The Highly Pathogenic E. Coli Genie is Out of the Bottle – Can You Withstand an Attack?

Wednesday, June 08, 2011
By: Byron J. Richards,
Board Certified Clinical Nutritionist
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The tactics are straight out of the terrorist textbook. A wave of suicide bombers hits the front line defensive fortifications. Most of this first wave blows holes in the defensive barriers and leaves a battlefield of inflammatory damage and debris. Some of these first wave terrorists hijack important communication systems relating to the natural defense mechanisms. If these defense mechanisms fail, invasion of the body is certain. Rather than that, the defense mechanisms, faced with impending doom, are forced to allow an inflammatory diarrhea response. But wait, the second wave of the terrorist attack is now under way. They are taking advantage of the damaged battlefield of the first wave of attack. They are armed with highly toxic chemical weapons, the type that is banned from “humane warfare.”  Welcome to the world of infectious E. coli.  And in Germany, welcome to the world of superbug infectious E. coli – resistant to antibiotics and armed with some of the most devastating toxins ever known. 

The German public is the first to be attacked by a large-scale outbreak, but this type of E. coli problem already exists in the United States. Do you have the confidence and skill to prevent this enemy from taking root in you or defeating it if it does?  Even the most infectious E. coli may not be able to cause you any problems if you have a competent defense system that can fend off the attack. The determining factors are the current balance of bacterial powers within your digestive tract, the amount of existing inflammation within your digestive tract, the amount of stress you are under, the ability of natural factors to disrupt quorum sensing, and your ability to bolster your gut barrier. 

E. coli 101

E. coli was discovered in 1885 by the German physician Theodor Escherich, thus its name Escherichia coli (E. coli).  E. coli is a normal inhabitant of your colon, part of the natural balance of foreign bacteria that make up an ecological rainforest with diverse and important roles for human health.  Under healthy circumstances E. coliis a friendly farmer toiling in the fields, helping to recycle trash and actually assisting in the healthy balance of GI tract bacteria. The human genome relies on the genomic work of bacteria for many substrates of compounds required for human health, including the contributions made by friendly E. coli.

E. coli is very good at gene swapping, which sometimes leads to the acquisition of virulence factors that are highly toxic and pathogenic to the human host. In these circumstances E. coli adopts a germ gang formation (biofilm), which means a single bacteria is now part of a team that has nothing good on its mind. Their activities are coordinated by molecular signals which are referred to as quorum-sensing molecules. Quorum-sensing molecules are essentially a communication system that is encouraging a coordinated attack. 

E. coli is rod shaped and many have filament projections (flagella) that allow them to move around and stick to human cells. Once infectious E. coli stick to a human cell they can inject toxins and other virulence factors into the human cell, such as an epithelial cell that lines your digestive tract or urinary tract. Virulence factors are trying to hijack or kill the human cell. They cause disruption of the cell membrane, which enables the bacteria to gain entry into the human cell while causing water loss from the human cell and preventing it from reacquiring water – which is what triggers diarrhea. Once inside the human cell they gain protection from the immune system, set up shop in a protected structure within the cell (vacuole), replicate as a parasite on the nutrients in the cell, as well as hijack the communication system of the human defense mechanisms and begin turning it to their advantage. 

Highly pathogenic E. coli readily stick to and invade epithelial cells of the digestive or urinary tract lining. Pathogenic E. coli superstrains have many tricks up their sleeves. They can hijack the macrophages1 of your immune system, replicate inside them without detection by your immune system, and induce your macrophages to inappropriately secrete large amounts of inflammatory TNFa.  In other words, not only are they highly toxic in and of themselves, they can turn your own immune system into part of their toxic team.

E. coli is a member of a large family of bacteria called enterobacteriaceae.  Infectious Salmonella2 is also a member of this family, which uses many similar mechanisms as pathogenic E. coli to attack the human host. Thus, studies on Salmonella infection are highly relevant to E. coli. Scientists are just beginning to unravel the molecular complexity of what is going on with these infectious bacteria3.

