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The Summer 2019 issue of MIT Spectrum reports on the travels of several MIT post-doctoral students who traveled to Malaysia in search of microbiome samples from indigenous villagers of the Batek tribe. Collecting the samples proved to be challenging, as skeptical villages unaccustomed to toilets, not to mention observers, were unwilling to put their personal habits on display. Fortunately an accommodation preserved the villagers' privacy while allowing the researchers to locate stool samples.
Although it sounds at first like an odd undertaking, the fact is that the Batek tribe living in the forest more than 250 miles from the capital in Kuala Lumpur offered a unique microbiome. As nomadic hunter-gatherers, the Batek tribe's microbiomes are the result of a diet free from processed food, and untouched by the vaccines, antibiotics, and chemicals that affect the microbiomes of those living in the industrialized areas of the globe. The successfully harvested samples were taken to MIT's Center for Microbiome Informatics and Therapeutics (CMIT) for further study. Launched in 2014, CMIT seeks to research the human microbiome to understand better its role in the diagnosis, treatment, and prevention of diseases like Crohn's Disease and Ulcerative Colitis. Source: Halber, Deborah, "Going for the Gut," MIT Spectrum, Summer 2019 Issue, available at: https://spectrum.mit.edu/summer-2019/going-for-the-gut/
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Are Your Medications Hurting Your Gut? Common Medications May Be Acting as Unintended Bactericides1/8/2020 Most everyone knows, or should know, that orally administered antibiotics destroy vast numbers of both the good and harmful bacteria that comprise the microbiome. Recent research has shown that the microbiome is also vulnerable to more than two hundred other medications that are not specifically antibiotics, like blood pressure medication, antihistimines, and painkillers.
The research, undertaken by the European Melocular Biology Laboratory in Heidelberg, Germany, was made possible by new techniques that permit the culture of anaerobic bacteria that live only in the absence of oxygen -- like those in the microbiome. The research also found that the same bacteria that were resistant to antibiotics were also resistant to adverse effects from other medications. An important revelation of this research is that antibiotic resistance can occur even when antibiotics are not used. For Crohn's Disease patients, this is important news. Ensuring a healthy microbiome is an essential approach to ensuring that a dysbiosis in the microbiome -- a hallmark of a Crohn's Disease inflammation flare -- does not occur. Knowing that many other medications, in addition to antibiotics, can adversely affect the microbiome is critically important. Source: Maier, Lisa, et al., "Extensive Impact of Non-Antibiotic Drugs on Human Gut Bacteria," Nature 555, 623-628 (19 March 2018). On May 16, The Washington Post published an important story that is mandatory reading for every family contending with Crohns Disease. The article, A Dangerous Delay, by investigative journalists Jenn Abelson, Amy Brittain, and Sarah Larimer, relays the harrowing and deeply tragic series of events surrounding The University of Maryland's delay of 18 days in informing students of an outbreak of a particularly virulent adenovirus strain on campus.
The story's focus, indeed the reason it is tragic, is Olivia Shea Paregol, a freshman student at Maryland in the Fall of 2018. Olivia was diagnosed with Crohns Disease in her senior year of high school, and was pursuing treatment with Humira injections. All Crohns patients are familiar with the treatment alternatives available, which have in common the mechanism of diminishing the individual's immune response, in varying degrees and in differing ways. As relayed in the Washington Post story, a humid and rain soaked summer in Maryland caused mold to grow at Elkton Hall dormatory on the College Park campus, where Olivia resided. Mold-related respiratory distress made Olivia, already immunocompromised due to the Crohns treatment, especially susceptible to the subsequent adenovirus exposure. This scenario is one that parents of Crohns patients (and indeed the patients themselves, depending upon their age) fear. Yet, it is theoretically manageable, provided the physicians and nurses know what they are treating. It is here where the Washington Post takes the reader in an unexpected, and devastating, direction. Olivia was initially thought to be suffering from a bacterial respiratory infection. What the University apparently knew, that Olivia's doctors did not -- and would not for eighteen days -- is that a severe form of adenovirus had been discovered on the Maryland campus. As Olivia failed to respond to antibiotic treatments and her condition worsened, the fact that a virulent respiratory virus remained secret. By the time Olivia's father was able to learn from the University's health center about the adenovirus outbreak and ensure that information was conveyed to Olivia's doctors at Johns Hopkins Hospital, it was too late. The article's description of Olivia's last days makes for heart breaking reading; but for the parents of Crohns patients it is also essential reading. A compelling piece of investigatory journalism, the article carefully, thoroughly, and compassionately sets forth the facts. Readers may draw their own conclusions about whether or not the University acted responsibly and appropriately, and whether the acts and omissions that comprise the article's narrative constitute a moral failure. For Crohns families in particular, the article is a potent and moving reminder that ostensibly minor health threats pose serious risk to the immunologically compromised. The article is also a sad reminder that Crohns patients and their families must maintain a perpetual and heightened state of alert against these threats. For more information about adenovirus see NIH's Patient Information sheet. |
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