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    Bile can serve as a reservoir for funghi, making them harder to treat

    Scheduled Pinned Locked Moved Literature Review
    bilefunghicandiapufa
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    • C Offline
      CrumblingCookie @Mauritio
      last edited by CrumblingCookie

      Result or (mutualistic) cause? It's pointing to the latter!

      Common fungal microbiome changes in hepatobiliary diseases.jpg

      Fungal infections and the fungal microbiome in hepatobiliary disorders, 2022

      @mauritio and others I urge you to read through the whole paper. It's a very scientifically sober and factual work which converges various interrelated aspects.

      Excerpts (it appears almost necessary to quote the whole thing):

      Although patients with cirrhosis already have elevated faecal levels of Candida [111], patients with HCC were found to have even higher faecal proportions of Candida and C. albicans than patients with cirrhosis, but lower proportions of the genera Kazachstania, Debaryomyces, Xeromyces, Amorphotheca, and Blastobotrys [122]. In a mouse model of HCC, gavage with C. albicans resulted in exacerbated HCC volume, which was dependent on the nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 6 (NLRP6) inflammasome [123]. Moreover, development of HCC in a patient with cirrhosis increases their risk of oesophageal candidiasis (OR 10.04) [113].

      Specific serum anti-C. albicans IgG and IgM titres are increased in patients with AUD vs. controls, and interestingly, the anti-C. albicans IgG titre (but not the IgM titre) decreases significantly in patients after abstinence [55]. These changes parallel elevated faecal proportions of C. albicans in patients with AUD (vs. controls), which decrease after abstinence [55]. Similarly, plasma anti-C. albicans IgG titres are increased in patients with NAFLD and advanced fibrosis (F3-F4) vs. patients with NAFLD and no/early fibrosis (F0-F2) and vs. controls, and anti-C. albicans IgG titres correlate with the faecal C. albicans/S. cerevisiae log ratio [56]. Anti-C. albicans IgG titres hence correlate with disease activity in ALD [55] and NAFLD [56], indicating more systemic exposure to C. albicans in more severe liver disease.

      Candidalysin is a secreted cytolytic peptide toxin from C. albicans that directly damages epithelial membranes, triggers a danger response signalling pathway and activates epithelial immunity [129]. C. albicans strains lacking this toxin do not activate or damage epithelial cells and are avirulent in animal models of mucosal infection [129]. The extent of cell elongation 1 (ECE1) gene encoding candidalysin was more frequently present in the stool of patients with AH than AUD [98]. Further, mice gavaged with wild-type ECE1-positive C. albicans had significantly higher serum alanine aminotransferase (ALT) levels, hepatic triglycerides and inflammation than mice gavaged with ECE1-negative C. albicans in a 2-week ethanol binge model, supporting the notion that ECE1-positive C. albicans exacerbates ethanol-induced steatohepatitis in mice [98].

      Secretory IgA also binds ECE1-derived candidalysin, though this binding is reduced in patients with Crohn’s, indicating fungi-related immune dysregulation [130].

      Antifungal treatment improves liver disease in various mouse models, including ethanol- and western diet-induced steatohepatitis [56, 97, 131]. Further, colonisation with C. albicans [98, 123] or Malassezia restricta [99] exacerbates liver disease. Therefore, fungi and their products contribute to liver disease.

      Chronic alcohol administration increases mycobial populations and the translocation of fungal beta-glucan into the systemic circulation in mice [97, 131]. Oral administration of the antifungal amphotericin B reduces faecal fungal overgrowth and beta-glucan translocation [97]. Antifungal treatment with oral amphotericin B or caspofungin prevents ethanol-induced liver disease in mice without changing plasma bacterial lipopolysaccharide levels [97, 131].

      Beta-glucan induces liver inflammation via CLEC7a on Kupffer cells, as shown in experiments employing bone marrow chimeric mice [97]. CLEC7a-dependent activation of caspase-1 via NLRP3 [134, 135] leads to increased inflammatory IL-1β expression and secretion, which subsequently contributes to hepatocyte damage and ethanol-induced liver disease [97]. CLEC7a also plays a role in diet-induced steatohepatitis, since its hepatic expression is significantly increased in patients with NASH and mice on a high-fat diet, whereas Clec7a-deficient mice and mice treated with a Clec7a-antagonist are protected from diet-induced steatohepatitis and fibrosis [136].

