[HN Gopher] Antibiotics damage the colonic mucus barrier in a mi...
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       Antibiotics damage the colonic mucus barrier in a microbiota-
       independent manner
        
       Author : cpncrunch
       Score  : 72 points
       Date   : 2024-09-12 00:10 UTC (22 hours ago)
        
 (HTM) web link (www.science.org)
 (TXT) w3m dump (www.science.org)
        
       | nashashmi wrote:
       | The standard treatment for H pylori is two antibiotics For 14
       | days.
        
         | thaumasiotes wrote:
         | Well, the standard treatment is to ignore it. It's present in
         | over a third of people and causes no symptoms.
        
           | throwuxiytayq wrote:
           | 20% of patients have symptoms and all carriers are at risk of
           | developing cancer.
        
             | thaumasiotes wrote:
             | All non-carriers are also at risk of developing cancer. How
             | much worse does _H. pylori_ make that situation?
             | 
             | Combining some reports from various places:
             | 
             | > Infection of the stomach with H. pylori is not the cause
             | of illness itself; over half of the global population is
             | infected but most are asymptomatic.
             | 
             | > Infection with _H. pylori_ is responsible for around 89
             | per cent of all gastric cancers
             | 
             | ( https://en.wikipedia.org/wiki/Helicobacter_pylori )
             | 
             | > 770,000 deaths of gastric cancer were estimated in 2020
             | 
             | ( https://www.thelancet.com/journals/eclinm/article/PIIS258
             | 9-5... )
             | 
             | 58 million deaths worldwide in 2019 according to
             | https://ourworldindata.org/grapher/number-of-deaths-per-
             | year ; I picked 2019 instead of 2020 because 2020 features
             | a spike in deaths for reasons that I'm assuming are
             | unrelated to cancer.
             | 
             | That puts gastric cancer deaths from _H. pylori_ at just
             | under 1.2% of all deaths, which frankly seems ridiculously
             | high.
             | 
             | https://seer.cancer.gov/statfacts/html/stomach.html
             | suggests that stomach cancer is 1.8% of all cancer deaths
             | (in the USA), which is perfectly compatible with the above
             | statistics as long as cancer is the cause of 67% of all
             | deaths.
             | 
             | The death rate from stomach cancer is about 3 per 100,000
             | people (in the USA). The overall death rate, per
             | https://stacks.cdc.gov/view/cdc/79486, is 864 per 100,000,
             | putting stomach cancer at 0.3% of all deaths. In the USA.
             | 
             | Is this actually something we worry about? Most people are
             | infected; virtually no one gets cancer.
        
           | nashashmi wrote:
           | No symptoms? Excess passing of gas and acid reflux and GERD.
           | They might be a series of ignored symptoms. Not a lack of
           | symptoms.
           | 
           | PSA: get yourself checked. The treatment will literally
           | destroy all your gut bacteria and renew your stomach to a
           | healthier state. It will be a miserable two weeks though.
        
       | ggm wrote:
       | Nothing to remediation or repair in this. So, observational in
       | mice, gut is gut and probably a good analogue for any non-
       | ruminating mammal. But, how to mitigate, how to repair, what to
       | do afterward is missing.
       | 
       | We need antibiotics. I don't want to go back into the world my
       | parents lived in before they existed, I'd prefer to be in the
       | world I was born into when they still had significant effect
       | without wildcat over-use.
       | 
       | Would phage therapy avoid the problem?
        
         | Valgrim wrote:
         | I don't think this result reflects all antibiotic treatments:
         | 
         | "RESULTS Oral antibiotic treatment disrupts the colonic mucus
         | barrier"
         | 
         | Intraveinous administration may or may not cause the same
         | effect, or a similar effect. Maybe oral antibiotics is
         | generally a bad idea because it disrupts the microbiome, but in
         | other forms it's generally fine.
        
         | Mistletoe wrote:
         | It's not permanent. Just take your antibiotics and when you
         | don't need them your gut will go back to normal.
        
           | jb1991 wrote:
           | Source? This article doesn't say anything about that.
        
