Friday Hope: Fermented Foods, the Gut Microbiome and ACE2

Fermented foods may help establish and maintain healthy gut microbiome and may ward against SARS-CoV-2 infection and Spike Protein damage.

Spike proteins of SARS-CoV-2 virus binding to ACE2 receptor expressed in enterocytes mediates viral entry inducing intestinal inflammation (release of pro-inflammatory mediators and recruitment of inflammatory cells) leading to alteration of gut microbiota. Created with Biorender.com.

It has been established that a dysregulated gut microbiome, via Spike Protein interaction with Ace2, may contribute to SARS-CoV-2 susceptibility and severe COVID disease. It may also be involved in the induction of Long COVID.

During SARS-CoV-2 infection, the downregulation of ACE2 would potentially result in unopposed functions of Ang II and decreased levels of Ang (1–7), thereby shifting the balance toward the pro-inflammatory side. In IBD, reduced small bowel but elevated colonic ACE2 levels are associated with inflammation, suggesting compartmentalization of ACE2-related biology in the small intestine and colon inflammation.

Mechanisms Leading to Gut Dysbiosis in COVID-19: Current Evidence and Uncertainties Based on Adverse Outcome Pathways
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505288/

Associations between gut microbiota composition, levels of cytokines and inflammatory markers in patients with COVID-19 suggest that the gut microbiome is involved in the magnitude of COVID-19 severity possibly via modulating host immune responses. Furthermore, the gut microbiota dysbiosis after disease resolution could contribute to persistent symptoms, highlighting a need to understand how gut microorganisms are involved in inflammation and COVID-19.

Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19
https://gut.bmj.com/content/70/4/698

Enter now fermented foods. There are many that are beneficial for the gut microbiome, such as Yogurt, Sauerkraut, Kefir, Kimchi and Kombucha.

Certain fermented foods and probiotics may deliver viable microbes with the potential to promote gut immunity. Prebiotics, on their side, may enhance gut immunity by selectively stimulating certain resident microbes in the gut. Different levels of evidence support the use of fermented foods, probiotics and prebiotics to promote gut and lungs immunity. Without being a promise of efficacy against COVID-19, incorporating them into the diet may help to low down gut inflammation and to enhance mucosal immunity, to possibly better face the infection by contributing to diminishing the severity or the duration of infection episodes.

In a context of impoverished and threatened intestinal microbiota, the consumption of home-made fermented foods (yoghurt, kefir, sauerkraut, kombucha) or the incorporation into the diet of commercial products containing probiotics and prebiotics, as food or food supplements, is part of a comprehensive nutritional strategy to enhance the function of the gut microbiota, to promote mucosal immunity and potentially upper respiratory tract immunity, to be potentially better prepared to face viral or bacterial infections caused by respiratory syndromes.

Also, establishing and maintaining a healthy gut microbiome may also be beneficial to sites distant from the gut.

In this way, a close relationship between COVID-19 and the intestinal microbiota might explain gut dysfunctions complications in some patients with more severe clinical course of the disease (Fanos et al., 2020). However, fermented foods, probiotics, prebiotics, and synbiotics are capable to modulate the gut and probably at distant sites such as the respiratory tract. Specific therapeutic strategies can be proposed, such as the use of probiotic for patients with COVID-related gastro-intestinal symptoms and in those with mild-moderate systemic symptoms, trying to prevent cytokine storm.

Potential contribution of beneficial microbes to face the COVID-19 pandemic
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378002/

While there is no “gold standard” yet for determining the efficacy of probiotics in relation to SARS-CoV-2, all the evidence related to respiratory infections (where COVID starts and, hopefully, limits itself) shows that probiotics are beneficial. On a personal note, I happen to enjoy the sour, tangy flavors of fermented foods. If anything can help us rid the body of the SARS-CoV-2 virus more quickly, or preventing it from infecting us, I believe it should be used.

The above is a work of medical research and not medical advice. As with all supplements and medicines, check with your primary care provider before using any medicines or supplements. Everything we can do to void the body of SARS-CoV-2 and its Spike Protein is certainly beneficial. Each positive action we take will almost certainly enhance the total effect of our regimens against this modern plague.

I wish you all a beautiful early fall weekend. Blessings and joy.