Gut brain connection

Question 1

microbial content of the gut is critical to the development of an appropriate _____ _____ later in life and that there is a critical window where colonization must occur to ensure proper ________ _____ _____.

Answer 1

stress response

HPA axis development

Question 2

patientswith hepatic encephalopathy. Develop Impaired cognition, tremors, dementia and even coma Treatment:

Answer 2

Treatmentisanoral,non-absorbedantibioticwhich works to reduce urease producing bacteria and therefore ammonia production and other neurotoxins.

Question 3

molecules present on the surface of gram-negative bacteria that elicit a strong immune response.

Answer 3

Lipopolysaccharides(LPS)

Question 4

messengersusedbytheimmunesystem to communicate with itself and other parts of the body including the CNS.
• These may be inflammatory, anti-inflammatory or
regulatory.

Answer 4

Cytokines

Question 5

Tight junctions control flow of ____ particles cells.

Answer 5

between (paracellular flow)

Question 6

Triggers for Gut Dysbiosis and dysfunction

Answer 6

• Stress
• Physical (infection) • Mental
• Environmental
• Chemical (medication, pollution)
• Dietary • Gluten
• Dairy
• Other food sensitivities • Alcohol
• Generally poor diet

Question 7

While the _____ Nervous system seems to display mild anti-inflammatory properties in the gut, the _____ nervous system has powerful anti- inflammatory effects.

Answer 7

sympathetic

parasympathetic

Question 8

Stimulation of the ____ nerve has been shown in

laboratory animals to prevent endotoxin-induced shock by reducing pro-inflammatory cytokine production

Answer 8

vagus nerve, parasympathetic control of gut

Question 9

cytokinesandendotoxins stimulate vagal afferents and the brain stem in a structure called the _____ _____ ____

Answer 9

nucleus tractus solitarius

Question 10

In return the ____ generates vagal out flow that modulates the inflammatory response.

Answer 10

nucleus tractus solitarius, hence why When selective vagotomy is performed, there is loss of inflammatory control of the gut.

Question 11

helps prevent antigens in the gut from being able to stick to the walls of the intestines.

Answer 11

SigA If these antigens are not excreted they are able to produce an inflammatory response that may break down the gut barrier.

Question 12

Acute stress____ immune response and SIgA.

Answer 12

up regulates

Question 13

Chronic stress ____ immune response and SIgA

Answer 13

down regulates

Question 14

could induce liver damage directly through increasing intestinal LPS translocation and endotoxemia.

Answer 14

fructose

Question 15

fructose combined with ____ reduced endotoxemia and fatty liver.

Answer 15

antibiotics

Question 16

fructose may alter _____ ____ through dysbiosis and activation of the immune system1

Answer 16

intestinal permeability

Question 17

Fructose story

Answer 17

1. Fructose consumed
2. Increased LPS translocation
3. LPS binds immune cells via toll-like receptors
4. Immune cells generate inflammatory cytokines
5. Inflammatory cytokines alter systemic inflammatory load

Question 18

Additionally, patients with depression have been shown to have abnormal _____ breath profiles after consumption of fructose and other sugars.1

Answer 18

hydrogen

Question 19

Elimination of ____ resulted in improved depression.2

Answer 19

fructose

Question 20

Fructose malabsorption also provides a substrate for bacterial fermentation that can alter:

Answer 20

• GI motility
• Mucosal biofilm
• Profile of microbiota

Question 21

Western diets lead to overgrowth of a class of bacteria called ___ and a reduction of growth of ____ species.

Answer 21

Firmicutes
Bacteroides

This change is unfavorable because it is associated with obesity and an increased inflammatory load.

Question 22

Additionally, diets high in _______ reduce Bacteroides species while increasing populations of Firmicutes.

Answer 22

omega-6PUFA

Question 23

mooddisturbanceandfatiguecanbe induced by injecting

Answer 23

LPS.

Question 24

associated with higher circulating LPS levels

Answer 24

depression and anxiety
Obesity
• High insulin, triglycerides, and cholesterol • Diabetes.

Question 25

Further supporting healthy GI microbiota and general health are studies showing oral probiotics favorably impact:1-3

Answer 25

* Systemic cytokine levels * Oxidative stress * Inflammatory markers • Mental outlook * Cognition

Question 26

Systemicinflammatorycytokinescaninducethe production of inflammatory cytokines in the CNS via _____ .

Answer 26

microglial activation

Question 27

Eventually this results in abnormal intracellular and extracellular communication, abnormal function and possibly _______ ______

Answer 27

neurodegeneration

Question 28

This systemic inflammation (and eventual glial activation) is increasingly being recognized as being stimulated by

Answer 28

LPS

Question 29

As a matter of fact, LPS at low levels have been shown to cause acute anxiety, depressive symptoms, cognitive deficits and decreased _____ _____ _____.

Answer 29

visceral pain tolerance

Question 30

LPS induced peripheral cytokine levels can cause:

Answer 30

* Altered neuronal activity in the amygdala1 * Excitotoxicity in neurons2 * Increase the activity of indoleamine 2,3-dioxygenase2

Question 31

The vast majority of circulating tryptophan is metabolized using these two enzymes into kynurenine. Less than 1% is available to be converted to serotonin in thebrain.1

Answer 31

indoleamine 2,3-dioxygenase (IDO) | Tryptophan-2,3-dioxygenase (TDO)

Question 32

____is usually the dominant enzyme but under immune stimulation, _____ is further activated. As a matter of fact, serum tryptophan maybe reduced __%-__%

Answer 32

indoleamine 2,3-dioxygenase (IDO) Tryptophan-2,3-dioxygenase (TDO) 25-50%!

Question 33

known mechanisms by which this occurs are:

Answer 33

Cytokines act on central sites where the blood brain barrier is weak or cause breakdown of the blood brain barrier themselves. • Cytokines may be transported in by selective transporters, bypassing the BBB. • Cytokines may act on peripheral nerves that send information into the central nervous system. • Cytokines can affect the secretion of molecules who are not limited by the BBB but can themselves affect neurochemistry. • Cytokines can be synthesized by immune cells that have infiltrated the CNS through a compromised BBB.

Question 34

how to use ADP

Answer 34

4 tablets 3x/day for 20-40 days

Question 35

Great adjunct to A.D.P.for parasites and SIBO.

Answer 35

Dysbiocide 2-3/day with food

Question 36

may help to stabilize the blood brain barrier.

Answer 36

Omega 3s

Question 37

decreases cytokine production

Answer 37

vitamin D