             | theultdev wrote:
             | They are living, they reproduce. Damaged ones die off.
             | 
             | That's why you're told to take yogurt/other fermented foods
             | after taking antibiotics, to provide a reproductive
             | environment for them to grow.
             | 
             | However it's still a risk you could kill off a whole
             | species and lose their function, so probably best not to
             | take antibiotics unless you really have to.
             | 
             | It's an easy analysis process though, you try to recover
             | for a couple days, if you cannot and no virus is detected,
             | you take antibiotics.
             | 
             | If it's a bacterial infection and it's spreading you have
             | to take antibiotics, otherwise you die and all of your
             | microbes die with you.
        
               | jb1991 wrote:
               | The other comments in this thread about the recovery
               | aren't as optimistic as you are. It seems there is
               | significant damage and it takes quite a long time to
               | recover, if it does.
        
               | theultdev wrote:
               | There's many variables, what kind of antibiotic, their
               | biome before taking the antibiotics, what microbe species
               | were killed and how many were harmed/killed, etc.
               | 
               | There's only a few total comments in this thread overall,
               | I counted 2 anecdotes, not exactly a scientific
               | consensus.
               | 
               | And people are more likely to comment when something goes
               | bad than when something goes good *checks product
               | feedback*
        
           | Choco31415 wrote:
           | For me that wasn't the case. I took antibiotics as directed
           | by my dentist and it caused years worth of issues.
        
             | mikeodds wrote:
             | Dairy intolerance?
        
               | Choco31415 wrote:
               | To clarify, I was on the medication for six months.
               | 
               | It caused a gut condition that involved nausea, insomnia,
               | and made it difficult to concentrate.
               | 
               | It was also causing me psychologically to feel as if the
               | rug had been pulled out from under me - I didn't know
               | what I was doing anymore.
        
           | majkinetor wrote:
           | It can take up to 2 years to recover your gut from AB. There
           | are papers about it, cbb to find it now.
        
         | AmericanChopper wrote:
         | Overprescription of antibiotics and overuse of antibiotics in
         | agriculture have both been known as public health risks for
         | decades. So perhaps a little more prevention is the best cure
         | could help address this.
        
         | woke_neolib wrote:
         | Two distinct classes of antibiotics (neomycin and vancomycin)
         | seem to induce ER stress in colonic cells which decreases mucus
         | production and increases risk of bacterial inflammation etc.
         | The point is that there appears to be a direct effect on the
         | host mouse physiology. There are other classes of antibiotics
         | that do not have this effect, phage would likely be one of them
         | (there is a theory that phage provided a persistent immunity by
         | dwelling in the mucus).
        
       | junto wrote:
       | As a counter to the negative comment about this submission, I'd
       | like to state that I really appreciate seeing content like this
       | on HN.
        
       | fnord77 wrote:
       | I have crohn's disease, who can I sue?
        
         | Diti wrote:
         | That's a question you should be asking to your lawyer, not to
         | HN.
        
       | Madmallard wrote:
       | I have had very high (3x upper limit normal or more) levels of
       | fecal secretory IgA ever since I took antibiotics in 2014. Also
       | numerous health issues and allergies that developed ever since.
       | Nothing has seemed to really work. I have to take antihistamines
       | just to not feel like I need to go to the emergency room from
       | reacting to things all the time. Pretty tilting since I developed
       | these problems at such a young age. It felt like it completely
       | robbed my life from me. And I'm fairly certain the antibiotics
       | did it because the problems literally just developed in the
       | months following, and some almost immediately after taking them.
       | One of the drugs, ciprofloxacin, seemed to cause severe
       | connective tissue problems that are actually permanent. It is
       | over 10 years later and I still extremely readily tear tendons
       | and ligaments, when before I took them I never once had any
       | problems with any of my tendons or ligaments no matter what I did
       | and no matter how often I did it. My first tendon issues ever
       | were the month after taking it.
        
         | OutOfHere wrote:
         | Did you bother taking or trying some good probiotics and maybe
         | prebiotics? How about L-glutamine, collagen hydrolysate,
         | vitamin C, MSM, glucosamine, chondroitin? Also quercetin.
         | 
         | There is a newssurvey software that you can use to do some
         | automated survey of what's out there (if you don't want to do
         | it manually).
         | 
         | My experience with antibiotics has been the opposite, that they
         | have saved me more times than one, but then I never used
         | ciprofloxacin.
        
