysbiosis and increased intestinal permeability:

Bacterial, select viral infections, parasites and some other stressors like certain deficiencies, can affect the tight cellular junctions of intestinal lining, impacting its structure and function which eventually may lead to the development of chronic intestinal disorders and could act as a trigger for diseases. Thight junctions of intestinal lining is modulated by a protein known as zonulin. Increased zonulin levels in the circulation are considered as an indication for an impaired intestinal barrier.

Once intestinal tight intercellular junctions is impacted, it allows the absorption of microbes, microbial products, food antigens, and foreign antibodies, which can then activate the immune system and increased production of inflammatory markers. Increased intestinal permeability is linked to several diseases such as crohn's, celiac disease, irritable bowel syndrome, inflammatory bowel disease, fatty liver, diabetes, rheumatoid arthritis, weight gain, allergic reactions, and mood disorders.

Amino acid glutamine is shown to play an important role in signalling entrocytes which are part of intestinal barrier. Pre-biotics and probiotics are also shown to reduce increased intestinal permeability.


Dysbiosis and SIBO:

Large intestine is populated with a vast diversity of microflora, while the small intestine contains limited number of microflora. SIBO is the dysbiosis of the small intestine which is commonly associated with indigestion and other digestive conditions such as bloating, flatulence, and a probable underlying cause of irritable bowel syndrome. Results from clinical trials suggest that therapy with only probiotics containing Saccharomyces boulardii and Lactobacillus casei or in combination with antibiotic, may help to improve SIBO condition.


Dysbiosis and oral health:

Periodontitis is an oral infection that can damage the bones supporting teeth and lead to tooth loss. Disruption of the oral microbiome is considered one of the major risk factors for periodontitis due to overgrowth of the pathogenic bacteria.


How to support and maintain a healthy microflora?

In recent years studies found an inevitable link between the gut microflora, diet, and physiology; suggesting that diet should be considered the main factor in maintaining a healthy microbiome and therefore a healthy body. Diet high in saturated fat is shown to promote dysbiosis, and intestinal permeability, and intestinal inflammation; while, diet rich in fiber supports growth of the microflora.

Prebiotics are the type of carbohydrates that are indigestible or partially get digested. Prebiotics promote and stimulate the growth or activity of advantageous microflora. Prebiotics are mainly sourced from plant-derived carbohydrate compounds called oligosaccharides. Fructans and Galactans are the main oligosaccharides known as Inulins, Fructooligosaccharides (FOS ) and Galactooligosaccharides (GOS) . Both FOS and GOS are found to stimulate the activity and growth of intestinal beneficial bacteria. Other dietary fibers such as pectin, beta glucans, and Xylooalsooligosaccharides(XOS) are also provide similar benefits and considered prebiotics.

Fermentable carbohydrates from fructans and xylans are very well documented examples of prebiotics. The FOS and inulin content in food sources is very low, so it is difficult to get sufficient prebiotics from food alone. Indigestible carbohydrate compounds that are categorized as prebiotics are a type of fermentable fiber; however, not all dietary fiber could be source of perbiotics. Raw oats, raw dry chicory root, artichoke, dandelion leaf, garlic, asparagus, and wheat bran are source of prebiotics. Usually 4-8 grams daily is recommended to help maintaining general digestive health, while 15 grams or more is recommended for those with digestive disorders.

Human breast milk contains oligosaccharides which are structurally similar to GOS. Human milk oligosaccharides (HMOs) are suggested to increase the Bifidobacteria bacterial population in breastfed infants, and to strengthen the infant immune system.

Consuming alcoholic beverages has been associated with dysbiosis, inflammation and increased permeability of the intestinal mucosa. Some evidence suggests certain individuals with increased gut permeability demonstrate higher rate of depression, anxiety, and cravings. Improving microbiome in this group may possibly reduce the risk of relapse.

Stress and poor sleep are shown to negatively impact the healthy balance of gut microbes. Research suggests that a sudden acute stressful situations, such as a disease, trauma, or burn injury, cause a significant reductions in gut microbial population and activity. Therefore, high stress conditions in the body trigger changes in the gut microflora and the regulation of some neurotransmitters. Reducing stress and getting healthy sleep might improve the health of the microbiome.

The digestive system has its own nervous tissue, which is known as the enteric nervous system. Enteric nervous system responds to the intestinal environment and regulates its activity. Although the enteric nervous system acts independently, it also communicates with the central nervous system via a network referred to as the gut-brain axis. This further defines the fact that the intestinal health and nervous system are mutually related.

Intestinal microbes produce variety of neuroactive compounds to help control intestinal barrier function, and modulate immune and inflammatory response. It has been shown that there is a link between intestinal microflora and several neurological disorders. In a study microbial transplant from human with Parkinson disease to genetically susceptible mice prompt manifestations of the disease while the a transplant from healthy human did not cause any change.

Animal studies also suggest that, most likely the intestinal microbiome play a role in controlling appetite, feeding behavior, and taste through the gut-brain axis.


