Can gut therapy save lives? Introduction Following its first outbreak in wet markets, COVID-19 has remolded modern-day society. It has transformed lives across the world including those of healthcare workers, grocery store baggers, teachers, as well as students. With the re-opening of schools just around the corner, we are looking at a drastically different school environment compared to that of a year ago. We, as students, must scramble to adapt to online learning without physical guidance from our teachers. Instead of looking forward to school dances or sporting events, we must sit for hour long classes facing computer screens. With all of these changes, I grew interested in understanding COVID-19 and how it impacts our bodies. In this article, I will explain what COVID-19 is and discuss how the disease might be impacting our guts and how gut therapy could combat this disease. What is COVID-19? COVID-19 is an infectious disease caused by SARS-CoV-2, a coronavirus belonging to the Coronaviridae family of viruses. This variant emerged in late-December 2019 in Wuhan, China, allegedly from human contact with infected-pangolins sold in the Huanan Seafood Market. Since the initial infection, COVID-19 has caused approximately 852,000 deaths worldwide, with over 182,000 deaths in the United States alonea. Biologically, scientists have discovered that the novel coronavirus shares 94.6% sequence identity between its replication domains and similar regions seen in viruses responsible for severe acute respiratory syndrome, otherwise known as SARS (Jin, Yang and Ji). Like SARS, COVID-19 causes vascular issues and can lead to respiratory failure, especially in immunocompromised people and the elderly. Although COVID-19 causes respiratory issues, SARS-CoV-2 has been found in feces of infected people, suggesting that the virus can travel through the gastrointestinal tract. This finding may suggest SARS-CoV-2 impacts gut health and the resident microbiota that lives there. What is the gut microbiota? Our gastrointestinal tract is home to billions of beneficial microorganisms, including bacteria, fungi, and various viruses, that are collectively known as the “microbiota.” These microbes perform important functions like aiding in digestion of the foods we eat and production of the vitamins we need. Interestingly, some of the most studied functions of the microbiota include its ability to control immune cells and systematic inflammation which includes inflammation in our respiratory system (He, Wang and Li). Though the research is still novel, COVID-19 and the microbiota may be linked through the angiotensin-converting enzyme-2 receptor, ACE-2, which impacts the body’s response to a virus and can control inflammation. COVID-19 and the ACE-2 receptor ACE-2 is an enzyme receptor that is exhibited throughout the body and is also the site where COVID-19 binds to human hosts in order to replicate, destroy healthy cells, and spread. Interestingly, the ACE-2 receptors present in the human intestine are needed for the expression of B0AT1, which leads to the production of peptides that fight off disease causing pathogens (He, Wang and Li). Thus, ACE-2 indirectly affects the susceptibility of the gut microbiota to dangerous pathogens and the overall composition of the gut. Since depleted microbiota composition can lead to systematic inflammation, COVID-19 might be impacting the gut microbiota. Conversely, the gut microbiota could be targeted to treat COVID-19. Gut therapy By targeting the gut microbiota, scientists may be able to prevent secondary infections of COVID-19 or decrease the severity of the initial infection. Specifically, probiotics, live microbes that are taken orally, could be studied for their effect on COVID-19. Since probiotics can modulate the human gut microbiota, some scientists hypothesize they can be used to impact systemic inflammation or control potential pathogens that emerge in the gut due to COVID-19 (Akour). An alternative to probiotics may involve replacing entire communities of the microbiota through fecal-microbiota transplantations (FMTs.) Replacing “inflammatory” communities with “anti-inflammatory” species could potentially alleviate COVID-19 symptoms by decreasing overall inflammation (He, Wang and Li). Gut therapy and viruses It is important to stress, nevertheless, that while targeting the gut microbiota may lessen the severity of COVID-19, this idea has not been definitively proven in any clinical trial or study. Yet, there is evidence that viral diseases can be treated through the microbiota. One study, for example, showcased how probiotic Lactobacillus lactis JCM 5805 fought off the pathogen responsible for influenza. It did this by helping stimulate immune cells that control viral replication such as plasmacytoid dendritic cells (Akour). Thus, scientists may hypothesize that probiotics and gut therapy would also benefit other respiratory diseases like COVID-19. Discussion COVID-19 is a respiratory / vascular-disease that has taken hundreds of thousands of lives worldwide. Current understanding suggests the virus enters cells via the ACE-2 receptor, which is found throughout the body including the intestine. As the COVID-19 pandemic progresses, we are trying to find various treatment options for the disease. One ongoing field of study is probing the impact of the microbiota on COVID-19 disease severity. While there isn’t much direct evidence of probiotics or gut-targeting therapeutics being helpful in combating COVID-19, there are previous studies that have shown probiotics as efficacious in treating other respiratory viral infections. It will be interesting to see if future therapies will include microbiota transplantation or probiotics like Lactobacillus rhamnosus GG. Footnotes: a —As of September 2nd , 2020 References Akour, A. "Probiotics and COVID-19: is there any link?" Applied Microbiology (2020). Review Article. He, Yu, et al. "Main Clinical Features of COVID-19 and Potential Prognostic and Therapeutic Value of the Microbiota in SARS-CoV-2 Infections." Frontiers in Microbiology (2020). Review. Jin, Yuefei, et al. "Virology, Epidemiology, Pathogenesis, and Control of COVID-19." Pathogenesis of Human and Animal Coronaviruses (2020): 3. Review. Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
5 Comments
Elizabeth
9/8/2020 06:22:17 am
Really interesting read!
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Elba Peter
9/8/2020 10:13:25 am
Amazing work that’s so useful and helpful for everyone out there!
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Divya
9/8/2020 01:47:38 pm
Excellent work Sarah - beautifully written, well put together and easy to read!
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Matthew C.
10/4/2020 09:46:08 am
Nice work Sarah M. Looking forward to your future articles.
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AuthorMy name is Sarah Mathew and I was a junior in high school when this pandemic hit. I wanted to help my community in the best way I knew how: writing. Archives
December 2020
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