Chronic Obstructive Pulmonary Disease (COPD) is a group of diseases that make it difficult to breathe. It includes emphysema, chronic bronchitis and, in some cases, asthma [src].  A friend’s wife has it and I decided to see if there was microbiome shifts associated with it, in the naïve hope that adjusting those shifts may reduce the severity.

There are many studies on the lung microbiome [110+ at present] but modifying that microbiome does not have the usual tools available. The sole one that came to mind was Symbioflor-1, which has a study from 2001 showing a 40% drop in incidences, Influence of a bacterial immunostimulant (human Enterococcus faecalis Bacteria) on the recurrence of relapses in patients with chronic bronchitis This good Enterococcus faecalis probiotic appears to suppress the bad, drug resistanct, Enterococcus faecalis found in lung from earlier studies [1993], Symbioflor-1 is provided as a liquid that is effectively gargled with(“Keep Symbioflor 1 One minute in the mouth and gurgle in front of the swallow.“) This allows some of it to get into the throat and eventually the lung.

More Literature on Symbioflor-1 for those that are interested

A Comparative Transcriptomic Analysis of Human Placental Trophoblasts in Response to Pathogenic and Probiotic Enterococcus faecalis Interaction. The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale (Can J Infect Dis Med Microbiol ) Vol: 2021 Issue Pages: 6655414 Pub: 2021 Epub: 2021 Jan 28 Authors Tan Q , Zeng Z , Xu F , Wei H , Summary Html Article Publication

Influence of Catecholamines (Epinephrine/Norepinephrine) on Biofilm Formation and Adhesion in Pathogenic and Probiotic Strains of Enterococcus faecalis. Frontiers in microbiology (Front Microbiol ) Vol: 11 Issue Pages: 1501 Pub: 2020 Epub: 2020 Jul 24 Authors Cambronel M , Nilly F , Mesguida O , Boukerb AM , Racine PJ , Baccouri O , Borrel V , Martel J , Fécamp F , Knowlton R , Zimmermann K , Domann E , Rodrigues S , Feuilloley M , Connil N , Summary Html Article Publication

In silico analyses of the genomes of three new bacteriocin-producing bacteria isolated from animal`s faeces. Archives of microbiology (Arch Microbiol ) Vol: 203 Issue 1 Pages: 205-217 Pub: 2021 Jan Epub: 2020 Aug 17 Authors Eveno M , Belguesmia Y , Bazinet L , Gancel F , Fliss I , Drider D , Summary Publication Publication

Probiotic Enterococcus faecalis Symbioflor 1 ameliorates pathobiont-induced miscarriage through bacterial antagonism and Th1-Th2 modulation in pregnant mice. Applied microbiology and biotechnology (Appl Microbiol Biotechnol ) Vol: 104 Issue 12 Pages: 5493-5504 Pub: 2020 Jun Epub: 2020 Apr 20 Authors Tao Y , Huang F , Zhang Z , Tao X , Wu Q , Qiu L , Wei H , Summary Publication Publication

Probiotic Potential and Safety Evaluation of Enterococcus faecalis OB14 and OB15, Isolated From Traditional Tunisian Testouri Cheese and Rigouta, Using Physiological and Genomic Analysis. Frontiers in microbiology (Front Microbiol ) Vol: 10 Issue Pages: 881 Pub: 2019 Epub: 2019 Apr 24 Authors Baccouri O , Boukerb AM , Farhat LB , Zébré A , Zimmermann K , Domann E , Cambronel M , Barreau M , Maillot O , Rincé I , Muller C , Marzouki MN , Feuilloley M , Abidi F , Connil N , Summary Html Article Publication

Draft Genome Sequences of the Probiotic Enterococcus faecalis Symbioflor 1 Clones DSM16430 and DSM16434. Genome announcements (Genome Announc ) Vol: 4 Issue 5 Pages: Pub: 2016 Sep 29 Epub: 2016 Sep 29 Authors Fritzenwanker M , Chakraborty A , Hain T , Zimmermann K , Domann E , Summary Html Article Publication

Probiotic Enterococcus faecalis Symbioflor® down regulates virulence genes of EHEC in vitro and decrease pathogenicity in a Caenorhabditis elegans model. Archives of microbiology (Arch Microbiol ) Vol: 199 Issue 2 Pages: 203-213 Pub: 2017 Mar Epub: 2016 Sep 21 Authors Neuhaus K , Lamparter MC , Zölch B , Landstorfer R , Simon S , Spanier B , Ehrmann MA , Vogel RF , Summary Publication Publication

In vitro comparison of the effects of probiotic, commensal and pathogenic strains on macrophage polarization. Probiotics and antimicrobial proteins (Probiotics Antimicrob Proteins ) Vol: 6 Issue 1 Pages: 1-10 Pub: 2014 Mar Epub: Authors Christoffersen TE , Hult LT , Kuczkowska K , Moe KM , Skeie S , Lea T , Kleiveland CR , Summary Publication Publication

Impact of actin on adhesion and translocation of Enterococcus faecalis. Archives of microbiology (Arch Microbiol ) Vol: 196 Issue 2 Pages: 109-17 Pub: 2014 Feb Epub: 2013 Dec 21 Authors Peng Z , Krey V , Wei H , Tan Q , Vogelmann R , Ehrmann MA , Vogel RF , Summary Publication Publication

Complete Genome Sequence of the Probiotic Enterococcus faecalis Symbioflor 1 Clone DSM 16431. Genome announcements (Genome Announc ) Vol: 1 Issue 1 Pages: Pub: 2013 Jan Epub: 2013 Feb 7 Authors Fritzenwanker M , Kuenne C , Billion A , Hain T , Zimmermann K , Goesmann A , Chakraborty T , Domann E , Summary Html Article Publication

