This blog is a way of sharing the information and resources that have helped me to recover my son Roo from an Autism Spectrum Disorder. What I have learned is to view our symptoms as the results of underlying biological cause, which can be identified and healed. I say "our symptoms" because I also have a neuro-immune disorder called Myalgic Encephalomyelitis.

And, of course, I am not a doctor (although I have been known to impersonate one while doing imaginative play with my son)- this is just our story and information that has been helpful or interesting to us. I hope it is helpful and interesting to you!

Sunday, February 7, 2016

Probiotics for Specific Conditions

The book A Mother's Guide To Probiotics has information about which strains of probiotics are suited to which specific health needs and diseases.

Probiotic Advisor is a fee-based service with access to evidence-based information about probiotics.
" provides independent, unbiased, evidence-based information on probiotics, their potential risks, and documented benefits."

Some people may need to reduce or avoid intake of d-lactate producing probiotics, because in some people the d-lactate can build up and cause the person to switch from aerobic to anaerobic respiration (this means the mitochondria produce much less energy).  For more on this read this post from the blog Mommypotamus. (L.acidophilis mainly produces d-lactate).  "Low ATP can affect cognitive function, create feelings of fatigue and impair coordination among other things. More generally, symptoms of D-Lactic acidosis include fatigue, confusion, impaired central nervous system function, impaired coordination, depression, nausea, vomiting, anxiety, anemia, headaches and in extreme cases encephalopathy."  Custom Probiotics has a d-lactate-free formulation.

It is best to avoid strep strains for people with PANDAS as they may trigger a flare.  S. Thermophilus seems to be the most common strep strain and is in many preformulated probiotic products.

There are several blog posts out there with lists of which probiotics are supposed to help certain conditions.  These can be like "cheat sheets" if you trust the blogger.  This is one from The Healthy Home Economist, and this is a list someone posted on a forum that I am intending to research further myself.

The Low Histamine Chef also has a post about probiotics that lower histamine levels and are anti-inflammatory here.  In her post she claims that "L. paracasei probiotic can reverse the gut permeability" and "stress can also cause bacteria to cling to the gastrointestinal tract, but this bacteria was prevented from sticking to the mesenteric lymph nodes (in this study) by a mixture of L. rhamnosus and Lactobacillus helveticus ". She also says that "Lactobacillus plantarum lowers/inhibits tyramine and putrescine but no effect on histamine)" She recommends Bifidobacterium infants, Bifidobacterium longum, Bifidiobacterium breve, and Lactobacillus reuteri.

"The probiotic Lactobacillus rhamnosus (and a few others) down-regulate the IgE and Histamine 4 receptor while also up-regulating anti-inflammatory agents like (IL)-8. In English (to quote a group friend): the probiotic turns down the dial on two important allergy/mast cell cell/histamine receptors, while enhancing the activity of anti-inflammatory agents.

Allergy information (this is not complete):

BioKult may contain traces of soy and milk from the growth medium.
PureEncapsulations ProbioMood contains milk.
Xymogen Probio Defense contains soy and milk (seems to contain some corn)
Standard Process ProSynbiotic contains milk and maltodextrin (probably corn).
Culturelle contains maltodextrin and some products contain artificial colors.
Custom Probiotics *may* be grown on corn.
BioRay products often contain maltodextrin.
Florastor contains milk and some products contain artificial flavors.
Theralac contains milk.
Some Garden of Life products contain oat grass and barley grass, another has banana, milk, and fish.
Threelac contains lemon and yeast.
VSL #3 unflavored has cornstarch.

Pure Encapsulations has a soy and dairy free product called Probiotic 50B.
Pure Encapsulations PureProbiotic (allergen-free)
Seeking Health brand seems to be pretty allergy friendly.
Kirkman brand has many different probiotic products, some are allergy-friendly.
Enzymedica ProBio is free of major allergens and has no fillers.  It does contain several strains that we will be avoiding according to the research in this post.
Jarrow Formulas Jarro-Dophilus® AF Allergen-Free is an inexpensive option (does contain L. Acidophilus)

Specific products that seem to match my own family's needs:

Kirkman CD Biotic
Kirkman Bifido Complex
Kirkman Lactobacillus Duo™ - Hypoallergenic
(contains Lactobacillus rhamnosus, Lactobacillus plantarum)
Thorne Bacillus Coagulans
Pure Encapsulations Lactobacillus Sporogenes (contains rice starch)
Seeking Health Probiota Bifido
Seeking Health Bacillus Coagulans
Seeking Health ProBiota Infant Probiotic Powder (except that it contains L. Casei)
Culturelle dairy and gluten free formula (does contain prebiotics)

