Voyages of the gut: how travel shapes our inner landscapes

New research highlights the transient effects of travel on the gut microbiota and antimicrobial resistance, revealing a swift return to pre-travel microbial diversity and ARG levels, offering insights into the gut's resilience and adaptability.

The globetrotting lifestyle holds profound implications for our inner ecosystems, as a compelling new study demonstrates. 1 Their investigation into the dynamics of antimicrobial resistance genes (ARGs) and the gut microbiome in international travelers reveals a captivating narrative of resilience and adaptation.

A Longitudinal Odyssey Tracing the Traveler's Trail

At the core of this research lies a critical objective: to follow the persistence of four ARGs (mcr-1, blaNDM, blaCTX−M, and tet(X4)), and shifts in the gut microbiome composition over an extended period post-travel. While previous studies 2 have shed light on the immediate impact of international journeys, this longitudinal study offers a comprehensive perspective on the lasting effects.

When travel breeds antibiotic resistance

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The research team conducted a prospective cohort study by analyzing stool samples from 89 healthy globetrotters from Guangzhou, China. The data was collected at three strategic timepoints: pre-travel, immediately post-travel, and three months after their return.

Resistance vs. Resilience

Interestingly, the study revealed that a staggering 53% of travelers acquired at least one ARG during their journeys. Yet, the vast majority of these acquisitions proved transient. Immediately following travel, a significant surge in the prevalence of certain ARGs was observed. However, in a remarkable display of resilience, these acquired ARGs were shed within three months, with the gut's defenses reverting to their pre-travel baselines.

The same happened with the gut microbiome that witnessed a temporary disruption in microbial diversity post-travel (72% of travelers showed a significant increase in microbial diversity after travel), followed by a remarkable restoration to pre-travel equilibrium within three months.

As the world becomes increasingly interconnected, the implications of these findings resonate profoundly within the healthcare landscape, underscoring the need for continued vigilance and research into the interplay between global travel, antimicrobial resistance, and the delicate balance of our inner ecosystems.

World AMR Awareness Week

World AMR Awareness Week (WAAW) is celebrated every year from November 18 to 24. In 2023, the theme chosen was “Preventing antimicrobial resistance together,” as in 2022. In fact, this resistance represents a threat not only to human beings, but also to animals, plants and the environment.

The aim of this campaign is to raise awareness of antimicrobial resistance and promote best practices, based on the "One Health" concept, among all stakeholders (the general public, doctors, veterinarians, breeders and farmers, decision-makers, etc.) in order to reduce the emergence and spread of resistant infections.

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Travel can disrupt your gut, but not for long

Who hasn't experienced intestinal troubles while traveling? Beyond the well-known discomforts such as diarrhea and bloating, journeys can affect our intestinal microbiota and lead to the acquisition of new genes, some of which are linked to antimicrobial resistance. Fortunately for us, our microbiota demonstrates great resilience, and these changes are resolved within 3 months.

The gut microbiota Antibiotic-associated diarrhea Travelers’ diarrhea

You may love exploring new destinations, but did you know that your international adventures can also impact the microscopic world within your gut? A fascinating new study 1 reveals that travel can temporarily alter your gut microbiome and increase antimicrobial resistance genes (ARGs). However, the good news is that these changes tend to be reversible for healthy individuals.

What is antimicrobial resistance?

Antimicrobial resistance occurs when bacteria, viruses, or other microbes develop the ability to resist the effects of medications designed to kill or stop their growth. This can make infections harder to treat and poses a serious global health threat.

The bounce-back effect

The research team followed 89 healthy travelers from Guangzhou, China, collecting stool samples before their trips, immediately after their return, and three months later. This long-term approach allowed them to track how the gut microbiome and ARGs respond over time.

The findings were remarkable: more than half of the travelers acquired at least one new ARG during their journeys. Immediately after travel, there was a significant spike. However, within three months, these resistance genes were shed, and the gut microbiome reverted to its pre-travel state, showcasing the incredible resilience of our inner ecosystems.

Traveling shapes our lives...but also our microbiota and antibiotic resistance

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The resilience of your gut microbiome

Your gut microbiome is a complex ecosystem of trillions of microorganisms, including bacteria, viruses, and fungi, that play a crucial role in your overall health. This study demonstrates that while travel can temporarily disrupt this delicate balance, 2 the gut microbiome has an amazing ability to bounce back to its original state in healthy individuals.
 

