Microbiome First Approaches in Pain Prevention and Management

Abstract

The Microbiome First Initiative aims to facilitate sustainable healthcare by focusing first and foremost on the human holobiont majority, the microbiome. Understanding how the human microbiome affects not only risk of disease but also human perceptions can help individuals thrive and pave the way for a healthy life course. Following a recent review of Microbiome First Medicine the context of health and safety, this present opinion article considers the role of the human microbiome, particularly the gut microbiome, on pain, sensory perceptions, and the prevention and multimodal management of pain. Microbial dysbiosis can be causative of some forms of immune-inflammatory and neurologic pain and the altered human microbiome can lock in the pain while at the same time interfering with analgesic/opioid therapies. Dysbiotic microbiota can make drug treatments less effective and with opioids, the microbes can significantly increase:1. Opioid tolerance 2. The risk of addiction 3. The likelihood of withdrawal failure.For these reasons, it is critical to move beyond simply thinking about the microbiome in dealing with pain to considering the microbiome as central in multimodal pain prevention and management strategies. The microbiome is key in any attempts to change physiology, metabolism, systems biology function, and receptor-based perceptions within the human body.

Nourishing the Human Holobiont to Reduce the Risk of Non-Communicable Diseases: A Cow’s Milk Evidence Map Example

“…infantis and related communities (a natural component of raw human breast milk) is key to human milk oligosacchrride (HMO) metabolism, difference in bile salt metabolism, changes in gut microbiome profiles, shifts in gut immune cells maturation/balance, reduced enteric inflammation, and protection against asthma and allergic diseases [4,54,55]. These findings support a major microbiome first type of application [1,5,6] for reducing the risk of entryway NCDs (e.g., asthma) that can lead to later-life multimorbidity and polypharmacy. One of the questions is whether raw cow's milk could mediate similar positive changes on the microimmunosome.…”

“…The most recent study of epidemiologic data in the US [29] analyzed a dataset from the US CDC National Outbreak Reporting System (NORS) database for dairy outbreaks reported from 2005 to 2016 and summarized outbreaks of illness, hospitalizations, and mortality for raw and pasteurized milks and dairy products. Whitehead and Lake (authors' Table 1) [29] reported the following numbers of outbreaks, illnesses, hospitalizations, deaths, and deaths/1000 illnesses, respectively, for raw milk (152, 1735, 176, 2, and 1.2) and for pasteurized milk (6,1903,20,4, and 2.1) in this time period. Whitehead and Lake [29] reported that raw milk was associated with 2 deaths in the 12 year time period assessed, both in cases with significant co-morbidities, one with campylobacteriosis, the other with listeriosis.…”

“…A series of recent reviews, [1,5,6], illustrated the benefits of what have been termed Microbiome-First Approaches for: (1) medicine and safety [1], (2) pain prevention and management [6], and (3) public health protection against both NCDs and pathobionts [1]. In this review, we begin examination of the potential for microbiota-laden foods to aid what has been termed the microimmunosome [7].…”

Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences

“…Two adverse outcomes received prior recent reviews within the Microbiome First series of papers. These concerned the capacity of the microbiome to regulate pain [95] and both the occurrence of substance abuse and the likelihood of successful withdrawal [20].…”

“…As recently reviewed in Dietert and Dietert [95], microbiome adjustment including treatment with probiotics and prebiotics has the capacity to alter a variety of different types of pain. These alterations include changes in the perception of pain and in its persistence at various life stages.…”