Possibly good:
Thorne FloraMend Prime Probiotic (pending research of L. Gasseri)
Jarrow Formulas Ideal Bowel Support 299v (does contain a trace of soy)
Natren Bifido Factor Dairy Free (contains potato and chickpea)

If you're not avoiding acidophilus:
Pharmax HLC Maintenance Probiotic Supplement

Gastrointestinal Health

The use of bacterial spore formers as probiotics.
"Among the large number of probiotic products in use today are bacterial spore formers, mostly of the genus Bacillus. Used primarily in their spore form, these products have been shown to prevent gastrointestinal disorders... Specific mechanisms for how Bacillus species can inhibit gastrointestinal infections will be covered, including immunomodulation and the synthesis of antimicrobials."

Review article: probiotics and prebiotics in irritable bowel syndrome
"A range of probiotics including VSL#3 and L. plantarum 299v enhance (intestinal) barrier function.

Many probiotics including Lactobacillus spp. ferment unabsorbed polysaccharides to generate SCFAs including lactic acid. This acidifies the colonic contents; this acidification inhibits some bacteria and allows others to flourish. Thus 2 × 1010 L. plantarum 299v daily in humans increased acetic, proprionic and butyric acid concentration, while increasing the number of faecal Bifidobacteria spp. and Lactobacillus spp. and reducing the numbers of Clostridia spp.

(S)tress-induced increase in gut permeability and associated visceral hypersensitivity can be inhibited by the probiotic L. paracasei and its soluble products.

Two probiotics, Lactobacillus farciminis, a nitric oxide producing probiotics and L. paracasei NCC2461, have been shown to reduce the increased colonic permeability induced by both partial restraint stress and maternal deprivation (in rats).

(A)dministration of L. rhamnosus to healthy volunteers increased IL-10 secretion and decreased TNF, IL-6 and interferon secretion by peripheral blood mononuclear cells (PBMCs). A similar effect was seen with L. rhamnosus GG, which increases serum IL-10 in atopic children. The probiotic mixture VSL#3 (mixture of .6 × 1010 Lactobacillus spp. (casei, plantarum, acidophilus, delbrueckii ssp. bulgaricus) together with Bifidobacterium (longum,breve and infantis) and one strain of Streptococcus salivarius ssp. thermophilus), which is known to exert an anti-inflammatory effect in pouchitis has also been shown to increase FoxP3 mRNA, a marker of Treg cells.

One relevant study using the Trichinella spiralis mouse model of postinfectious IBS showed that the inhibition of small intestinal contractions seen postinfection was reversed by treatment with L. paracasei, both live and using culture media supernatant. A proteomic analysis showed that supernatant treatment normalized a number of proteins related to cytoskeletal organization and stress response and also reduced a number of markers of inflammation.

E. coli Nissle 1917 has been shown to inhibit the visceral hypersensitivity associated with trinitrobenzene sulphonic acid (TNBS) colitis and L. paracasei inhibits the visceral hypersensitivity associated with inflammation in healthy mice in whom the bacterial microbiota have been disturbed by antibiotics.

An entirely novel mode of action of probiotics has recently been demonstrated in which L. acidophilus increased the expression of μ-opioid and cannabinoid receptors in normal animals, a phenomenon which was associated with an inhibition of visceral sensitivity equivalent to that of morphine 0.1 mg/kg. This action appears independent of an anti-inflammatory effect.

Along with colonization of the gut, L. plantarum significantly decreased the number of sulphite-reducing Clostridia spp. within a week of starting intake.

Treatment with B. infantis was shown to cause a significant reduction in a composite IBS score which included abdominal pain and bloating and difficulties with bowel movements. This was also associated with a change in PBMC cytokine production as assessed by the ratio of IL-10 to IL-12."

Lactobacillus reuteri accelerates gastric emptying and improves regurgitation in infants.
"In infants with functional GER, L. reuteri DSM 17938 reduce gastric distension and accelerate gastric emptying. In addition, this probiotic strain seems to diminish the frequency of regurgitation."