Your first line of natural defense is to prevent E. coli from colonizing too many of your human cells. If that happens, then you must also prevent them from multiplying. Finally, you absolutely must prevent them from breaching your gut barrier and entering your body, as that can be a life-threatening situation requiring urgent medical treatment (as is currently seen in Germany).  The current German E. coli outbreak is a superstrain of E. coli that is resistant to antibiotics, has two powerful toxins, and can attack red blood cells causing them to die. This results in the hemolytic-uremic syndrome which can cause severe anemia and kidney failure which is potentially life-threatening.

The United States is Already Under Attack

While the story in Germany is getting everyone’s attention, the problem already exists in the United States and experts at our Centers for Disease Control (CDC) are very concerned. There are many different kinds of E. coli.  In the past, most dangerous infections came from a type known as O157:H7, which produces the Shiga toxin that destroys red blood cells leading to anemia and kidney failure. Efforts to control this strain in the food supply, typically by feeding antibiotics to farm animals, has led to new pathogenic strains that the experts call “non-O157” types.

“For a number of years, almost all of the strains of this kind of E. coli [highly infectious] were that O157:H7,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Over the past 15 years, we’ve seen a very sizable increase in the number of non-O157:H7 strains.”

The E. coli strain in Germany is the new kid on the block, referred to as O104:H4.  Our CDC first identified this strain two years ago in eastern Europe. Experts are concerned because this strain is harder for them to identify and it is clearly on the rise in the U.S., along with many other potentially infectious non-O157 types.

The outbreak in Germany has over 2700 documented cases, 600 cases of kidney failure, and 25 deaths so far. It is getting attention because it is one large outbreak. However, U.S. health officials estimate that at least 100,000 Americans suffer infectious E. coli attacks each year, causing thousands of hospitalizations and around 80 deaths per year. The problem in the U.S. is already larger than the German problem – it is just more isolated in terms of a rapid outbreak. Over half of these serious E. coli food poisoning problems in the U.S. are now the non-OH157 types which include the O104:H4, which is why alarm bells are quietly going off at our CDC.

Furthermore, many Americans have high levels of infectious E. coli that are causing major health problems but are not classified as a food poisoning situation. It is now known that up to 87% of patients with Crohn’s disease4, ulcerative colitis, and irritable bowel syndrome have higher-than-normal levels of infectious E. coli and that in over 1/3 of these cases it is some of the most pathogenic E. coli that is causing or contributing to their problems. 

Anyone with diarrhea on a short-term basis should be thinking E. coli attack. Anyone prone to ongoing diarrhea, even if it comes and goes or alternates with constipation, should be thinking that they have an ongoing battle with infectious E. coli that has set up shop in their colon. While this may not always be the case, the odds are that infectious E. coli or one of its cousins is involved.

E. coli’s interaction with the human host, as friend and foe, has been going on for millions of years.  As scary as E. coli may sound, the human defense system has to be better, otherwise our race would not have survived. There is no point living in fear of E. coli, as the fear-related hormones actually help it spread. There is a point in minimizing your risks and understanding what you can do if you are under an attack or have an ongoing lower-grade problem that is interfering with your quality of digestive health.

Basic Precautions

There are many basic precautions that are common sense. Some of these are widely promoted by public health officials and others are ignored completely by public health officials – for fear of implicating groups like the AMA and doctors who are actively contributing to infectious E. coli risk.

Hygiene is important, especially for workers in the food industry. The failure to wash hands thoroughly after going to the bathroom can readily pass along infectious E. coli.  Such contamination could occur at any point in the food production and distribution process – which is why tracking down a major outbreak is such a difficult proposition.

Dairy and beef cattle, as well as pigs, are major sources for potential E.coli issues. This problem has been made far worse by the use of antibiotics to “prevent” E. coli infection in these animals.  E. coli rapidly mutates in response to antibiotics, so it is not at all surprising that new strains of E. coli are antibiotic resistant.  Furthermore, E. coli is so good at gene swapping that it helps other bacteria, like Staphylococcus, gain antibiotic resistance.  This is why the meat in our food supply, from these factory farms that raise unhealthy animals, have set the stage for a future of food poisoning outbreaks. I wouldn’t buy meat of this type, although it makes up the majority of meat in the U.S. food supply. Obviously, such poor-quality meat should be fully cooked.

