Evidence that Crohn's may be caused by dysbiosis

[tex]

Joe,

Thanks for the response. It's great to see a post from you. I hope that means that you're feeling better these days.

That reaction you had when you had to discontinue the antibiotic treatment is what really caught my attention. Are you saying that you don't believe that the reaction could have triggered changes in your immune system (or altered gene expressions) that might have made you more vulnerable to the development of MG?

I apologize for asking, but I'm trying to reassure myself that I don't need to be checked for possible MG symptoms.

Tex

[Joefnh]

Tex hello there...I am starting to feel a bit better, its taken since June till now to be back at work full time, but it feels good to be back, if not a bit tiring. Its been a long summer and honestly a tough recovery, physically and emotionally. I am glad MIT gave me the summer off, I fully needed it.

I have not found anything in the research or literature that suggest a link to developing MG post exposure to Cipro. Of course that just means that a link has not been found as of yet. The mechanisms are different as the antibodies block the signal by destroying the muscle receptors ability to recieve commands from the brain. This is problematic when it affects breathing. The meds like Cipro appear to cause problems in the neural transmission of the signal from the brain to the muscle end plate. For someone without MG or asthma that may very well not notice the difference Cipro makes.

When taking the meds that can make MG worse the symptoms are similar but not really the same. The meds such as Cipro induce some low level weakness and a mild sense of muscle fatigue. This can be a problem if you are already near a crisis with MG. The weaknes with MG is also body wide affecting all aspects of daily life.

The meds that help the MG are Imuran, Prednisone, Cellcept and the chemo treatment Rituximab / Methotrexate. I will be going back to Rituximab in a few weeks along with Methotrexate. We have to get better control of my MG as the breathing issues can be significant. I am a the point I have E size oxygen tanks with me at work, in my car and at home should a crisis start again.

It would be great to calm all of this down

[Joefnh]

The history of MG does precede the use of antibiotics by a fair amount making it suspect that antibiotics are the cause or trigger for MG

A bit of history:

"History
Myasthenia Gravis (MG) is a chronic autoimmune disorder of neuromuscular transmission resulting in muscle weakness. The term "myasthenia" is Latin for muscle weakness, and "gravis" for grave or serious. Thomas Willis first described a patient with MG in 1672. There were other sporadic case descriptions over the years and in 1900, Campbell and Bramwell collected 60 cases of MG from the literature. Still the cause of the disease remained a mystery, until 1960 when Simpson proposed that myasthenia gravis was caused by antibodies against the acetylcholine receptor. In 1973 Patrick and Lindstrom demonstrated that MG is autoimmune in origin by showing that rabbits immunized with Torpedo acetylcholine receptor became myasthenic. Today, MG is one of the most thoroughly understood neurological disorders, which has lead to treatments which vastly improve the length and quality of life of myasthenics.
Clinical Presentation
Epidemiology


I believe Cipro was invented in 1983

[tex]

You're right of course. I had forgotten that MG was such an old disease, and I agree that the mechanisms involved don't appear to be congruent.

That's certainly good news that you're back at work full time again. That's quite an accomplishment, considering your condition a few months ago. You really had us worried.

Many thanks for the detailed information, and the valuable insight. I hope that you have some smooth sailing ahead of you. You've certainly earned it.

Tex

[JFR]

Joe,

So good to hear from you and that you are doing so much better. What a hard road you have been on. You are certainly resilient. I hope that remission is in your future, sooner rather than later.

Jean

[tex]

I have to disagree. Disrupted microbe populations, have been shown to set off the inflammatory response,

So what? That certainly does not prove that they cause IBDs, or even IBD flares. It simply confirms that they are an undesirable consequence of IBD reactions.

and probiotics have proven anti-inflammatory properties.

That appears to be true only in carefully selected cohorts, apparently. Too many researchers hired by manufacturers to prove an agenda are very good at their job (they select subjects who respond to the product they are testing, and they cull out those who do not respond, or who respond adversely). Here's a report on a recent study (from last year) that disputes earlier claims about the benefits of probiotics for Crohn's patients:

Probiotics do not prevent relapse in Crohn's disease patients

Here's a 2011 research article about a randomised double-blind placebo-controlled trial where probiotics struck out with UC:

A randomised double-blind placebo-controlled trial with Lactobacillus acidophilus La-5 and Bifidobacterium animalis subsp. lactis BB-12 for maintenance of remission in ulcerative colitis.

They don't help with baby's colic:

More Evidence That Probiotics Won't Ease Baby's Colic

They even struck out in this C. diff study:

Probiotics Fail to Foil Diarrhea in Setback for Gut-Taming Pills

I'm sure that you can cite a few studies where they appeared to actually help, but the point is, they are not a dependable solution. They work for a few individuals, but they don't work for most of us. Most of us can tolerate probiotics after we are in remission, but while we are reacting, many cannot. While we are reacting, they tend to either have no effect, or make us much sicker. So what good are they for treating MC? Only a handful of us on this discussion board have actually seen benefits from probiotics while we were were still reacting. And after we are in remission, they're a moot point.

Our bodies then mount an inflammatory defense against them. Dietary changes can affect the gut microbiome, but cannot usually restore "good bugs" lost to antibiotics, etc.

That theory has been promoted for decades, but no one has ever managed to prove it. Where is the proof that the autoimmune reaction is actually directed at bacteria? It doesn't exist. Why? . . . because the reaction is directed at either food or medication sensitivities, and when those antigens are removed from the diet, the reactions cease, thus proving that the exogenous antigens were responsible for the so-called autoimmune reaction in the first place. How can a reaction actually be autoimmue, when removing an exogenous antigen permanently stops the reaction? Not only that, but removing the exongenous antigens stops the production of the anti-tTG antibodies, thus proving that they are also secondary to the reaction against the exogenous antigens. True autoimmune reactions may not actually exist in the real world. In the instances that are still in question, we probably simply have not isolated the correct exogenous antigens.

And whether or not so-called "good bugs" are restored is irrelevant as long as remission is maintained. And it turns out that with MC at least, remission is maintained quite nicely by diet alone. No probiotics needed.

But I certainly agree with your position on antibiltics. As I pointed out in an earlier post in this thread, antibiotics have evolved from a life-saving treatment to an iatrogenic drug in many situations, because of misuse/overuse.

Tex

[tex]

Joe,

Best of luck with that treatment, and please keep us informed, when you have the time and energy to spare.

Tex