 By Tetyana Obukhanych, Ph.D.
A study performed at Massachusetts General Hospital has made a strong link between intestinal permeability (aka ‘leaky gut’) and COVID-19 complications in children. Although COVID-19, in and of itself, is not a serious disease in children, there are some who develop a severe complication called Multisystem Inflammatory Syndrome, MIS-C. MIS-C is associated with a prolonged gut infection by the SARS-CoV-2 virus. Children who developed MIS-C in the study had high plasma levels of zonulin, a marker for intestinal permeability. They also had the Spike protein in the circulation, presumably leaking from the gut where the virus was replicating. MIS-C is typically treated with immunotherapies, such as IVIG and steroids. But those treatments were not enough to get inflammation fully under control in these children. Therefore, an investigational drug larazotide, a zonulin antagonist, was added to the treatment of one severely ill patient under compassionate use authorization. The study reports that after the administration of the zonulin antagonist, the Spike protein rapidly disappeared from the blood circulation and systemic inflammation subsided beyond that achieved by IVIG and steroids, demonstrating the gut-immune system connection. Plasma markers of disrupted gut permeability are accompanying severe COVID-19 in adults as well, per this study. These patients are dealing not only with the viral infection itself but also with bacterial and fungal products that translocated into the blood via an impaired gut barrier. The authors state: "These markers of disrupted intestinal barrier integrity and microbial translocation correlate strongly with higher levels of markers of systemic inflammation and immune activation, lower levels of markers of intestinal function, disrupted plasma metabolome and glycome, and higher mortality rate. Our study highlights an underappreciated factor with significant clinical implications, disruption in gut functions, as a potential force that may contribute to COVID-19 severity." Why would gut permeability be induced during an illness like COVID-19? This is likely mediated by the depletion of an amino acid glutamine. Glutamine is a well-recognized immuno-nutrient, which is required (and used up) by the immune system during its activation. It is also central to maintaining gut barrier integrity. When glutamine is depleted, resulting in a leaky gut, what would be leaking into the bloodstream? Our gut is supposed to be populated by a diverse microbiome. Many gut bacteria produce lipopolysaccharide, LPS. If the bacterial LPS were to reach the immune system, what would happen? Researchers have investigated the properties of LPS from a healthy human microbiome and found that the majority of the gut bacteria produce LPS that is non-inflammatory. But there are exceptions. For example, commensal E. coli and Prevotella are known to produce pro-inflammatory LPS. Pro-inflammatory LPS is fully acetylated, whereas non-inflammatory LPS is under-acetylated. If you were to obtain LPS from E. coli and incubate it with white blood cells (leukocytes), the latter would start pumping out a lot of pro-inflammatory cytokines, such as IL-6 and IL-1beta. The consequences of having an excessive or constant production of these cytokines would be devastating. And, actually, some of the biological effects of IL-6 are the same as the symptoms of severe COVID-19, as seen HERE. When people have a diverse microbiome, they are not likely to be at risk of having pro-inflammatory LPS leak through their gut barrier, even if they are transiently depleted of glutamine due to an acute illness. That’s because a diverse microbiome produces predominantly non-inflammatory LPS. But do we really have a diverse microbiome nowadays when we are constantly exposed to glyphosate (Roundup)? In rats, Roundup was shown to select for the very bacteria (E. coli and Prevotella) that produce pro-inflammatory LPS. And we’ve been exposed to Roundup for generations! Now, any impact that results in a leaky gut due to glutamine depletion, be it an infection, vaccination or even physical trauma, may put us at risk of having pro-inflammatory LPS from the gut reach the immune system in the blood. This LPS can keep re-stimulating the immune system, getting us stuck in a vicious cycle of chronic inflammation that further depletes glutamine and prevents healing of the gut barrier. What can we do to start restoring the microbiome and gut barrier integrity? First and foremost, we need to eliminate exposure to glyphosate and rehabilitate our gut microbiome from overabundance of glyphosate-favored bacteria that put us at risk of chronic inflammation, back to the microbial diversity of the old days. Healing leaky gut will likely heavily depend on having adequate supply of glutamine, which can be obtained from dietary sources (such as bone broth, collagen, gelatin, or as L-glutamine supplement) and via moderate exercise. Our muscles are a major source of glutamine production in the body. However, over-exertion depletes glutamine, and so does physical inactivity. Athletes often supplement with glutamine to avoid gut permeability problems. But there’s also an increased need for glutamine during an acute illness. Do you remember being told to have chicken soup when sick? That’s for glutamine. While chicken soup may not be sufficient to stave off severe COVID-19 in at-risk patients, in a small-scale study L-glutamine supplement has been found to be beneficial in treating hospitalized adults, essentially eliminating the qSOFA (quick Sequential Organ Failure Assessment) score, the ICU use, and death and reducing overall hospital stay. COVID-19, with its added burden of the Spike protein toxicity, has magnified the importance of maintaining the functional gut barrier and microbiome diversity in regulating the immune system and disease outcomes. _______________________________________________________ Dr. Tetyana Obukhanych has a BA in Biochemistry and a PhD in Immunology. She is a Founding member and Immune Science Educator at BBCH (Building Bridges in Children's Health). Join BBCH to be part of an international online community of parents, doctors, and health advocates dedicated to learning the science that supports healthy immunity. Comments are closed.
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