A "resilient microbiota" or "resilient microbiome" refers to the ability of the community of microorganisms living in the gut (or another part of the body) to recover and return to its original, healthy state after being disrupted or disturbed. Specifically, it means that despite changes or perturbations to the microbiota caused by factors like diet, antibiotics, illness, or as shown in this study - travel, the microbiota has the capacity to bounce back and re-establish its previous, balanced composition and function.

Travel health risks

While exploring new destinations is thrilling, let's not forget about the potential souvenirs you might bring back – traveler's diarrhea, food poisoning, respiratory infections... Talk about memorable mementos! Jokes aside, these travel bugs are no laughing matter. It's crucial to take precautions such as consulting a travel health professional (they're like personal travel bodyguards for your immune system), getting recommended vaccinations, and practicing good hygiene. A little prevention can go a long way in ensuring your adventures are filled with happy memories, not feverish hallucinations.

World AMR Awareness Week

World AMR Awareness Week (WAAW) is celebrated every year from November 18 to 24. In 2023, the theme chosen was “Preventing antimicrobial resistance together,” as in 2022. In fact, this resistance represents a threat not only to human beings, but also to animals, plants and the environment.

The aim of this campaign is to raise awareness of antimicrobial resistance and promote best practices, based on the "One Health" concept, among all stakeholders (the general public, doctors, veterinarians, breeders and farmers, decision-makers, etc.) in order to reduce the emergence and spread of resistant infections.

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Irritable Bowel Syndrome (IBS) Awareness Month 2024

More than 10 000 IBS Diagnosis tools spread worldwide to better diagnose IBS and help physicians to communicate with their patients.
 

Homepage HCPs - World IBS Awareness Month

10 000 IBS diagnosis tools spread worldwide in congresses and symposia

15 000 IBS diagnosis tools reprinted

300 IBS diagnosis tools downloaded on the Institute’s website

One year after its launch by three international gastroenterologists, the IBS diagnosis tool keeps its momentum. To mark IBS Awareness Month, the Biocodex Microbiota Institute is going a step further providing healthcare professionals and the lay public a dedicated journey to better understand IBS and its link with the microbiota. 

Since 1997, April is irritable bowel syndrome (IBS) Awareness Month. IBS is a complex disorder, its genesis is likely multifactorial and not fully understood.  But there are several lines of evidence that implicate microbiota in IBS. This why, during this month, the Biocodex Microbiota Institute joins patients, healthcare professionals and family members to increase awareness about IBS and its link with gut microbiota.  Patients’ testimonials, experts’ interviews, infographic, certification training courses, articles... Here are some tools to raise the visibility of IBS and microbiota. 

IBS diagnosis tool: a helpful physician resource

Launched in 2023 by three internationally renowned gastroenterologists Professor Jean-Marc Sabaté, Professor Jan Tack, and Dr. Pedro Costa Moreira, with the support of the Biocodex Microbiota Institute, the IBS Diagnosis tool provides physicians an easy-to-use checklist to differential diagnosis (diagnostic criteria, IBS subtypes, checklist of warning signs, etc.) and to improving communication with patients.

Thousands of gastroenterologists but also family physicians, pharmacists, dietitians have already adopted this innovative tool. Available in three formats, this tool has received the endorsement of the World Gastroenterology Organisation.

It can be downloaded here.

This tool puts the physician in a very practical way in the diagnostic process when confronted with his patient

Pr. Jan Tack, one of the co-creators

IBS infographic, thematic folder, and training courses: tailored educational opportunities! 

Many patients with IBS suffer for years before discussing their symptoms with their physician. However, due to their prominent position in daily patient care, physicians play a crucial role to play in promptly diagnosing and effectively treating patients with IBS. They are also well positioned to establish open and trusting relationships with their patients. This is the reason why, the Biocodex Microbiota Institute provides healthcare professionals with customized tools and content to improve their day-to-day practice and quickly become experts on IBS. IBS certification training course, infographics to share with patients, expert videos, thematic paper, but also the latest scientific news... A range of innovative, updated and easy-to-use contents to become an IBS expert.

