Hidden Dangers of Antibiotic Use: Increased Gut Permeability Mediated by Increased Pancreatic Proteases Reaching the Colon
Abstract
s we learn more about the importance of our Amicrobiome in inflammatory, metabolic, and functional disorders, we are coming to appreciate the risks of disturbing this with broad-spectrum antibiotics. We have known for many years that as antibiotics have dramatically reduced the risk of infectious diseases, the incidence of other diseases such as inflammatory bowel disease, obesity, and type 2 diabetes mellitus have increased. Although the causes undoubtedly are multifactorial, meta-analysis showed that for Crohn’s disease (CD), antibiotic exposure nearly doubles the risk. The current article provides one possible mechanism where by this might occur. The authors studied 32 patients who provided stool samples before and after taking a range of antibiotics. They found that 8 patients showed a marked increase in fecal protease activity, mostly owing to increased pancreatic proteases. Supernatants from the stools with increased protease activity increased permeability when applied to a polarized monolayer of cultured colonic epithelial cells. This was particularly evident in patients given antibiotics such as levofloxacin and metronidazole, which are known to markedly reduce fecal microbiota, although this was much less obvious after antibiotics such as rifaximin, which have less impact on the microbiota. The pancreas secretes approximately 500 mg of tryptase daily into the gut, yet only approximately 1 mg is excreted and early animal experiments have shown that this degradation…
How strong is the evidence?
Evidence Hub reads this as a editorial / letter, done in animal, not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 32 participants or records.
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