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Medical Forum / Diseases and Disorders / Sinusitis / March 2008

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A novel method to control the balance of skin microflora. Part 1.     Attack on biofilm of Staphylococcus aureus without antibiotics.

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truehawk - 05 Mar 2008 22:50 GMT
Katsuyama M, Ichikawa H, Ogawa S, Ikezawa Z.

Life Science Research Center, Shiseido Co. Ltd., Tsuzuki-ku, Yokohama,
Japan. masako.katsuyama@to.shiseido.co.jp

BACKGROUND: Staphylococcus aureus (SA) is usually present in atopic
dry skin, and not only in regions seriously affected by atopic
dermatitis. SA discharges various toxins and enzymes that injure the
skin, and forms a biofilm from fibrin fiber and glycocalyx; the
biofilm is important for adhesion of SA to the skin and for resistance
to anti-microbial agents. Even highly effective moisturizers do not
work perfectly on atopic dry skin. Staphylococcus epidermidis (SE) is
a major constituent of skin microflora on healthy human skin, and
provides protection against the growth of pathogenic bacteria.
OBJECTIVES: Since treatment with anti-microbials may lead to re-growth
of SA, which grows faster than other Staphylococci and often shows
antibiotic resistance, we searched for novel approaches to control the
skin-microfloral balance without using conventional anti-microbials.
METHOD: Biofilm formation by SA in vitro was observed in detail using
scanning electron microscopy. Approximately 500 substances were
screened for a selective effect on SA growth and SA biofilm. RESULTS:
We found that xylitol inhibited the formation of glycocalyx, and
farnesol dissolved fibrin fibers. Farnesol suppressed the growth of
only SA, and did not affect that of SE. Xylitol and farnesol
synergistically inhibited biofilm formation by SA. CONCLUSION: Xylitol
and farnesol have potential for controlling the skin-microfloral
balance because of their selective effects and inhibition of biofilm
formation. They might provide a useful and safe method to care for
skin colonized by SA, without using antibiotics.

PMID: 15927813 [PubMed - indexed for MEDLINE]
truehawk - 05 Mar 2008 22:55 GMT
> Katsuyama M, Ichikawa H, Ogawa S, Ikezawa Z.
>
[quoted text clipped - 27 lines]
>
> PMID: 15927813 [PubMed - indexed for MEDLINE]

A note:
splenda seems to work too.
judy.n - 06 Mar 2008 00:58 GMT
> > Katsuyama M, Ichikawa H, Ogawa S, Ikezawa Z.
>
[quoted text clipped - 30 lines]
> A note:
> splenda seems to work too.

So, the xylitol in our rinses, either added or via a product like
Xlear, could inhibit or eradicate biofilms. I like it.

FYI, my husband went to a course for dentists on pediatric dentistry
and they discussed biofilms, the lecturer was from U of Michigan.
Judy
truehawk - 06 Mar 2008 04:14 GMT
> > > Katsuyama M, Ichikawa H, Ogawa S, Ikezawa Z.
>
[quoted text clipped - 37 lines]
> and they discussed biofilms, the lecturer was from U of Michigan.
> Judy

Yep, along with Farnesol.
Farnesol, a complex alcohol found in plant extracts such as those of
rose and balsam dissolves fibrin and selectively inhibits SA. without
bothering S epidermis.  But shell or the center membrane is still the
most gentle and effective way to get rid of most of the goo. Farnesol
containing compounds can hurt pretty bad, but not the pecan.

And dentists have my profound respect for continueing to exhibit
logical reasoning and connect the dots.
I think that the main run of doctors are trying to remember so many
things that their ability for intelligent inference suffers.

If my childhood family doc, or the dentists were in charge of
sinusitis, I am pretty sure the cause and cure for CS would have been
established 20 years ago.
truehawk - 06 Mar 2008 04:31 GMT
> > > > Katsuyama M, Ichikawa H, Ogawa S, Ikezawa Z.
>
[quoted text clipped - 53 lines]
> sinusitis, I am pretty sure the cause and cure for CS would have been
> established 20 years ago.

Which reminds me that I bought some balsam conditioner that I was
going to try versus the film, and I have not yet done so.
Sergei91 - 21 Mar 2008 20:17 GMT
> > Katsuyama M, Ichikawa H, Ogawa S, Ikezawa Z.
>
[quoted text clipped - 30 lines]
> A note:
> splenda seems to work too.