Better understand the complex link between microbiota & IBS 

What are the IBS symptoms? Why do I develop IBS? Is it linked to the microbiota? Is there a microbiota-gut-brain axis? To increase awareness about IBS and answer all the questions the lay public may ask, the Biocodex Microbiota Institute is handing the floor to an expert in the field, Pr. Premysl Bercik, clinician and researcher at McMaster University, Canada.

Pr. Premysl Bercik

During the last decade, increasing attention has been given to gut microbiota as a key in IBS.

Pr. Premysl Bercik

Living with IBS: patients’ testimonies

Aline, Jennifer and Mihai are IBS patients. In a series of video testimonials, they speak openly about how the disease has changed their lives and give advice on how to live with IBS. The first episodes of “patients stories” were produced with the support of the French Association of Irritable Bowel Syndrome Patients (APSSII). 

With this holistic awareness campaign, the Biocodex Microbiota Institute intends to actively encourage all stakeholders (patients and health professionals, as well as family members, caregivers, health authorities, and the general public, etc.) to get a better understanding of the disease itself, and the latest research advances pointing to the role played by the gut microbiota.

If there is still some way to go in terms of managing IBS and considering symptoms, there is no doubt that the development of new diagnostic tools will soon change the game.

I’ve been in this field for a long time, and I’ve seen the view on IBS really evolved. There was a prejudice thirty years ago that it was maybe all psychosomatic. We are now fully aware this is an impactful disorder that we need to treat it properly.” 

Pr. Jan Tack

About the Microbiota Institute

The Biocodex Microbiota Institute is an international hub of knowledge that aims to foster better health by spreading knowledge about human microbiota. To do so, the Institute addresses both healthcare professionals and the lay public to raise awareness about the central role of this important organ.

Contact us

Olivier VALCKE

Public Relation & Editorial Manager
Phone : +33 (0) 6 43 61 32 58
o.valcke@biocodex.com

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Decoding gut health trends on social media

There are a lot of misinformed trends that take off on TikTok, claiming to heal your gut without providing scientific evidence. In this article, Shania Bhopa discusses how to spot misinformation and critically analyze social media gut-health content.

The gut microbiota Diet Digestive disorders

The era of mis-information is ever expanding. In health information shared on platforms like TikTok, the critical evaluation of content becomes paramount, especially concerning gut microbiota. The gut microbiota, composed of trillions of microorganisms, plays a pivotal role in digestion, metabolism, immune function, and mental health.

Here are some stats on the hashtag #guthealth:

540k videos on TikTok

5.5 million videos on Instagram

Misinformation can be particularly harmful to individuals with conditions such as Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD), where accurate and evidence-based information is crucial for managing symptoms effectively. Evidence-based practice ensures that interventions and treatments are founded on robust scientific evidence, improving patient outcomes and optimizing healthcare delivery.

The goal is to have individuals feel confident in their ability to discern credible information from falsehoods. This not only aids in the better management of gut health conditions but also prevents the potential exacerbation of symptoms caused by following misguided advice.

The following topics have been commonly discussed on social media platforms. Let's talk about the evidence.

Drinking Aloe Vera every day will help your gut and gut microbiota

Research on aloe vera juice and its effects on digestion highlights its potential benefits. Aloe vera juice has been proven to provide a useful source of vitamins and amino acids when consumed orally. 1 However, while aloe vera's benefits for digestion are noteworthy, it's crucial to recognize this as just a fragment of the complex gut health puzzle. Our lifestyle, diet, stress levels, and other environmental factors impact gut microbiota, underscoring the importance of a holistic approach to digestive health.

Actu GP : Microbiote oral et grand âge : un jus de betterave - et des nitrates -, et ça repart ?

Drink Beet juice to “flush 8-10lbs” of waste from your body

Research indicates that beet juice could be beneficial for the digestive system due to its rich content of bioactive compounds, antioxidants, and fibres. Betalains and phenolics in beet juice can positively modulate the gut microbiota and promote gastrointestinal health, making it a healthy choice for improving digestive function. 2 

While sensational claims on platforms like TikTok, such as “drinking beet juice to eliminate 8-10lbs of waste”, lack scientific backing and veer into misinformation, the truth about beets and digestion is grounded in their nutritional composition. The presence of betalains and phenolics in beet juice has been found to influence gut microbiota and bolster gastrointestinal health positively, underscoring the value of beets in promoting digestive function. Therefore, while the extravagant claims about beet juice may not hold up, its legitimate benefits for digestion highlight the importance of integrating such nutrient-rich foods into our diets for overall gut health and well-being.

