Ever heard of ‘the microbiome’? This little guy plays a significant role in gut health. The gut microbiome helps control digestion and benefits your immune system. Billions of bacteria reside in the gut and probiotics may hold great potential to prevent infections during your body’s healing process. Probiotics are often called ‘good’ or ‘helpful’ live bacteria because they help keep our gut healthy.
The largest organ of our body – our skin – provides a natural barrier to the environment and is actually quite crucial for our general health, it protects us from invasive pathogens like bacteria and viruses. When the skin barrier is damaged however, these pathogens are ready to make their way into the body to colonize it and it is particularly dangerous if the bacteria in question causes widespread damage to the skin or other tissues, especially if they are resistant to antibiotics!
Staphylococcus aureus – Staphylococcus aureus is temporarily present in the nose in 30% of healthy adults and on the skin of 20% of the population. It is mostly harmless but when the skin barrier breaks, S. aureus can cause a severe infection. This risk is higher for people who are patients in a hospital or who work there. The diseases caused by these bacteria can range anywhere from mild to life-threatening. S. aureus is a gram-positive, sphere-shaped (coccal) bacteria, which often causes skin infections and can also cause pneumonia, bone infections and heart valve infections. If S. aureus spreads to the blood, it can also cause sepsis, which is a significant cause of death in children who have experienced severe burn injuries.
Probiotic Bacteria Show Promising Potential
So do bacteria have antibacterial properties? Yes, they do! They naturally compete with each other for living space and food and in their competition, bacteria produce antimicrobial molecules that specifically prevent the growth of other bacteria. This becomes possible by altering the growth environment in their favor and disrupting communication between other bacterial cells.
Catherine O’Neill, Ph.D., senior lecturer in the Division of Musculoskeletal and Dermatological Science at the University of Manchester in the United Kingdom and her team have tried to harness these properties by using bacteria to prevent pathogen infections. According to Dr. O’Neill however, there has not been enough research done on the health effects of probiotics on the skin and there isn’t enough knowledge about the skin’s microbiome and how it interacts with the wound.
So therefore she uses lactobacillus bacteria instead of probiotics; according to her research these are a group of friendly bacteria. Lactobacilli are mostly harmless and some strains are crucial for our daily lives as they facilitate the fermentation of products such as yogurt, beer and wine. Dr. O’Neill’s team showed that both L. rhamnosus GG and L. reuteri could protect skin cells in the laboratory from an infection caused by S. aureus. In a recent study published in the journal Scientific Reports, Dr. O’Neill further showed that the two lactobacilli had different effects on skin cells in a wound-healing model.
From the Laboratory to Animal Models
A handful of studies have gone further, and tested the effects of probiotics in mouse models of burns and wound healing. Susan E. Erdman, assistant director in the Division of Comparative Medicine at the Massachusetts Institute of Technology in Cambridge and her team studied the effects of adding probiotics to the diet of mice. Their study, published in PLOS One, showed that feeding L. reuteri to mice increased oxytocin. Oxytocin is a hormone important in reproduction, childbirth, lactation and social behaviour. The hormone is often referred to as the ‘love hormone’ given the significant increase in its levels while indulging in emotional as well as physical acts of love like kissing or hugging as well as during an orgasm. Interestingly, the increase in oxytocin resulted in a faster rate of wound healing in mice – their wounds closed twice as fast.
In another study published in Clinical Microbiology and Infection, Juan Carlos Valdéz, Ph.D., from the National University in Tucumán in Argentina and his colleagues showed that L. plantarum can inhibit the growth of P. aeruginosa, both in vitro and in a mouse model of burn wound healing. Similarly, Sandeep Kathju, M.D., an associate professor in the Department of Plastic Surgery at the University of Pittsburgh School of Medicine in Pennsylvania and his colleagues investigated the effect of L. plantarum on P. aeruginosa-induced sepsis in a mouse burn model. The study, published in PLOS One, showed that in 12 out of 13 mice, L. plantarum prevented sepsis and did not have any detrimental effects on burn wound healing.
While these studies in mice are encouraging, is there any evidence for this kind of healing in humans?
Patients Improve with Probiotic Treatments
Dr. Valdéz and his team performed a small study with eight patients in the Plastic Surgery and Burns Unit at Hospital Centro de Salud ”Zenón Santillán” in Tucumán, Argentina. These patients had a mix of second- and third-degree burns. The team found that the bacteria L. Plantarum was as efficient as silver sulfadiazine (commonly used antimicrobial) in preventing and reducing burn wound infections.
Richard J. Kagan, M.D., a professor of surgery at the University of Cincinnati College of Medicine in Ohio and his colleagues reported the results of a clinical study on pediatric burn patients in the Journal of Burn Care & Research. This study included twenty children, ten out of which received a probiotic and the other ten were treated with a placebo. The average age of the patients was around seven years, and the treatment was administered daily, starting ten days after their initial burn and lasted until their wounds closed. Result: The scars of patients undergoing probiotic treatment healed at a faster rate than those treated with a placebo.
Based on these studies, you may wonder – why are probiotics not common in clinics around the world then? It’s a question of numbers.
Probiotics as a Treatment for Infectious Diseases
Due to the rise in media reporting on the increase in antibiotic resistance, many consumers are looking for alternative measures to treat infectious diseases. Recently, probiotics have enjoyed a renewed interest as a consumer option, primarily because of their low cost and advertising. Even though probiotic-containing products have started gaining popularity, there is still limited evidence of probiotics treating antibiotic-associated diseases.
Pharmacists are finding themselves in an awkward position to answer queries related to the health benefits of probiotics. Many studies have demonstrated promising results for a variety of probiotic bacterial strains, but additional clinical research is needed in this direction.
Not Enough Evidence
Baljit Dheansa – lead surgeon for burns at Queen Victoria Hospital in East Grinstead, U.K. believes that there is very little evidence proving that probiotics have a significant effect on wound healing. If probiotics were to enter the wound healing arena, well-constructed research studies need to be conducted that would help establish proper evidence for their use in real wounds in humans, rather than just in labs.