Covid-19 & Your Gut Microbiota

For months we have debated if we should or even if we needed to modify our gcmaf yogurt in the face of the Covid-19 epidemic. Many of the strains researched to reduce RTI (respiratory track infections ) are already contained in our Gcmaf Yogurt products. We thought why fix something that is not broken while on the other hand we thought their is always room for improvement.

For some time we thought it best to stay out of the Covid-19 situation and that it would resolve itself and go away, as we all now know this is not the case.

After reaching out to many of our practitioner customers and getting some feedback from them we decided to modify our already popular gcmaf yogurt kit to include additional beneficial bacteria which are researched to:

  • Reduce RTI
  • Have Immunomodulatory action
  • Decrease inflammation
  • Anti-diarrhoeal
  • Increase vitamin D3 levels
  • Induced IgA antibody production by Peyer’s patch
  • Anti-microbial
  • Showed specific immunomodulatory effects on the proliferative activity of B and T lymphocytes
  • Stimulated type 1 helper T (Th1) cells
  • Activated the cellular immune system and inhibited incidence of tumors and IgE production.
  • Prevented enteric infections and stimulated secretory IgA in malnourished animals
  • Enhanced IL-10 generation
  • Helped activate innate immunity
  • Stimulation of antigen-presenting cells and T lymphocytes
  • Stimulated macrophage and T-cell cytokine production
  • Anti-candida
  • Activated the humoral immune system
  • Augmented anti-rotavirus IgA production or anti-influenza virus (IFV) IgG production
  • Protected against rotavirus infection or influenza infection, respectively
  • Prevent and treat small intestinal bacterial overgrowth (SIBO) 
  • Supply Butyrate-producing colon bacteria
  • Efficient viral clearance
  • Naturally produce Oxytocin
  • Produce GcMAF from colostrum

This is our current mission to improve our already very successful and effective gcmaf yogurt product by adding some additional strains of bacteria to the current bacterial species in our gcmaf yogurt product.

The additional strains or sub-strains of an already included bacteria strain is important as some strains have a whole host of different effects some of which are very beneficial or do their jobs better.

Orally administered probiotic strains can reduce the incidence and severity of viral RTIs. At a time when doctors are using drugs with little anti- COVID-19 data, probiotic strains documented for anti-viral and respiratory activities (not low-quality undocumented imitations) should become part of the armamentarium to reduce the burden and severity of this pandemic. Probiotic strains and indigenous beneficial microbes should be recommended as part of the overall strategy to flatten the curve.

Covid-19 causes gastrointestinal symptoms, such as nausea and diarrhoea, about 10% of the time. Anything that affects the gut inadvertently involves the gut microbiota therein. Not by analogy, but because the state of gut microbiota partly depends on the host’s gut physiology, and vice-versa.

Gut inflammation leads to leaky gut, for example, which alters the microbial composition in the gut. Lack of butyrate-producing gut bacteria will not provide sufficient butyrate that heals the gut lining and lowers inflammation.

The long-awaited question is: Does Covid-19 lead to significant alterations in the gut microbiota? Or does gut dysbiosis contribute to Covid-19 severity? Understanding this is paramount, considering that the gut microbiota influences 12 other organs in the human body.

In a published paper in Gastroenterology, 21 researchers at the Chinese University of Hong Kong sequenced the gut microbiome of 15 moderate-to-severe Covid-19 patients, six pneumonia controls, and 15 healthy controls. They tracked changes in their gut microbiota throughout the hospital stay (median = 21 days) and correlated it with measures of disease states.


What the Gut Microbiota of Covid-19 Patients Look Like

Covid-19 patients had increased abundance of opportunistic gut pathogens known to cause bacteremia — such as Clostridium hathewayiActinomyces viscous, and Bacteroides nordii — in comparison to all controls. This finding is independent of age, sex, disease comorbidities, or antibiotic usage.

On top of that, beneficial gut microbes — such as Fecalibacterium prausnitziiLachnospiraceae bacterium, Eubacterium rectaleRuminococcus obeum, and Dorea formicigenerans — were depleted in Covid-19 patients vs controls.

These undesirable gut microbial alterations were worse in Covid-19 patients undertaking antibiotics (n = 7).

On the 10th day follow-up after recovery and being tested negative from the throat swab and stool, the gut dysbiosis remained in 10 out of 15 ex-Covid-19 patients. Their gut microbiota were still markedly different, in a bad way, from those who never had Covid-19.

“Among all host factors, Covid-19 infection showed the largest effect size in affecting the gut microbiome, followed by hyperlipidemia, pneumonia, and antibiotics, while age and gender showed no significant effects on gut microbiome alterations,” the researchers found.