Photo: Irritable bowel syndrome (IBS) - disease page

If you are not pooping after every meal... You are CONSTIPATED!

According to the American Gastroenterological Association, constipation is typically characterized by having fewer than three bowel movements in a week, not by the absence of bowel movements after each meal. 3 However, it's important to note that normal bowel movement frequency can vary greatly from person to person, ranging from several times a day to three times a week. The spread of misinformation such as the claim that not pooping after every meal equates to constipation, underscores the critical need for evidence-based health information.

Drink a lemon/ginger/honey shot on an empty stomach for your gut health

Research suggests that ginger extract can indeed have beneficial effects on gut health, particularly in ameliorating antibiotic-associated diarrhea, restoring gut microbiota, and improving intestinal barrier function. 4 However, it's crucial to highlight that most of this evidence stems from animal trials, which may not directly translate to human health outcomes. Additionally, while ginger shots are generally safe for consumption, excessive intake can lead to gastrointestinal discomfort, including heartburn, diarrhea, or an upset stomach.

There is no evidence to suggest the frequency and quantity of lemon/ginger/honey shots to be beneficial to gut microbiota.

“Drink the magic potion green juice every morning” to improve your gut microbiota

Evidence suggests that while juice can provide some nutritional benefits, its lack of fibre content may limit its effectiveness in supporting digestion. Fibre is crucial in increasing fecal mass and reducing intestinal transit times, contributing to healthier digestion processes. Since juice typically lacks fibre, it might not aid effectively in digestion compared to whole fruits or vegetables that contain soluble and insoluble fibers.

Moreover, while specific juices, such as citrus juices, might offer some health benefits, they can also directly irritate the esophageal mucosa, potentially exacerbating symptoms in individuals with irritable bowel syndrome (IBS) and thus not aiding digestion. 5

In summary, while juice may provide some nutritional benefits, its lack of fibre makes it less effective in promoting digestion than whole fruits and vegetables. The emphasis on consuming whole foods with natural fibre remains essential for digestive health and overall well-being.

What can you do to learn more about evidence-based health and critically analyze your social media posts?

Various tools like Consensus, You.com, and ScholarAI play pivotal roles in deciphering evidence on health topics. These tools not only streamline the process of accessing and interpreting scientific evidence but also empower individuals to take charge of their health by equipping them with the knowledge they need to make evidence-based choices.

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Decoding gut trend_EN

Dietary practices shape the composition of microbiota

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Robust microbial signature for autism was discovered thanks to AI

Using artificial intelligence (AI) and machine learning techniques, researchers have identified 26 bacterial taxa in the gut microbiota that can distinguish children with an autism spectrum disorder (ASD) from those without ASD.

Could AI revolutionize our understanding, diagnosis, and management of ASD?

This is one of the questions a team of Dutch researchers has tried to shed some light on. The results of their study have just been published in Scientific Reports. 1 

Thanks to machine learning, these scientists were able to identify 26 bacterial taxa characteristic of the gut microbiota of children suffering from autism. This discovery opens the door to new diagnostic techniques and provides potential targets for therapeutic intervention.

Overcoming dietary and lifestyle biases

To unearth these findings, Lucia Peralta-Marzal and her team used data on gut microbiota composition from 60 autistic American children aged 2 to 7 years and 57 of their siblings not affected by the disorder (control group). 

By choosing children from the same sibling group, the scientists sought to reduce biases – common in traditional statistical analyses – linked to diet, living environment, and lifestyle. Their goal was to identify a gut microbial signature specifically linked to ASD.

What does the microbiota of autistic children look like?

An analysis of the gut microbiota of children with ASD in the three cohorts used by Lucia Peralta-Marzal’s team indicates that there are:

  • fewer bifidobacteria: in previous studies, this bacterial group had been correlated with alterations in the metabolism of tryptophan, a compound associated with ASD severity;
  • abnormal levels of Clostridia: these bacteria are known to be associated with increased susceptibility to neurodevelopmental disorders and certain behavioral parameters in ASD;
  • a reduction in Butyricicoccus: work on animal models of ASD has shown that these bacteria recover in the event of fecal microbiota transplantation (FMT).