The vegetables most commonly associated with outbreaks of E.coli are sprouts, cucumbers, and spinach. In general, all vegetables should be washed thoroughly and many may choose to use some form of disinfectant as a soak or wash.
 
The medical profession, with its rampant over-use of antibiotics, has clearly helped produce antibiotic-resistant strains5 of E. coli and other superbugs. Additionally, even one or two courses of antibiotics can alter the digestive balance of power wherein undesirable strains of unfriendly bacteria begin to dominate the landscape of your digestive terrain – a problem that can go on for years. This is a different problem than antibiotic resistance. It is a very dangerous alteration of the ecological rainforest that should comprise digestive health. The blame falls squarely on the AMA and doctors – who ironically are the very people you are forced to turn to if you have a severe E. coli attack. Use antibiotics only as a last resort.

How to Prevent and Combat E. coli Infection

In addition to good hygiene, safe-food handling practices, and staying away from antibiotics, there are many things you can do to ensure you are more resistant to an infectious E. coli attack.

The solutions, center on the health of your digestive tract. You have ten times the number of cells that are foreign in your digestive tract compared to human cells that comprise your body. The diversity of these foreign cells is significant, meaning you have one hundred times the genomic activity in these foreign cells than your human genome. In health, your human genome is relying on the work done by these foreigners to support your health. In disease, the genomic activity of the foreigners can by highly toxic and damaging. Antibiotics knock out a lot of the friendly flora and enable the hostile bacteria to have more of a say – which is why they are potentially so detrimental to your health, as well as increasing your risk for infectious E. coli issues.

Every person has a different bacterial mix, even between healthy people. However, a recent study6 has proven that when you have too many of one type of bacteria, then you are much more susceptible to an invasion by the pathogenic forms of that bacteria. In other words, if you have digestive imbalance that already contains too much E. coli, even if that extra E.coli is the more or less friendly type, then you are more at risk for infectious E. coli taking hold, if you happen to swallow some. It is as if your immune system has become inappropriately unable to keep the numbers of E. coli organisms in proper balance and is therefore unable to properly identify and act swiftly against an infectious form of E.coli. 

This is why antibiotics are so bad. However, it’s not fair just to blame antibiotics, since a poor quality diet also has a large bearing on your balance of digestive power. Junk food, high-sugar intake, too much alcohol, and a lack of fiber all contribute to digestive imbalance that sets the stage for E. coli infection. Conversely, eating higher quality food with plenty of fiber (fruits, veggies, and whole grains) will encourage better bacterial balance. This makes extra supplemental fiber and friendly flora (acidophilus) two of the basic additional strategies you can employ to help correct an imbalance of power in your gut – especially if you have a history of poor diet, antibiotic use, or existing digestive problems.

It is now known that friendly flora can battle the adhesion signals7 that enable infectious E. coli to stick to human cells, a fact that has been confirmed by detailed animal testing8. A specific strain of friendly flora, Lactobacillus rhamnosus9, was found to disrupt E. coli biofilms. Friendly flora in general was found to have a positive impact on killing infectious E. coli.  Another strain of friendly flora, Lactobacillus plantarum10, has been shown to preserve the integrity of the gut barrier in the face of E. coli infection.  Cell studies show that friendly flora can help reduce the toxin release11 by pathogenic E. coli

Adequate dietary fiber is needed as the substrate for friendly flora fermentation. Since most Americans eat half the fiber they should, we have a population at high risk. Additionally, various nutrients may help catalyze the growth of friendly flora while reducing E. coli.  It has recently been shown that zinc and quercetin12 can help the growth of friendly flora while at the same time inhibiting the growth of E. coli. The science of friendly flora, fiber, and related compounds towards the production of better bacterial balance and helping to control problems is now crystal clear and has been extensively reviewed – even by the Germans13!  It is actually harmful to public health that public health officials won’t promote these basic strategies for protection in the face of a deadly E. coli outbreak.

