Mold-Induced Illness

(work in progress)

Significant exposure to mold and related organisms, usually prolonged, can cause a wide range of symptoms and conditions.  This is a common cause or exacerbating factor for MCAS.  Common symptoms of mold illness include fatigue, headaches, digestive problems, respiratory problems (including asthma and shortness-of-breath), cough, sore throat, allergies and reactions that look like allergies (such as sneezing, hives, rashes), excessive thirst, muscle cramps, joint pain, stiffness in the morning, sleep problems, night sweats, brain fog and related cognitive issues (such as problems with memory and executive function), light sensitivity, blurred vision,  numbness, tingling, and tremors.

Mold illness can be diagnosed as many things, including- ME/CFS, Fibromyalgia, MS, Somatization disorders, anxiety, depression, PTSD, ADHD, dementia, Irritable Bowel Syndrome, and more.  That is to say that you may meet criteria for one or more of these diagnoses, but mold exposure is the reason that you have the symptoms in the first place.  For some people, treating and healing from the mold illness allows them to heal and lose the diagnosis.  Whether or not they "actually had" the illness then becomes a semantic issue rather than a scientific one.

The Basics of Mold Illness and Toxicity
Mold Toxicity - Depression, Anxiety, Fatigue, Brain Fog & Inattention 
Mold "can contribute to Pyrrole Disorder due the stress it puts on the body.  It can lead to elevated copper by overwhelming one of the antioxidants in the body that regulates copper.  Because it interferes with the immune system, it can lead to a susceptibility to candida/yeast, Lyme and its co-infections.  It also frequently worsens mast cell activation."

Mold can thrive in water damaged buildings or anywhere indoors where there is retained moisture, including AC units and ductwork.  The mold thrives because it has the ideal conditions for growth and because it doesn't have the competition that keeps it in check outdoors.  Additionally, mold spores and toxins build up inside without the natural ventilation that exists outside.  Mold can poison us with toxins and it can also colonize our bodies, such as our sinuses and GI tract.  Some people also have mold allergy.

"Seemingly 25% of people are unable to make antibodies to mold toxins. Add to that the 50% of buildings that have water damage, and you have a lot of people who are unknowingly becoming toxic while spending time in affected homes, schools, workplaces, cars, dorms, and nurseries."

"Mold toxins basically go from the body, to the liver and gallbladder where they are bound to bile and sent out into the gastrointestinal tract. The bile, however, is recycled (as a means of conservation), and thus take toxins back into the body."  

Some of the symptoms that she lists that I don't see listed often include: electric shock sensations, ice-pick pains, Atypical Parkinson's Disease, Atypical ALS, Psychogenic seizures or pseudo-seizures​​, Tics, spasms and seizure like events; Sensitivity to light touch, Suspected or Diagnosed PANS/Pediatric Acute-Onset Neuropsychiatric Syndrome, Rapid weight gain, Body temperature dysregulation, and diagnosis of fibromyalgia, or chronic fatigue.  
Detection of Mycotoxins in Patients with Chronic Fatigue Syndrome
"Urine specimens from 104 of 112 patients (93%) were positive for at least one mycotoxin (one in the equivocal range). Almost 30% of the cases had more than one mycotoxin present. OTA was the most prevalent mycotoxin detected (83%) with MT as the next most common (44%). Exposure histories indicated current and/or past exposure to WDB in over 90% of cases. Environmental testing was performed in the WDB from a subset of these patients. This testing revealed the presence of potentially mycotoxin producing mold species and mycotoxins in the environment of the WDB. Prior testing in a healthy control population with no history of exposure to a WDB or moldy environment (n = 55) by the same laboratory, utilizing the same methods, revealed no positive cases at the limits of detection."

Most doctors who specialize in mold illness use urinary mycotoxin testing to figure out which mycotoxins a patient is dealing with, as treatment consists largely of the use of binders and different ones bind different toxins  

Comprehensive Guide to Mycotoxin Binders

MCAS & Mold: Fungal Colonization of the Sinuses (video)

Mold often co-occurs with other organisms, such as bacteria, in water-damaged buildings.
Aerobic Actinomycetes of Clinical Significance

CIRS (Chronic Inflammatory Response Syndrome)
There is another condition called CIRS (Chronic Inflammatory Response Syndrome) which seems to me to be essentially another name for MCAS, but was recognized and described without as thorough an understanding of the underlying immunological mechanisms.  CIRS-WDB refers specifically to the condition when developed after prolonged exposure to the inside of water-damaged buildings.  According to this 2024 study, CIRS is "an acquired medical condition characterized by innate immune dysregulation following respiratory exposure to water-damaged buildings (WDB).", and states that ME/CFS is "a common misdiagnosis of CIRS".  MedicineNet gives a more detailed description of CIRS "a multisystem and multi-symptom illness that occurs when a person gets exposed to toxins such as mold spores or biotoxins found in tick or spider bites. These toxins get attached to the immune system to trigger an inflammatory response and induce hormonal changes. The immune system produces an excess of cytokines that can lead to the immune system attacking its tissues, causing inflammation and other associated symptoms."  This source further defines biotoxins as "fat-soluble molecules that travel from cell to cell without entering the bloodstream" and further states that "measuring biotoxins in the blood is difficult, but doctors usually identify them by the damage inflicted on various organs."

