The Role of Biofilms in the Induction and Maintenance of Latency (伏)


Hi, I’m Virginia Doran hosting another episode for, to the point, generously hosts, hosted and produced by the American Acupuncture Council. Today. My guest is Brandon Horn. He’s going to speak on the role of biofilms in the induction and maintenance of latency and, uh, being that I live in a very chick ridden area.

Click here to download the transcript.  You can download the PPT slides here.

I’ve come to learn a lot about biofilms and, uh, certainly they influence other diseases, but I think it will be valuable for you across a host of different conditions that you might be treating. So, uh, Brandon is a real Renaissance man, and, uh, I can’t even really, uh, get into all his, um, bio, but you could go and see that low to Um, he’s been a senior student of Jeffrey UN for years. He’s has a doctorate of philosophy in classical Chinese medicine, uh, from American university of complimentary medicine in Los Angeles.

Uh, he’s been a licensed acupuncturist since 2000 and, uh, he has many specialties in fertility, rheumatology, pediatrics, uh, he’s published, um, in books and in articles, um, many times and various subjects. And I think it’d be very interesting for you if he has a healthy seminars, uh, course on, uh, optimizing ovarian reserve. And there’s really just so many, uh, things as he’s done, I’d be talking for quite a long time to tell you all that. So without further ado, I would like to introduce Brandon and if I left something important out brand the pizza, let me know. Um, but otherwise I’ll hand it over to you, Brian. Brandon. Okay. You hear me okay? Yes. Okay, great. Um, so thank you, Virginia. Uh, and, uh, just more thank you and the AAC for inviting me to, um, to speak with you today. Um, so, uh, I originally, as you noted, wanted to present some information on code for you guys, but I’m not allowed to, because I was told that Facebook has decided to pull down people’s accounts. If they’re disseminating information about Coda, that’s not from an official source. Uh, at any rate I’ve been presenting a series on latency, uh, at international,

Uh, integrative Chinese medicine conference in Australia. Um, and this, um, uh, these talks are now, if you want to pursue today’s lecture further. So, um, I’ll get into as much detail as we have time for. Um, but there is a resource available if you want more. So, um, we’re going to talk about biofilms today, which is apparently not on Facebook sensor list, uh, yet, uh, but biofilms are quite fascinating. And really when you begin to study microbiology, I, you start to understand the details of what the, uh, the ancient doctors were observing and what they’ve been describing for millennia.

So, all right. Um, uh, I’m taking slides straight out of, uh, one of the talks that I gave called managing microbial resistance. And again, this is available in, uh, for those who want to hear the full lecture, because biofilms is only one part of the lecture and I had to cut it down a bit to fit within a half an hour. Um, so in that lecture, we’re talking about latency or lurking pathogens as some people call them. Uh, and this is more from the perspective of bacteria in this particular lecture because different pathogens have very different ways in which they form and maintain latency. And also our weight. She responds very differently as well. So from a big picture, bacterial latency perspective, we have, uh, three major players, uh, here. Um, these are the persisters, the persister organisms, the biofilms and the in time microbial resistant organisms.

So these groups of organisms are all on a spectrum of latency, uh, that we’ll look at in the net. But, um, first I’d like to briefly review the origins of latency in Chinese medicine, for those of you who are not necessarily familiar with the concept. Um, so in Chinese, uh, the term we use for latency or for lurking is cool, uh, and this has been popularized or revived in some ways, uh, in TCM from the, uh, from the one thing school, right? But the origins of this concept of latency are much older than that. Uh, the earliest mentions go all the way back to the majoring and chapters three and five of the N, which States that when one is harmed by cold in the winter, one will suffer a warm disease in the spring.

So what that’s saying is that, yeah,

But you really get cold in the winter and then you’ll end up with a one being in the spring. It’s really giving us this concept that, uh, infection and disease are not the same thing, meaning that you can be infected asymptomatically. Um, but that asymptomatic infection does not mean that you’re off the hook, right? So this is important. Uh, it has very important ramifications with disease etiology, and particularly with how we approach diseases. So for example, in another topic that Facebook loves to sensor, we find that these vaccines are designed to induce latency either immediately, which is in the case of live vaccines or upon contact with a pathogen as is the case with most of the other vaccines that we have. And we know for example, that vaccinating, uh, if you take, for example, for testis, uh, that prevents you, assuming that it works, it prevents you from becoming symptomatic with, for testis, but it does not prevent infection with four to tele pertussis.