As it turns out, your body weight is now recognized as a key sign of digestive imbalance – both underweight and overweight.  Underweight typically means you can’t absorb food properly, reflective of a digestive imbalance of bacteria as well as high levels of inflammation. Overweight people almost always have imbalanced bacteria that typically have extra E. coli as part of the problem. When underweight individuals are able to gain weight and when overweight individuals are consistently losing weight, it is reflective of their digestive balance of powers moving in a better direction. However, being stuck under or over weight and not being able to make consistent improvement, is a clear sign of bacterial imbalance that places you at higher risk for a hostile E. coli attack. I have reviewed this issue extensively in three other articles:  How Digestive Problems Prevent Weight Loss, Malfunctioning Immunity Causes Weight Gain, and Germ Gangs Block Weight Loss.

Your human system and whatever E. coli is in your gut, are in a constant state of cross communication. There are receptors for adrenaline on infectious E. coli that turn on the virulence genes that activate the infectious potential of E. coli. This means that a happy and more relaxed person is less likely to get a bad case of infectious E. coli if exposed. It also means that substances in your gut that can bind to adrenaline receptors on E. coli could be one angle on addressing this problem. The best natural compound that does this, is quercetin, which as mentioned previously, has science showing that it reduces E. coli infection. Quercetin is the most abundant flavonoid in fruits and vegetables, especially apples and onions.  It is available as a dietary supplement in highly concentrated amounts (500 mg per capsule vs. 50 mg in a ripe apple).  Quercetin lowers the LPS toxicity14 that is typically part of the toxic profile of infectious of E. coli.  It also helps stabilize immune cells15 in the face of stress.  Both quercetin and resveratrol16 have been shown to inhibit E. coli from making energy. In terms of practical application, virtually any nutrient that helps you offset stress will be of potential assistance in reducing the risk for an infectious E. coli attack, one important angle on the problem.

Another interesting aspect of friendly flora is that it also helps regulate the stress response17 in your digestive tract. It helps your gut barrier function better in response to stress and can help lower the inflammatory gene signal NF-kappaB that is central to inflammation.

The next important topic to understand is that of quorum-sensing (QS) molecules.  It means that there is communication signals going on that are activating the genes that enable the bacteria to behave in concert with each other as part of a hostile gang (biofilm).  If you can disrupt QS signaling then you interfere with the infectious orders coming from the germ gang – hitting at the source of the infectious intensity. 

It should come as no surprise to anyone, that many natural compounds demonstrate QS-disrupting molecules. This is because fruits and vegetables have been dealing with bacterial infection for millions of years, including E. coli. Tomatoes, carrots, peas, habanero chilies, and garlic have all been shown to possess bacterial QS-disrupting molecules18.  What this means, in part, is that a diet including a variety of plants and fruits is also vital for helping to keep bacteria in natural balance in your digestive tract. One study shows that oregano oil, allspice oil, and garlic oil all have infectious E. coli disrupting ability – especially oregano oil19.

Several studies now indicate that quercetin is a potent QS-disrupter for E. coli germ gangs. A brand new study shows that broccoli extracts contain potent QS disrupting compounds for infectious E. coli – and quercetin20 was the most active compound in this regard isolated from the broccoli extracts.  Another study shows that citrus-derived flavonoids21, including quercetin, possess QS-disrupting properties for E. coli.  When these studies are combined with all the above-mentioned quercetin studies it means that quercetin is a natural and potent anti-E. coli compound.

Pathogenic bacteria are obviously a major threat to survival of the human species and are highly problematic for infants who are at risk for germ gang formation. Thus, it is also not surprising to find some of the very best protective remedies are in mother’s milk, especially first milk colostrum. Since this wonder beverage is not readily available for dietary supplement use, everyone should be happy that numerous studies show that bovine colostrum, whey protein, and specially filtered whey protein have potent E. coli disrupting activities.  Furthermore, many of their modes of operation are rather gentle yet highly effective, since they have to work in newborns. 

Bovine colostrum has been proven to lower the LPS toxicity22 of E. coli infection, which otherwise may lead to septic shock.  In fact, bovine colostrum in infants has been shown to help clear up bloody diarrhea (E. coli hemorrhagic diarrhea) while reducing the likelihood of progression to full blown hemolytic uremic syndrome as is being experienced in Germany right now. 