So what would be a better approach, addiding Xylitol to irrigation or
adding Splenda, and where do you get farnesols?
Sergei911
truehawk - 21 Mar 2008 22:24 GMT
> > > Katsuyama M, Ichikawa H, Ogawa S, Ikezawa Z.
>
[quoted text clipped - 34 lines]
> adding Splenda, and where do you get farnesols?
> Sergei911

Canada balsam, used in hair conditioner, is one source.
I like Splenda better.
Sergei91 - 22 Mar 2008 00:15 GMT
> > > > Katsuyama M, Ichikawa H, Ogawa S, Ikezawa Z.
>
[quoted text clipped - 37 lines]
> Canada balsam, used in hair conditioner, is one source.
>  I like Splenda better.
I just went out and bought some Xylitol at Vitamin Shoppe a large
canister was like 9 bucks.  so should I add Splenda too, or is it one
or the other?
I'm also adding Johnsons baby shampoo, so in total here is my
extensive anti-biofilm mix.
500cc warm water with 1 tsp baby shampoo, 2 packets of SinuRinse or 1
packet Grossan's premixed packets, 1 tsp of Xylitol (if I don't have
any of Grossan premixed packets, it already has the Xylitol) plus 15mg
EDTA nebulized or added to the irrigation.  I think that's it
Sergei91
truehawk - 22 Mar 2008 05:37 GMT
> > > > > Katsuyama M, Ichikawa H, Ogawa S, Ikezawa Z.
>
[quoted text clipped - 48 lines]
> EDTA nebulized or added to the irrigation.  I think that's it
> Sergei91

Try it.
I think you are going to find it really drying.

Then try Michael's tea rinse.
I like a hair conditioner comprised of complex alcohols, canada balsam
and EDTA. As one wag said about baby shampoo, it would leave my nose
hairs soft and manageable (if I had any).
I add splenda, and powdered clove, and cinnamon (both of which kill e-
coli and are really inexpensive).
What is amazing to me is the gallons of goo.
I will soak off one layer only to soak off another one.
My breathing passages are open all night and my ears are clear, my
sense of smell has returned since I started treating it again in
January.
I started with clyndiamycian and sporanox, and mupricin wash, but the
tannins and wash that I make for myself is just as effective, and not
only do the co-payments get expensive, but I would much rather run to
the gym than to the lab for a liver function tests. I have had to deal
with it with very limited access to prescription antibiotics for so
long because all the ENTs are were on the surgery/allergy kick, that I
am used to making do without.

It was that things would close up if I missed treating it for a day,
now I could miss 3 or 4, but I neglected it when it started until it
got thick enough to block my breathing,  so it will take several more
months of patient treatment to make it go away semi-permanently.
Becca - 22 Mar 2008 16:59 GMT
> Try it.
> I think you are going to find it really drying.
[quoted text clipped - 22 lines]
> got thick enough to block my breathing,  so it will take several more
> months of patient treatment to make it go away semi-permanently.

It would be fantastic to have a sense of smell again.  It sounds like
you have a handle on your situation, I am so happy for you. This gives
hope to the rest of us.

You mentioned using a mupricin wash, and I am wondering if you used the
ointment or the cream?  The ointment would be more difficult to disolve
in water.

For those who celebrate, have a happy Easter.  For those who don't, have
a great weekend.

Becca
truehawk - 22 Mar 2008 22:08 GMT
> > Try it.
> > I think you are going to find it really drying.
[quoted text clipped - 35 lines]
>
> Becca

I have retrived my sense of smell before with just the pecans and
clove, so it is doable with a tannin wash without a prescription.

That said the mupircin wash is among the things that seem to work
well, and everything does not have the overlay of the smell of deviled
ham, which gets a bit tiresome.

The one that I have was compounded to the ENT's instructions.
The script lable reads Mupir2%301/Pulmico .5mgX6/NS and the bottle is
500ml of .9% normal saline.
We had the "steroids don't touch it"  conversation and he said that it
works better with, so it is with.
it also noticeably works better with a touch of clove oil, and a drop
of geranium oil.