Effect of Bacillus subtilis PB6, a natural probiotic on colon mucosal inflammation and plasma cytokines levels inflammatory bowel disease.
"The pathophysiology of inflammatory bowel disease (IBD) involves the production of diverse lipid mediators, namely eicosanoid, lysophospholipids, and platelet-activating factor, in which phospholipase A2 (PLA2) is the key enzyme. Thus, it has been postulated that control of lipid mediators production by inhibition of PLA2 would be useful for the treatment of IBD. This hypothesis has been tested in the present study by examining the therapeutic effect of a novel natural probitic Bacillus subtilis PB6 (ATCC- PTA 6737). B. subtilis PB6 is found to secrete surfactins (cyclic lipopeptides) which have anti-bacterial potential. These surfactins inhibit PLA2, a rate-limiting enzyme involved in the arachidonic acid associated inflammatory pathway and could downregulate the inflammatory response by regulating the eicosanoid and cytokine pathways. With this concept, an experimental animal trial has been conducted in a rat model of 2, 4, 6-trinitrobenzene sulfonic acid (TNBS)-induced colitis. The oral administration of PB6 suppresses the colitis as measured by mortality rate, changes in the weight gain, colon morphology and the levels of plasma cytokines. The animals treated orally with PB6 at 1.5 x 10(8) CFU/kg thrice daily from day 4 to 10 significantly improve gross pathology of the colon and regain the colonweight to normal (p < 0.05), compared to TNBS-induced positive control. The plasma levels of pro-inflammatory cytokines (TNF-alpha, 1L-1beta, IL-6 and IFN-gamma) are also significantly lowered (p < 0.05) and anti-inflammatory cytokine (IL-I0 and TGF-beta) significantly (p < 0.05) increased after the oral administration of PB6 on day 11. The present study supports the concept that PB6 inhibits PLA2 by the secreting surfactins. In a clinical investigation, it is found to be well tolerated by all the healthy volunteers."

This is an article with more information about B.Subtilis and it's role in human health.  Sources of this probiotic include MegaSporeBiotic, PeakBiotic, and NST Probiotics.

Immune Modulation

"in the subset of forty-four randomized subjects providing biological samples, we showed that consumption of B. subtilis CU1 significantly increased fecal and salivary secretory IgA concentrations compared to the placebo. A post-hoc analysis on this subset showed a decreased frequency of respiratory infections in the probiotc group compared to the placebo group. Taken together, our study provides evidence that B. subtilis CU1 supplementation during the winter period may be a safe effective way to stimulate immune responses in elderly subjects."
Allergy and Mast Cell Response

Specific probiotics alleviate allergic rhinitis during the birch pollen season
"Birch pollen allergy was shown to be associated with changes in fecal microbiota composition. The specific combination of probiotics used (Lactobacillus acidophilus and Bifidobacterium lactis) was shown to prevent the pollen-induced infiltration of eosinophils into the nasal mucosa, and indicated a trend for reduced nasal symptoms."

"Human peripheral-blood-derived mast cells were stimulated with Lactobacillus rhamnosus (L. rhamnosus) GG (LGG(®)), L. rhamnosus Lc705 (Lc705), Propionibacterium freudenreichii ssp. shermanii JS (PJS) and Bifidobacterium animalis ssp. lactis Bb12 (Bb12) and their combination.

LGG and Lc705 were observed to suppress genes that encoded allergy-related high-affinity IgE receptor subunits α and γ (FCER1A and FCER1G, respectively) and histamine H4 receptor. LGG, Lc705 and the combination of four probiotics had the strongest effect on the expression of genes involved in mast cell immune system regulation, and on several genes that encoded proteins with a pro-inflammatory impact, such as interleukin (IL)-8 and tumour necrosis factor alpha. Also genes that encoded proteins with anti-inflammatory functions, such as IL-10, were upregulated.

CONCLUSION: Certain probiotic bacteria might diminish mast cell allergy-related activation by downregulation of the expression of high-affinity IgE and histamine receptor genes, and by inducing a pro-inflammatory response."

Immunomodulatory effects of potential probiotics in a mouse peanut sensitization model
"Prophylactic treatment with both HMI001 ( L. Salivarius) and LCS ( L. casei Shirota) attenuated the Th2 phenotype (reduced mast cell responses and ex vivo IL-4 and/or IL-5 production).  In contrast, WCFS1 ( L. Plantarum) augmented the Th2 phenotype (increased mast cell and antibody responses and ex vivo IL-4 production).  In vitro PBMC screening was useful in selecting strains with anti-inflammatory and Th1 skewing properties. In case of HMI001 (high IL-10/IL-12 ratio) and LCS (high interferon-γ and IL-12), partial protection was seen in a mouse peanut allergy model. Strikingly, certain strains may worsen the allergic reaction as shown in the case of WCFS1."

Effect of a New Synbiotic Mixture on Atopic Dermatitis in Children: a Randomized-Controlled Trial
"This study provides evidence that a mixture of seven strains of probiotics and Fructooligosaccharide can clinically improve the severity of AD in young children. Further studies are needed to investigate the effects on underlying immune responses and the potential long term benefits for patients with AD.