      Rats infected with C. albicans by intraperitoneal injection develop hepatic steatosis, increased serum ALT levels, inflammatory markers, and pronounced lipid peroxidation [137]. This raises the question of how C. albicans causes liver disease. One effector could be its secreted cytolytic toxin candidalysin. Candidalysin exacerbates ethanol-induced liver disease and is associated with increased mortality in mice [98]. Candidalysin does this independently of Clec7a

      Candidalysin can damage primary hepatocytes in a dose-dependent manner in vitro and is associated with liver disease severity and mortality in patients with AH [98]

      The PGE2-producing fungus Meyerozyma guilliermondii was increased in mice with ethanol-induced steatohepatitis [131]. Further, supplementation with Meyerozyma guilliermondii worsens ethanol-induced liver disease

      Concurrent administration of an antifungal also abrogates PGE2 formation and ethanol-induced liver disease [131].

      Moreover, C. albicans is a potent inducer of the Th17 response via PGE2; PGE2 is induced by the C. albicans components mannan and β-glucan that are recognised by the mannose receptor and the Clec7a/Tlr2 pathway, respectively [147, 148].

      C. albicans has evolved the capacity to produce PGE2 from arachidonic acid to promote its own colonisation in the host gut [152–154]. C. albicans mutants lacking PGE2 production (genetically missing ole2, a fatty acid desaturase) are unable to colonise the murine gastrointestinal tract

      Key points:

      Despite a relatively small number of fungal cells in the human body, fungi are involved in the development of liver and biliary diseases.

      Various rodent models of fungal microbiome (mycobiome) modulation, including increasing the fungal burden (e.g. colonisation with fungi) or decreasing the fungal burden (i.e. via antifungals), have demonstrated the impact of the mycobiome on hepatobiliary conditions.

      Fungal products including toxins and metabolites can exacerbate liver and biliary diseases.

      In particular, the genus Candida and the species Candida albicans play a central role in the pathogenesis and progression of essentially all hepatobiliary conditions.

      Serum antibodies against fungal populations have predictive value with regard to disease severity and survival in hepatobiliary diseases.

      Conclusions

      Mycobiome changes have now been established in essentially all hepatobiliary conditions. However, they are still a kind of dark matter, as we often do not know their true identity and characteristics, since we cannot culture many of them. [...]
      Further, they do not colonise mice easily, so we do not have good mouse models. Nevertheless, we know that some fungi are hepatotoxic themselves and not just bystanders – for example, rodents colonised with C. albicans develop liver disease without additional stimuli.
      Fungi might hence possibly exacerbate liver disease in a two-hit model, one hit being alcohol, western diet, or a toxin, and another hit being the presence and deleterious impact of fungi.
      We are learning more and more about the mechanisms by which fungi contribute to liver disease, be it via fungal cell wall components or secreted toxins, such as beta-glucans or candidalysin, or fungal metabolites including prostaglandins.

      Wild! Profound implications for clinical practice and the foundational models of hepatobiliary diseases!

      sunsunsunS MauritioM 2 Replies Last reply Reply Quote 2
      • sunsunsunS Offline
        sunsunsun @CrumblingCookie
        last edited by sunsunsun

        @CrumblingCookie there is a study showing pancreatic cancer patients usually have a fungal infection of the pancreas

        and secondly, there is a case report of elevated liver enzyme ALP going down after anti fungal treatment in suspected fungal infection. this is with the generally liver toxic anti fungal drug.

        C MauritioM 2 Replies Last reply Reply Quote 1
        • C Offline
          CrumblingCookie @sunsunsun
          last edited by CrumblingCookie

          @sunsunsun Yes, yes! The clinical neglect and snotty obfuscation into esoteric quackery is maddening!
          Will update soon on what I'm doing.

          1 Reply Last reply Reply Quote 1
          • MauritioM Offline
            Mauritio @CrumblingCookie
            last edited by

            @CrumblingCookie thanks for sharing!
            Very interesting. Let us know how your anti fungal cycle goes. I might try some stronger anti fungals ,too.

            Dare to think.

            My X:
            x.com/Metabolicmonstr

            1 Reply Last reply Reply Quote 0
            • MauritioM Offline
              Mauritio @sunsunsun
              last edited by Mauritio

              @sunsunsun said in Bile can serve as a reservoir for funghi, making them harder to treat:

              there is a study showing pancreatic cancer patients usually have a fungal infection of the pancreas

              I found this study.
              The microenvironment of a pancreatic tumor has a distinct micro biome including bacteria and fungi. Fungi are increased in mice and human samples with pancreatic cancer. Malassezia was the most prevalent species (interestingly most people with hair loss have a scalp infection of it)

              They found that fungi caused cancer growth!
              "...the fungal mycobiome promotes pancreatic oncogenesis (11)."

