The possibility of “manipulating the intestinal and lung microbiota to provide further treatments for lung disease and in particular for Sars-CoV-2 infection, as well as to prevent infection itself”. To make the point for Adnkronos Salute on this research frontier is the immunologist Mauro Minelli, head of the Foundation for personalized medicine for Southern Italy. “It would be useful and important for the scientific debate around Covid to widen a little more – he underlines – also involving research fields unjustly left at the extreme corners of an increasingly monothematic communication. There is a confirmation widely acquired by the scientific community – highlights the specialist – of an alteration of the intestinal microbial composition, for example, in bronchial asthma and allergies, cystic fibrosis or lung tumors. It is as if the mediation of the bacterial flora, along the intestine-lung axis, managed to modulate the effectiveness of the immune response and, consequently, the extent of inflammatory processes, not only local. The same intestine-lung ‘cross-talk’ has also been credibly re-proposed in the pathogenetic dynamics of Covid-19, in the context of which has been hypothesized a leading role for the intestinal microbiota “. According to Minelli, “respiratory virus infections can cause alterations of the intestinal microbiota” and, in fact, “microbiota anomalies have been identified, through fecal tests, in patients after Sars-CoV-2 infection, highlighting intestinal dysbiosis characterized by the exhaustion of beneficial microbes and abundant presence of pathogenic bacteria called ‘opportunists’. In particular – the immunologist specifies – the number of Coprobacillus, Clostridium ramosum and Clostridium hathewayi has been noted to be associated with the severity of Covid-19. an inverse correlation was found between the increase in Faecalibacterium prausnitzii and the severity of the disease (higher concentrations of Faecalibacterium prausnitzii correspond to a lower severity of Covid which, on the other hand, is clinically more severe in the case of low presence of Faecalibacterium prausnitzii), and between the expressions of Ace2 (the main cellular entry receptor Sars-CoV-2) and al some microbial species “. “There are also those who have identified in the strains Dorea, Streptococcus, Collinsella, Agathobacter, Eubacterium hallii group, Ruminococcus torques group, Fusicatenibacter – lists Minelli – interesting diagnostic biomarkers capable of signaling the presence and severity of Covid-19. ‘other, considering that the microbiota is not only intestinal, recent studies have linked a dysbiosis of the respiratory tract to altered immune responses and the development of lung diseases “. But is it a diseased microbiota that favors the development of Covid disease or, for a change, is it the virus that alters and sickens the microbiota of the infected subject? “It is still not clear today – replies the immunologist – whether it is the Sars-CoV-2 infection that generates dysbiosis or whether it is dysbiosis that promotes the viral infection. What can certainly be said is that intestinal bacteria, as already mentioned, they are a very important factor in the regulation of various metabolic processes in man. An important intermediary of these functions is represented, for example, by butyric acid, one of the short-chain fatty acids (SCFAs) normally produced by gut microbiota in equilibrium. Butyric acid has, among others, the function of blocking histone deacetylase (Hdac), a key enzyme in the ‘invasion strategies’ of Sars-CoV-2. through butyric acid, a healthy and balanced microbiota can interfere with the penetration of Sars-Cov-2 into the human cell. This obviously does not happen in subjects with an unbalanced intestinal flora deprived of its beneficial components. he “. “It seems clear – concludes the expert – how, in the light of these acquisitions, the potential for treatment inherent in the intestinal microbiota restoration strategies, aimed at rebalancing it in a specific and peculiar way for each subject, cannot be neglected. select with care and competence precision pre-biotics and pro-biotics, excluding a priori prescriptions of summary lactic ferments of the type one is as good as the other. All this will allow to achieve both an accurate prevention to be associated with vaccination practices, and an effective and convincing therapeutic support aimed at mitigating the severity of the Covid-19 disease “.
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