The looming antibiotic crisis

Dr Paul Clayton’s Health Newsletter May 2014

The WHO recently warned that “a post-antibiotic era in which common infections and minor injuries can kill … is a very real possibility for the 21st century.”

The word is in common use, but what exactly is an “antibiotic” and why might they be in “crisis”?

An antibiotic is a substance used to kill bacteria. Since the prefix anti- means fighting, opposing, or killing, and bios is the Greek word for “life,” antibiotic literally means life-killing. But doctors prescribe them primarily to kill the bacteria responsible for infections in the body. (A virus, on the other hand, cannot be treated with an antibiotic, so doctors are always making a distinction between a viral and a bacterial infection.)

So of course if we want to understand why antibiotics might be in crisis, we need to look in detail at microbes and bacteria. Bacteria have a generally negative image, but it’s more complex than that.

Many bacteria are becoming (and in come cases already are) resistant to our most common antibiotics. The WHO (World Health Organization) has warned that we should ‘anticipate many more deaths’ as it becomes routine for people to develop lethal infections from minor cuts or grazes, while hospital operations become potentially deadly in patients at risk of developing infections that were previously treatable.

Scientists in the field also point out that anti-viral medicines are becoming less effective against flu and other viruses, which are also developing resistance. The causes of resistance to antibiotics include:

  • Over-use in farming – 70% of all antibiotics in the USA are fed to healthy chickens, pigs and cattle!
  • Over-prescription by medical practitioners
  • Misuse by patients
  • Over-zealous use of antiseptics
  • And we cannot keep up. The simple fact is that the bugs breed and evolve in a very short time frame – many reproducing every 12 minutes as compared with our average 25 years! So they develop immunity to our drugs faster than we can develop new ones.

    Just three examples:

  • VRE (vancomycin-resistant enterococcus), is on the rise and is far more dangerous than MRSA.
  • In 2009 a virulent new strain of MRSA emerged that is five times more deadly than previous MRSA and kills up to 50% of its victims.
  • PRSP (Penicillin-Resistant Streptococcus Pneumoniae) is reported to account for 40% of hospitalisations for pneumonia.
  • Laura Piddock, Professor of Microbiology at the University of Birmingham, said last year: “Within just a few years, we might be faced with unimaginable setbacks, medically, socially, and economically, unless real and unprecedented global coordinated actions to improve surveillance and transform the way antibiotics are regulated and developed are taken immediately.”

    New Scientist (24th May 2014) confirmed the threat and pointed out that the underlying problem is that drug companies have no immediate replacements. Many older antibiotics are off-patent and so are cheap; therefore new ones have to be priced low. And unlike many drugs given for lifelong conditions, antibiotics are generally only given for short periods of time. Big Pharma has little incentive to develop replacement antibiotics – it is a low-return area of research.

    One proposed solution is for governments to jump-start antibiotic R&D with state money – and this is being actively investigated. Another idea, says Pascal Simonet of the University of Lyon, is to use bacteriophages – viruses that attack bacteria. This is a current area of exploration in controlling plant bacteria like tomato blight.

    But if the prospect of introducing a virus to kill a bacteria sounds as if it might risk collateral damage, and waiting for new drugs seems too passive, is there another way? Could we give our immune systems a helping hand to resist the bacteria in the first place?

    Bacteria are not all negative – we need the positive ones
    This has to be a sensible strategy, not least because antibiotics also have a negative side. I’ve been reading a fascinating book called Missing Microbes by Martin Blaser of New York’s School of Medicine and Head of the Human Microbiome project.

    He points out that we evolved with bacteria. They may be invisible, but they comprise the bulk of the world’s biomass – more than all the Earth’s mammals, fish, reptiles and trees put together. Within us, they outnumber our own trillions of cells by 10:1. They help digest food, some help make vitamins (like vitamin K), others metabolise drugs – so we disrupt them at our peril.

    This is becoming a major area of concern with antibiotics because, whenever we take an antibiotic to kill a pathogen, we wipe out masses of ‘innocent’ and health-positive bacterial bystanders. Blaser suggests the general microbial disruption caused by antibiotics may be involved in diabetes, asthma, food allergies and certain cancers. He makes a persuasive case that antibiotics may also contribute to obesity by disrupting gut bacteria that play a role in absorbing nutrients from food and regulating satiety.

