Breaking down digestive “plaque,” a colloquial term for a type of bacteria biofilm that builds on the mucosal walls of the digestive tract, is emerging as an important target for probiotic formulations.

According to ongoing research supported by probiotics brand BIOHM, it’s been found that in individuals with digestive issues like Crohn’s disease, inflammatory bowel disease, and more, harmful bacteria tend to colonize on the epithelial walls of the intestine, forming biofilms that become increasingly resistant to treatment.

Mahmoud Ghannoum, PhD, co-founder of BIOHM, discussed the state of science on digestive plaque as a possible target for probiotics intervention, as well as the science on BIOHM’s own blend formulated to prevent and target biofilm formation.

He noted that digestive plaque is common in a wide population, including healthy people with minor digestive complaints, and is often attributed to a low diversity of microorganisms in the gut that often stems from Western diets.

“When people have Crohn’s disease or other gut issues, harmful bacteria often colonize and form a biofilm on the lining of the gut,” he said. “The microbes in this biofilm become resistant to our own immune system, as well as treatment with antibiotics and probiotics. They start to erode gut barrier integrity, leading to what’s referred to as ‘leaky gut.’ So the job at hand has been clear for some time: to find some way to eliminate this plaque. I’ve been supported by the NIH for many years in order to study biofilms and digestive plaques, beginning with catheter-related infections but then looking toward the gut.”

BIOHM FX, a blend of probiotic bacteria Lactobacillus acidophilus, Lacticaseibacillus rhamnosus, Bifidobacterium breve, the fungus Saccharomyces boulardii, and the digestive enzyme amylase, is now featured in several of BIOHM’s products designed for the elimination of digestive plaque.

Research & Discovery

Following a 2019 study published in Therapeutics and Prevention, which found that BIOHM FX ameliorated biofilm formation and improved microbial diversity in an in vitro model of digestive plaque, Ghannoum co-authored a study published in Gastroenterology that assessed the extent to which BIOHM FX was able to address biofilm formations in a human population.

“Consistently, biofilms appeared with increases in the populations of three harmful bacteria, namely C. albicans, C. tropicalis, and E. coli. We calculated, based on correlations, which candidate probiotics could best break down or inhibit the colonization of these strains,” Ghannoum noted.

In the human clinical study, a cohort of 49 people supplemented with BIOHM FX for 4 weeks. The investigation concluded that the product led to significant reductions in the two harmful Candida strains and E. coli.

While BIOHM FX has been clinically evaluated at dosages of 30 billion CFUs, which is available through the company’s healthcare practitioner line, it was more recently tested in a human clinical study at 1 billion CFUs. Products with this dosage are available in the company’s consumer line of products called BIOHM Essentials. There were positive findings in digestive comfort, biofilm elimination, and even self-reported measures of anxiety in the study, which awaits publication, according to Ghannoum.

“We were able to show in the past that these strains, fungus, and enzyme could break down biofilm formation and improve inflammatory symptoms; for instance, a significant reduction in alpha-cytokines was achieved, and gut lining and barrier function markers improved. The clinical trial we just finished now evaluated for the first time primary criteria like bloating, abdominal discomfort, and other GI complaints in order to see if all of these changes in biofilm formation and microbial balance would translate to direct and noticeable improvements in the way people feel. We were also able to show that anxiety, as a tertiary endpoint, improved significantly as well.”

Ghannoum noted that some of the company’s products containing its proprietary blend, which includes BIOHM Essentials Digestive Greens and Digestive Reds, also contain 24 vitamins and minerals that, when deficient in individuals, are linked to harmful colonization of proteobacteria, Candida strains, and more. Digestive fibers are also added for prebiotic benefits. “We’re addressing the microbiome from many different angles, including the basic essential nutritional elements needed for prevention,” Ghannoum said.

Future Expectations

Ghannoum said that big data will continue to serve as one of the biggest potentiators for BIOHM’s product development, as finding the best solutions to bridge a diverse range of microbial populations requires population-wide data.

“Consumers send us their stool samples, which we gather data from in order to compare those microbiomes to about 5,000 samples we have of people who are considered healthy,” he said. “We give each sample provider a set of 50 questions about stress, BMI, digestive health issues, and more, in order to connect certain types of imbalances with different health issues, so that we know which kinds of imbalances we need to address. All of this precedes in vitro stages. This will be especially important for research on communication between the gut and the brain, which is a two-way signal in that stress and digestive problems each have downstream effects on one another.”

He also noted that the list of beneficial fungi within the gut, which he refers to as the “mycobiome,” is ripe for innovation, despite being “largely ignored by clinicians” today. One of the most promising areas, for instance, is supplementing with helpful fungus strains during the use of antibiotics, he added.