The researchers analyzed raw 16S rRNA gene sequencing data extracted from the gut microbiota of the children in the cohort using an algorithm called recursive ensemble feature selection (REFS) based on machine learning.

This sub-domain of AI, which uses algorithms to discover patterns in datasets, enabled them to identify 26 amplicon sequence variants (ASVs). These ASVs correspond to 26 bacterial taxa capable of differentiating the children with autism from those in the control group.

5 things you need to know about ASD

  • In the United States, 1 in 36 children suffers from ASD, with a ratio of 4 boys to every girl. 2
  • While the underlying causes of these disorders remain unclear, genetic and environmental factors (prenatal exposure to air pollutants and pesticides, maternal obesity and
  • immune disorders, premature birth, etc.) appear to play a major role. 3
  • There are clear differences in microbial composition in the gut of people with ASD compared with control populations, and the microbiota may contribute to symptoms. 4
  • People affected by this disease generally suffer from gastrointestinal disorders (diarrhea, constipation, abdominal pain, etc.), which are correlated with the severity of ASD. 5
  • In a Phase 1 clinical trial, fecal microbiota transplantation (FMT) significantly improved behavioral scores and gastrointestinal symptoms. 6

A precise, robust, and validated predictive tool

By using these 26 taxa to analyze the same type of data, but this time from two Chinese cohorts (223 children, including 125 with ASD), Lucia Peralta-Marzal and her team succeeded in confirming the ability of this signature to identify autistic children, thus demonstrating the signature’s reliability and reproducibility. 

They calculated the average area under the curve (AUC) to be 81.6% in the US cohort and 74.8% and 74%, respectively, in the Chinese cohorts, proving that confounding factors such as lifestyle do not alter this signature.

Further studies will be needed to understand the role of the 26 taxa in the pathophysiology of ASD. However, this signature can already be used for diagnostic purposes and to provide new information on the molecular mechanisms at play in the microbiota-gut-brain axis. 

In any case, the study confirms that the gut microbiota is strongly associated with ASD and should not be overlooked as a potential target for therapeutic intervention.

Everything you need to know about the microbiota gut-brain axis

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Male infertility: are bacteria in semen involved?

What if some of the bacteria present in men’s semen were involved in their infertility? This is suggested by the results of a study published in early 2024, which looked into this microbiota. 1

The urinary microbiota The vaginal microbiota Bacterial vaginosis - vaginal microbiota imbalance

When a couple has difficulty conceiving, the fertility of both partners is assessed. In men, a sperm analysis called a (sidenote: Spermiogram An examination that evaluates the quality of a sperm sample, including its volume (average normal volume = 1.4 mL), pH (which should be equal to or greater than 7.2), sperm concentration (normally greater than or equal to 16 million per mL), sperm motility (at least 30% must be able to move progressively forward, rather than spinning around or not moving forward) and vitality (> 54%). Other factors are also taken into consideration, such as sperm morphology, the overall appearance of the sample and its viscosity. For a given patient, a semen analysis can never confirm fertility or infertility; the person’s fertility potential also depends on several other parameters and the fertility potential of the person’s partner.
  Source: WHO
)
is usually prescribed. Despite this examination, almost 1 in 3 cases of (sidenote: Male infertility A disease most often caused by problems with ejaculation, the absence or low quantity of spermatozoa, or abnormal sperm shape (morphology) or movement (mobility).
  Source: WHO
)
  (sidenote: Infertility Disease of the male or female reproductive system defined by the inability to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. 
  Source: WHO
)
remain unexplained. But a new avenue is now being explored: that of the sperm microbiota.

Key figures on infertility

1 in 6 people suffer from infertility during their lifetime. 2

50-60%: significant drop in sperm count between 1973 and 2011 among men in North America, Europe, Australia and New Zealand. 3

30-50% of explained cases of infertility are linked to men. 4

L. iners, an anti-fertility bacterium?

As we all know, semen is far from sterile. It is home to a community of microorganisms, with the most numerous being the bacteria Enterococcus faecalis, Staphylococcus epidermidis, Corynebacterium tuberculostearicum and Lactobacillus iners. However, there are subtle differences associated with sperm quality. For example, in men whose sperm have difficulty moving forward (and therefore have difficulty reaching the egg), Lactobacillus iners bacteria are much more prevalent: they account for 9.4% of bacteria in semen, compared with 2.6% in men whose sperm have normal motility.