Probiotics and their beneficial impact on digestive conditions:

The World Health Organization (WHO) defines probiotics as live micro-organisms that, "...when administered in adequate amounts, confer a health benefit on the host". Most probiotic supplements contain bacteria, and commonly include species from the Lactobacillus and Bifidobacterium genera. Some species of yeast Saccharomyces are also used in probiotic supplements. Probiotic supplements are usually measured in colony forming units (CFUs), which represent the number of live cells. Safety and the therapeutic efficacy of the probiotics are well documented. However, there are potential of concerns for very young or very old age, individuals with compromised immune system, those who are critically ill in intensive care, and individuals with advanced damage to the lining of the intestinal tract like cases with sever colitis.

Recent developments in genetic sequencing technology has provided better understanding of the probiotics and their possible health benefits. Many studies are exploring probiotics effects on intestinal inflammation, diarrhea, urogenital infections, immune modulating, and much more.

Data show the Lactobacillus reuteri can decrease duration of diarrhea in children, and L. rhamnosus GG is beneficial for diarrhea due to antibiotics in both adults and children. Results from randomized controlled clinical trials showed that the participants are 51% less likely to develop antibiotic-associated diarrhea when supplemented with L. rhamnosus GG and S. boulardii in daily doses higher that 5 billion CFUs appeared to be more protective.

Saccharomyces boulardii and other probiotics include L. rhamnosus GG, L. acidophilus, and B. bifidum are also suggested to prevent traveler's diarrhea .

Evidence from multiple clinical trials are indicative of probiotic supplements are beneficial to stimulate intestinal motility and therefore relieving constipation. The results from all the studies showed that probiotic supplementation offers a significant improvement in consistency and the frequency of the stool, bowel movement, and decreased severity of constipation. Clinical trials using different strains of B. lactis , L. casei, L. reuteri , and L. paracasei, L. plantarum were able to manage chronic constipation in participant.

Studies on probiotic B. longum BB536 , have found this probiotic is able to provide a modulatory effect on the intestinal movement and it is beneficial for both conditions of low and frequent intestinal activities.

Probiotic supplementation is also found to be helping improve overall symptoms and quality of life in patients with IBS. Results from studies suggest that the IBS conditions respond better to treatments with a single strain Probiotic instead of the multi-strain formulations. IBS patients reported improvements in their symptoms by Probiotics containing only Lactobacillus species, reduction in abdominal pain while taking S.cerevisiaeand general improvementwith probiotics containing strains of Bacillus coagulans .

IBD (Inflammatory bowel disease) represents major autoimmune conditions of ulcerative colitis and Crohn's disease. The intestinal microflora population in individuals with IBD is very unstable. Dysbiosis, immune condition, and inflammation are commonly observed initially and during flare-ups. Data from several randomized controlled trials have found probiotics safe and effective for colitis and help to contain their remission.

Clinical trials from VSL3 which contains four Lactobacillus species (L. acidophilus, L. plantarum, L. casei, and L. bulgaricus), three Bifidobacterium species (B. longum, B. breve, and B. infantis), and one Streptococcus species (S. thermophilus ) has shown higher rates of clinical response and remission is those given VSL#3 compared with placebo group.

Clinical trials also found some single-species probiotic supplements to be useful in managing ulcerative colitis. For instance, B. longum BB536, at higher doses of 200–300 billion CFUs per day, induced the clinical remission rate and improved the appearance of the colon tissue. Similarly adding L. rhamnosus GG or S. boulardii to the treatment has shown to induce remission of colitis symptoms .

Some other studies, showed when S. boulardii added to standard medical treatment for Crohn's disease it helped to reduce some of its symptoms and clinical relapses.

Gastritis and Peptic Ulcer Disease are common digestive conditions which often caused by Helicobacter pylori infection, certain anti inflammatory medications, alcohol, and smoking. Research suggests over half of the population worldwide carry gastric H. pylori while most do not demonstrate any symptoms. However in some H. pylori may initiate changes to the digestive system and lining of the upper intestine which increases risk of gastric or duodenal ulcer and gastric cancer. H. pylori resistance to common treatments by antibiotics has led to much lower success rate in treating this condition.

Probiotics although unable to eradicate H.Pylori, they can reduce its adhesion to the mucosal lining, reduce digestive inflammation, and improve immune response to the infection. Some probiotics are also able to produce antimicrobial compounds which can suppress H.Pylori. Several clinical trials used probiotics with no other treatment and found while probiotic do not eliminate H. pylori, they can reduce the number of H. pylori. Probiotics from the Lactobacillus, Bifidobacterium, or Saccharomyces species and range of single-and multi-strain probiotics shown to effectively improve H.Pyloi's elimination rate and treatment tolerance.


Probiotics and Cardiovascular health:

There are some evidence from clinical trials that have shown probiotic and prebiotic supplements could help weight management and improve metabolic and inflammatory markers related to the cardiovascular health.

For example, data from multiple trials including 485 participants are indicative of probiotic therapy being able to effectively reduce total and LDL-cholesterol levels. In this research, L. acidophilus strains were found to have great lipid-lowering effects.  Also, other Lactobacillus bacteria like; L. reuteri and L. plantarum, have shown to decrease total cholesterol and LDL- levels.


