New Study - Lyme disease and the Human Gut Microbiome

This is a really interesting study – very much along the lines of some of our recent discussion on the forum here with those interested in the gut related aspects of Lyme disease.

https://mbio.asm.org/content/11/5/e02310-20

The study authors basically compared the microbiome in the stool samples of three cohorts of patients, those with “post treatment Lyme disease syndrome”, those in ICU, and healthy controls.
( I am putting in inverted commas as I think most here would question whether such a thing exists or if in fact it is simply an ongoing chronic infection - but let’s park that for the moment as its discussed elsewhere)
Via comparisons of the relative abundance of the various genera of bacteria in the samples they were able to demonstrate a recognisable shift in most of those patients with “PTLDS” that was separate and distinguishable from those who were in the Healthy or ICU groups.

Also interesting – was that the main difference was in a single genus of bacteria called Blautia - this genus was significant raised in “PTLDS” patients - but not others.

These shifts were sufficiently clear that a machine learning algorithm could use them to correctly identify the “PTLDS” patients from the controls – 66% of the time ( this is interesting as it is better than any of the serology based Lyme tests we have at present by the way )

“PTLDS” patients also had reduced abundance of the entire Phyla of Bacteroides - which is also associated with other diseases that have overlap with symptoms patterns in “PTLDS” - eg CFS, Fibromyalgia, MS etc
Perhaps this points to a shift in the gut environment caused by Lyme disease - or perhaps it represents a pre-existing pattern of microbiome present in those that are susceptible to getting “PTLDS” or similar illnesses

The not so good things are -
1- generally, this next gen PCR analysis of stool samples seems a bit problematic at present – with different labs producing very different results. See my other post on the subject of a comparison of two of the main ones. So I am not convinced the technology is mature and reliable at this point in time.

2- the PCR step was done in 2 different methodologies and different sites ( although the authors say they found no consistency errors that affected the results - it would have been cleaner if they has all used the same methodology)
My partner and I had both had microbiome tests done while still in the middle of our Lyme illness via the now defunct Ubiome - and interestingly, it found reduced levels of Blautia compared to Ubiomes average. And increased levels of Bacteroides Ie the reverse of this studies findings. But as I mentioned there is doubt over the findings from Ubiome.

We soon afterward had another PCR stool test done - this time the GI Map test - unfortunately, blautia was not measured - but overall Bacteroidetes were reduced according to this test - so more in line with the findings of the study.

Beyond this slightly cloudy anecdote - and the above study – what can we actually do with this data ?
Well, there are people out there on the internet researching what can be done to increase or decrease certain Genus of bacteria in our gut in order to influence health outcomes.
There is a guy here called Ken Larssesen who believes CFS is a “death by 1000 microbial cuts” caused by dysbiotic gut bacteria populations directly causing systemic disease and symptoms.

https://cfsremission.com/

And he links to another site that is trying to produce a kind of growing searchable database that tries to synergise all available research on the topic into a useable format of – “ if you have too much of genus XXXXX?” - “then do these interventions “

https://microbiomeprescription.com/Library/Details?taxon=572511

this gives the following natural substances that studies have shown decrease Blautia's abundance ….

General Substance Specific Substance Effect
Herb or Spice glycyrrhizic acid (licorice)
📓 Decreases from 1 studies
Herb or Spice licorice
📓 Decreases from 1 studies
Herb or Spice triphala
📓 Decreases from 1 studies
not classified caffeine,(coffee or non-herbal tea)
📓 Decreases from 1 studies

And give me one more excuse to drink coffee 😊
Of course the not all the research has been done to make this entirely practical- and much of the research that has been done did not control for some variables or confounded ingredients - so it’s a bit rough - but there may be some useful ideas there.

Maybe some people here have done their own research and have ideas on why this particular Genus is so abundant - pH? , oxygen availability, inflammation, immune dysregulation etc etc

And is it reasonable to think that adjusting the microbiome back towards what looks like a more normal distribution of abundance might contribute to recovery …?

Anyway, I thought it worth posting up for discussion

K07 - I think Blautia is in 99% of all samples in the general population - so unfortunately it's the levels that have the most meaning as almost everyone has some.

I took a look at the Virome gut sample report and saw that they just list all the genus and species* found - but do not state the levels as you mention.
this surprising as the machines they will be using will spit out how many counts of each 16S region it finds as the main output for free - i would guess they have this data and you may be able to access it from them somehow - like a raw data download from their website. I did that with my Ubiome report.

*species identification by PCR methods is highly dubious by the way as the 16S region is only able to correctly identify species around 60% of the time.