Baseline Gut Microbiota and Covid-19 Outcomes

The Hong Kong researchers then determine if baseline gut microbes upon hospital admission could predict who is more likely to suffer more severe Covid-19.

The three bacteria that had the strongest correlation with increasing Covid-19 severity were Coprobacillus species, Clostridium ramosum, and Clostridium hathewayi. The latter two are causative agents of human bacteremia infection based on existing literature. And Corpobacillus species is known to magnify ACE2 expression in the mice gut.

In contrast, Alistipes onderdonkii and Faecalibacterium prausnitzii were the two top bacteria that correlated with good Covid-19 prognosis. Alistipesspecies participate in the tryptophan-serotonin metabolism essential for gut homeostasis. Faecalibacterium prausnitzii is one of the largest butyrate producers in the gut, providing a substantial anti-inflammatory resource.


Gut Microbiota and Fecal Virus Clearance

In a recent study a list of 14 gut bacteria was correlated with efficient viral clearance. Four of these are Bacteroidetes species known to lower ACE2 expression in the mice gut. “These data suggest that Bacteroides species may have a potential protective role in combating SARS-CoV-2 infection by hampering host entry through ACE2,” the authors wrote.

Only Erysipelotrichaceae bacterium species correlated with increasing faecal viral load, indicating a poor viral clearance. And this bacterium is known to contribute to gastrointestinal inflammatory disorders like Crohn’s disease. Baseline levels of Erysipelotrichaceae were also associated with severe Covid-19. The authors, hence, wrote that “gut Erysipelotrichaceae may play a role in augmenting SARS-CoV-2 infection in the host gut.”


To Sum Up the Study

Notably, the present study included a sample of only 15 moderate-to-severe Covid-19 patients. So, findings may not apply to mild or asymptomatic cases. Notwithstanding this caveat, they provided multiple pioneering discoveries:

  • Compared to pneumonia and healthy controls, Covid-19 patients had a distinct gut bacterial profile characterized by the loss of beneficial species important for maintaining gut homeostasis and the growth of opportunistic and inflammatory species.
  • The gut dysbiosis persisted at the 10th day following recovery and virus clearance in the majority of ex-Covid-19 patients.
  • Some degree of gut dysbiosis at baseline predicted who were more likely to have more severe Covid-19.
  • Several gut Bacteroidetes species correlated with efficient virus clearance.
  • Covid-19 patients with antibiotics usage had the worse gut dysbiosis among all — advocating for the prudent use of antibiotics.

This study also corroborates that of China where they examined gut microbiota profiles of 30 Covid-19 patients, 24 influenza patients, and 30 healthy controls. It was found that Covid-19 patients had lowered gut microbiota diversity and levels of butyrate-producers, and higher levels of opportunistic pathogens including StreptococcusRothiaVeillonella and Actinomyces species. And this gut dysbiosis further correlated with pro-inflammatory and pro-coagulant biomarkers of Covid-19 severity.

Although influenza patients also suffered reduced gut microbial diversity, the composition is still different from Covid-19 patients. As the study concluded: “The gut microbial signature of patients with COVID-19 was different from that of H1N1 [influenza] patients and healthy controls.”


The Gut-Lung Axis

Before this study appeared, several research groups have already pondered on the implications of the gut-lung axis in Covid-19. And whether probiotic or diet interventions would confer therapeutic potential.

“The gut-lung axis is supposed to be bidirectional…and when inflammation occurs in the lung, it can affect the gut microbiota as well,” said a 2020 review appearing in Virus Research. Likewise, gut dysbiosis could weaken the lung immunity too. To this end, they proposed that a diet providing nutrients that nourishes gut microbes could help the lung immunity to stay in top shape.

In another research review published in the Frontiers of Cellular and Infection Microbiology, researchers wrote that the “gut-lung axis can shape immune responses and interfere with the course of respiratory diseases.” Their premise is based on mice studies showing that antibiotics-induced gut dysbiosis increased their vulnerability to the influenza virus. Isolating lung immune cells from these mice revealed lower phagocytic activities. Germ-free mice bred in a sterile environment and, thus, lack a gut microbiota were also more likely to die from lung infections.


Would Probiotics Help?

In humans, two meta-analyses of randomized controlled trials (RCTs) have calculated that probiotics could decrease the incidence and duration of respiratory virus infections. In two RCTs, one with 146 and the other with 235 patients on mechanical ventilation, probiotics improved pneumonia outcomes compared to placebo.

A number of researchers have made statements such as. “Probiotics are generally safe, even in the most vulnerable populations and in intensive care settings,” David Baud, a professor of obstetrics and gynaecology, and colleagues stated in a review paper in the Frontiers of Public Health. “Rather than consider intensive care patients too ill to receive probiotic and prebiotic therapy, RCTs of probiotics for the prevention of ventilator-associated pneumonia provide a reason to consider them.”

