Friday, February 21, 2020

Leaky Gut: How and Why it Occurs

Image result for leaky gut images from biotek

Leaky Gut: How and Why It Occurs

 October 2, 2019 at 11:08 AM / by Dr. Chris Meletis, ND
When the intestinal epithelial lining barrier is compromised, it leads to a leaky gut. The foundation of this barrier consists of only a single layer of specialized epithelial cells joined by tight junction proteins. However, other factors are involved in intestinal barrier support including mucins, antimicrobial molecules, secretory IgA (sIgA), and cytokines.
The most abundant immunoglobulin in the body, sIgA is found on intestinal mucosal surfaces where it interacts with commensal bacteria to protect against pathogens, toxins and other irritants. Every day, the human body synthesizes approximately 3 grams of sIgA into the intestinal lumen. Although other aspects of gut barrier function can sometimes compensate for a decline in sIgA, optimal levels of this immunoglobulin are important for gut health. sIgA also is secreted in other mucous membranes, such as the oral cavity, where it protects against viral, bacterial, and parasitic assaults. In the intestinal tract, sIgA is secreted when there is an immune reaction to foods.
While underproduction of sIgA can result in impaired gut barrier function and increase intestinal permeability, dysregulation of zonulin, a physiological modulator of intercellular tight junctions, also poses a threat to gut barrier integrity. Zonulin plays a role in intestinal innate immunity. It is upregulated in animal- and human-derived intestinal epithelial cells exposed to the wheat protein gliadin, thus impairing gut barrier function and increasing intestinal permeability by weakening tight junctions.
Zonulin upregulation also is linked to increased intestinal permeability in people with type 1 diabetes and their relatives. Interestingly, in these subjects, zonulin upregulation occurs before disease development, pointing to an interplay between increased intestinal permeability, environmental exposure to non-self antigens, and the pathogenesis of autoimmunity in people who are genetically susceptible.  I routinely test my patients for IgG, IgA and IgE food reactivity to minimize immune triggers in patients with leaky gut.
Factors contributing to the disruptions in intestinal integrity responsible for leaky gut include food sensitivities/allergies, exposure to environmental toxins, chronic psychological stress, a diet high in sugar and processed foods, alcohol abuse, antibiotics, and anything that results in dysbiosis of the gut microbiota. These factors can all act together to compromise gut barrier function. Athletes are also susceptible to increased intestinal permeability with associated gastrointestinal problems. Other factors that may predispose to the development of leaky gut include consuming a low-fiber or high-fat diet.
Clinically, I routinely consider supplementation of glutamine and mitochondria support for athletes that present with either decreased performance or increased GI or allergic symptoms. I find that increased intestinal permeability arising from relative depletion of glutamine that is used for muscle, immune and gut integrity is often a key clinical consideration. Additionally, subclinical mitochondria dysfunction may also contribute to some athletes manifesting with intestinal permeability changes and decreased exertional performance.

Qinghui M, Kirby J, Reilly CM, et al. Leaky Gut As a Danger Signal for Autoimmune Diseases. Front Immunol. 2017:8:598.
Wells JM, Brummer RJ, Derrien M, et al. Homeostasis of the gut barrier and potential biomarkers. Am J Physiol Gastrointest Liver Physiol. 2017 Mar 1;312(3):G171-193.
Ferguson A. Mechanisms in adverse reactions to food. The gastrointestinal tract. Allergy. 1995;50(20 Suppl):32-8.
El Asmar R, Panigrahi P, Bamford P, et al. Host-dependent zonulin secretion causes the impairment of the small intestine barrier function after bacterial exposure. Gastroenterology. 2002 Nov;123(5):1607-15.
Clemente MG, De Virgiliis S, Kang JS, et al. Early effects of gliadin on enterocyte intracellular signalling involved in intestinal barrier function. Gut. 2003 Feb;52(2):218-23.
Drago S, El Asmar R, Di Pierro M, et al. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scand J Gastroenterol. 2006 Apr;41(4):408-19.
Fasano A, Not T, Wang W, et al. Zonulin, a newly discovered modulator of intestinal permeability, and its expression in coeliac disease. The Lancet. 355(9214);29 April 2000:1518-19.
Sapone A, de Magistris L, Pietzak M, et al. Zonulin upregulation is associated with increased gut permeability in subjects with type 1 diabetes and their relatives. Diabetes. 2006 May;55(5):1443-9.
Lamprecht M, Frauwallner A. Exercise, intestinal barrier dysfunction and probiotic supplementation. Med Sport Sci. 2012;59:47-56.

Desai MS, Seekatz AM, Koropatkin NM, et al. A Dietary Fiber-Deprived Gut Microbiota Degrades the Colonic Mucus Barrier and Enhances Pathogen Susceptibility. Cell. 2016 Nov 17;167(5):1339-53.e21.

Thursday, December 15, 2016

Recipe for a healthy spread

Lemony Hummus with Toasted Cumin Seeds
Lemony Hummus with Toasted Cumin Seeds

Fresh lemon juice along with grated zest imparts a lovely citrus flavor to the hummus. It makes a fine snack or an excellent dip for a party. Serve with toasted whole wheat pita triangles or cut-up raw vegetables.
Note: The recipe halves easily. If you don’t feel like toasting the seeds, simply substitute 1 1/2 teaspoons ground cumin; you need a little more because the flavor is milder.
1 teaspoon cumin seeds
2 cups cooked chickpeas, rinsed and drained
1/3 cup tahini (Middle Eastern sesame seed paste)
1/2 teaspoon grated lemon zest
2 to 3 tablespoons fresh lemon juiceSwiss Secret
3 tables extra virgin olive oil
1 teaspoon sea salt
1/2 cup warm water
Paprika, sweet or hot to taste
1. In a small dry skillet, toast the cumin seeds over medium heat, shaking the pan once or twice, until they are lightly browned and fragrant., 2 to 3 minutes. Transfer to a mortar and crush lightly, or grind in a spice grinder or mini food processor.
2. Combine the chickpeas, tahini, lemon zest, 2 tablespoons of the lemon juice, olive oil, salt and toasted cumin seeds in a food processor or blender. Add 1/2 cup water and puree until smooth.
3. Season with more lemon juice and additional salt to taste. Transfer to a bowl and serve at room temperature, with a dusting of paprika on top.

Monday, August 31, 2015

The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen. - Elisabeth K-R

Tuesday, June 16, 2015

"I fully admit to being wrong. ... (We) have simply followed the recommended mainstream diet that is low in fat and high in polyunsaturated fats and carbohydrates, not knowing we were causing repeated injury to our blood vessels. This repeated injury creates chronic inflammation leading to heart disease, stroke, diabetes and obesity.
Let me repeat that: The injury and inflammation in our blood vessels is caused by the low fat diet recommended for years by mainstream medicine. " Dwight Lundell, MD, cardiologist and heart surgeon
We physicians with all our training, knowledge and authority often acquire a rather large ego that tends to make it difficult to admit we are wrong. So, here it is. I freely admit to...

I was reading an article in "Oncology" journal and was thinking about some of my patients. I believe this article mighty be interesting for them

Is Chemoradiotherapy Beneficial for Stage IV Rectal Cancer

Huh J.W. · Kim H.C. · Park H.C. · Choi D.H. · Park J.O. · Park Y.S. · Park Y.A. · Cho Y.B. ·Yun S.H. · Lee W.Y. · Chun H.-K. Oncology (DOI:10.1159/000371390)