However, uh, what the nagging is telling us is that you can contract the pathogen asymptomatically, but later on, you’re going to manifest the disease in a different way, right? So pharmaceutical companies, uh, they don’t like to look up for that kind of problem because it rains in on their profit parade. Uh, but fortunately there are a few researchers that have noticed these kinds of problems and published about them, but bad things tend to happen to their careers, uh, at any rate, as they say, trust science, uh, but not necessarily scientists. Alright, I’m done with politics. Uh, the second, the second thing,

An example of that, you know, uh, could you give an example of the, uh, of this latency?

Uh, yeah. I’m going to give you lots of examples. Yeah. So the, you know, we’re going to talk about a whole spectrum of latency in a minute. I have some slides on, so, okay. So, um, anyway, the second thing, uh, that it’s telling us is that, uh, environment is primarily responsible for this change in packaging, from being asymptomatic to transforming into a disease, right? They say, it said, one thing happens in winter. The next thing happens in the spring. This is environment. Um, there are other things here as well in terms of discussing people’s constitution, uh, and things like that. But that’s a little more involved in the uptime for right now. Sorry about that. Uh, the main point here is that Chinese medicine has understood this idea of a hidden pathogen or asymptomatic infection, uh, or subclinical infection, if you want to call it for millennia.

And so in Chinese medicine school refers to any kind of infection that can hide or take on a dormant state, uh, or that can resist being expelled by the body. Now. So this gets to your question here a little bit, or well now from then aging, how we can differentiate different kinds of latencies. There’s latent, cold, latent heat, latent down and Layton wind. And then the one being school added really latent fire. But for this particular lecture, the most important are latent cold, latent heat and latent dam. Um, really latent fire and wind are all under latent heat for young faculty, right. Um, so at any rate to give you some idea of how this is important, uh, within microbiology have a kind of a spectrum of what Chinese medicine really calls a fool. And these are again from Leighton close to Laden heat. And of course in between cold and heat is damn right. We’re yin and yang meat, uh, is damp now, uh, what the spectrum is describing is both phenotypical alterations of the organisms. So this would be a cold pathogen transforming you to like heat pathogen, for example, or it could be describing the environment that the pathogen is in, and these concepts are related, but when we’re discussing biofilms themselves, we’re talking both about the environment of the biofilm, as well as the pathogen mix. Uh, so biofilms as the earth element, uh, contain the entire spectrum from cold, uh, to eat.

So what exactly are biofilms? Well, um, biofilms are basically these kinds of small fortresses. Uh, if you want to think about them, that pathogens build to protect themselves from our way T and to allow them to persist in our bodies without having to worry about the immune system. So basically they are one of the main methods of latency within our bodies. Uh, and in my opinion, this is why sensimilla thought slam was a major part of disease. And he was right. It turns out that up to 60% of all human infections are believed to be caused by biofilms. That’s all human infections. And 80% of bacterial diseases are believed to be caused by biofilms. And when we look at the chemistry of biofilms, how we see that they’re essentially what they are. Is there a matrix of biopolymers that are, as I say, highly hydrated.

So in other words, they’re full of water, right? So polymers are just like, uh, they’re technical, they’re repeating chain of molecules. So it’s kind of like if you take Legos and you just use the Legos to build, you know, the same size and the same pieces to build the kind of more complicated structure, um, that’s essentially what you have. And they’re also again, highly hydrated. And so you see that from a chemistry perspective, these bio polymers that make up the outer coating of the biofilms R and D data, right. But polymers of course, can be very tough substances. So like plantain. So we think of like, so if you think of some polymers, things like PVC is a poem, right? Or even natural polymers, like rubber or hemp and so forth. So they can be very difficult to break down. And one more point here that I want to make is that biofilms are made of our sessile organisms.