So correcting the microbiome in gut would help with dealing with Lyme? Am I simplifying this out of ignorance because I can assure you on trying to read Garzie's post, my eyes became crossed and brain hurt. And it isn't because it wasn't written well. It's me.

All I can think of right now is Bluto from "Animal House." But I would like to understand the basic concept. My apologies.

running wild said...
So correcting the microbiome in gut would help with dealing with Lyme? Am I simplifying this out of ignorance because I can assure you on trying to read Garzie's post, my eyes became crossed and brain hurt. And it isn't because it wasn't written well. It's me.

All I can think of right now is Bluto from "Animal House." But I would like to understand the basic concept. My apologies.

Yeah, it's meant as more of a question for discussion - rather than a prescription for a cure.

it hurts my brain as well by the way - but i refuse to give up trying to understand what might be going on in these many intertwined systems of our bodies - as each bit i understand better, even if only in terms of broad understanding - or within the limits of what is currently known, gives me a better chance of finding another lever to pull on which may help my body overcome this extremely challenging illness.

i dont think we understand yet how or why Lyme seems to cause so many gut issues - but we do know of many downstream effects that will detract from overall health if these gut issues are present - so if we could understand how and why this is happening better - it is likely we could do some kind of intervention that would be targetted upstream where it counts most, and thereby move a sick person significantly more towards health.
This is at least a hypothesis that i feel is worth further thought and investigation.

this study seems to shine a light on a bit of the puzzle and may hold clues as to what the mechanism is that is causing the dysbiosis - so we could begin to try to counteract that - but currently, there are still many gaps in our knowledge

still, i feel it is worth discussing the possibilities - and someone here may have done more research than i and have some evidence in the form of studies that would support one of the possible explanations
eg
-is it a microcirculation issue starving the gut lining cells from the nutrients or oxygen they need to manage the microbiome
-or mitochondrial damage to the immune cells - preventing them from having enough energy to perform their microbiome regulating function in the gut
-or is its Borreliia's powerful immune dysregulating effect via its epigenetic modification of signaling pathways like teh VDR or the TLR4 pathways - that is preventing the body from being able to maintain normal balance in the microbiome - as we have touched on in other discussions.
- etc etc

proof positive of one theory or another may not be necessary - as it will likely come down to trial and error of the most likely mechanisms and interventions in any case. so more a case of just finding new things to try.

this is a link to a snapshot of things that reduce Blautia abundance - according to published studies - presented as a map.
it took me a little while to figure out that the way the data is presented in terms of substances that reduce blautia often do so by increasing other genera of gut bacteria ( eg by competition for resources) so the bacteria genera in green are increased by the factors listed and thereby indirectly reduce the blautia abundance - this focuses of the substrata the bacteria use - rather than drugs or chemical interventions that may inhibit them....

https://ibb.co/JmL3384

yeah, pots, the way I read it is that anything that competes in the same space as the Blautia genus may reduce Blautia abundance - by any one of several mechanisms - and this would apply to other members of the same family or order.

they may do this by simply competing for resources - eg food/ substrate - or attachment sites on the gut lining.
also, many of the organisms listed also secrete inhibitory chemicals that are bacteriostatic to other bacteria - so that's another mechanism that may be at work. it's a complex ecosystem

the Bacteroides angle is also an option - so much we do not know - i think there is something going on re Lyme and the microbiome that we do not yet understand - i suspect that the microbiome changes may be downstream of that - and may not be causal at all - in terms of lyme symptoms ...hard to know when we have only partial info.

i am reading a rather extensive summary of what is known of the Blautia genus at the moment - in case there are more clues there -it's a recent review of all the literature out there on this genus (and even here there are more gaps than knowledge).

the paper so far seems to be making the case that in general Blautia are seen as beneficial bacteria - with higher levels often associated with positive health outcomes - and may even be candidates for use as probiotics ....but then we do know that high levels can be associated with things like MS, Lyme and auto-immune conditions - so something not quite clear going on

https://doi.org/10.1080/19490976.2021.1875796

k07 said...
I have 2 strains of Blautia identified through Viome, but unfortunately they do not give a level.

I initially did Wahl’s protocol (everything but the organ meats - can’t do that!) when I developed symptoms because I was thinking MS. Only stuck with it for a few months. But I did get better. Not 100%, but maybe I would have if I continued. I also supplemented b vitamins, d, magnesium. I also had a short course of steroids. Maybe I’ll buckle back down and give it a shot for a few months. These days I feel about 80% well, which is probably as good as many in the general public! I do get extremely fatigued after an hour workout, which I know isn’t normal. But I’m just happy to be able to workout for an hour! My other symptoms are mild (numbness, buzzing, tinnitus, urinary frequency, memory, cold intolerance, trouble sleeping).