In a previous study, the high presence of this bacterium in women’s vaginas was associated with less successful medically assisted procreation (MAP). Its harmful effect could be explained by its pro-inflammatory qualities, which generally do not make for a very good nesting place for fertility!

Everything you always wanted to know about penile microbiota (but were afraid to ask)

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Pseudomonas also involved

The 3 other bacteria singled out by the researchers all belong to the genus Pseudomonas, previously unknown to the fertility police: semen with a low sperm concentration is richer in Pseudomonas stutzeri and P. fluorescens, and less rich in P. putida. Researchers therefore suspect that the first two bacteria of this genus may go hand in hand with low fertility, while the latter could have a beneficial effect.

Of course, once again, these are only correlations, not cause-and-effect relationships. Nevertheless, these results suggest that these bacteria could play a role in sperm quality, and therefore male fertility. To be continued in future studies..I

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Male infertility: is sperm microbiota involved?

In men with abnormal sperm parameters, the sperm microbiota is altered. This suggests that certain microorganisms could influence sperm quality and therefore male fertility.

Male infertility may be common, but it’s still poorly understood in almost 1 in 3 cases. Could sperm microbiota be involved? Until now, it’s been difficult to find out, as few studies have been dedicated to this microbiota. Even rarer were those approaching the subject from a fertility angle. Hence the interest generated by the work of an American team: according to them, a small group of microorganisms could contribute to reduced fertility in men. 1

Key figures on infertility

1 in 6 people suffer from infertility during their lifetime. 2

50-60%: significant drop in sperm count between 1973 and 2011 among men in North America, Europe, Australia and New Zealand. 3

30-50% of explained cases of infertility are linked to men. 4

Fertility, sperm and microbiota

73 men undergoing fertility evaluation or requesting vasectomy after one or more children were divided into groups according to the results of analysis of their sperm quality. The first finding of the study: sperm abnormalities (sperm concentration, sperm motility) do not necessarily reflect fertility or subfertility. The group with a normal spermiogram included 40% of the men being evaluated for hypofertility. The second finding: contrary to the results of other studies (different populations? methodology?), the researchers did not observe any significant change in the (sidenote: Alpha diversity Number of species coexisting in a given environment ) or (sidenote: Beta diversity Rate of variation in species composition, calculated by comparing the number of unique taxa in each ecosystem ) diversity of the microbiota between normal and non-normal sperm. So, according to the authors, it may not be a global dysbiosis that contributes to subfertility, but a more subtle change in certain species.

Bacteria associated with sperm abnormalities

Overall, Enterococcus faecalis, Staphylococcus epidermidis, Corynebacterium tuberculostearicum and Lactobacillus iners are the most abundant bacteria in semen. But there are subtle differences between anomalies. Sperm with poor motility were richer in Lactobacillus iners (9.4% vs. 2.6%). Similarly, semen samples with a low sperm count were richer in Pseudomonas stutzeri (2.1% vs 1.0%) and P. fluorescens (0.9% vs 0.7%), but had a lower abundance of P. putida (0.5% vs 0.8%).

While this observational study provides only correlations, and by no means causal relationships, its results suggest that some bacteria may play a role in the disturbance of sperm parameters. Especially since L. iners, a pro-inflammatory agent, is also implicated in reduced fertility in women undergoing medically assisted procreation (MAP). This study is therefore the first of its kind to demonstrate a relationship between the presence of L. iners and male infertility.

Far from providing a definitive conclusion, the results of this single-center observational study should be used as input for future studies (mechanistic, longitudinal and multi-center). This might not only lead to a better understanding of sperm microbiota, but also to potential therapeutic options for improving male fertility.

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"Interesting!"  -@Amasvingwe (From Biocodex Microbiota Institute on X)

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How S. aureus bacteria are trying to get under your skin

Understanding the mechanisms through which a simple skin bacterium can trigger itching is the key to preventing one of the steps and being able in the future to produce a simple cream that soothes the irresistible urge to scratch.