And that means that these are organisms that are attached to the biofilm. So when the organisms are swimming around, we call them planktonic. But, um, these are just different phenotypes that the same organism can become and organisms that are in this particular phenotype that we call a sessile state respond very differently to antibiotics and to the immune system, then planktonic organisms do. Um, however, almost all of the literature that you read about with earth, they matter, or this antibiotic or whatever, killing XYZ bacteria, these are done when they’re in new planktonic state and not when they’re in necessitate state. So these may actually have no effect on the organism when it’s expressing assessable phenotype. So for example, in a biofilm, and this is another reason why it’s really hard to kill a biofilm organisms for a candidate.

Okay. So here you have a couple of images of what a biofilms look like a close up, and you can see it, it really is plenty, uh, in some ways. So I like these images because it’s similar to what you can feel impulses, uh, or when you palpate. Right? So a lot of what Jeffrey UN for example, refers to as bands or some of these phlegm modulations that aren’t obviously lymph nodes or something, uh, or these calcification type things, or what Kiko Matsumoto, if any of you follow her cause gummies or crunchies, these are really a lot of times, these are the effects of biofilms on tissue and both Jeffrey and Kiko. I’ll break these down. And they’d like to use moxibustion as well, which we have a slide on the minute Jeffrey, like salsa using WashDOT go doesn’t really use croissant to my knowledge.

Um, so, uh, so we saw that the photograph of the surface of a biofilm, but inside the biofilm, it’s a little different. So inside of a biofilm, we basically have three layers under the surface. So you can think of it as kind of like a three story house or something, right. In some ways. So at the top layer, you have the, uh, it’s full of and blood kind of like, you know, like young men, right. Uh, and then you have the next layer that is high in substrate and low in oxygen. So that’s the shallow young layer. That’s where Dan pathogens that have to use fermentation for energy, right? Because it’s low in oxygen, that’s where there’s a live right in that layer. And then finally you have the third layer, which is low and substrate and low in oxygen. Uh, and this is where you have the persister cells or the, what we call in Chinese medicine, these cold pathogens.

Right. Um, so what you see here is that, uh, w um, you get sort of multiple phenotypically the States within one biofilm. And what that means once again, is that it’s really tough to kill, right? So even if you remove the surface and you expose the bacteria to the immune system or to antibiotics, then the persister cells are still going to survive, and eventually they’re going to become planktonic again, and then they can reinfect you again. And this is why we need to think longterm, you can’t just treat symptomatically. And once the symptomatic, the symptoms are gone, then you stop treating because the pathogen is going to remain latent, and it’s going to pop up somewhere else as a different kind of disease, or it can pop up in the same place as well. So you get rid of, let’s say, you get rid of the person’s knee pain or whatever, but really you just, you know, release pathogen.

And then six months later, it’s growing on the person’s neck or their spine. And then you end up with another kind of disease that you don’t necessarily correlate with that this is really a micro biological reality of divergent channel theory. If you have any of you follow jeopardy, uh, you might have some of the other teachers teaching at divergent channels. Um, so to treat biofilms, uh, we should perse take a look at how they’re formed. Uh, and then we’re going to discuss a little bit of some of the approaches we can use to treat them. So, um, the, with the formation of biofilms, of course, it’s going to first start with, uh, adhesion right at first has to, uh, adhere to a surface. And, um, so, uh, once that happens, then it’s going to attach, uh, and then grow the biofilm on it. So this first stage is really in the CI level, uh, because the initial adhesion is done through electrostatic or vendor walls, uh, interactions, which if you’re not familiar with the band or walls forces, they’re basically like what, you know, geckos use the stick to the ceiling or, or to the wall or something like that.

Um, but yeah, that’s what they use. So at any rate, because this is the cheat level, we can use cheese to prevent adhesion. And so we can really look at things like cheese gong, or like using East them, if you’re not, you know, if you think she goes to esoteric for you use East them, or you can alter the pH various pH altering strategies work, uh, hydration is also very helpful. Uh, all of this can disrupt biofilms from forming. I also have a list of herbs here as well. So things like green tea, which of course they, you know, they use in Chinese restaurants to clean the grease off the glass tables, uh, you know, cause it’s really good at breaking down, uh, you know, dampness, right. Uh, it’s also, um, uh, there’s cranberry, which is popular for preventing UTIs and it also helps prevent the formation of biofilms as well. Um, and also keep in mind, there are different methods that different bacteria use to form biofilms. So these herbs aren’t going to necessarily work on all biofilms, but certainly they do help with many different times.