(Yes I found one that at least has an open mind, did not treat me as
if I was from Mars or anything.  He seems to be a "whatever works"
kinda guy. His name is David Powell and he is an ENT with a group at
1830 Bethel Rd, in Columbus, Ohio. He may not subscribe to all of my
theories, but I think that he makes makes a genuine commitment to
making one better.  He will prescribe massive antibiotics and wait and
see before he cuts anything out. And that is about as good as it
gets.
judy.n - 23 Mar 2008 01:59 GMT
> > > Try it.
> > > I think you are going to find it really drying.
[quoted text clipped - 59 lines]
> see before he cuts anything out. And that is about as good as it
> gets.
Recently I heard about mupromicin washes, and a "sinus pharmacy" that
compounds them: they usually mix up either 15 or 30 mg in saline for
once or twice a day washes for a month. I wrote to them, and they
wrote back that a recent paper suggested  400mg, but they aren't
comfortable with that dose. I was trying to get a price quote from
them, but only got information and an order form.

Personally, I do the bacroban on the q tip thing when things act up.
Works for me, but I think the washes are a good idea, I'd just like
them to be widely and easily available.

Judy
Becca - 23 Mar 2008 20:42 GMT
> I have retrived my sense of smell before with just the pecans and
> clove, so it is doable with a tannin wash without a prescription.
[quoted text clipped - 19 lines]
> see before he cuts anything out. And that is about as good as it
> gets.

It sounds like you found an ENT in Columbus, who listens to you, and
works with you. I have not looked for an ENT here in Shreveport, LA, but
I can only put it off, for so long.

Becca
truehawk - 24 Mar 2008 22:49 GMT
> > I have retrived my sense of smell before with just the pecans and
> > clove, so it is doable with a tannin wash without a prescription.
[quoted text clipped - 25 lines]
>
> Becca

Becca:
I would highly recommend that you take advantage of the effects of the
pecan tannins while you search for an ENT.
As I have said on a few occasions, most ENTs think that a biofilm is
something that appears on the history channel, so it might take a
while.
Becca - 27 Mar 2008 21:04 GMT
>> It sounds like you found an ENT in Columbus, who listens to you, and
>> works with you. I have not looked for an ENT here in Shreveport, LA, but
>> I can only put it off, for so long.
>>
>> Becca

> Becca:
> I would highly recommend that you take advantage of the effects of the
> pecan tannins while you search for an ENT.
> As I have said on a few occasions, most ENTs think that a biofilm is
> something that appears on the history channel, so it might take a
> while.

Thanks for your help. I am using the pecan tannins and I am irrigating
twice a day with Xylitol and salt.  Before I go to bed, I use the Xlear
(Xylitol) nasal spray.

Something is helping my drainage quite a bit. When I tilt my head to the
right, I can feel my sinuses draining (but not when I tilt my head to
the left).

Some day, I hope I can quit taking antibiotics.  I stopped taking them
2-3 times in the past 2 years, and all Hell breaks loose. It moves into
my lungs, and that not good.  When that happens, I have to take
prednisone to get rid of it.

Becca
Kofi - 21 Mar 2008 02:22 GMT
I'm getting ready to post something on cathelicidin, vitamin D3 and
HIF-1a in the skin.  In the meantime, you might find this tidbit
interesting.  It turns out this pathway is vital for maintaining gut
barrier function too and, I suspect, the sinus barrier as cathelicidin
mRNA is upregulated in sinusitis but actual sysnthesis of the protein is
not, indicating some sort of short in the pathway.  Cathelicidin also
appeals to quell mast cells from the kind of overactivity seen in
allergy.

FYI, as an iron chelator, green tea extracts often activate HIF-1a.

J Invest Dermatol. 2008 Mar 6; [Epub ahead of print]
 
Critical Role of HIF-1alpha in Keratinocyte Defense against Bacterial
Infection.
Peyssonnaux C, Boutin AT, Zinkernagel AS, Datta V, Nizet V, Johnson RS.

1Division of Biological Sciences, University of California, San Diego,
La Jolla, California, USA.

Skin, the first barrier against invading microorganisms, is hypoxic,
even under baseline conditions. The transcription factor
hypoxia-inducible factor-1alpha (HIF-1alpha, the principal regulator of
cellular adaptation to low oxygen, is strongly expressed in skin
epithelium. HIF-1alpha is now understood to play a key role in the
bactericidal capacity of phagocytic cells such as macrophages and
neutrophils. In the skin, keratinocytes provide a direct antibacterial
activity through production of antimicrobial peptides, including
cathelicidin. Here, we generate mice with a keratinocyte-specific
deletion of HIF-1alpha and examine effects on intrinsic skin immunity.
Keratinocyte HIF-1alpha is seen to provide protection against necrotic
skin lesions produced by the pathogen group A Streptococcus. RNA
interference studies reveal that HIF-1alpha regulation of keratinocyte
cathelicidin production is critical to their antibacterial
function.Journal of Investigative Dermatology advance online
publication, 6 March 2008; doi:10.1038/jid.2008.27.

