And happy birthday

Merry Christmas from me x

Bill the Pony would like a word

@mchopra.bsky.social

What does the future look like? Very promising, but we need more research into children, but also different ethnic backgrounds as current literature is SE Asian (Mestre 2022). There is also promise in individually targeted probiotic strains which would allow a personally catered probiotic therapy.

Probiotics offer a strong, cheap adjunct therapy alongside traditional medicine. The efficacy of different species, such as Lactobacillus, Bifidobacterium and Saccharomyces spp., varies and a multi-biotic approach is necessary to gain result, though more paediatric research is needed.

The benefits against Hp are threefold. 1. Probiotics secrete antimicrobials, 2. They secrete volatile acids and modulate cytokines which help reduce pH and inflammatory reactions within the gastric lumen and 3. May competitively bind to endothelial surface reducing Hp anchoring points.

Treatment does carry side effects such as diarrhoea and bloating. Research shows that application of mixed (Yasar 2010) probiotic strains can ameliorate these symptoms, as well as increase eradication of Hp. Curative benefits do not replace therapy but should be considered supplementary.

Currently Hp is cured via proton pump inhibitors, amoxicillin, and clarithromycin. There is concern around antimicrobial resistance to the latter two, and metronidazole is recommended as a fourth treatment where local resistance is proven. Gastritis and malignancy does improve with eradication.

This hypochloridic state of the gastric lumen is exacerbated by the attraction of immune cells reacting to Hp presence. These exude pro-inflammatories that leads to further damage of the gastric mucosa. This immune response has a secondary impact against the reduced gastric biodiversity.

Hp first releases enzymes that raise the pH via ammonia and bicarbonate. With the lumen hypochloric Hp enters the gastric mucosa via flagellate movement. Here it attaches to endothelial cells and releases antimicrobial agents which kill healthy bacteria leading to dysbiosis of the gastric lumen.

Historically the gut was considered sterile due to its high acidity. However, we now know its highly diverse which creates a healthy digestive system. We also know that presence of Hp dramatically decreases this richness leading to dysbiosis of the patient, 262-33 phylotypes in Andersson (2008).

Antibiotics are an efficient therapy against Hp, however there is increasing concern of its use as antimicrobial resistance grows globally. However, therapeutic probiotic treatment has promising results in fighting HP and mitigating the broader dysbiotic symptoms of antibiotics.

Working from home after a light hernia op but otherwise grand thanks 😁 how're you liking Bluesky? I'm only using it for uni I think (spend enough time on SM!) So expect a 10 tweet thread about something sciencey in the next week or two 😁

MKG Andrew here, put me top of the list 👊