The skin microbiota Skin disorders Allergic eczema

“Does it tickle, or does it itch?” Dr Knock’s famous question in Jules Romains’ play of the same name may have inspired the authors of a recent study. Their aim? To better understand the mechanisms that trigger  (sidenote: Itch Itch is an unpleasant sensation that evokes a desire to scratch. Itch originates in the nerve endings just beneath the skin, at dedicated receptors called pruriceptors. It then follows nerve pathways up to the brain, where it activates sensory (feeling the itch), emotional (wanting to scratch), and motor (actually scratching) brain areas.  
Source : Ameli
)
and the resulting irresistible urge to scratch. They achieved their results thanks to a series of experiments on mice and samples of human nerves and skin.

The skin microbiota

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From bacteria to scratching...

The focus of their research: the Staphylococcus aureus bacterium, widely present on our skin. Staphylococcus aureus feeds on the skin lesions of those prone to atopic dermatitis and plays a role in impetigo, a contagious skin disease feared in nurseries and kindergartens. To its resume can be added a direct involvement in pruritus, the scientific name for itching.

Its modus operandi has now been revealed: S. aureus produces a protein called V8, which binds to the skin receptor responsible for itching. By activating this receptor, V8 triggers an alert that travels via a nerve pathway to the brain. The response to the itch is immediate: scratching, often frantic, to the point of damaging the skin.

40 % of those surveyed said they had previously heard the term “skin microbiota” but only 15% could say precisely what it meant

... then to invasion or spread

Isn’t that exactly what the bacterium wanted? While not wanting to impart to a microorganism any sinister intentions, all of this clearly suits Staphylococcus aureus: scratching is the perfect way for it to reach new tissue, such as the hand or paw used to relieve the itch, or even new individuals, if they happen to be close enough to the skin being scratched. Better still, the lesion induced by scratching is a chance for the bacteria to penetrate a little deeper into the skin. In short, whether through spread or invasion, S. aureus has everything to gain by making us scratch.

Skin disorders

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Relieving itchy skin

However, this study also paves the way for possible therapeutic solutions to relieve itching and save your skin. A simple cream containing a molecule that can block the famed nerve receptor should help reduce itching. Another promising option is to target protease V8. All ways to treat itchy skin.

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Itchiness: learning about the mechanism of action of S.aureus from scratch

The aim of this study was to provide relief to patients suffering from pruritus through a better understanding of why S. aureus causes an irresistible urge to scratch.

Although seemingly harmless, itchy skin can be difficult to live with if it lasts long enough to disrupt daily life or even sleep, or if it results in scratching lesions. Pruritus is associated with a dysbiosis of the skin microbiota and is a major factor in the reduced quality of life of patients suffering from skin diseases (atopic dermatitis, psoriasis, etc.). But what causes pruritus? The results of a study published in 2024 show that opportunistic pathogen Staphylococcus aureus triggers itching by activating dedicated sensory neurons, the (sidenote: Pruriceptors Pruriceptors are the sensory neurons that mediate itch and a desire to scratch. Pruriceptor nerve endings are mainly found in the epidermis, unlike nociceptors, which innervate both skin and deeper tissues.
  Source: https://www.has-sante.fr/jcms/c_2579446/fr/zontivity-vorapaxar-antiagregant-plaquettaire
)
.

From S. aureus to scratching

To better understand the mechanisms involved, researchers conducted an extensive series of experiments in vivo (mice) and in vitro (skin and neuron samples, including human neurons). It all starts with the S. aureus bacterium, which is capable of producing proteins that facilitate the colonization and invasion of host tissues. These include various toxins (α-hemolysin and phenol-soluble modulins) and around ten proteases. One of these bacterial enzymes, protease V8, is a critical factor in evoking itch. How? Protease V8 induces itch in mice and humans by stimulating pruriceptors via the activation of this neuron’s PAR1 subcutaneous receptor. The bacterium may take advantage of the itch it causes, since scratching potentially enables it to spread to other areas of the body, or even other hosts, while the skin lesions induced may allow the pathogen to penetrate deeper into the injured layer of skin. 

90 % of AD lesions are colonized with S. aureus, which is thought to be a trigger of inflammation.

Other mechanisms also considered

As for the toxins secreted by S. aureus, the study showed that α-hemolysin and phenol-soluble modulins are also capable of activating sensory neurons and triggering itch. However, S. aureus bacteria that are unable to produce these toxins still trigger itching in mice, suggesting that bacterial toxin levels alone are not sufficient to trigger itch.