    Not just two, but even three immune systems?
    It is well recognised that we have two immune systems – the acquired immune system and the innate immune system. Both rely on distinguishing between self and non-self – which is why the health of the immune system is so important in reducing the risk of cancer.

    The acquired (or adaptive) immune system is the one with ‘memory’. It recognises a pathogen it has been exposed to before and adapts by producing antibodies, T-cells and B-cells that fight that threat. This is the basis of inoculation – by exposing the body to a safe form of a pathogen, you create antibodies to fight a real threat in the future.

    Our innate immune system evolved first. Its three main components are neutrophils, Natural Killer (NK) cells and macrophages – cells that envelop and ‘eat’ pathogens. This trio continually patrols the body looking for any foreign threat. They mobilise almost instantly, working faster than the acquired immune system. The innate immune system is therefore the front line of your defences, and also includes physical and chemical barriers against pathogens such as skin and gastric acid, and powerful anti-microbial enzymes in saliva and other secretions.

    Microbial scientists are now suggesting a third – a microbial immune system, consisting of favourable microbes living inside us, primarily in our gastrointestinal tracts. These trillions of microbes living inside us do not themselves ‘want’ to be invaded by outsider bacteria, and they excrete antibiotic-like substances called bacteriocins which are poisonous to the intruders.

    So how to ensure your immune systems are working effectively?
    As always, the first priorities involve food and lifestyle. The immune system, like any army, marches on its stomach. Both the acquired and innate immune systems rely on a wide range of nutrients to work well. These include:

  • Vitamins A, B6, C, E, and the anti-inflammatory polyphenols which you’ll find in colourful fruits and vegetables, especially those with purple, blue, red, orange, and yellow hues.
  • The carotenoids beta carotene, lycopene and lutein – found in apricots, asparagus, broccoli, carrots, green peppers, kale, mangoes, collard greens, nectarines, peaches, pink grapefruit, spinach, sweet potato, tangerines, tomatoes.
  • 1-3, 1-6 beta glucans – found in the cell walls of yeast and other fungi
  • Zinc: in oysters, red meat, poultry, beans, nuts, seafood, whole grains, fortified cereals, and dairy products
  • Selenium: in Brazil nuts, tuna, beef, poultry, fortified breads, and other grain products.
  • Vitamin D – from exposure to sun and in a few foods like salmon, mackerel, tuna and eggs.
  • Protein: prefer chicken, turkey, salmon, tofu, and other lean meats. Other vegetarian protein sources include kidney beans, pulses and black beans.
  • And the immune system responds less well as we age
    Researchers believe that the ageing process leads to a reduction of immune response capability, which in turn contributes to more infections, more inflammatory diseases, and more cancer. Compared with younger people, the elderly are far more likely to contract infectious diseases.

    But why? No one knows for sure, but some scientists observe that this increased risk correlates with a decrease in T-cells, possibly from the thymus atrophying with age and producing fewer T-cells to fight off infection.

    Ageing also means you no longer produce such an abundance of antibodies or lymphocytes, all key components in immune function. In addition, ‘immunosenescence’ (the ageing of the immune system), coincides with a dramatic increase in chronic inflammation, which leaves you susceptible to degenerative diseases like heart disease, diabetes, and cancer.

    Some researchers suggest that absorption of nutrients becomes less efficient with age. Others suggest that as older people tend to eat less and often have less variety in their diets, they may be suffering from exacerbated “multiple micronutrient depletion”.

    Nutritional supplementation to counter multiple nutrient depletion
    All of which indicates that a comprehensive supplement at optimum levels like NutriShield, which provides both wide-spectrum micro-/phyto-nutrient support and potent anti-inflammatory activity, will help support the immune system generally; especially when combined with the beta glucans in ImmunoShield.

    Vitamin D is vital for a healthy immune system – and most people are depleted.
    • A 2007 US study of more than 30,000 women found those eating food containing higher levels of calcium and vitamin D were up to 40 per cent less likely to develop breast cancer before the menopause.

    • US researchers from Winthrop University Hospital in Mineola found that giving supplements of vitamin D to a group of volunteers reduced the occurrence of colds and flu by 70 per cent over three years. The researchers concluded that the decline in vitamin D levels between November and March could be the reason for the peak in colds and flu during the winter months.

    • In 2009 the results of a study, published in the Journal of the British Association of Urological Surgeons, showed that a daily dose of vitamin D reduced PSA (prostate-specific antigen) levels – an indicator of prostate problems – by as much as half in a significant cohort of patients.