Okay. So then after, uh, after we have the initial sort of, uh, adhesion then attachment, so once they’re together, then they have to start, uh, binding. Right. So then we start, uh, physically binding, right. Um, so, uh, at any rate, once that happens, then that’s what we consider to be more at the blood level, right? So we need to use herbs because it’s something more structural, more physical. So we need to use herbs that break up blood stagnation or blood spaces to prevent formation at this state or to break things down at this stage. So I just put up, you know, herbs with studies here, but of course you can use the regular wounds. You know, now not applying is, is particularly effective for this space, by the way. Um, but you should be careful with that. Not all finances is actually quite strong.

Um, okay. So once it’s anchored, uh, then the start to collect on it so they can call, uh, we basically call that swarming, right? Everything just starts swarming towards it. And there are some herds listed here that we can use to inhibit the sort of swarming function. Uh, and then as they’re swarming and gathering into a community, uh, then they need to communicate. So this is done towards, uh, by something called forum sensing, which I discuss in detail in the main lecture, but I, here are a list of herbs that interfere with that process. So quorum sensing is also very important when we’re dealing with antibiotic resistant organisms, which are different than biofilms, and these require different strategies than just, you know, dealing with biofilms. So then we have that the, uh, outer coating the EPS, uh, so inhibition of the formation of EPS. So these are some strategies for, uh, breaking down the biopolymer or the phlegm, uh, as we discussed. So again, I know all of, you know, which herbs treat land in Chinese medicine. So I only listed herbs here that has studies on them directly inhibiting, uh, the EPS formation. Uh, but of course you can use other herbs that, you know, uh, deal with phlegm as well.

And finally, after the biofilm is formed, uh, it eventually gets too crowded. And at some point, uh, at bursts open and we call that the dispersal stage. Uh, so it can be stimulated also by environmental factors like extreme temperatures, uh, pH extremes, dietary changes, and so forth. So of course, you know, saunas can cause dispersal as can dietary supplements, uh, and of course verbal medicines can as well. Uh, and so this is one of the prime causes of the so-called, you know, healing crisis, uh, where all of a sudden these latent pathogens get released, and then you need to deal with them. They’re no longer latent. They’re spreading. Again, this is divergent channel theory, where if you’ve studied with Jeffery yang, he talks about how you have two or maybe three approaches when you’re dealing with chronic pathogens. And one is the maintenance, uh, I mean the general approaches one is to maintain latency or induce latency.

And the other is to stimulate the pathogen to come out of latency and then expel it from the body. Now, of course, it’s very difficult to permanently rid yourself of the pathogen, but it can help to reduce the pathogenic load on the body if it’s using too many resources to maintain latency. So you only have so many, uh, you know, jail cells, so to speak. And if you don’t clear out your jail cells, there’s not going to be any room, a room for new criminals that are coming, right. So, you know, I mean, that’s really kind of how it is. So here’s some herbs and so forth here that I’ve listed that can help inhibit dispersal. And some of these actually are counterintuitive because traditionally we’ve used cold to maintain latency, but hearing you see garlic and onions and cinnamon bark, uh, those can inhibit biofilm dispersal.

Of course, you know, these studies keep in mind, these are usually done in vitro, meaning in a test tube or in a Petri dish or something. And, you know, it can behave very differently when it’s in vivo or when it’s in the body. Right? So for me, when I’m trying to inhibit dispersal, which may be, if I know my patient is going into some extreme conditions, or if they are going through something really stressful, or maybe they’re having a current healing crisis, then I don’t use garlic. I’m, you know, I’m recommending things that are cooling and cold. So from here, you can see things like cactus and apples and leafy greens and so forth, things like that. Of course, you know, cinnamon bark you can use in small doses to actually pull things back into latency, but that’s, you know, that’s another discussion in general as a general concept, cooling and cold is what I use. Like [inaudible] soup for those of you who’ve studied some of the classical medicine. Yeah.

Recommend the patient, do things to kind of open the detoxification pathways, something like glutathione or something so that their detoxification of this, of whatever they have, um, makes it easier, a smoother, less cathartic list, you know, uh, Herxheimer reaction at all.

