Intestinal microbiota, pain, dementia

The review is dedicated the interconnection between neurodegenerative diseases, chronic pain and gut microbiota's structure and function. The gut microbiota's role in gut-brain axis, neuroimmune interaction is considered. The modern data about gut dysbiosis in Alzheimer disease, Parkinson disease, osteoarthrosis, neuropathic pain in COVID infection, muscular-skeletal pain in fibromyalgia, irritable bowel syndrome et cetera are provided. The gut microbiota's modification by means of pre and probiotics in combination with medicines and diet modification can be used for the treatment of chronic pain and dementia.Copyright © T.M. MANEVICH.

Psychobiotics: a new way in psychopharmacology, or How do bacteria manage our brain?.

Psychobiotics are a special class of probiotics that have a beneficial effect on human mental health. During the last decade, convincing evidence has emerged that the gut microbiome influences mental health, cognitive abilities (learning and memory), and behavioral processes through neurological, metabolic, hormonal, and immunological signaling pathways. This review provides available information on the mechanisms of regulation of neuroimmune axes by the microbiota, describes the schemes of interaction of the microbiota with the intestinal nervous system and the brain-gut axis, the effect on behavior, cognitive functions and emotions, and discusses the evidence base and current views on the use of psychobiotics as a safe and effective therapeutic alternative to classic psychotropic drugs in depressive and anxiety disorders, stress, autism spectrum disorders, Alzheimer's disease and other conditions.Copyright © 2022, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. All rights reserved.

Interoceptive Abilities in Irritable Bowel Sydrome from Long Covid Disease

SCOPO DEL LAVORO: Long COVID is defined as the continuation of symptoms much longer than usually expected or the persistence of symptoms despite the recovery of the infection. While research on long COVID is in full swing, only little attention has been paid to the associated psychiatric symptoms. In particular, the association between long COVID and somatic symptom disorders (SSD) has been overlooked. Beyond anxiety and depression symptoms, patients with COVID-19 present a high risk to develop SSD. SSD, previously known as somatoform disorders, have been defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as persistent and clinically significant somatic symptoms accompanied by excessive and disproportionate health-related thoughts, feelings and behaviours regarding the symptoms. Noviello et Al (2021) in their study show that acute SARS-CoV-2 infection may affect the brain-gut axis. Five months after the acute infection, mild gastroenterological symptoms persist, in particular in patients reporting diarrhea in the acute phase of the infection. Infected patients are also at increased risk of chronic fatigue and somatoform disorders, thus supporting the hypothesis that both functional gastrointestinal (like IBS) and somatoform disorders may have a common biological origin. IBS present an impairment in interoception and high levels of alexithymia. Interoception refers to the ability to accurately detect internal body changes. Alexithymia is a personality construct that implies difficulties identifying and describing one's own feelings, limited imaginative processes, an externally oriented cognitive style, and difficulties in distinguishing between feelings and bodily sensations. This construct is associated with many disorders, such as gastrointestinal pathologies. Given the relationship between long covid disease and gastrointestinal somatoform disorders (like IBS), and between interoceptive abilities and Irritable Bowel Syndrome, then it's conceivable a mediating role of interoceptive abilities in long covid IBS that deserves to be analyzed. MATERIALI E METODI: Subjects: All the patients aged between 18 and 60 years who tested positive at least 5 months before. Measures: - Toronto Alexithymia Scale - Hospital Anxiety and Depression Scale - Structured Assessment of Gastrointestinal Symptoms (SAGIS) questionnaire - Heart Rate Variability - Blood samples were collected between 8:30 am and 9:00 am. RISULTATI: There is a deficiency in interoceptive skills and high levels of alexithymia in patients with IBS and who have been infected with covid. CONCLUSIONI: In a current society, undermined by the psychophysical consequences of covid, Identifying factors that affect the well-being like Interoception training (as it is a learned skill), renders possible an intervention to modify some of these factors or promote a better understanding of patients with IBS who experience alternate periods of remission and relapse. .

Effectiveness of Probiotics

Background: To evaluate the potential of probiotics in stress management caused by the Covid-19 pandemic. Material(s) and Method(s): PubMed, Elsevier, New England journal of Medicine and Google Scholar were searched for the keywords "Probiotics and stress management during the Covid pandemic" up to 30th April 2022. Result(s): Probiotics have a great potential of managing mild stress. The pandemic has brought about physical as well psychological distress and has had a negative impact on the mental health of individuals. Stress increases the risk of cardiovascular diseases, hypertension and neuropsychiatric disorders. Probiotics can be used to alleviate mental stress. Probiotics maintain ecological balance of gut and provide immunity. They also affect mood and health of host by regulating gut-brain axis of host and may be used as Psychobiotics by altering various neurotransmitters like dopamine, serotonin, adrenocorticotrophic hormone, epinephrine, norepinephrine and GABA. The use of probiotics in mild stress will help reduce the risk of adverse effects and dependence associated with the psychotropic drugs. Conclusion(s): The ongoing studies on probiotics seems to be a good solution towards stress and related problems which is rapidly increasing due to COVID-19 pandemic. Probiotics seem to be beneficial in handling stress as they alter the release of neurotransmitters reducing stress level of an individual and have a positive effect on mood. The current pandemic is likely to continue and there is a need for greater preparedness of stress management, therefore, it is essential to explore the full potential of probiotics application in stress management. Copyright © 2022 Authors.

A Randomized, Double-Blind, and Sham-Controlled Trial of an Innovative Brain-Gut Photobiomodulation Therapy: Safety and Patient Compliance.

