Wounds:  Probiotic Solutions

INTRODUCTION 

Chronic wounds affect 6.5 million patients at an annual cost of US $25 billion , focusing on a growing, aging population polarized with antibiotic resistance. We have investigated/ reported on our use of eco-friendly   skin probiotics with a multi-tiered in vitro approach integrating: 1) Disruption: Reconstruction; 2) tissue engineering via a SMarT Gauze,  3)contoured to wound  3-D dimensions,  while selecting 4) 4 pools of probiotics  targeted against common wound pathogens. The recent emergence of the Hologenomic Theory of Co-Evolution catalyzed our theme of “Dual Citizenship” and the DUAL role of re-establishing the skin microbiota as a 1)biologic and 2) antimicrobial  barrier via “restorative microbiology”,  facilitated by selection using a unique Decision Tree analysis (Partners-4-Life) www.globalbugs.com. (Probiotic Solutions). 

PURPOSE 

We expand our wound focus, targeting the elimination of wound gauze colonization (Ping- Pong Hypothesis) which provides a biofilm reservoir for re-inoculation of the wound bed VIA PLANKTONIC METASTISIS, DISSRUPTION, while re-establishing the healthy skin architecture RECONSTRUCTION. Secondarily, we have wanted to characterize features of beneficial probiotics as featured in published literature, addressing potential designer, intelligent   probiotics as “therapeutic bacteria”, highlighting a BENEFICAL BIOFILM based on literature review and evaluation, perhaps administered simultaneously, GUT and skin, recognizing the dual axial brain link.

METHODS  

Here, we have expanded our 7 layer decision tree based on initial review of 310 manuscripts (Bac-2-Health) to include 51 new chronic wound manuscripts addressing 1) wound and probiotics, 34 selected, highlighting 2) the growing awareness of fungi in tissue infections and prevention of healing. Reviewed Manuscripts are Grouped into 2 basic categories reflecting the burgeoning, young information data sets:  1) Wound Theory and 2) Wounds and Probiotic Intervention.  5 criteria are used, mimicking the original outline of Bac-2-Health, now evolving into Partners-4-Life including: Condition, Study Type, Strength, Microbes and Probiotics.

CONCLUSION

These published studies, collectively,  reinforce our theme that  “restorative microbiology” with dual function probiotics, is possible, but establishes the need for frequent gauze exchange given the loss of activity over 7 days, a potential   health care provider problem. Articles continue to list a variety of microbes and pre/probiotic combinations, but studies are lacking in Study type and Strength of Evidence, given most studies are industry and market driven.

DISCUSSION

The Probiotic Solutions and use of a decision Tree (Partners-4-Life) highlight the growing investigation of probiotic in wound intervention.  We hypothesize that a BENEFICAL probotic needs to form a resilient biofilm, be pH stable, match our Microbial Clock, perhaps lysogenic and a certain molecular size/weight, yet to be determined.   Also, skin probiotics should incorporate a fungal component, Saccharomyces bulardi, integrated into a SMarT Gauze, CONTOUR FITTING. Further, the simultaneous probotic use in GUT and skin should be evaluated.

Finally, to catalyze the importance of the Hologenomic Theme of Co Evolution and its importance of probiotics in wound care RESOLUTION, we created the new Center for Hologenomic Clinical studies. (www.globalbugs.com) focusing on MOA via the Ying/Yang Hypothesis. It is our Goal to construct a future probiotic data set that can be integrated into emerging AI (Artificial Intelligence) stratagies of human diseases, incorporating our 2 Themes: “Microbes Matter” and “Don’t Trash your Microbiota.”  

Wound and Theories

The listed beneficial microbes are referenced in the corresponding WOUND THEORIES: Cross Section of Published Articles table:

W-1.   Matthew, A et al .2013.  The future of skin metagenomics. Research in Microbiology.  http://dx.doc.org/10.1016/j.resmic.2013.12.002.

W-2.  Manch, K. et al. 2013.  Wound biofilms lessons: lessons learned from oral biofilms.   Wound Repair and Regeneration. 21:352-362.

 W-3. Kalan, L. et al. 2016.  Redefining the Chronic wound microbiome: fungal communities are prevalent, dynamic, and associated with delayed healing. mbio September 6th.  7(5).piieO1058-16.doc:10.1128/mBio.01058-16.

W-5. Trsuillet,S. et al. 2009.  Three-dimensional assessment of skin wounds using a standard digital camera.   Transactions on medical imaging. 28 (5). May:752-762.

W-12.   Ehrlich, G et al. 2004.  Intelligent implants to battle biofilms.  ASM news. 70 (3):127-133 number three pages 127. Next paragraph

W-21.  G. Dominguez-Bell0 and Martin J Blazer. 2008 Do you have a probiotic in your future?  Microbes and Infection. 10: 1072 – 1076.

W-X.   Zmora, N. et al. 2016. Taking it Personally:  Personalized Utilization of the Human Microbiome in Health and Disease. Cell Host and Microbe.  Jan 13:12-20.

 

 

Wounds and Probiotics

The listed beneficial microbes are referenced in the corresponding WOUND PROBIOTICS: Cross Section of Published Articles table:

W-7. Wong, V. et al.  2013.  From Germ Theory to Germ Therapy:  skin microbiota, chronic wounds and probiotics.  Plastic and Reconstructive surgery. 132 (5):854e-861e(1plasreconsurg/toe/2013/1000.

W-10. DoKyung, L. et al. 2013. Probiotics with antimicrobial activity against multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumani.   Korean Journal of Microbiology. 49 (3):245-252.  

W-19. Jones, M. et al.2012.  Novel nitric oxide producing probiotic wound healing patch: preparation and in Vivo analysis in a New Zealand white rabbit model of ischemic and infected wounds. International wound Journal. 9: 330-34 3.  

W-20.   Hannah Sikorski and Wanda Smoragiewicz. 2013. Role of probiotics in the prevention and treatment of methicillin-resistant Staphylococcus aureus infections. International Journal of Antimicrobial agents. 42:475-481.

W-22.  Valdez, JC.  2005.  Interference of Lactobacillus plantarum with Pseudomonas aeruginosa in vitro and in infected Burns: the potential use of probiotics in wound treatment.  Clinical microbiology and infection. 11 (6): 472 – 479