           | Madmallard wrote:
           | I have tried everything
        
             | OutOfHere wrote:
             | Probiotic products can be very diverse in their coverage
             | and usefulness. The one I like is Epic Pro 25.
             | 
             | In any case, how about folate as Quatrefolic? It has shown
             | relevance in a related issue such as Ehlers-danlos
             | affecting connective tissue. It is unclear if your
             | homocysteine level is normal or not, but if it's not, it
             | can probably be resolved by various B vitamins in good
             | forms and doses.
             | 
             | In any case, I doubt you have tried newssurvey software to
             | do a survey on:
             | 
             | 1. What causes ciprofloxacin (or its class
             | fluoroquinolones) to harm connective tissues?
             | 
             | 2. What is its resolutions, whether pharmacological or
             | nutritional or via supplements, or anything else?
        
               | ziggyzecat wrote:
               | > 1. What causes ciprofloxacin (or its class
               | fluoroquinolones) to harm connective tissues?
               | 
               | mTOR Signaling
               | 
               | Fluoroquinolones are known to affect the mTOR (mammalian
               | target of rapamycin) pathway, which is critical for
               | protein synthesis, cell growth, and tissue repair. mTOR
               | integrates signals from nutrients, growth factors, and
               | energy status to regulate cellular anabolic processes
               | like collagen synthesis and fibroblast activity. However,
               | fluoroquinolones can induce oxidative stress and
               | mitochondrial dysfunction, which may disrupt normal mTOR
               | signaling. This interference can impair the normal
               | anabolic functions of mTOR, potentially leading to
               | diminished protein synthesis and weakened connective
               | tissue repair.
               | 
               | Mitochondrial Dysfunction
               | 
               | Fluoroquinolones can damage mitochondrial DNA, which may
               | reduce ATP production and impair cellular energy
               | homeostasis. Since mTOR activity is energy-dependent,
               | reduced ATP availability could downregulate mTOR
               | signaling, inhibiting processes like fibroblast
               | proliferation and collagen synthesis. This could explain
               | the tendinopathy and cartilage damage sometimes
               | associated with fluoroquinolone use.
               | 
               | Collagen Synthesis and Matrix Remodeling
               | 
               | The anabolic processes that support collagen production
               | and extracellular matrix (ECM) remodeling are crucial for
               | connective tissue integrity. Fluoroquinolones have been
               | observed to impair collagen synthesis by disrupting the
               | fibroblast function, and this may be due to their impact
               | on the energy-intensive processes governed by mTOR.
               | 
               | Fluoroquinolones have also been reported to cause central
               | nervous system (CNS) effects, including anxiety, tremors,
               | and other neurological symptoms, suggesting an impact on
               | adrenergic pathways. This dysregulation could interfere
               | with normal stress adaptation mechanisms, including the
               | modulation of inflammatory and regenerative processes in
               | connective tissues.
               | 
               | Connective tissue healing depends on the body's capacity
               | to manage energy demands and stress responses during
               | recovery. Fluoroquinolones can impair mitochondrial
               | function and create an energy deficit at the cellular
               | level, reducing the ability of fibroblasts to engage in
               | critical processes like collagen synthesis and ECM
               | remodeling. The systemic impact on both dopaminergic and
               | adrenergic systems can further weaken the body's ability
               | to manage stress and energy during recovery, exacerbating
               | the negative effects on tissue repair.
               | 
               | Fibroblasts and Collagen Production
               | 
               | Fibroblasts are the key cells responsible for producing
               | collagen in connective tissues. Under conditions of
               | oxidative stress and energy depletion, fibroblasts may
               | enter a senescent state, reducing their capacity for
               | collagen synthesis and matrix repair. This can lead to
               | weakened connective tissue and increased susceptibility
               | to injuries like tendon ruptures, which have been
               | reported with fluoroquinolone use.
               | 
               | Collagen and Tendon Health
               | 
               | Fluoroquinolone-induced dysregulation of cell signaling,
               | energy metabolism, and oxidative stress management all
               | converge on a critical issue: the weakening of collagen
               | structure and connective tissue integrity. This has been
               | particularly evident in the association between
               | fluoroquinolones and tendinopathy or tendon rupture,
               | likely linked to the disruption of collagen synthesis,
               | the downregulation of mTOR, and the stress on connective
               | tissue cells such as fibroblasts.
               | 
               | Some Sources:
               | 
               | [ ] https://academic.oup.com/bmb/article/130/1/39/5366272
               | 
               | [ ] https://pubs.rsc.org/en/content/articlelanding/2016/r
               | a/c6ra1...
               | 
               | [ ] https://www.frontiersin.org/journals/physiology/artic
               | les/10....
               | 
               | [ ]
               | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056716/
        