              And more importantly, killing that fungus stopped cancer growth!
              "Ablation of mycobiome with antifungal medications, such as amphotericin B or fluconazole, protected mice against oncogenic progression."

              Has this been tried in humans ?
              This should be another reason why Haiduts anti cancer protocol works, high dose B3 and Aspirin are anti fungal.

              P.S. the authors also mention how bacteria influence tumor progression.
              https://pmc.ncbi.nlm.nih.gov/articles/PMC7607088/

              "PDA tumors harbored a ~3000-fold increase in fungi compared to normal pancreas in both mice and humans."
              https://pmc.ncbi.nlm.nih.gov/articles/PMC6858566/

              Itraconazole inhibits proliferation of pancreatic cancer cells through activation of Bak-1
              https://pubmed.ncbi.nlm.nih.gov/30260036/

              Pancreatic cancer patient was already admitted to palliative hospital. Then received itraconazole, the tumor became operable, survived several years.

              "After he received his nine-month course of itraconazole, the pancreatic cancer was readdressed and he was then deemed to be resectable and had a Whipple procedure. Over the next several years, he showed no evidence of pancreatic metastases or relapse."
              https://pubmed.ncbi.nlm.nih.gov/25670260/

              Dare to think.

              My X:
              x.com/Metabolicmonstr

              sunsunsunS 1 Reply Last reply Reply Quote 0
              • sunsunsunS Offline
                sunsunsun @Mauritio
                last edited by sunsunsun

                @Mauritio high dose niacinamide is not nearly as effective in vivo for dogs against what im pretty sure is mallessezia compared to a normal dose of fluconazole. and ketoconazole seems about the same as fluconazole. no experience with itraconazole but will prob try it at some point, it is very expensive in north america or europe. just observations not really scientific. in humans iirc terbinfine might be pretty good for mallessezia but in dogs they excrete it too quickly apparently.

                if a dog has itchy ear , one dose of fluconazole will knock it out for a couple weeks. no need to give everyday.

                imo cancer patients could probably all try an antimicrobial protocol with an antibiotic, antifungal, and antiparasite drug. reaearchers keep looking for a side target of the above drugs but im guessing the actual antimicrobial part is probably anticarcinigenic

                i also have seen evidence anti serotonin drugs are anti parasite. theres a study on cyproheptadine being an anti parasite drug, from https://www.cabidigitallibrary.org/doi/full/10.5555/19900860028?__cf_chl_tk=ThtQHEaB7fbCcC9qnD19tIV6PYSAm9plCdzDERWJ0R0-1775529914-1.0.1.1-pMIrmBv2QC7gUB4mLmBDUGspQSWjaQ7agFuosFIZ.fI

                1 Reply Last reply Reply Quote 1
                • E Offline
                  Ecstatic_Hamster
                  last edited by

                  The late and great Travis believed that boron is antifungal and that's why borax often works against arthritis. I wonder if reasonable qualities of borax could help kill fungi in the body. Travis believed so

                  M yerragY 2 Replies Last reply Reply Quote 0
                  • M Offline
                    maplesyrupbro @Ecstatic_Hamster
                    last edited by

                    @Ecstatic_Hamster Late Travis? Is he dead?

                    1 Reply Last reply Reply Quote 0
                    • yerragY Offline
                      yerrag @Ecstatic_Hamster
                      last edited by

                      @Ecstatic_Hamster said in Bile can serve as a reservoir for funghi, making them harder to treat:

                      The late and great Travis believed that boron is antifungal and that's why borax often works against arthritis. I wonder if reasonable qualities of borax could help kill fungi in the body. Travis believed so

                      Good idea. My knees are sore and there are many reasons to make if sore. But it is as context specific just as it is for high blood pressure.

                      I need to add borax to my daily supplements to see if this works.

                      Temporal thinking is the faculty that’s
                      engaged by an enriched environment, but it’s
                      wrong to call it “thinking,” because it’s simply
                      the way organisms exist... - Ray Peat Nov 2017 Newsletter

                      yerragY 1 Reply Last reply Reply Quote 0
                      • yerragY Offline
                        yerrag @yerrag
                        last edited by

                        @ecstatic_hamster

                        How much borax is a daily dose you woukd recommend?

                        Temporal thinking is the faculty that’s
                        engaged by an enriched environment, but it’s
                        wrong to call it “thinking,” because it’s simply
                        the way organisms exist... - Ray Peat Nov 2017 Newsletter

                        1 Reply Last reply Reply Quote 0
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