Since cows are typically exposed to E. coli their colostrum often contains factors directed at preventing E. coli infection – as was demonstrated in a recent control trial23 wherein specially prepared colostrum readily stopped E. coli traveler’s diarrhea.  Another study shows clearly that bovine colostrum24 contains peptides that disrupt infectious E. coli.  And yet another study indicates that bovine colostrum25 can have a 45.9% to 96.7% ability to inhibit the hemolytic damage to red blood cells that can be caused by nasty E. coli infections.

Lactoferrin is one of the active proteins in colostrum and whey protein.  It is also available as a purified bovine lactoferrin. This compound demonstrates broad-spectrum antimicrobial activity, including direct inhibition26 of infectious E. coli.  Lactoferrin is rapidly internalized27 by E. coli and then triggers disruption of the E. coli cell membrane.  Lactoferrin can bind to human cells28 and prevent bacterial invasion or bind to bacterial cells and prevent them from sticking to human cells.  Lactoferrin29 is a potent E. coli disrupting compound.

Whey protein is a known booster of immune cell function30Whey protein31 has been shown to be effective at preventing infectious E. coli from sticking to and invading human cells.  A new study with goat-derived whey protein32 showed that as whey protein is digested it produces peptides that have direct activity against infectious E. coli.  Interestingly, edible whey protein coatings for turkey hot dogs33 and roasted turkey34 inhibited the formation of infectious E. coli in these ready to eat foods.

The dairy industry has taken advantage of the unique immune-support properties of whey protein, developing specially filtered whey protein that concentrates the immune-active components such as the sialic acid-containing glycomacropeptides (GMPs) as well as lactoferrin.  GMPs35 have shown a potent ability to bind on to infectious E. coli and render it harmless, based in part on the sialic acid they contain.  GMPs36 also bind on to infectious E. coli toxins, helping to neutralize them so they cannot damage human cells.  This type of whey product is one of my long time favorites for helping almost any kind of GI distress and is easy for kids to use.

Virtually all of the nutrients discussed so far, have an anti-inflammatory effect on the GI tract lining, thus supporting gut barrier integrity. Many of these nutrients also support the healthy structure of the GI tract lining. Additionally, glutamine37 is the primary amino acid that makes up the structure of your digestive lining and a well known nutrient for digestive immunity. A recent animal study has shown that supplemental glutamine can protect the gut barrier from attack by infectious E. coli

Grape seed extract is another potent antioxidant nutrient that attaches to collagen structures and helps strengthen them, including your gut barrier integrity.  Research done by our U.S. Department of Agriculture38 showed that grape seed extract could inhibit the toxin of highly infectious E. coli.  Grape seed extract has been shown to inhibit the growth of E. coli in cooked ground beef39. I like grape seed extract for infants and children as the product is a basic fruit extract that is very safe and capsules are easy to pull apart and mix in almost anything for easy consumption. This is also true of many of the whey products, like specially filtered whey protein.

Summary

New strains of superstrain E. coli are here to stay and are already in the U.S. The primary public health crisis that caused these problems is the overuse of antibiotics in factory farm animals and the overuse of antibiotics in humans. Ironically, the overuse in farm animals was trying to eradicate the O157:H7 strain and unfortunately has now created even worse superstrains of E. coli

The underlying health of your digestive terrain, determines your actual risk for infectious E. coli should you be exposed to it. Hopefully this information will serve as a wake up call to eat better and to correct any existing digestive problems.

There is an array of helpful nutrition that can assist you to have better digestive health. Many of these nutrients have millions of years of experience in dealing with infectious E. coli – making them a safe and effective option for supporting your health. Your foundation is a healthy diet with a wide variety of fiber and active compounds that are found in fruits, vegetables, and whole grains.

Health freedom in Germany is long gone, and their population does not have easy access to many of the nutrients I have listed here. Health freedom in the United States hangs by a thread, with our FDA actively trying to suppress you from knowing about or acting on the type of information I have presented here.  The Obama FDA is now engaged in the use of armed U.S. marshals to bully dietary supplement companies, as the police to enforce their bizarre drug-based paradigm for human health. 