Yeah. So I actually, uh, I don’t go there right away. So this will be sort of an individual thing for each patient, but as a general proposition, it’s, it’s not actually a lot of people like to detoxify. Um, but that’s really, usually not the, in my opinion, that’s not the correct strategy to start with the correct strategy to start with is to make sure that all of your exits are open, right? So you want to make sure that the person’s vowels are moving well. You want to make sure that their urination is going well. They’re able to sweat, you know, these types of things, because you can do as much, you know, detoxification as you want. And that’s just like taking a bathtub and trying to clean it without much water. You know, you just got one without the drain being open, even if you have water, right.

You’re just going to switch it around and it’s not really going to do much. So you first have to make sure that all the exits are going smoothly. So if the person’s constipated or they have dry stools or, you know, these types of things and you need to correct, I recommend correcting that first, anytime you’re doing any of this stuff, um, and then you can get in, or a person needs glue to buy on, or a person needs, whatever. You know, I, I am actually as much as I talk about all this Western stuff, you know, I am at part a on herbalist and acupuncturist first, and that’s always my go to initially and I do functional medicine types of things and types of testing. I do it frequently, but these are things that I do for people where they’re, it’s more remote oftentimes. So I don’t have to check their pulses necessarily, or I can use it also as a, you know, if what I’m doing in the herbal medicine, isn’t working well enough for the person sensitive. So that’s kind of,

I think we’re actually saying the same thing. Yeah. The Goodwill line just opens up the liver so that it can detoxify more smoothly, um, as you know, but anyway, yeah. It’s just interesting to hear your approach.

Yeah, exactly. So you, you can open up the liver, but, but it still has to get out of the body. Right. So that’s all I’m saying is that I would agree to, you know, that this is, you know, you’re assuming step one is done. So, um, so for treatment then biofilms, since that’s this, this slide, we can talk about that a little bit. Um, the approach then. So this is just kind of a general idea of where you first ensure that the body strong enough to handle the breakdown of biofilms and this release of latency, and then next you attack the matrix, right? So after the person’s strong enough, then you go after the matrix of the biofilms and you can use some of the strategies that we talked about that caused biochem this first. So like saunas or jumping into a frozen Lake, or getting beaten by a tree branch.

These are the kind of Russian methods, but at least there’s a sauna at the end. So that’s good. And then finally you need to sort of clear the pathogen out and then loop back to step one until you no longer get symptomatic after step two. So you’re going to keep going through the cycle that as soon as the symptoms over time, they’re going to be less and less as you’re clearing things out. Um, so let’s take a look at the different stages. We’re actually not going to talk much about the first stage because that’s just standard TCM. Pretty much everyone is trained and you know, how you, uh, strengthen the body and blood and made sure that they’re strong enough for this. Um, so then the second thing is that, uh, we’re going to attack the matrix. So other than the, uh, environmental manipulations that I just mentioned, uh, we work primarily with the aid extra channels on this eye and the low channels for this stage.

And really if you’re looking at biofilms, low channels are the primary way to treat these because biofilms, again, as we mentioned, they’re, um, most oftentimes, uh, present as phlegm and his blood stagnation and the channel system that deals with phlegm and blood stagnation on the low channels, right? So you can use a guash Shaw on the bandit areas, or you can use needles and moxa to break that down. Uh, those are also very effective from the, uh, eight extra channel perspective. Uh, we work with young way Maya as the primary channel, and then secondarily, then we can work with [inaudible] ciao. And I guess you need some of that extra power or whatever, then possibly you’ll tap into Duma as well, but it’s more the diet and Yung chow for this. So now, as, as I mentioned moxibustion before, um, so here’s a slide on that.

It’s very useful for breaking down biofilms and there has been research in this area in terms of temperatures, not in terms of moxibustion directly, but in terms of temperatures that biofilms begin to break down with. So then we can look at what temperature the moxa gets up to, right? And this of course is going to also depend on the blend that you’re burning. So you can check the temperatures if you want with those laser thermometers, if you’re a metal type and you need to have those exact numbers, but basically you want the area of the tissue that you’re trying to break down to hit 50 degrees centigrade, which is about 122 degrees Fahrenheit. Um, but for me, I use centigrade for this not to be fancy, but just because it’s easier to remember. Uh, so I use that. So 50 is your target for biofilm breakdown, uh, and 60 is where your skin burns.