In vitro comparison of commensal, probiotic and pathogenic strains of Enterococcus faecalis. The British journal of nutrition (Br J Nutr ) Vol: 108 Issue 11 Pages: 2043-53 Pub: 2012 Dec 14 Epub: 2012 Feb 21 Authors Christoffersen TE , Jensen H , Kleiveland CR , Dørum G , Jacobsen M , Lea T , Summary Publication Publication

Comparative genomic analysis for the presence of potential enterococcal virulence factors in the probiotic Enterococcus faecalis strain Symbioflor 1. International journal of medical microbiology : IJMM (Int J Med Microbiol ) Vol: 297 Issue 7-8 Pages: 533-9 Pub: 2007 Nov Epub: 2007 Apr 27 Authors Domann E , Hain T , Ghai R , Billion A , Kuenne C , Zimmermann K , Chakraborty T , Summary Publication Publication

Functional characterization of pro-biotic pharmaceuticals by quantitative analysis of gene expression. Arzneimittel-Forschung (Arzneimittelforschung ) Vol: 53 Issue 5 Pages: 385-91 Pub: 2003 Epub: Authors Giese T , Zimmermann K , Meuer SC , Summary Publication Publication

[Reduction of acute recurrence in patients with chronic recurrent hypertrophic sinusitis by treatment with a bacterial immunostimulant (Enterococcus faecalis Bacteriae of human origin]. Arzneimittel-Forschung (Arzneimittelforschung ) Vol: 52 Issue 8 Pages: 622-7 Pub: 2002 Epub: Authors Habermann W , Zimmermann K , Skarabis H , Kunze R , Rusch V , Summary Publication Publication

[The effect of a bacterial immunostimulant (human Enterococcus faecalis bacteria) on the occurrence of relapse in patients with]. Arzneimittel-Forschung (Arzneimittelforschung ) Vol: 51 Issue 11 Pages: 931-7 Pub: 2001 Nov Epub: Authors Habermann W , Zimmermann K , Skarabis H , Kunze R , Rusch V , Summary Publication Publication

Now the gut!?!

Here we have few studies.

• Ruminococcaceae, Mogibacteriaceae, Lachnospiraceae, and Clostridiaceae  are suggested INCREASED from rodent studies [2019]
  • Chronic exposure to ambient particulate matter induces gut microbial dysbiosis in a rat COPD model [2020] reports major increases of Firmicutes but was unable to further identify because of small sample size.
• Dynamic changes of gut and lung microorganisms during chronic obstructive pulmonary disease exacerbations [2020] was from human studies, but lack controls to detect the shifts (they compared lung to gut in patients)
• Effects of compound Caoshi silkworm granules on stable COPD patients and their relationship with gut microbiota: A randomized controlled trial [2020] and concluded
  “CCSGs have beneficial effects in the improvement of symptoms in stable COPD patients over a 3-month treatment period. The potential underlying mechanism may be attributable to the difference in gut microbiota among patients. However, more research is needed to confirm this conclusion.” I suspect that a different silkworm extract that is available via Amazon etc, Serrapeptase may have similar positive effects.
• 💥💥💥Comprehensive profiling of the gut microbiota in patients with chronic obstructive pulmonary disease of varying severity [2021] is the Rosetta stone. It is based on human subjects and show the changes seen with progression o COPD.
  

From the last study we see Veillonella, Corynebacterium 1, Romboutsia, Aerococcus and, Megasphaera, increasing, Lachnoclostridium decreasing. Fortunately, one of our tools on Microbiome Prescription allows us to enter these shifts and then compute with AI what would counter them.

The results are shown below (remember, they are scaled so the highest value is 1 — and the value is based on not the impact, but the number of studies reporting a desirable shift)

For those not familiar with fucoidan, Fucoidan is a long chain sulfated polysaccharide found in various species of brown algae. Commercially available fucoidan is commonly extracted from the seaweed species Fucus vesiculosus, Cladosiphon okamuranus, Laminaria japonica and Undaria pinnatifida [wikipedia]. It is available from many suppliers on Amazon, for example:

Bottom Line

When I started working on this post, I was not expecting to fine anything significant. To one’s surprise, there was an ideal study published this year using human data with different degrees of severity. There are two really strong suggestions to be discussed with your MD before starting. – most of the rest come from Artificial Intelligence on the microbiome alone and not clinical experience; yet agree with existing studies.

• Symbioflor-1
• Fucoidan [Cigarette smoke triggers macrophage adhesion and activation: role of lipid peroxidation products and scavenger receptor} 2003
• Other items suggest above may also help, and is supported from independent studies
  • Vitamin D: “Strong evidence for beneficial effects on pulmonary function decline was found only for vitamin D supplementation.” [2021]
  • Vitamin B9 (Folate) “High Serum Folate Concentration Is Associated with Better Lung Function in Male Chronic Obstructive Pulmonary Disease Patients Who Are Current Smokers: Analysis of Nationwide Population-Based Survey” 2020
  •  saccharin “The effect of furoyl saccharin, a novel non-peptidic acylating protease inhibitor, on experimental emphysema in the hamster” [1985]
  •  selenium “Echinacea purpurea along with zinc, selenium and vitamin C to alleviate exacerbations of chronic obstructive pulmonary disease: results from a randomized controlled trial“[2011]

Remember, these suggestions are coming solely from the reported bacteria shifts with no information about the medical condition using AI. The suggestions are supported by medical studies (where there are some)