Probiotics and oral health:

Several studies found that probiotics can reduce oral conditions such as; gum bleeding, gingivitis, cavities, and periodontal pocket depth in patients with periodontal disease. Probiotics benefits have been linked to their abilities to compete with harmful microbes for nutrients, produce antimicrobial compounds which restrict other harmful bacteria, and trough improving immune response.

Probiotics lozenges with bacterium L. salivarius has shown to reduce levels of harmful bacteria in dental plaque,

plaque formation, gum disease, gum bleeding, and the risk of periodontal disease. A randomized controlled trial found that L. reuteri lozenges helped to improve inflammatory conditions related to the tissues around a dental implant.

Probiotic Streptococcus salivarius has exhibited antibacterial effects against S. mutans, which is an oral bacterium known to be responsible for the formation of dental cavities. In addition, Streptococcus salivarius produces an enzymes that decrease dental plaque accumulation and acidification. Data from a randomized controlled study on children found that significantly better results are achieved with higher doses of S. salivarius to control plaque formation and promote higher elimination rate of harmful S. mutans.

Chewable probiotic combinations including types of Lactobacillus and Bifidobacterium species have also shown to inhibit S. mutans, reduce plaque and improve gum health better than a placebo in children.

Xyletol has been vastly studied for its prebiotic benefits for oral and intestinal health. Xylitol, in toothpastes, mouth rinses, chewing gums, and candies, has been shown to be able to decrease number of cavity-causing bacteria in the saliva and plaque, reduce plaque formation, and suppress tooth decay.


Probiotics and urinary & vaginal infection:

Trials in healthy women indicate that both oral and vaginal use of Lactobacillus probiotic species such as L. casei rhamnosus, L. rhamnosus, L. paracasei, L. fermentum, L. plantarum , and L. gasseri may help to improve their vaginal colonization over time. Data analysis suggests that probiotics containing at least one type of Lactobacillus could be considered as an important part of prevention and treatment for bacterial vaginosis and urinary tract infections in women.

Lab research found Probiotic Lactobacillus to provide antifungal effects and ability to regulate the immune response against Candida yeast species in laboratory research . Certain probiotic strains, such as L. rhamnosus GR-1 and L. reuteri RC-14 , may be able to interrupt the metabolic activity of yeast cells and even affect genes of resistance to antifungal medication.

Lactobacillus may reduce risks of urinary tract infection by inhibiting colony formation of infection-causing microbes near the outer of the urinary tract, and via improving immune response. In a clinical study a preventative treatment by oral administration of L. rhamnosus GR-1 and L. reuteri RC-14 daily to postmenopausal women with recurrent urinary tract infections helped lowering the frequency of urinary tract infections.


Probiotics and respiratory health:

Microflora of the throat, nose, and sinuses are much like the intestinal microbiome, help limit the presence of harmful microbes and regulate immune response. There are some similarities with the oral and nasal microbial types, but the lungs also contain a specific type of microflora which is important to maintain health and immunity .

Oral probiotics have shown to reduce the frequency and duration of upper respiratory tract infections. New research is exploring the benefits of nasal spray probiotics to restore a healthy microbial balance in the upper respiratory tract. Nasal spray of Streptococcus salivarius 24SMB is suggested that might help children with chronic or recurrent otitis media.


Probiotics and skin health:

The skin microflora is not the same across the body in the same individual and also between individuals. The skin microflora stays stable within the body even with its exposure to changing conditions. Skin dysbiosis has been linked to skin conditions such as; acne, atopic dermatitis (eczema), psoriasis, rosacea, seborrhea, and dandruff.

As an example use of probiotic supplements during pregnancy and when given in the first years of life may help prevent atopic dermatitis. Review of many studies on preventing eczema in infants and children, indicated supplements with Lactobacillus species, and Bifidobacterium species, or both, provide protective effects.


Probiotics and mood:

In a human double-blind placebo-controlled clinical trial supplementing with a formulation containing L. helveticus R0052 and B. longum R0175 , improved psychological conditions within 30 days. Participants who took the probiotic showed improvements in depression, anger-hostility, and problem solving.

In animal studies the same probiotic combination reduced anxiety-like behavior and depression scores, after a heart attack; restored intestinal permeability, decreased cell death in different brain regions, it also prevented brain changes due to chronic psychological stress.

The human body is in a dynamic and interdependent relationship with beneficial microorganisms all of which are recognized as essential to our health.  Probiotics have received renewed attention in the 21st century from product manufacturers, research studies, and consumers. The history of probiotics can be traced to the first use of cheese and fermented products, Bifidobacteria were first isolated from a breast-fed infant by Henry Tissier, who also worked at the Pasteur Institute. Preliminary research is evaluating the potential physiological effects of multi-strain Probiotics, as opposed to a single strain. As the human body contains several hundred microbial species, theories suggest that the body may benefit more from consuming multi-strain probiotics.


Articles and products featured by Health Palace are collected from a variety of sources and are provided as a service by Health Palace. These newsletters, while of potential interest to readers, do not necessarily represent the opinions nor constitute the advice of Health Palace. Presented materials are only for information purposes and do not intent to treat, cure, or prevent any disease.


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