BACKGROUND: Recent innovative non-pharmacological interventions and neurostimulation devices have shown potential for application in the treatment of Alzheimer's disease (AD). These include photobiomodulation (PBM) therapy. OBJECTIVE: This pilot study assesses the safety, compliance with, and efficacy of a brain-gut PBM therapy for mild-to-moderate AD patients. METHODS: This double-blind, randomized, monocentric sham-controlled study started in 2018 and ended prematurely in 2020 due to the COVID-19 pandemic. Fifty-three mild-to-moderate AD patients were randomized, 27 in the PBM group and 26 in the sham group. All patients had 40 treatment sessions lasting 25 min each over 8 weeks and were followed for 4 weeks afterwards. Compliance with the treatment was recorded. Safety was assessed by recording adverse events (AEs), and efficacy was evaluated using neuropsychological tests. RESULTS: The PBM therapy proved to be safe in regard to the number of recorded AEs (44% of the patients), which were balanced between the PBM and sham groups. AEs were mainly mild, and no serious AEs were reported. The majority of the patients (92.5%) were highly compliant, which confirms the feasibility of the PBM treatment. Compared to the sham patients, the PBM patients showed lower ADAS-Cog comprehension subscores, higher forward verbal spans, and lower TMT-B execution times, which suggests an improvement in cognitive functions. CONCLUSION: This study demonstrates the tolerability of and patient compliance with a PBM-based treatment for mild-to-moderate AD patients. It highlights encouraging efficacy trends and provides insights for the design of the next phase trial in a larger AD patient sample.

Neurocysticercosis, Epilepsy, COVID-19 and a Novel Hypothesis: Cases Series and Systematic Review

Background: There have been many patients with neurological manifestations reported in medical literature following a COVID-19 infection. We conducted a literature review to identify patients with coronavirus disease (COVID-19) who presented with Neurocysticercosis (NCC) and associated seizure disorders/ epilepsy. Currently, there is a new variant of the COVID-19 virus strain invading South Africa and no indication when this pandemic will end and what kind of tardive sequelae may occur going forward. Case: We searched the medical literature looking for all publications regarding NCC, Status Epilepticus (SE), Epileptic Seizures (ES), and Epilepsy (Ep), in patients infected by COVID-19. Based on the therapeutic response of our series, we propose a novel approach for patients presenting NCC, epilepsy and associated with COVID-19. We have hypothesized on the pathogenesis of ES and SE from the NCC/Cytokine Release Syndrome (CRS), SARS-CoV-2/CRS, including the role played by gut microbiota from the enteric nervous system (gut hormones, gut metabolites, inflammatory factors, neuroactive substances, and microbiota-derived products) to the medulla oblongata/hypothalamus-pituitary-adrenal axis via microbiota gut brain axis in ES, Ep and associated depression, plus the mechanism of hyperferritinemia on the overall process. This article is the first publication approaching this comorbidity as far as we know.

Prenatal Stress and the Microbiome in the Time of COVID- A Prospective Cohort Study

Background: Given the emerging importance of the role of the gut microbiota-brain-axis in mediating prenatal stress-induced neurodevelopmental outcomes, a prospective cohort study was conducted. The COVID-19 Pandemic occurred halfway through study recruitment (n=35). The study aims to a) evaluate perceived stress across gestation, b) determine whether maternal microbiome composition changes with stress, and c) discern the influence of the COVID-19 pandemic on maternal stress, psychometric scores, and alterations in the microbiome. Methods: This longitudinal study design includes five time points across pregnancy and the post-partum period, at which biological samples were collected and psychometrics administered. Samples include maternal rectal and vaginal swabs. Psychometrics include measures of perceived stress, anxiety, depression, sleep, diet, and childhood adversity. Study participants identify as 62.9% White and 31.4% Black or African American. Finally, PacBio full-length 16S rRNA sequencing using SMRT Cell technology is used to identify the maternal rectal and vaginal microbial communities. Results: Participants delivering during the pandemic reporting greater perceived stress (p≤0.05). Of note, there were no significant differences in anxiety or depressive symptoms across gestation in the pre-pandemic participants as compared to participants during the pandemic. During the second trimester, increased depression associated with increased rectal alpha diversity, and increased perceived stress was associated with increased levels of Prevotella, Sneathia, and Gardnerella in the rectal samples. In contrast, participants with increased depressive symptoms during the third trimester had reduced vaginal alpha diversity measures at delivery. Conclusions: Findings suggests maternal perceived stress and depressive symptoms are associated with alterations in maternal microbiota Keywords: Gut Microbiome, Prenatal Maternal Stress, Gut-Brain Axis

Impact of COVID-19 on the Intestinal Microbiome.

PURPOSE OF REVIEW: This review article aims to explore the GI changes induced by SARS-CoV-2 and how gut microbial homeostasis can influence these changes and affect the lung-gut axis and its relationship with the induction of the cytokine release syndrome in severe COVID-19 patients. RECENT FINDINGS: Coronavirus disease 2019 (COVID-19) affects not only the respiratory system but can produce multi-systemic damage. The expression of angiotensin-converting enzyme 2 (ACE-2) receptors in the gastrointestinal (GI) tract, the high prevalence of GI symptoms in severely ill COVID-19 patients, and the abnormalities described in the gut microbiome in these patients have raised concerns about the influence of GI tract as a risk factor or as a potential modulator to reduce the severity of COVID-19. Understanding the mechanisms by which gut dysbiosis may influence viral transmission and disease progression in COVID-19 may help in shaping how accessible therapies, like diet modulation, can potentially help beat the devastating consequences of COVID-19.