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NEW DELHI: A gut friendly bacteria, available as a dietary supplement and added to various foods like dairy products, has proven effective as a “prophylactic” therapy for managing both pulmonary and extrapulmonary acute respiratory distress syndrome (ARDS) in various lung diseases, including Covid-19, infectious diseases and sepsis, a pre-clinical study by AIIMS on mice has found.
The study, published in an international journal, Clinical Immunology, in Jan this year, found that the prophylactic administration of the bacteria — lactobacillus rhamnosus (LR) — increased the survival rates of ARDS/sepsis animals by up to 50% thereby reducing the fluid build-up in their lungs. The doctors are planning to conduct a clinical trial of this study.
ARDS is a progressive form of respiratory failure and a life-threatening development in Covid-19, pneumonia, sepsis, and trauma. It accounts for nearly 10% of intensive care unit admissions and 40% of mortality.
Despite the extensive studies in medicine, there is no specific treatment for ARDS. Instead, an evidence-based symptomatic management approach is followed by the clinicians, which includes treating infections, ventilation for supporting lungs function and general nutritional supplementation.
However, recent studies show that gut dysbiosis (an imbalance in the gut microbiome that occurs when harmful bacteria outweigh beneficial bacteria) promotes ARDS and other respiratory complications.
Dr Rupesh Srivastava, associate professor, department of biotechnology, and his research group used the probiotics LR as a preventative strategy for dampening the symptoms of ARDS in animal models. He said that the study has immense clinical implications in reducing the chances of developing ARDS-related complications, and minimising/preventing ICU admissions and associated mortality.
He elaborated that in-house mice models were developed to study the role of LR in both pulmonary and extra-pulmonary ARDS (severe manifestation of sepsis). LR works its magic beyond the digestive system by producing several small molecules called short-chain fatty acids, like butyrate. It enters circulation and reaches the lungs, acting upon various receptors responsible for regulating the immune responses. This results in minimising tissue damage and minimised cytokine storm-like situations within the lungs.
Doctors said that in ARDS and sepsis, white blood cells (WBCs), particularly the neutrophils, are a double-edged sword causing inflammation. Though these WBCs are vital in fighting off infections and help heal the tissue injury site, a delay in the clearance of these WBCs from the lungs causes the air sacs to lose their function, leading to a fatal condition of ARDS, accompanied by fluid build-up within the lungs, compromising the oxygen exchange.
Dr Srivastava said that the neutrophils use traps as their anti-microbial toolkits the treatment with probiotic LR significantly reduced the formation of these notorious traps in the acute respiratory distress syndrome mice.
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