Initially the the thinking of why Wahl’s worked was directed at mitochondria function, but has since been revised to improved microbiome.

I would definitely buckle back down and try it again if it helped.

I went on a big microbiome kick a couple months ago if you all remember, i was posting about this quite often. I came to the conclusion that the reason keto helps me is because it a.) removes inflammatory foods and b.) reduces overall levels of bacteria levels, which helps keep my dysbiosis under control. When I tried to take it one step further w/ Thryve and GI Maps and figure out what exactly is dybsiotic about my gut, I didnt really get anywhere. I really dont think the technology is there, unfortunately. I'm not sure I even trust the tests to give us accurate readings of whats in our gut based on a single fecal point.

There really is so much conflicting information. I remember reading one day on one site that a gut too acidic causes an excess of streptococcus because they "eat" these acids, while another site said that an acidic gut meant you had too few of a benefical strain that eats lactic acid. Which is it, does the ample food source invite strains that eat it, or is it a consquence of not having enough strains that eat it? Millions of these examples.

I do think that there is some feedback loop where inflammation, both from infections and diet, affects motility and the secretion of acids/enzymes/bile which affects what kind of bacteria survive, and the food sources you put in your body come into play as well and affect population levels, which affects vitamin levels, which causes further inflammation. And around she goes and a state of dysbiosis becomes the steady-state. We just dont understand exactly what it takes to push a normal gut into that steady-state of dybsiosis.

Ultimately, I came to the conclusion that my gut is dysbiostic. That much is certain. I also concluded that the science isn't there to tell me what strains I'm lacking in which I have too many of. So my options are to continue on a whole foods diet and hope that it eventually shifts the microbiome permanently.

I also have this blasto which I need to try to treat. Just like this blautia, I had a researcher tell me that blasto is commensal. But then I've met many people like me who got infected with it, and were devastated. I think that low levels can live perfectly healthy in the body, but if you have an acute infection, much like lyme, it can wreak havoc, and the immune system probably continues to react to it after that point. Apparently its big in Bali, lots of people w/ "Bali Bloat", which is Blasto. I met a girl today who got a blasto infection, severe diarrhea and weightloss just like I had. She then developed neuropathy and a bunch of other health issues. Eventually she tested positive for blasto on a stool test, and treated it with a few antibiotics, and improved rapidly, both her gut symptoms and her neuropathy. She then got cocky, started eating poorly, and relapsed. Eventually she did an FMT in Melbourne, and that was the game changer for her.

So I think I'm going to have to stick to this diet and what I've got going on w/ peptides, doing well w/ that (knock on wood), but I'm also goin to have to try to treat the blasto at some point. My plan is to start w/ some herbs to lower my levels of dysbiosis, and then re-introduce Mutaflor, and hopefully it takes this time. If that doesnt work, I will do the FMT, but that's down the road.

Anyway K07, i would def try to get back on that diet. Sounds like you have a lot of the same neurological things going on as me w/ the numbness, buzzing, frequent urination (thats an autonomic nerve issue). My experience from talking to people in the FMT group is that a lof of us w/ neurolgoical issues can point to their gut as the trigger, either an infection or preceeding dybsiosis. 70% of your immune system resides there because it's responsible for 90% of your interaction w/ the outside world, makes sense to keep it healthy.

Anyway didnt mean to highjack your thread Garzie, i just went on a wandering stream of consciousness, the point of which is that i do think the gut is important and there are material changes that take place, and often times they can be causal, but we just dont have the tools to identify and quantify these changes yet, so you are left with a few blunt tools to rectify it, namely diet, probiotics (I still think Mutaflor is one of the only worthwhile ones), maybe herbs, and FMT.

Post Edited (dcd2103) : 2/18/2021 6:26:52 PM (GMT-7)

I don't fully understand what you are writing about, but gut health is very important for the immune system. I had Blasto and a bad balance of good and bad bacteria when I did a test a long time ago and haven't taken any new test after that. IBS was my biggest problem and it's not perfect as I still react to some fodmaps, but it's so much better now, and there are so many more things I can eat now.

For me, its was avoiding food that made it worse, grains, dairy, and fodmaps. And reducing sugar. Different probiotics where I still take MegaSporeBiotic but only about once a week. GI Ultramax to build things up in my gut.
https://www.motherearthlabs.com/product/our-gi-ultramax-supplement/
I also think a lot of general health work like sleep has been improving this, bone broth, etc.