Of course, there are many other protease-secreting bacteria, whose role should be investigated: Staphylococcus epidermidis produces the protease EcpA, which causes skin lesions in patients with atopic dermatitis; while Streptococcus pyogenes produces the protease SpeB, which is involved in skin infections. And what can be said for fungi, viruses and parasites, whose potential contribution of itch-provoking proteases remains unknown?

Relieving patients

These initial results may one day help to relieve patients suffering from chronic skin itching, including cases of atopic dermatitis. This may be achieved by targeting protease V8, for example. Another promising option is the PAR1 receptor, the inhibition of which (e.g. using (sidenote: Vorapaxar Vorapaxaris a PAR1 antagonist. It inhibits the thrombin action on the PAR1 receptor, preventing platelet aggregation via this pathway. In the United States, it has been approved by the Food and Drug Administration (FDA) as a drug that reduces the risk of thrombotic cardiovascular events. In France, its medical benefits as an antiplatelet agent have been judged insufficient.
Source: https://www.has-sante.fr/jcms/c_2579446/fr/zontivity-vorapaxar-antiagregant-plaquettaire
)
) is sufficient to reduce (but not entirely eliminate) itching, making it a prime target for the development of a new generation of topical creams. 

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Tasting the difference: how our oral microbiota influences flavor perception

Have you ever wondered why identical dishes taste remarkably different to each of us? Recent groundbreaking research reveals the key lies in the diversity of our oral microbiota. This study suggests that the vast array of microbes inhabiting our mouths, from those that love sugary delights to those that thrive on bitter greens, plays a crucial role in unlocking the mysteries behind our unique taste experiences.

The ENT microbiota Diet

It turns out, the secret to why the same food can taste differently to different people might just lie within our mouths - not just in our taste buds, but in the microscopic world of our oral microbiota. According to recent research 1 led by scientists from the French Center for Taste and Food Sciences at Dijon 2, the variety of bacteria residing in our saliva and on our tongue (oral microbiota) could play a crucial role in how we perceive basic tastes.

The ENT microbiota

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A microbial influence on every bite

Using cutting-edge shotgun metagenomic analysis, scientists comprehensively identified over 650 microbial species inhabiting the tongue and saliva of 100 diverse human test subjects. While the oral microbiota's total richness and biodiversity didn't directly correlate with variations in taste sensitivity, the relative abundances of certain key bacteria species and genera did appear influential. Two bacteria groups in particular, Streptococcus and Prevotella, stood out as having dramatic effects — though impacts varied significantly depending on the specific species.

Did you know?

A staggering 57% of 6,500 individuals surveyed by The International Microbiota Observatory 3 were unaware of the oral microbiome's existence!

Sour sensitivities on our tongue

Higher proportions on the tongue of Streptococcus gordonii and S. parasanguinis, two common plaque bacteria, were associated with substantially reduced sensitivity to all five basic taste modalities:

  • sweet
  • salty
  • bitter
  • sour
  • savory umami

These adept adherers likely alter the structural landscape of the tongue's biofilm in ways that physically hinder diffusion and access of taste molecules to the underlying receptors.

On the flip side, an unclassified Prevotella species had the opposite effect, linking to enhanced intensity of perception of four of the five taste qualities. Intriguingly, comparing microbiota compositions from the tongue itself versus whole saliva, the latter ecosystem actually proved more predictive of multiple taste sensitivities. This suggests that oral bacteria likely modulate flavor perception through microbial community dynamics and metabolic interactions, not just through local influences on taste bud exposures.

While more research is still needed to clarify the mechanisms involved, these compelling findings reveal an underappreciated contributing role for our endogenous oral microbiota in actively shaping flavor experiences — essentially "tasting" for us by differentially processing food cues en route to the taste receptors themselves.

Understanding these modulatory microbial impacts could eventually help inform approaches to combat nutritional issues related to age-related, medication-induced or disease-linked taste loss and dysfunction. Also, a next step would be to understand the contribution of the oral microbiota alongside other factors involved in taste perception such as the genetics of taste receptors, the number of taste buds or the biochemistry of saliva.

More broadly, the research importantly highlights just how astonishingly complex even basic eating is as a fully multisensory process integrating our perception, digestion, immunity and microbes.

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