According to Dr Shoemaker, there are some HLA-DR/DQ haplotypes (combinations of genes that are inherited together) that make a person less able to clear biotoxins, such as mold toxins, from their bodies, making them more likely to develop CIRS when exposed to mold, which then cause the innate immune system to overreact and lead to chronic inflammation.  These include:
HLA-DR4-3-53
HLA-DR7-2/3-53
HLA-DR11-3-52B
HLA-DR13-6-52A/B/C
HLA-DR17-2-52B
HLA-DR18-4-52A

Diagnostic Process for Chronic Inflammatory Response Syndrome (CIRS): A Consensus Statement
Report of the Consensus Committee of Surviving Mold
"Clinical management of patients with a complex, multisystem, multi-symptom illness identified as a chronic inflammatory response syndrome (CIRS) has expanded. Often associated with illness due to exposure to low molecular weight biotoxins and inflammagens found (i) inside water-damaged buildings (WDB); (ii) following exposure to blooms of cyanobacteria; (iii) following consumption of ciguatoxic fish; and (iv) following confirmed acute Lyme disease, persistent despite reasonable use of antibiotics, CIRS is increasingly recognized. A need for a formal case definition and case management protocol has arisen. Patients with CIRS will have abnormalities in innate responses, reduced levels of
regulatory neuropeptides MSH and VIP, elevated inflammatory markers of C4a, MMP9 and TGF beta-1.  Systemic illness, based on abnormal gene activation and suppression, as shown by RNA Seq and transcriptomics, requires a multi-factorial, rigorous diagnostic assessment to assist in both differential diagnosis and monitoring response to therapy. A consensus statement is herein provided to assist practitioners in case identification and management."

Chronic inflammatory response syndrome: a review of the evidence of clinical efficacy of treatment

Dr. Scott McMahon, a board-certified pediatrician and CIRS specialist (Podcast)

Treatment for Mold Illness
The Shoemaker Protocol is widely recognized as the best treatment for mold-induced illness, whether or not you call it CIRS.  

Doctors who specialize in treating people with mold-induced illness tend to use urinary mycotoxin testing to identify which mycotoxins a person is dealing with, and prescribe substances that bind and remove those specific toxins as part of the treatment protocol.  Examples of binders include bentonite clay, activated charcoal, chlorella, cholestyramine, and colesevelam HCI. 

Finding and Remediating Mold in Your Environment
Consensus Statement for Microbial Remediation 2020
(Indoor Environmental Professional Panel of Surviving Mold)

Dr Jill Carnahan is considered by many to be an authority on cleaning mold and mold remediation.  This page from her website has the basics:
How to Get Rid of Mold – Definitive Mold Removal Guide

"Michael Rubino provides valuable resources and professional guidance on safely addressing mold issues in your home. His website offers detailed information on proper mold cleaning techniques, prevention, and the importance of air quality in maintaining a healthy living environment."

This is information given to me by someone with specialized knowledge of building materials:
"MDF is Medium-Density Fiberboard. There is also OSB, or Oriented Strand Board, and there are number of other building products like particle board made with the tailings or trash from milling lumber, held together by resins. The wood millings are damp from cutting, lay around in damp piles, and develop mold. The mold in this wood is fed by the resins used to make it into building materials. The paper backing on drywall has the same issue. I understand that there is now third-party certified mold-free OSB and MDF made differently."

ImmunoLytics swab tests

Resources Regarding Mold and Mold Illness:
Dr Ritchie Shoemaker's "Surviving Mold" website

International Society For Environmentally Acquired Illnesses / ISEAI website

American Academy for Environmental Medicine 
(database of practitioners who treat environmentally acquired illnesses including mold)

Dr Neil Nathan, MD is an expert in mold illness.  This book from him is highly regarded:
Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness

Dr Jill Crista, ND is a highly respected mold doctor.  "Dr. Jill focuses on conditions that cause injury to the brain and nervous system, including mold, PANS/PANDAS, Lyme disease, and concussion."
Dr Jill Crista online courses about mold 

Dr. Efrat Lamandre focuses on integrative and functional medicine, offering solutions for mold toxicity, chronic illnesses, and environmental health issues. Her practice emphasizes a holistic approach to diagnosing and treating mold-related conditions. Her website provides information and support for those navigating mold toxicity and other environmental health concerns.
Toxic Overload and Chronic Illness: How Mold, Plastics and Pesticides Make You Sick

#moldfinders: RADIO (Podcast)
Mold expert Brian Karr shares his secrets on how to find and remove mold and mycotoxins from your home,

The Virginia Center for Health and Wellness (has video series from Dr Andrew Heyman 