So the sweet spot is between 50 and 60 degrees Celsius. And as you can see here, a moxibustion can get you there. Um, but keep in mind that the temperature at the surface of the skin is not the same as the subacute temperature, subcutaneous temperature. Um, so what I find to be the most effective personally is using Chico style of doing direct moxibustion on the needle itself, you know, meaning, meaning that you, you insert the needle and then you’re putting the moxibustion at the border of the needle, uh, and the skin, uh, right. And you put a little burn cream on there for those of you who aren’t familiar with that. And then you do the small rice grain boxes on top and keep going. Um, if you use needle moxa, what happens is it typically is going to cool off too much, uh, by the time it gets to the biofilm, uh, unless you’re using a particularly hot mocks that formula you’re burning it for a particularly long time, then you might be able to get enough there.

Um, so, uh, I’m not going to discuss during the pathogen so much because that’s, you know, there are many ways to do that. I tend to use low channels a lot in these that really the most for clearing and verbally, once these things are active, you can use your standard things. Your Shanghai online formulas are one big strategies, depending on what your, you know, what you’re trying to do at that point. Um, so, uh, here in this slide, um, I just wanted to bring up this a caution that when you release late, I can see it can spread and it can cause widespread problems that can be serious. And as you see here, it can disseminate into the blood, which means that it could cause sepsis, right? If the patient isn’t strong enough to clear it out. So, uh, again, my recommendation is to go slowly, but sometimes, you know, we don’t have a choice because someone gets sick, someone gets a fever and then bang, it starts to pause, disperse a little biofilms.

And these are where you get a lot of secondary bacterial infections to a primary viral infection, like say a cold or flu, or that other thing that shall not be named that some people are taking as it for my son. Uh, so if you’re aware of this, we can employ some of the acupuncture and herbal strategies as a prophylaxis. Um, now, uh, some of the practitioners, particularly natural paths or some functional medicine, practitioners love to use a lot of anti biofilm substances. And I would really caution against being overly aggressive with those, because unless you know how to monitor pulses again, you’re only going to know something is happening otherwise, if the patient’s symptomatic, but these things can spread asymptomatically as well. And then they can go places that are less than ideal, right? Your body put them in a particular place, perhaps on purpose.

And then we, you know, then they can start spreading the places your body didn’t want. So if you check pulses, then you’re much less likely to run into a problem, but if you don’t check pulses, then I think it’s best, uh, personally to err on the side of just moving slower, uh, to release the, uh, latency. So again, these are all, uh, citations to, uh, articles and, uh, uh, in the NCBI. So you can follow up that, yes, fever, induced, biofilms do release a new Macaca. Uh, and this has been shown to result in bacterial dissemination and sepsis, for example. So this is not just Chinese medicine docking. This is also, you know, what’s been confirmed in medical research. I mean, non Chinese medicine, medical research, I personally relied more on Chinese medicine. Vertical research is much more, um, uh, much more accurate, but that’s a whole nother discussion.

So lastly, um, I just want to mention that biofilms are everywhere in our environment or they’re on your showers. They’re already here, they’re all over the place everywhere. I, and also everywhere in our bodies and some of them are actually beneficial. So just like if we take too many phlegm resolving herbs, we can damage our yen. If we remove biofilms too aggressively, we can end up compromising our health rather than helping. Um, so here’s one example of biofilm syrup, the lower jaw that protect the body from other pathogens. So here you see that lactobacillus form may fit protective layer. Uh, the biofilm basically in the email, you’re a genital system that provides protection against bacterial infections and the vaginal cells are completely covered with, uh, healthy biofilms. And that’s a good thing. So I think that’s pretty much it. Uh what’s that, that’s great. Yeah. Okay. Yeah. And so I just want people to know that they can, the full presentation is available talking about the persister organisms, a little more detail on biofilms, but I’m also talking about the antibiotic resistant organisms themselves and how to approach those. Um, that’s available at AUC, um, dot, uh, online, uh, and it’s only three hours, so it’s not like you have to watch it for two years, um, by some of my other ones.

Okay. Well, I want to thank you all for tuning in and next week, the guests will be [inaudible] and, uh, he’s always interesting. And, uh, again, thanks to the American Acupuncture Council, um, Virginia Doran of And we’ll see again, soon all right. Thank you. Thank you, Brandon.

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