Latest news with #LancetInfectiousDiseases
The Star
17-07-2025
- Health
- The Star
Long Covid: Probiotics could form a potential treatment
There is no single treatment option for those with post-acute Covid-19 syndrome or long Covid, which remains a serious, but poorly-addressed public health concern worldwide. Globally, it is estimated to have affected some 400 million individuals who experience lingering symptoms such as brain fog, digestive issues and general malaise. In an attempt to find a solution, a team of researchers from the Chinese University of Hong Kong (CUHK) decided to assess a symbiotic preparation (a formulation that combines probiotics and prebiotics) to see if it could alleviate long Covid symptoms. This is as previous CUHK studies had shown that long Covid patients had altered gut microbiomes. Their formulation was developed based on a decade of research on Asian gut microbiomes. It consists of three probiotics ( Bifidobacterium adolescentis , Bifidobacterium longum and Bifidobacterium bifidum ) and three prebiotic fibres (galactooligosaccharides, xylooligosaccharides and resistant dextrin). From 2021 to 2022, 463 recovered patients with at least one long Covid symptom were recruited for the randomised controlled trial in Hong Kong. Nearly 70% were suspected to have been infected with the SARS-CoV-2 Omicron variant. The patients were randomly assigned to receive either the formulation or a placebo containing low dose Vitamin C for six months. At the end of the study, 70% of the former reported improvement in digestive problems, compared to 54.1% in the placebo group. The group taking the formulation also had more improvements for symptoms like fatigue, difficulty in concentration, memory loss and general unwellness, compared to those taking the placebo. Analysis of their stool also showed that the formulation resulted in increased bacteria diversity, increased abundance of 'favourable' bacteria, and reduced abundance of 'unfavourable' bacteria in the gut. 'To our knowledge, this is the first clinical trial to show that modulation of the gut microbiome can improve long Covid symptoms, including memory and concentration problems. 'These data support the importance of the gut-brain axis. 'Restoring a healthy gut microbiota is a novel approach to improve neurological symptoms via the production of beneficial metabolites from gut bacteria that circulate to the brain to improve brain function,' says study lead investigator and gastroenterologist Professor Dr Siew C. Ng. The groundbreaking research was published in the March 2024 issue of the Lancet Infectious Diseases journal. 'We've seen that gut bacteria colonisation takes about six to 12 months to happen, so I tell my patients to take the formulation for a minimum of six months. 'If symptoms improve, they can come off it. 'A small proportion of them can do this, but over time, the bacteria may drop depending on diet, whether you received antibiotics, etc. 'However, a lot of patients are still on it after three years as they reported that once they stopped taking it, some of their symptoms returned. 'There is really no one-size-fits-all approach,' she says in a recent interview. Probiotic supplements are generally taken for health benefits, but if you're already healthy, do you need them? Prof Ng says: 'It's all right to be sceptical of probiotics as there are so many out there that claim to work. 'You're taking them for prevention, but it makes no difference if you're healthy as you won't know if it is working!' The associate dean of CUHK's Faculty of Medicine, who has been doing probiotics research for decades, is on a mission to educate doctors and pharmacists on how to choose or prescribe probiotics. 'Personally, I need scientific back-up to gauge the effectiveness of probiotics. 'We have isolated strains in our laboratory and know that not all of them have equal benefits. 'We've done clinical studies that showed no difference in gut microbiota when you take some of them. 'My advice to the public is to first try lifestyle measures to modulate the gut before taking probiotics. 'Then look at the large clinical studies and digest the information before deciding if you really need these supplements,' she says, adding that their formulation is now available in selected pharmacies in Malaysia. Click here for more on CUHK's research on restoring the gut microbiota to address eczema in children.