The FDA prefers you follow the directions of the profession that has helped create the superstrain E. coli risk, a profession that has almost no clue about anything I have just explained to you.  Be wary of the German path to socialized medicine that resulted in their loss of freedom and choice. Be wary of being a sheeple in the public health herd.

 


Referenced Studies:
  1. ^ The Insideous Nature of Pathogenic E. coli Infection  Gut Microbes  Rolhion N, Hofman P, Darfeuille-Michaud A.
  2. ^ Mechanism of Salmonella Infection  Mol Syst Biol.   Misselwitz B, Dilling S, Vonaesch P, Sacher R, Snijder B, Schlumberger M, Rout S, Stark M, von Mering C, Pelkmans L, Hardt WD.
  3. ^ The Science of E. coli and Salmonella Infection  Infect Immun.  Bulgin R, Raymond B, Garnett JA, Frankel G, Crepin VF, Berger CN, Arbeloa A.
  4. ^ High Levels of Infectious E. Coli with Inflammtory Bowel Problems  Int J Med Microbiol.  Thomazini CM, Samegima DA, Rodrigues MA, Victoria CR, Rodrigues J.
  5. ^ E. coli and Other Bacteria Have Developed High Levels of Antibiotic Resistance from Overuse  Am J Rhinol.   Saubolle MA.
  6. ^ Related Bacteria Enable Infection of Pathogenic Strains  PLoS Pathog.   Stecher B, Chaffron S, Käppeli R, Hapfelmeier S, Freedrich S, Weber TC, Kirundi J, Suar M, McCoy KD, von Mering C, Macpherson AJ, Hardt WD.
  7. ^ The Insideous Nature of Pathogenic E. coli Infection  Gut Microbes  Rolhion N, Hofman P, Darfeuille-Michaud A.
  8. ^ Probiotics Can Stop E. coli from Sticking to Host Cells  Vet Res.   Daudelin JF, Lessard M, Beaudoin F, Nadeau E, Bissonnette N, Boutin Y, Brousseau JP, Lauzon K, Morris Fairbrother J.
  9. ^ Friendly Flora Disrupts Infectious E. Coli Biofilms  Colloids Surf B Biointerfaces.  McMillan A, Dell M, Zellar MP, Cribby S, Martz S, Hong E, Fu J, Abbas A, Dang T, Miller W, Reid G.
  10. ^ Lactobacillus Plantarum Protects Gut Barrier from E. Coli  World J Gastroenterol.   Liu ZH, Shen TY, Zhang P, Ma YL, Moyer MP, Qin HL.
  11. ^ Friendly Flora Inhibits Toxin Release by E. Coli  Lett Appl Microbiol.   Tahamtan Y, Kargar M, Namdar N, Rahimian A, Hayati M, Namavari MM.
  12. ^ Zinc and Quercetin Help Friendly Flora while Reducing E.coli  Biofactors.   Yadav S, Gite S, Nilegaonkar S, Agte V.
  13. ^ The Power of Friendly Flora and Fiber to Promote Multiple Aspects of Health  Adv Biochem Eng Biotechnol.   de Vrese M, Schrezenmeir J.
  14. ^ Quercetin Lowers LPS Toxicity  Adv Exp Med Biol.  Zhang M, Swarts SG, Yin L, Liu C, Tian Y, Cao Y, Swarts M, Yang S, Zhang SB, Zhang K, Ju S, Olek DJ Jr, Schwartz L, Keng PC, Howell R, Zhang L, Okunieff P.
  15. ^ Quercetin Protects Against Stress  Journal of Medicinal Food.  Anil Kumar, Richa Goyal
  16. ^ Quercetin and Resveratrol Inhibit E. coli Energy Production  Int J Biol Macromol.   Dadi PK, Ahmad M, Ahmad Z.
  17. ^ Probiotics Help Offset Stress-Induced GI Dysfunction  Curr Mol Med.   Lutgendorff F, Akkermans LM, Söderholm JD.