    • In another study in 2014, researchers from Imperial College London discovered that people with the highest concentrations of vitamin D in their blood had a 40 per cent reduced risk of bowel cancer compared with those recording the lowest levels of the vitamin.

    • The latest research from Canada suggests a strong link between vitamin D and a gene that increases the risk of the incurable neurological condition multiple sclerosis (MS), which is an inflammatory disease of the nervous system.

    Professor Ebers, lead researcher said: “Our research has married two key pieces of the puzzle. The interaction of vitamin D with the gene is very specific and it seems most unlikely to be a coincidence of any kind… I think it offers the potential for treatment which might prevent MS in the future.”

    The trace mineral selenium is an essential element in a healthy immune system. The selenium content of grains, fruits and vegetables depends on the amount of selenium in the soil they’re grown in. The level of selenium in the soil throughout the UK is low. For example, the selenium levels in bread-making wheat are as much as 10 to 40 times lower than similar wheat in the US and Canada.

    The American Journal of Clinical Nutrition reported on a Liverpool University study team which recruited 22 subjects who had low concentrations of plasma selenium. Over a period of 15 weeks, subjects received supplements of 100 mcg of selenium, or a placebo. Six weeks into the trial period, each subject was given an oral vaccine containing a live but restricted poliomyelitis virus. By measuring the immune system components that react to viruses (such as an increase of T-cells and cytokines), researchers showed that immune response was significantly boosted in those subjects who received selenium supplements, compared to the placebo group. In addition, patients who took selenium cleared the virus from their bodies faster than the placebo subjects.

    Direct immune priming with beta glucans
    There are compounds in yeasts and fungi that naturally ‘prime’ your immune system to be in a high state of readiness to seek out and destroy invading pathogens. Unfortunately, these compounds, 1-3, 1-6 beta glucans, are now far less prevalent in our diets, due to food refinement techniques, over-processing and an excessive focus on kitchen hygiene.

    Long before we evolved, all higher life forms were so surrounded by yeasts and fungi that our immune system evolved to combat the threat, so much so that it cannot work effectively without that stimulus!

    1-3, 1-6 beta glucans can prime all three of the main immune defence components: neutrophils, Natural Killer (NK) cells and macrophages.

    For a full description of how beta glucans work, and their detailed research backing, READ MORE HERE in the article “How beta glucans prime the immune system”.

    Prioritise exercise, relaxation and personal hygiene
    Regular exercise improves cardiovascular health, lowers blood pressure, helps control body weight, and protects against a variety of diseases. It may contribute directly to immune health by promoting good circulation, which allows the cells and substances of the immune system to move through the body and do their job efficiently.

    Adults aged 18-64 and those over 65 with no existing medical conditions should do at least 2 hours and 30 minutes of aerobic exercise like brisk walking each week and at least two hours per week of muscle strengthening activities like lifting weights.

    Personal hygiene. You should obviously wash your hands after using the toilet, but it’s now become more important before, after, and while cooking food, after handling animals or animal waste, and before eating.

    Manage stress. We may have always suspected it, but now scientists at Yale University have found that the more stress your body is under, the more prone you are to infection from colds, flu, bacteria and other pathogens. The Yale findings, published by Professor Tian Xu in ‘Nature’, also show that any stress, whether physical or emotional, can “act as a pathway between cancerous mutations in your cells”, for the first time linking common illnesses like colds, flu and other infections with potentially life-threatening diseases such as cancer.

    A research team from Ohio State University suggests that psychological stress affects the immune system by disrupting communication between the nervous system, the endocrine (hormonal) system, and the immune system. These three systems “talk” to one another using natural chemical messages, and must work in close coordination to be effective.

    So make time for relaxing activities like meditating, yoga, pilates, dancing, walking, playing sport or making love!

    SUMMARY
    Chronic infection, inadequate nutrition, plus mental and physical stress weaken your immune system. As a result, wounds heal more slowly, and bone marrow slows down the production of new immune cells. This is why we become more vulnerable to joint pain, abnormal cell growth and viral, bacterial or fungal infection.

    For a direct boost to your immune system, consider the beta glucans via ImmunoShield www.immunoshield.com.

    NutriShield indirectly contributes because it provides all-round nutritional support.

    REFERENCES
    http://www.who.int/mediacentre/news/releases/2014/amr-report/en/