How much do our microbiota and its associated microbiome protect us against COVID-19, that is, against coronavirus infection?
The microbiota is the community of living organisms that lives in and on our body. Microorganisms inhabit our skin and mucous membranes and the digestive, respiratory and urinary tracts. We live and die with them. The Human Microbiome Project systematically studies and monitors the microorganisms that inhabit us, and it contributes significantly to the progress of medicine. The immune balance and coexistence between us and the microorganisms that inhabit us is a very complex process that affects the breakdown of food and medicines and our defence against infections and attacks by other organisms. The microbiota modulates our immune system, and we provide it with a rich source of food. The microbiota, with its specific genetic system – the microbiome – inhabits us from infancy, and the number of microorganisms in our body only grows over the course of our lives. The health consequences of breastfeeding or not breastfeeding, the use of antibiotics or colonisation with artificially introduced microbiota cause a shift in this balance and the possible development of disease. The symbionts we take in can benefit our health, and they are used more and more often to maintain a healthy, beneficial microbiome and microbiota. By taking various probiotics and prebiotics uncritically, we can upset the balance. Differences in how medicines act in a particular population are often the result of differences in the composition of our microbiota. In rheumatology, we know that the same medicine sometimes acts differently precisely for this reason. Food rich in microorganisms, such as cheese, yoghurt and kefir, has a positive effect on our microbiota. The microbiota of other mammals (cows, goats, sheep) is partly contaminated from the environment and partly matures during fermentation, or ripening. When the body is ill, its microbiota is disturbed. A body weakened in this way can be attacked even by otherwise harmless microorganisms, so caution is needed so as not to take in uncritically everything that is advertised. Doctors are very cautious about this, and the excessive advertising we see every day can cost us dearly.
Dysbiosis is a disturbance of our microbiota, and restoring a dysbiotic microbiota is being researched and is also used as a treatment for inflammatory diseases. Terms that are increasingly common in medicine, including physiatry and rheumatology, are linked to the microbiota, the microbiome and the individual composition of the microorganisms themselves. For the influence of the microbiota and microbiome on health, disease and the body's rehabilitation to be as beneficial as possible, we must pay attention to the food we eat, dietary supplements and medicines, which affect not only us but also all the organisms we live with. The fungal microbiome, the virome and the bacterial biome inhabit our skin and mucosal system (mucous membranes), and these microorganisms can penetrate and change our tissues, which then become diseased. The microbiota also protects us from colonisation by pathogenic microorganisms, while in other circumstances it can itself become pathogenic or tip the balance towards disease.
The influence of our microbiota on protection against viruses, bacteria and fungi is being researched intensively. The coronavirus attacks our lungs by binding to receptors on our cells (the so-called ACE2 receptors). The expression of ACE2 receptors is altered in conditions such as hypertension, bronchitis, asthma, chronic obstructive pulmonary disease, heart disease, diabetes, rheumatoid arthritis, ankylosing spondylitis, psoriasis and psoriatic arthritis, lupus, reactive arthritis, conditions after trauma, the period after surgery and similar conditions. These conditions can lead to a more severe course and a worse outcome of coronavirus infection, that is, of COVID-19. Finally, social distancing and preventive measures are, for now, the only way to fight this infection, and if medicines such as antibiotics are taken without first consulting a doctor, they can only weaken your immune system. Wearing masks and washing hands are good general prevention. What awaits us in the – hopefully near – future is the development of a good vaccine and medicines. Until then, prevention is the best protection.
