Research on difficult to treat parasitic infections continues to point towards biofilms being the limiting factor. As with most thing relating to the host-parasite interaction it is a multifactorial issue. Still biofilms are worth considering, especially if you are struggling to eliminate an enteric infection.
Biofilms can be thought of as little cities of microbes. The foundation for these cities are laid by bacteria in the form of exopolysaccharides (EPS). It’s important to note that even though bacteria are mainly responsible for biofilm formation, many different organisms can find shelter there including protozoan parasites, viruses, other bacteria and even fungi.
There are many reasons that organisms seek out and join biofilm communities. They can communicate with one another, swap genetic material but most importantly the biofilm matrix is a form of shelter and could be contributing to antimicrobial resistance (1).
Frontline treatment of many enteric parasites is a combination of antibiotics. Sometimes two and even three different antibiotics are used together in conjunction with a proton pump inhibitor. Unfortunately the cure rates are still less than ideal with one paper estimating them to be at about 80%. A number of different reasons were proposed including patient compliance, medication side effects, antibiotic resistance and the presence biofilms (2).
Bacteria, Protozoa & Fungi Infections
The list of organisms that have been associated with biofilms is long, too long to list them all here. I have seen a number of these (but not all) flagged on stool tests run here in Byron Bay, NSW.
- Helicobacter pylori
- Entamoeba histolytica
- Giardia spp. (1).
Biofilms Resist Treatment
“Growth as a biofilm almost always leads to a large increase in resistance to antimicrobial agents” (5).
This statement pretty much sums it up. Microbes seek out biofilms and as such they become harder to treat. The literature is pretty clear on this with many different papers exploring this issue.
Protection within the polymeric matrix that makes up the biofilm is the main issue. Antibiotics and herbal antimicrobials have a difficult time actually breaking into the substance. The other theory regarding poor success rates and biofilms proposes that the microbes within biofilms are experiencing nutrient limitation, a hibernation as it were (6).
Let’s get down to business.
We have established that biofilms do exist and that they are by their nature resistant to antimicrobial treatments, be it pharmaceutical or herbal. Thankfully there are a number of different supplements, herbs and even foods that can help to break down the biofilm matrix so that antimicrobial interventions can succeed.
The best advice that I have come across is to use a biofilm disruptor within the context of a herbal antimicrobial protocol. All biofilm disruptors should be taken on an empty stomach (30 minutes before food or 2 hours after) and should ideally be followed with herbal antimicrobials about 30 minutes after taken.
- Interphase Plus by Klaire labs
This is the number one biofilm buster that is recommended across the board to be used in conjunction with a herbal antimicrobial treatment. Unfortunately they won’t ship it to Australia for some reason so we are out of luck on that one, at least for now!
- Biofilm Defense by Kirkman Labs
Another highly recommended biofilm buster that is made up of very similar enzymes as interphase plus. Unfortunately for some with allergies and food sensitivities it does contain soy
- Immune support by Thermamedix bioset
A digestive enzyme blend with particular enzymes suited for biofilm treatment (particularly Nattokinase)
Supplements for Biofilms
- N acetylcysteine (NAC)
One small control trial used the frontline antibiotic treatment for Helicobacter pylori. One group received NAC leading up to the antibiotic course, the other didn’t.
65% of the NAC + antibiotic group eradicated H. pylori while only 20% of the antibiotic only group eradicated the bacteria (9).
Found in coconut oil and shows promising antimicrobial activity as well as being a potential biofilm treatment (10).
Herbal Medicine for Biofilm
There are a whole range of other herbal medicines that have biofilm disrupting qualities. So much so that some herbalists don’t agree that a biofilm agent is necessary when treating infections. Currently I am withholding judgment. If you have been through a number of herbal antimicrobial protocols and still can’t seem to eliminate your infection then biofilms maybe to blame.
References and Resources
- The Potential Role of N-Acetylcysteine for the Treatment of Helicobacter pylori
- Review article: bioﬁlm formation by Helicobacter pylori as a target for eradication of resistant infection
- Characterization of Mucosal Candida albicans Biofilms
- Medical Implications of Biofilms
- Bacterial biofilms: a common cause of persistent infections.
- Helicobacter pylori Resists the Antimicrobial Activity of Calprotectin via Lipid A Modification and Associated Biofilm Formation
- Biofilm Formation by Helicobacter pylori and Its Involvement for Antibiotic Resistance
- Biofilm demolition and antibiotic treatment to eradicate resistant Helicobacter pylori: a clinical trial.
- In vitro evaluation of antifungal activity of monolaurin against Candida albicans biofilms
- Berberine Antifungal Activity in Fluconazole-Resistant Pathogenic Yeasts: Action Mechanism Evaluated by Flow Cytometry and Biofilm Growth Inhibition in Candida spp.
- Survey of the Antibiofilm and Antimicrobial Effects of Zingiber officinale(in Vitro Study)