Biofilm Theory

[RobinN]

I am writing this to clarify information that is circulating regarding the biofilm theory that I presented to the Defeat Autism Now Think Tank last week.

True Health Medical Center:
"Potential Implication of Biofilm Formation in Patients with ASD",
Presented to the Defeat Autism Now Think Tank, Oct. 11, 2007

I presented a theory about the implications of biofilm production by resistant strains of bacteria/fungus in our ASD patients who have persistent dysbiosis. The literature search that I conducted with the help of Teresa Conrick, MS and Sonja Hintz, RN was quite convincing. The abnormal production of biofilm by resistant strains of microorganisms may be a possible etiology of why many of our patients who do not have positive stool cultures for yeast or pathogenic bacteria do well when placed on antifungals and antibiotics, yet relapse when they stop. The biofilm produced by these resistant organisms can only be seen by electron microscopy and makes it difficult to culture these bugs. This theory might also explain subtypes of our ASD subpopulation who have abnormal behaviors, such as head banging or agitation, that seem to be gut pain related, yet again have negative studies. The third subset that this seems relevant for is the group of children that have recurrent strep infections, OCD, perseverative, or repetitive behaviors who get worse in the spring and fall, yet may not test positive for strep.

Why do so many of our ASD kids have persistent dysbiosis? This is my theory. We all know that the quality of our air, water and food is not ideal and
contains numerous toxins and pollutants. Our children have a genetic susceptibility in their ability to handle this toxic burden. Research shows us
that resistant organisms tend to grow in toxic, hostile environments, and after numerous rounds of antibiotics. They maintain their viability by producing a polysaccharide matrix that protects them from the hostile environment in which they are trying to survive. This extracellular matrix is called biofilm. Our normal flora also produce a natural biofilm, but resistant organisms produce their own biofilm which then takes over, preventing the normal flora from flourishing. Experiments done in vitro show that this polysaccharide matrix is negatively charged, and that it is held together by positively charged ions such as Ca, Mg, and Fe. Iron seems to play a big role in how these bacteria evade the immune system. Further work on VRSA/MRSA and pseudomonas biofilms in vitro indicate that this biofilm may be penetrated by using a combination of EDTA and an antibiotic; the studies used Vancomycin for Staph and Gentamicin for Pseudomonas.

The protocol that my staff and I developed was presented in its infancy at the October 2007 Think Tank. The Defeat Autism Now Think Tank is usually a forum where ideas are presented for discussion and further research. This protocol was not discussed in great detail (15 minutes was allotted for this discussion), rrand it was not meant for wide distribution at this time. However, Dr. Bradstreet presented it in his talk on New Advancements and clinicians and patients from all over the world are now asking for our protocol.

However, let me start with a few caveats. First of all, this is brand new. We have used this approach on about 60 patients. The first two were Teresa's
and Sonja's children - one with ASD/self injurious behavior and one with colitis, no ASD. Both initial patients are doing well. However, this treatment
has to be individualized for each patient's unique constitution and ability to handle both die-off and detox type reactions. From our other patients we are seeing a variety of responses from decreased hyperactivity and stimming, to increased agitation, to no response. Of course we may have a few bumps along our journey to recovery. The big bumps with this approach are related to awakening the immune system to these organisms which it has not been recognizing. The body finally sees the bacteria or the candida that has been there creating other types of havoc all along. Acutely, patients may experience vomiting, diarrhea, high temps. Rashes may appear, especially if the die off is sudden. The other theoretical issue is that the biofilm may be holding on to toxic metals such as aluminum and lead. As this toxic biofilm degrades heavy metals may be released into the gastrointestinal tract for excretion. Our protocol was developed to address this possibility.

I urge all of you to have patience and wait for us to gather more data on this approach so that you are presented with the safest, most effective protocol. Remember, your doctor should implement this approach gradually with the unique needs of your child in mind. Because of the possibility for negative side effects, and the need to closely monitor the patients, and the possible use of pharmaceuticals, this treatment plan should be implemented only with the help of your physician.

True Health Gut Biofilm Protocol™

Step One: Lysis and Detachment of the Polysaccharide Matrix (empty stomach, 30-60 min prior to Step 2)
-Use of specific enzymes. (these are being refined and developed, as the enzymes we have available at this moment are not ideal)
-Use of a chelator that can grab hold of minerals in the Matrix. (if not implemented appropriately this may cause mineral depletion in the body - do not attempt chelation without proper medical supervision)

Step Two: Target the Microbe
- Consider using antibiotics, herbals, or homeopathics. (our office has had extensive experience with all three modalities, and have found that the choice "depends upon the kid". We are also researching a fourth modality that looks quite promising for eradicating these pesty organisms.

Step Three: Clean Up
(This is the most crucial of all the steps. DO NOT SKIP!!! Give 1-2 hrs after Step 2 if possible or at night)
-Here we use anything that can bind up the matrix (mucus), by products of die off, and potential metals in the gut. Products include activated charcoal, alginate, clays, algaes, zeolites,.... we like pectin the best. Sometimes we use all of the above.

Other important factors
-Probiotics, of course.
-Anti-inflammatory agents such as EFA's, antioxidants, curcumin...
-Natural fermented foods such as kefir, kombucha...
-Healthful, non toxic foods (hormone- free, antibiotic-free, organic)

This is a short-term treatment plan, we are using it for about 2-3 months.

This protocol is still being developed and is not fully defined. We have only been using this for about 6 months in a specific subgroup of our patients.
Remember, our ultimate goal is to restore the normal flora and the normal biofilm. This takes time and the process is slow. It took years for some our
patients to reach this point, it may take time to reverse.

With hope for a better future for our kids and grandkids,

Dr. Anju Usman
Medical Director
True Health Medical Center
603 E. Diehl Rd. Suite 135
Naperville, Illinois

™True Health Medical Center, June 2007

“…the autoimmune process can be arrested if the interplay between genes and environmental triggers is prevented by re-establishing intestinal barrier
function…”
Mechanisms of Disease: the role of intestinal barrier function in the
pathogenesis of gastrointestinal autoimmune disease. (Fasano, 2005)

[Bernard]

That was interesting. I look forward to reading more about their work as they refine the protocol.