  18. ^ Quorum Sensing Inhibitors to Combat Bacterial Germ Gangs  Microbiology.   Rasmussen TB, Givskov M.
  19. ^ Oregano and Food Poisoning  Journal of Food Science,   Du, W-X, Olsen, Avena-Bustillos, McHugh, Levin, Mandrell, R. Friedman, Mendel.
  20. ^ Quercetin from Broccoli Extracts Inhibits E. Coli Biofilms  FEMS Microbiol Lett.  Lee KM, Lim J, Nam S, Yoon MY, Kwon YK, Jung BY, Park Y, Park S, Yoon SS.
  21. ^ Quercetin and Other Citrus Flavonoids Disrupt E. Coli Biofilms  Appl Microbiol.  Vikram A, Jayaprakasha GK, Jesudhasan PR, Pillai SD, Patil BS.
  22. ^ Bovine Colostrum Lowers LPS and Inflammation  Int J Clin Pharmacol Ther.   Struff WG, Sprotte G.
  23. ^ Bovine Colostrum Prevents E. Coli Infection in Humans  Scand J Gastroenterol  Otto W, Najnigier B, Stelmasiak T, Robins-Browne RM.
  24. ^ Bovine Colostrum Contains Peptides that Inhibit E. Coli  J Appl Microbiol.   Birkemo GA, O’Sullivan O, Ross RP, Hill C.
  25. ^ Bovine Colostrum Inhibits Hemolytic Actviity of E. Coli  Clin Vaccine Immunol.  Vilte DA, Larzábal M, Cataldi AA, Mercado EC.
  26. ^ Lactoferrin Protects Against E. Coli  Biometals.  Yen CC, Shen CJ, Hsu WH, Chang YH, Lin HT, Chen HL, Chen CM.
  27. ^ Lactoferrin Disrupts Cell Membrane of Candida and E. Coli  Peptides.   van der Kraan MI, van Marle J, Nazmi K, Groenink J, van ‘t Hof W, Veerman EC, Bolscher JG, Nieuw Amerongen AV.
  28. ^ Lactoferrin is Part of the Foundation of Natural Immune Defense Against Bacterial & Viral Infection  Cell Mol Life Sci.   Valenti P, Antonini G.
  29. ^ Lactoferrin’s Broad Anti-microbial and Anti-Candida Power  Biometals.  Orsi N.
  30. ^ Whey Protein and Immunity  Journal of Nutrition  Daniel Rusu, Réjean Drouin, Yves Pouliot, Sylvie Gauthier and Patrice E. Poubelle.
  31. ^ Whey Protein Inhibits Infectious E. Coli  J Appl Microbiol.   Halpin RM, Brady DB, O’Riordan ED, O’Sullivan M.
  32. ^ Digested Whey Protein Contains Peptides Active Against E. Coli  Br J Nutr.   Almaas H, Eriksen E, Sekse C, Comi I, Flengsrud R, Holm H, Jensen E, Jacobsen M, Langsrud T, Vegarud GE.
  33. ^ Whey Protein Coating Inhibits E. coli in Packaged Poultry  J Food Sci.  Gadang VP, Hettiarachchy NS, Johnson MG, Owens C.
  34. ^ Whey Protein Coating Inhibits E. Coli on Roasted Turkey  J Food Prot.  Min S, Harris LJ, Krochta JM.
  35. ^ Glycomacropeptides Inhibit E. coli  Biosci Biotechnol Biochem.   Nakajima K, Tamura N, Kobayashi-Hattori K, Yoshida T, Hara-Kudo Y, Ikedo M, Sugita-Konishi Y, Hattori M.
  36. ^ Glycomacropeptides Bind E. Coli Toxins  Br J Nutr.  Brody EP.
  37. ^ Glutamine is Vital for Healthy Immunity  Amino Acids.   Calder PC, Yaqoob P.
  38. ^ Grape Seed Extract Inhibits E. Coli Toxin  Appl Environ Microbiol.   Quiñones B, Massey S, Friedman M, Swimley MS, Teter K.
  39. ^ Grape Seed Extract Inhibits E. Coli in Cooked Ground Beef  Food Microbiol.   Ahn J, Grün IU, Mustapha A.

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