
Fungus in humans identified for first time as key factor in Crohn's disease - ph0rque
https://www.sciencedaily.com/releases/2016/09/160920151435.htm
======
hospes
"Furthermore, we found strong similarities in what may be called the 'gut
profiles' of the Crohn's-affected families, which were strikingly different
from the Crohn's-free families."

It seems that fecal transplant (or pills based on them) can alter/fix gut
profiles[1]. I wonder if someone tried fecal transplant to cure Cron's
disease.

[1]
[https://youtu.be/e_dF1N-Ckbw?t=1m44s](https://youtu.be/e_dF1N-Ckbw?t=1m44s)

Edit: It seems this has been tried and pretty successful[2].

"A recent publication in the journal Inflammatory Bowel Diseases titled,
“Fecal Microbial Transplant Effect on Clinical Outcomes and Fecal Microbiome
in Active Crohn’s Disease,” reports seven of nine patients with Crohn’s
disease were effectively treated using FMT in a Seattle Children’s research
study."

[2] [http://pulse.seattlechildrens.org/study-suggests-fecal-
trans...](http://pulse.seattlechildrens.org/study-suggests-fecal-transplant-
could-be-effective-treatment-for-crohns-disease/)

~~~
redtuesday
If I remember correctly there was another study a few years back in europe (by
Prof Raedler?) which was not as effective. Will try to dig it up tomorrow, I'm
too sleepy right now.

~~~
redtuesday
My memory has failed me.

[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209544/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209544/)

[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974513/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974513/)

------
matchagaucho
In my experience Crohn's bacteria, and now apparently fungi, _love_ to feed on
processed sugars and dairy products.

To stay in remission, I focus on diet and exercise, and deny the bacteria the
fuel they require (at least, that's my theory).

Big pharma has largely focused on alleviating the inflammatory symptoms of
auto-immune response. Treating the symptoms and not the cause unfortunately
allows the vicious cycle to continue.

I hope discoveries like this will encourage more Medical Professionals to
pursue preemptive dietary, naturopathic, and lifestyle remedies for managing
Crohn's.

However, these remedies are not profitable, so I'm not optimistic :-(

~~~
fosco
would love to hear more about your experiences and how your diet influences
'good' and 'bad' choices to stay in remission or go into in the first place.

~~~
matchagaucho
I wish there were more "absolute" rules. There are so many dietary exceptions.
Here are a few I live by to manage Crohn's.

Water: Probably the #1 most important thing for Crohn's patients to manage is
water consumption. Bottled water whenever possible. More specifically, the
more alkaline the better. Tap water, unless you live in the mountains, is
commonly bad on the digestive tract.

Fried food: Generally "bad", but food fried with certain oils seems to be
okay. The oil needs to be fresh. Fried food from fast food chains is always
"bad".

Sugars: Complex sugars are "bad". Monosaccharide sugars, found in fruits or
honey, are okay.

Vegetables: "Good" when steamed. But undigested raw veggies increases risk of
triggering an auto-immune response. I eat small salads... ideally chef salads
with some protein (ham/bacon/turkey).

Fruits: Similar to veggies, only small portions. Don't let roughage linger in
digestive system too long.

Dark Chocolate: 80%+ cocoa in moderation tends to be okay. The endorphin rush
is a plus and a good substitute for coffee.

Popcorn: Definitely off limits. Auto-immune response triggers when the body
detects undigested kernels.

Dairy: Odd mix. Milk is _extremely_ "bad". Won't even touch it. So is milk
chocolate. Eggs are okay if used in cooking, but I avoid eating plain eggs for
breakfast. Butter and many gourmet cheeses are fine (processed cheese is
"bad").

Coffee: I drink a _lot_ of coffee. Probably too much. The water, beans, and
preparation process all contribute to coffee being "good" for Crohn's. Coffee
becomes "bad" if there are any additives, such as dairy or sugar. Not even
dairy substitutes, like soy, can be added.

Meats: Okay in moderation, but lately I've been cutting back on red meats
after learning more about increased risk of colon cancer in Crohn's patients.
High quality beef burgers and fish are common staples.

Alcohol: I abstained from drinking for many years when first diagnosed with
Crohn's, but was pleasantly surprised to discover that I could introduce many
"top shelf" brands in moderation without any real symptoms. I've learned a lot
about the distillation process of wines and spirits as a result. There are
such things as "good" and "bad" alcohol.

Craft Beer: Similar to above, there are "good" and "bad" beer yeasts and
fermentation processes. It's very hit or miss, but when I discover a craft
beer that "works" with my digestive system, I stick with it. Lagunitas is an
example of a beer that happens to be "good" with my gut bacteria.

~~~
fosco
Thanks for sharing, I have UC and am always looking to see what others are
doing. I know There are differences but I suspect the root cause is similar.

------
jobu
_test-tube research by the Ghannoum-led team found that the three work
together (with the E. coli cells fusing to the [Candida tropicalis] cells and
S. marcescens forming a bridge connecting the microbes) to produce a biofilm
-- a thin, slimy layer of microorganisms found in the body that adheres to,
among other sites, a portion of the intestines -- which can prompt
inflammation that results in the symptoms of Crohn 's disease._

That seems like a huge find. Biofilms can be very hardy and difficult to break
down. I wonder what a treatment for something like this would be.