Low levels of Vitamin D and high levels of Covid-10 mortality

Recent studies have found an association between vitamin D and Covid-19 severity and mortality. Vitamin D may protect from viral infection and ameliorate the symptoms of Covid-19, including the cytokine storm.

Now included in our gcmaf yogurt kit GLYCO-D:

  • Vitamin D3
  • A Bacterial strain shown to Increase vitamin D3 levels 22.5%

One of the recent vitamin D studies demonstrated that in 20 European countries, an association exists between low levels of vitamin D and higher numbers of Covid-19 cases and mortality. Vitamin D levels are found to be severely low for the older population in these countries, especially in Spain, Italy, and Switzerland. As these are some of the more vulnerable populations to developing Covid-19, this might play an important role in vulnerability to the disease.

Another recent Indonesian retrospective cohort study of 780 Covid-19 patients indicated that the majority of death cases had below-normal vitamin D levels and that vitamin D status was strongly associated with Covid-19 mortality.

Vitamin D has a known effect on the immune system, as previous studies have found an association between susceptibility to respiratory tract infections and low vitamin D levels. Vitamin D levels being low have been associated with numerous factors including older age, less sun in the winter, darker skin pigmentation, exposure to less sunlight, and diet. Diets rich in vitamin D, such as those that include fatty fish, orange juice, cheese, and eggs yolks, can help prevent vitamin D deficiency, along with supplementing vitamin D.

Higher vitamin D levels are found in northern Europe due to a diet heavy in cod liver oil and a higher amount of vitamin D supplements. Scandinavian nations have lower numbers of Covid-19 cases compared to the rest of Europe. Italy is one of the worst affected European countries, and has very high levels of vitamin D deficiency, especially in the elderly. Increased pigmentation results in reduced vitamin D production via sun exposure. Individuals in institutions, such as hospitals and care homes, are more likely to be severely deficient in vitamin D due to lack of sun exposure or diet.

Vitamin D plays a role in the functioning of the immune system and modulates white blood cells by preventing them from releasing too many inflammatory cytokines. This could help lessen the Covid-19-induced cytokine storm. Vitamin D also helps to reduce lung injury and reduces the risk of acute respiratory tract infections.

Because about 40% of the US population is vitamin D deficient, understanding the role vitamin D plays in Covid-19 immune response could help reduce the mortality of the disease.

Oxytocin as a potential defence against Covid-19?

LACTOBACILLUS REUTERI

While our product always contained L. reuteri we have now added two specific bacterial strains of L. reuteri used in research has shown to naturally produce Oxytocin. Studies that experimented with L. reuteri yogurt consumption in animals & humans suggested dramatic health benefits for both. (not all L. reuteri strains produce Oxytocin).

According to the research advances on COVID-19, we propose that oxytocin (OT) a nonapeptide hormone acting in the body and the brain, constitutes a biological target against coronavirus infection, especially in high-risk population, with underlying conditions including diabetes, high blood pressure, cardiovascular issues and obesity.

OT exerts a dual effect by mobilizing the immune defense potential, and by suppressing pathogenic responses due to over-reactions of the innate immunity. In human, increase in plasma OT levels reported in the early phases of infectious disease, can limit the excessive pro-inflammatory and oxidative stress reactions, by decreasing interleukins levels in the macrophages. OT exerts a metabolic functional role in cardiovascular disease (by regulating, heart rate, blood pressure, muscle contraction), in diabetes (via glucose uptake and insulin secretion), and obesity (food intake and satiety), in gastric injury (by antiulcer properties), and in osteoporosis (with bone formation and resorption). These effects can be explained by the presence of local OT producing cells (brain, heart, gastrointestinal tract), and by extensive expression of OT receptors.

Of particular interest to Covid-19, is the nitric oxide (NO), which is a key signalling molecule acting as a host response modulator in viral infections . In humans, activation of the OT receptor, which are expressed by endothelial cells in the pulmonary artery, produce a vasolidatory effect via stimulation of the nitric oxide (NO) pathway. In animal models of acute lung injury, OT exposure reduces the expression of inflammatory proteins in the lung tissue. Literature also reveals that viral infections in human (including influenza) attenuate OT receptor expression, indicating a key role for the OT system for human health. As OT secretion and levels seems to adjust to pathogen threat and infection, to elicit initial adaptive inhibitory responses and to restore the host homeostasis, OT administration, which is safely deliverable in humans could be used as a prospective therapeutic agent for Covid-19 viral replication and infection.

Our Gcmaf yogurt Glyco-D has relevant probiotics that produce immune effects and naturally produce oxytocin and Vitamin D. These should be considered during the Covid-19 pandemic.

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