National Institute of Environmental Health Sciences Mold Information

CDC Information About Mold 

EPA Information About Mold

RealTime Laboratories, Inc. (RTL)
"RealTime Laboratories, Inc. (RTL) is a CAP and CLIA accredited clinical and environmental diagnostic laboratory that specializes in testing for and identifying hazardous mold, toxins, and infectious diseases."  They have a free e-book called:
Mycotoxins 101: An Introduction to Crucial Facts

MyMycoLab provides mycotoxin testing

Mold prevention strategies and possible health effects in the aftermath of hurricanes and major floods

The Hidden Connection: COVID, Mold Exposure, and Viral Reactivation 

A comprehensive review of mold research literature from 2011 - 2018

Legal Resources
Well.Law is a legal practice that understands the complexities of mold-related and environmental illness cases. They support clients navigating housing issues, disability rights, and toxic exposure with compassion and legal expertise. She started the personal injury firm she couldn't find.

How to get the most insurance money for mold remediation
"Learn the secrets insurance companies don’t want you to know that will maximize your insurance coverage amount."

Mold Insurance Playbook with Corey Levy (Podcast)
"It can be really expensive... But what if you didn’t have to pay full price for remediation? That’d be awesome! Today we share our entire playbook on how to maximize your coverage! Here is the quick overview... and we go in depth on each one of these in the episode: 1) DON’T CALL YOUR INSURANCE COMPANY! 2) STOP the water 3) Mold Inspection 4) Get Remediation Bids 5) Hire a public adjuster 6) Now you can contact your insurance company... If you go out of order you can literally cost yourselves tens of 1,000s of dollars!"

Parasites Can Alter the Behavior of Their Hosts

These are my notes for a TED talk about parasites called "Suicidal wasps, zombie roaches and other parasite tales" by Ed Yong.



Ed Young talks about ways that parasites can alter many attributes of their hosts, including behavior, to serve the needs of the parasite rather than the host.  One example is that when a certain kind of tapeworm infects a brine shrimp, it turns the shrimp red and causes it to gather in large groups.  This allows the shrimp to be easily seen and caught by flamingos, who are the only hosts in which this tapeworm can reproduce.  There are many cases like this in which a parasite makes it's host behave in ways that are dangerous and even fatal to it but serve the needs of the parasite.  He gives an example of a kind of worm that infects a cricket, and releases chemicals to cause the cricket to jump into water and drown.  Once it's drowned the worm is free to leave and look for a mate.

Since parasites are hidden through much of their lives, it is easy to underestimate their numbers.  He mentions research in which it was found that the biomass of a particular kind of worm in a particular estuary was the same as that of all of the fish in the same estuary, and 3 to 9 times that of the birds.  Because of the sheer volume of parasites, manipulation is not unusual in the natural world- it is a "critical and common part of the world around us".

Scientists have found hundreds of examples of parasites capable of manipulation, and is now beginning to understand some of the specific means by which they accomplish this.  There is a wasp that has a specialized feeler so that it can reach into the head and locate the brain of it's victim (a roach), and it carefully injects a very specific type of neurotoxin into two very specific regions of the roach's brain.

This raises the question of whether there are parasites that are able to manipulate humans in the same way.  This question is deeply unsettling since as humans we tend to think of ourselves as in control of our own behavior, pretty much all the time.  One candidate is toxoplasma gondii, which is capable of infecting mammals in general but can only reproduce inside of a cat.  If a mouse or rat becomes infected with toxo it will not only avoid cats but will seek them out.  The cat then kills and eats it, and the parasite is able to reproduce.  They are not entirely sure how this works, but they do know that toxo makes an enzyme that makes dopamine; we also know that it targets a part of the rodent brain involved in sexual arousal.  Estimates are that 1 in 3 people around the world is infected with toxo.  For the most part, toxo is dormant in humans and it is not immediately obvious if someone is infected.  However some small signs have been found, such as a slightly increased likelihood of being in car accidents (this is hypothesized to be due to slowed reaction times).  There is also some evidence that people with schizophrenia are more likely to be infected.  Although we don't know exactly how or how many parasites such as toxo are able to influence us humans, given how widespread this phenomenon is in the world it is extremely unlikely that humans would be the one exception, the one animal not able to be influenced by parasites.  He adds that viruses and fungi can also be considered parasites, which raises a lot of questions about human behavior and infections.  These questions are difficult and we don't have a lot of answers but they do seem like very important things to consider.

This is another video on the topic that presents some additional information:

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.
"ProbioticAdvisor.com 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

Doctor's Best Probiotic -- 20 billion CFU

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

Probiotic strain Bacillus subtilis CU1 stimulates immune system of elderly during common infectious disease period: a randomized, double-blind placebo-controlled study

"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."

Probiotic Lactobacillus rhamnosus downregulates FCER1 and HRH4 expression in human mast cells

"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. "

Psychological Health

Combination of Lactobacillus helveticus R0052 and Bifidobacterium longum R0175 reduces post-myocardial infarction depression symptoms and restores intestinal permeability in a rat model.

Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve

"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."