~~~
abledon
A traditional mixture could consist of pau d'arco, wormwood, black walnut
bark, clove, and garlic. This is used often in Native-American/Indian/Chinese-
Medicine.

~~~
Retric
BS, these plants are not from the same area, so there is nothings traditional
about combining them.

Black walnut is from North America. Wormwood is from Eurasia and Africa.

~~~
glibgil
Be kind. Consider that they meant "what people have been trying since the
1970s when health food stores popped up everywhere" when they say
"traditional". There is nothing despicable about trying to experiment on your
own to cure an ailment. It's a type of hacking

~~~
ajamesm
Funny, I can't recall any hacks of mine where the public ended up footing a
$150,000 ER bill to save my kidneys or my liver.

~~~
glibgil
Oh, please. Too much acetaminophen and alcohol does the same thing when the
general public tries to hack happiness and pain. The public covers that all
the time

------
serg_chernata
Gut bacteria is in the news a lot lately. As an interesting side note, during
one of Joe Rogan's podcasts someone mentioned that if you think of our
digestive system as a tube connecting two holes in the body then everything
inside of our stomach is external. I've never thought of it that way.
Fascinating.

For anyone interested Joe's podcast is actually incredibly informative and
dense with good information.

~~~
runeb
There are so many good podcasts I can never get into, because they are often
multiple hours per episode. Joe Rogan often on the 3 hour mark. How do people
find time to listen/watch all the good content out there?

TL;DR is the zeitgeist, and I want to fight it. I want to read long form
articles, books and listen to these great podcasts, but the number of hours in
my day don't seem to allow it.

Do people set aside time? Am I just inherently bad at managing my time?

~~~
chadgeidel
I listen to podcasts for at least 10 hours per week and I probably manage to
listen to 20 hours of podcasts in that time. Most podcasts I listen to can be
sped up to about 1.3x speed with no obvious loss in quality. Additionally I
use a podcast app [1] that "removes audio gaps" which basically chops out
"pauses" and "no sound" areas of the podcast.

[1] [https://overcast.fm/](https://overcast.fm/)

------
eth0up
Perhaps a (key?) factor in Alzheimer's too.

[https://www.ncbi.nlm.nih.gov/pubmed/24614898](https://www.ncbi.nlm.nih.gov/pubmed/24614898)

[http://www.nytimes.com/2016/05/26/health/alzheimers-
disease-...](http://www.nytimes.com/2016/05/26/health/alzheimers-disease-
infection.html)

------
M_Grey
My college roommate had Crohn's and it was... brutal just to see what it did
to him. I remember spending some time in our dorm room helping him get some
Ensure down one time, and he told me how scared he was of ending up in a
wheelchair with a colostomy and so on.

~~~
Broken_Hippo
I worked with a young guy that suddenly found out he had it. He started
feeling ill, then pain, and wound up in the hospital for some time. He didn't
know he had it: I know for a while he wound up with a colostomy bag as his
colon healed, and was looking at a lifetime of restricted eating and other
such things.

To make matters worse, his long-term girlfriend/fiance left him while he was
in the hospital.

I wish I knew what happened to him. He wound up moving out of state to stay
with his parents as he got better, and basically cut most folks out of his
life at that time.

~~~
M_Grey
A somewhat similar end result with my college roommate... he move home to be
with family and his world seemed to shrink. We lost touch as well.

------
dmix
I read in another article that Fungus has been neglected in medical pathology
research:

> As of November 2015, only 269 of more than 6,000 Web of Science search
> results for the term “microbiome” even mention “fungus,” and the scientific
> search engine returns only 55 papers pertaining to the “mycobiome.”

> Despite this lack of attention, a handful of recent studies point to the
> importance of our commensal fungal inhabitants as critical players in human
> health and disease.

[http://www.the-
scientist.com/?articles.view/articleNo/45153/...](http://www.the-
scientist.com/?articles.view/articleNo/45153/title/The-Mycobiome/)

Hopefully this type of research will help with a large variety of illnesses.

------
mynegation
Gut microbiome seems to be linked to many diseases. My knowledge in biology
and medicine is next to zero, but I was wondering if the following would be a
feasible strategy:

* collect many samples from people with various symptoms

* do metagenomic sequencing on these samples to find what species are present in which samples

* machine learn the s--t out of this to find associations/correlations

* ...um, profit?

What would be the main problem on this way? Cost? Reliability of sequencing?
Correlation not implying causation? Me talking nonsense?