PMID: 18323789
truehawk - 21 Mar 2008 03:30 GMT
> I'm getting ready to post something on cathelicidin, vitamin D3 and
> HIF-1a in the skin.  In the meantime, you might find this tidbit
[quoted text clipped - 34 lines]
>
> PMID: 18323789

Are you still on that allergy kick?
The bugs have the arsenal to muck with HIF-1 and other enzymes,
including the chloride ion channel modulator. Bet they have an enzyme
to interfer with HIF-1 as well.

http://www.sciencedaily.com/releases/2008/02/080213140826.htm

Bacterial Toxin Closes Gate On Immune Response, Researchers Discover

ScienceDaily (Feb. 19, 2008) -- Researchers at the University of
Pennsylvania School of Medicine have demonstrated that a bacterial
toxin from the common bacterium Staphylococcus aureus shuts down the
control mechanism of the tunnel, called an ion channel, in immune cell
membranes. Shutting down ion channels has long been known to suppress
the immune response, and the bacteria may use the toxin to neutralize
host defenses against bacteria.

This research has implications for finding new ways to fight MRSA,
which is a strain of Staphylococcus aureus that has become resistant
to the antibiotic methicillin.

Immune cells, like other cells, have ion channels in their membranes.
When the voltage-sensing part of the channel detects an electrical
change in the cell membrane, the channel gate opens, allowing small
ions such as sodium, potassium, or calcium to flow across the cell
membrane. The channels in immune cells called Kv1.3 channels allow
only potassium ions to pass, and the activity of these channels is
required for triggering an immune response.

"We have provided a key piece of evidence for the hypothesis that the
negatively charged phosphate groups of membrane lipids around voltage
sensors provide the critical electric balance for some of these
positive charges in the sensors," says Zhe Lu, MD, PhD, of the
Department of Physiology at Penn. The research team, that included
Yanping Xu, MD, PhD and Yajamana Ramu, PhD, showed that removal of
phosphate head groups from some membrane lipids by the bacterial toxin
called sphingomyelinase (SMase) C shuts down the Kv1.3 channel.
Therefore if the positive charges are not properly balanced by
negative charges, the electrical sensor cannot move to "open the gate"
of the channel. And, if the channel fails to open, the immune response
is derailed.

"Our study builds on the efforts of two senior colleagues in the
Department," says Lu. Twenty-five years ago, Professor Clay Armstrong
(now emeritus) hypothesized that the positive charges in the
electrical sensor must be balanced by negative charges for the sensor
to function properly. And a few years later, Professor Carol Deutsch,
among others, demonstrated the presence of potassium channels
controlled by voltage in immune cells.

SMase C is made by, among other bacteria, S. aureus, a pathogenic
bacterium that causes a range of infections from minor skin lesions to
toxic shock. "This finding raises the intriguing possibility that the
SMase C action against Kv1.3 helps S. aureus to neutralize host
defenses," state the authors in the paper.

The findings of this study suggest the possibility that identifying
inhibitors of SMase C may be a way to combat S. aureus infections. One
strain of S. aureus is the much-talked-about, MRSA, or methycillin-
resistant S. aureus. Specific inhibitors of SMase C may expand the
choice of therapies for treating MRSA and other resistant S. aureus
infections.

This study was conducted in a common experimental system where frog
eggs were engineered to have particular voltage-gated ion channels in
their membranes. SMases used in the study were purified from bacteria
engineered to produce the enzymes.

This new study follows a 2006 study by the same research team showing
that an SMase from the brown recluse spider could activate voltage-
gated ion channels. In 2007 the team discovered that SMases from lung-
infecting bacteria inactivate ion channels that conduct chloride ions,
which would in turn aggravate lung infection in some cystic fibrosis
patients.

The study is published in the February 14 issue of Nature. The
National Institute of General Medical Sciences provided funding for
this research.

Adapted from materials provided by University of Pennsylvania School
of Medicine.
Need to cite this story in your essay, pap

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