               | OutOfHere wrote:
               | If premature senescence is the mechanism, then quercetin,
               | fisetin, and urolithin A are in general extremely
               | relevant to fight it. Personally, I make sure to take
               | collagen hydrolysate daily to assist the body.
        
             | ziggyzecat wrote:
             | Have you tried a 3 to 6 month long retreat at an organic
             | farm with no supps and only the meds that you really need?
             | You can bring your gear and build games there, too.
             | 
             | I wanted to dive into the production of all the different
             | supps for a while but intuition tells me it'll end up in
             | some reverse confirmation bias aka "job security and
             | esoterically enhanced anti-pla-no-cebo thinking" ... and
             | that kills my mood.
        
         | lurking15 wrote:
         | Even if you never got a SIBO diagnosis, look into the mBiota
         | elemental diet course they offer. 2 weeks of it has been proven
         | to normalize the gut microbiome for SIBO patients (methane &
         | hydrogen).
         | 
         | I also had a very negative reaction to ciprofloxacin and later
         | moxifloxacin (I took them for different infections). In any
         | case, I haven't suffered tendon issues just neurological
         | effects (hard to describe how my cognition changed but I was
         | simply unable to sleep for several days until I stopped the
         | medication prematurely).
        
         | Melatonic wrote:
         | Sounds possibly like Ankylosing Spondylitis. I'm no doctor
         | though
        
           | Madmallard wrote:
           | I've had the full-scale workup. Nothing. But the inflammation
           | and other issues are plainly visible in the tendons.
        
             | Melatonic wrote:
             | If it's not AS then no idea - I assume they did the gene
             | testing and whatnot.
             | 
             | Lot of people swear by this odd Japanese fermented food
             | called Natto - might help. It's basically just soybeans.
             | Uses a very unique bacteria though. Most Asian markets have
             | it
        
       | OutOfHere wrote:
       | It is most important to take a very good probiotic capsule about
       | three hours after taking every antibiotic pill. If you choose not
       | to take it, the shock to the gut can be profound. Also, things
       | like L-glutamine are good for helping the gut heal to the extent
       | that it can.
        
       | algobro wrote:
       | Annual vaccines are much more convenient and are preferable to
       | one-off treatments like antibiotics, (which reduce the nations
       | GDP as well because of they "cure" the problem cheaply), and have
       | proven to be safe.
       | 
       | I call for an immediate ban on antibiotics. Only high ranking
       | members of society should have access. And people with good
       | social credit scores.
        
       | bottom999mottob wrote:
       | Unfortunately we still need oral antibiotics for things like
        
       | bottom999mottob wrote:
       | Unfortunately we still need oral antibiotics for things like Lyme
       | Disease and Rocky Mountain Spotted Fever. As tick-borne illnesses
       | go up with longer summer seasons, we'll probably have to
       | prescribe more antibiotics. Oh well
        
         | theGnuMe wrote:
         | Umm, we still need oral antibiotics for A LOT of things..
        
           | bottom999mottob wrote:
           | Yes I never disputed that. Just listing an example for why I
           | don't think we'll ever be post oral antibiotics
        
       | tmnvix wrote:
       | A lot of comments here claiming we need antibiotics. I can't
       | disagree. But what can be said about the antibiotics we use on
       | livestock? From my understanding it is a heck of a lot. When we
       | then eat the meat do we essentially ingest 'unnecessary'
       | antibiotics and do they contribute to the type of effect
       | described in the article?
        
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