In a randomized, double-blind, placebo-controlled trial, we aimed on studying the clinical and immunologic effects of a mixture of seven strains of probiotic bacteria (Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium infantis, Lactobacillus bulgaricus) and Fructooligosaccharide in the treatment of AD in infancy and early childhood."

Screening selected strains of probiotic lactic acid bacteria for their ability to produce biogenic amines (histamine and tyramine)
"The aim of this study was to investigate the production of biogenic amines (BA), histamine and tyramine by some probiotic lactic acid bacteria (LAB). Fifteen strains representing six LAB species were screened qualitatively by growing them in a decarboxylase medium. Lactobacillus casei (TISTR 389) and Lactobacillus delbrueckii subsp. bulgaricus (TISTR 895) were found to produce BA. The highest levels of histamine (1820.9 ± 3.5 mg L−1) and tyramine (5486.99 ± 47.6 mg L−1) formation were observed for the TISTR 389 strain, while TISTR 895 produced only histamine (459.1 ± 0.63 mg L−1) in the decarboxylase broth. Biogenic amine potential was not observed for the Lactobacillus acidophilus, Lactobacillus lactis subsp. lactis,Lactococcus lactis subsp. lactis, and Lactobacillus plantarum strains studied. This study confirmed that BA formation is strain dependent and not related to the species. "

"There is increasing, but largely indirect, evidence pointing to an effect of commensal gut microbiota on the central nervous system (CNS). However, it is unknown whether lactic acid bacteria such as Lactobacillus rhamnosus could have a direct effect on neurotransmitter receptors in the CNS in normal, healthy animals. GABA is the main CNS inhibitory neurotransmitter and is significantly involved in regulating many physiological and psychological processes. Alterations in central GABA receptor expression are implicated in the pathogenesis of anxiety and depression, which are highly comorbid with functional bowel disorders. In this work, we show that chronic treatment with L. rhamnosus (JB-1) induced region-dependent alterations in GABAB1b mRNA in the brain with increases in cortical regions (cingulate and prelimbic) and concomitant reductions in expression in the hippocampus, amygdala, and locus coeruleus, in comparison with control-fed mice. In addition, L. rhamnosus (JB-1) reduced GABAAα2 mRNA expression in the prefrontal cortex and amygdala, but increased GABAAα2 in the hippocampus. Importantly, L. rhamnosus (JB-1) reduced stress-induced corticosterone and anxiety- and depression-related behavior. Moreover, the neurochemical and behavioral effects were not found in vagotomized mice, identifying the vagus as a major modulatory constitutive communication pathway between the bacteria exposed to the gut and the brain. Together, these findings highlight the important role of bacteria in the bidirectional communication of the gut–brain axis and suggest that certain organisms may prove to be useful therapeutic adjuncts in stress-related disorders such as anxiety and depression."

'Psychobiotic' May Help Ease Stress, Improve Memory
"Taking a probiotic strain of Bifidobacterium longum reduced physiologic and psychological stress and led to a modest improvement in memory in a small pilot study of healthy men.

In response to acute stress, B longum NCIMB 41676 led to a reduction in cumulative output of the stress hormone cortisol, as well as a blunted increase in subjective anxiety. On the questionnaire, the men reported being less stressed and anxious while taking the probiotic. They also showed subtle improvement on a visual memory task after receiving the probiotic, as well as altered EEG output.

"This study represents a proof of principle," Dr Clarke said. "The question we are asking now is, can we advance this further and can we use these psychobiotics to deal with the stressors that we encounter on the roller coaster of life, or develop further psychobiotics for patients with stress-related disorders such as depression or anxiety."

Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects.
"In a previous clinical study, a probiotic formulation (PF) consisting of Lactobacillus helveticus R0052 and Bifidobacterium longum R0175 (PF) decreased stress-induced gastrointestinal discomfort. Emerging evidence of a role for gut microbiota on central nervous system functions therefore suggests that oral intake of probiotics may have beneficial consequences on mood and psychological distress. The aim of the present study was to investigate the anxiolytic-like activity of PF in rats, and its possible effects on anxiety, depression, stress and coping strategies in healthy human volunteers... Daily subchronic administration of PF significantly reduced anxiety-like behaviour in rats (P < 0·05) and alleviated psychological distress in volunteers, as measured particularly by the HSCL-90 scale (global severity index, P < 0·05; somatisation, P < 0·05; depression, P < 0·05; and anger-hostility, P < 0·05), the HADS (HADS global score, P < 0·05; and HADS-anxiety, P < 0·06), and by the CCL (problem solving, P < 0·05) and the UFC level (P < 0·05). L. helveticus R0052 and B. longum R0175 taken in combination display anxiolytic-like activity in rats and beneficial psychological effects in healthy human volunteers."