This finding, from what I understand, connected Crohn to the presense of three
species working together to form a microfilm. Would not that be something to
be found with the method like this?

~~~
hanklazard
You'd also want to analyze the genomes of each individual from which the
samples were taken, particularly for immune factors. While no one has figured
out exactly why specific gene variants such as HLA-b27 seem to be implicated
in a number of autoimmune diseases, the associations are clearly there.

------
drvdevd
Reading the overview of this study - am I incorrect in thinking "correlation"
not "causation" wrt the particular species of fungi (Candida tropicalis) and
the biofilm produced being a _key_ factor?

~~~
andrewflnr
I don't know, but "lockstep" is a pretty darn strong correlation, with a solid
hypothesis for a causative mechanism. I'll wait to see if the treatments
actually work, but as someone with a friend who suffered from this, I'm
excited.

------
nickpsecurity
This is good news. I like how they identified a precise mechanism that might
contribute to it. Maybe eliminating at least one of these three in the body
might knock out or reduce the condition. Depends on if other stuff is
involved.

~~~
kale
Biofilms are nasty stuff. I did part of my master's thesis on them. They group
together and communicate with each other (with electrical grids, according to
Dr. Costerton, one of the forefront researchers of biofilms before he passed
away). Some species use the film to coordinate a certain percentage of bugs
stay in a "dormant" state, so they won't intake an antibiotic and die.

For artificial joints like a hip and a knee joint, you have a lot of exposed
materials like titanium, stainless steel, or medical polymer, so it doesn't
have an immune system. Getting a biofilm infection forming on an artificial
joint sometimes means taking the implant out, even if it's working fine.

So biofilms are a tough problem. They're far more sinister than conventional
bacterial colonies. Since this is in the digestive tract, I wonder if some
type of detergent can be found that simply dissolves the film matrix, washing
away the bacteria and fungi.

~~~
technofiend
I had one form in my mouth after overexposure to an antifungal. It has
resisted several rounds of antibiotics including Cipro. Nasty stuff. As far as
I know it's unique to me, so if you know any grad students who want a mouth
swab let me know.

------
calinet6
I'm so happy to see the increase in gut microbiome research lately, as someone
suffering from an immune-related colitis. There's very clearly a correlation
with anti-microbial and microbe-influecing things (pepto bismol, herbal
antimicrobial supplements, and probiotics) and my general well being, but
let's just say it's very difficult to get specialists to focus on anything
other than treating symptoms.

The microbiome matters a whole lot, and it's starting to become clear how.
These are great developments and I hope to see the trend continue.

------
tylorr
I wonder if this finding could help with ulcerative colitis as well

~~~
dmix
Wondering the same thing, from my understanding UC is a variation of Chrons.
Although I've personally found it pretty easy to manage after my initially
attack in my early 20s. But I've heard Chrons is different and treatment is
much more diet-based. Whereas with Colitis there doesn't seem to be a
connection to nutrition (yet).

~~~
HillRat
Crohn's is best understood as a collection of symptoms than an actual
diagnosis, because -- this article being a case in point -- the underlying
etiology isn't understood. For example, treatments that work on Crohn's
patients in Japan don't work on US patients, indicating that the diagnosis is
covering multiple disorders.

~~~
HillaryBriss
Interesting note about treatment working in Japan but not US. Do you have any
more details about that? Thanks.

~~~
HillRat
The gold standard protocol in Japan has traditionally been exclusive enteral
nutrition, but Crohn's in western countries has generally been refractory in
studies. Japanese remission rates are reported in the 70-90% range, so it's a
pretty significant finding.

The _Royston Vasey Journal of Culinary Medicine_ also had some intriguing
results from a meat-based therapeutic diet, but the control population
disappeared before conclusive results could be drawn.

~~~
HillaryBriss
Ah. Yes. I'm familiar with that RVJCM "study." Supplied the raw ingredient you
know.

I told them: don't blend this with anything else. My special stuff isn't
hamburger helper is it now? Bloody doctors. They should have listened when
they had the chance.

------
themodernlife
Reminds me of this article:
[http://www.theatlantic.com/science/archive/2016/07/how-a-
guy...](http://www.theatlantic.com/science/archive/2016/07/how-a-guy-from-a-
montana-trailer-park-upturned-150-years-of-biology/491702/)

Fungi play an interesting role in these systems.

------
just_a_guy_101
Maybe we can finally begin to take a closer look at naturopathic remedies. The
key to killing fungus in humans is to a) deny their fuel source through diet
and b) strengthen the human system by proper carb/fat/protein ratio, essential
oils, and healthy fats (omega 3/6/9, medium-chain saturated fats, etc).

~~~
blacksmith_tb
That might be an approach, though it would be helpful to see citations (not
that improving diet is a bad idea in general). There are also drugs like
Lufenuron [1] which is a chitin synthase inhibitor (fungi make their cell
walls from chitin, while mammals don't synthesize chitin at all).

1:
[https://en.wikipedia.org/wiki/Lufenuron](https://en.wikipedia.org/wiki/Lufenuron)