The Guardian
02-04-2025
- Health
- The Guardian
Could antibiotics stop working? Yes – but the biggest danger isn't prescription-happy GPs
If the antibiotics we use to treat infections ever stopped working, the consequences would be catastrophic. It is estimated that the use of antibiotics adds about 20 years of life expectancy for every person worldwide (on average). As the King's Fund put it, if we lose antibiotics, 'we would lose modern medicine as we know it'. Doctors, public health experts and governments take the threat of antimicrobial resistance (AMR) very seriously, yet the problem appears to be getting worse. A report from the National Audit Office in February finds that out of five domestic targets set in 2019 to tackle AMR, only one has been met – to reduce antibiotic use in food-producing animals. Others, such as the target to reduce drug-resistant infections in humans by 10%, haven't made much progress; in fact, these infections have actually increased by 13% since 2018. AMR is often misunderstood. I have often heard people say 'I'm afraid of taking antibiotics and becoming resistant to them.' But AMR isn't about individuals becoming resistant to antibiotics. It's about pathogens – most often bacterial infections but also viruses, fungi and parasites – evolving to become resistant to our current drugs, so that the infections they cause become untreatable. Think of ear, urinary tract and chest infections, or procedures such as C-sections and other routine surgeries, becoming life threatening because the drugs we use to treat infections or to prevent them after medical procedures don't work. However, I despair at Britain beating itself with yet another stick. The country has actually been fairly good at tackling AMR. In 2023, our research team led by Jay Patel published an analysis in the Lancet Infectious Diseases journal measuring the global response to AMR in 114 countries. The UK made the top three 'best performing' countries with only the US and Norway ahead, followed by Sweden, Denmark, Germany and Japan. The credit in the UK largely sits with Dame Sally Davies, the chief medical officer for England from 2011 to 2019, who made it a priority during her tenure and continues to lead as the UK special envoy on AMR. The UK government has led on national guidelines and oversight in human and animal health in conjunction with the EU. We may worry about doctors overprescribing antibiotics in the NHS, needlessly exposing pathogens to these drugs and allowing them to evolve resistance. But having worked on AMR governance before, my take is that the biggest threat is the rise of resistant pathogens emerging in countries using huge amounts of antibiotics in their animals for growth and cheap meat. Think of pigs, chickens and cattle in China, Brazil, India and, even until recently, the US. Livestock alone is estimated to consume 50% to 80% of the antibiotics produced in high- and middle-income countries. These resistant pathogens develop in animals, which are given antibiotics as a prophylactic even when they're healthy. They then infect a human, who may travel and spread it to other humans. It is a straightforward formula. Antibiotics in animals plus farm workers plus air travel equals drug-resistant infections in the UK, and elsewhere. It is not just theoretical. In 2018, a study in Nature found that widespread colistin-resistant bacteria, including in hospitals in London, could be traced to a single event in 2006 in China when a bacteria jumped from pigs into humans. Colistin is a last-line antibiotic for certain infections, meaning it is given after other drugs have failed, yet it was used heavily for growth promotion in pig farming in China. Since these findings, the Chinese government, as well as India and Japan, banned colistin in animal feed. This probably will have a larger impact on reducing AMR than anything being done in UK clinics and with human prescribing practices. The UK is best protected from drug-resistant infections by working with other countries to regulate the use of antibiotics, especially in animals. Davies has tried hard to push this agenda globally, bringing together human health, agricultural and vet experts to agree on standards and regulations that are a universal good. However, there is a clear conflict with those who argue that boosting animal production, including of cheap and available meat, is the priority, especially in middle-income countries with large populations. Why can't we just develop new antibiotics if our current ones become ineffective? Simple question and tough answer. These are technically difficult drugs to develop and we have made very slow progress. Developing similar versions to existing antibiotics isn't enough because they won't be as effective against pathogens that have developed resistance: we need totally new classes of drugs. And a recent World Health Organization report noted that since 2017, while 13 new antibiotics have obtained authorisation, only two represent a new chemical class. Our best to shot to tackle AMR is to protect our current arsenal of drugs and make sure they remain effective. This means working with other countries on a shared approach to how and when drugs are used in humans and animals. This is an ongoing challenge, especially in a world where cooperation is breaking down and isolationist approaches are on the rise. Yes, we can blame the UK government for many things, but on the issue of AMR it is a standout country and a global leader. Prof Devi Sridhar is chair of global public health at the University of Edinburgh, and the author of How Not to Die (Too Soon)
