Breaking Up is Hard to Do – The sticky, icky world of biofilms

Have you ever slipped on a rock while crossing a creek, or had a difficult time washing the slime out of your dog’s water bowl? That annoyingly sticky film is a biofilm.

A common example of a biofilm you can likely relate to is dental plaque. If your teeth feel a little fuzzy, you likely have a slimy buildup of bacteria that have formed a biofilm on the surfaces of your teeth. The biofilm won’t go away unless it’s mechanically removed. Left alone, it can lead to the demineralization of the enamel and cavities.

Biofilms are bad for your health!

Biofilms can also be found on the skin, mucous membranes throughout the body, and on implanted medical devices. When they form on a surface in the body it is difficult for your own immune defenses or antibiotic therapies to remove them. This can result in an ongoing cycle of health issues. Recurrent tonsillitis, sinusitis, ear infections, and GI issues are some examples.

In the last few decades, biofilms have been receiving more attention for the major role they play in ongoing conditions. In fact, the National Institutes of Health (NIH) revealed that 80% of chronic infections are associated with biofilm formation.¹

Why are biofilms such a problem? Simply put, they are difficult to eradicate.

To better understand, let’s explore more about what biofilms are.

 Biofilms: When Microorganisms Stick Together

We could actually learn a lot from biofilms. 

They are living communities of organisms that stick together and attach to surfaces. Biofilms develop as a defense mechanism to prevent the clearance of undesirable microorganisms. They don’t discriminate. Bacterial, fungal, and viral species of microorganisms are all welcome to join this polymicrobial colony. And if speed is a virtue, they’ve got that covered. Biofilms can form in less than an hour.²

How do they form?

Biofilms are drastically different from free-floating microorganisms. Approximately 10% of bacteria are free-floating while the remaining 90% form colonies, excreting a sticky matrix called extracellular polymeric substance (EPS).³ The EPS creates a barrier protecting the internal microorganisms from the immune system and antimicrobials. Think of it as an invisibility cloak.

Once formed, the tight-knit community of microorganisms in a biofilm exchanges nutrients and ushers out waste. This creates an environment where a variety of microbial species can support each other and multiply.

Risk Factors that Contribute to Biofilms

• Implants
• Prosthetics 
• Catheterization 
• Oral appliances 
• Antibiotic-resistant bugs 

Microbial imbalances (For more on this topic, read Your Gut Microbiome: What It Is and Why You Should Care)

Lifecycle of a Biofilm

The lifecycle of a biofilm can be divided into five stages:

1. Initial Attachment – The formation begins with a reversible attachment of the free-floating microorganisms onto a surface.
2. Irreversible Attachment  – The bacteria then form a single layer and irreversibly attach to tissues.
3. Maturation I – Formation of microcolonies through cell-to-cell communication. Colonies grow, multilayers appear, divide, and develop a  biofilm.
4. Maturation II –  During later stages, the biofilm forms a three-dimensional “mushroom”-like structure.
5. Dispersion – Finally, some cells start to detach and the biofilm will disperse, potentially reseeding infection and starting a new cycle of biofilm formation. This is the stage where individuals may experience a resurgence of problematic symptoms.

A hideout for the bad guys

By adopting an immobile mode of life embedded in a biofilm, harmful microorganisms enjoy several advantages over their free-floating counterparts:

• Protection from environmental fluctuations in moisture, temperature, pH, and UV light
• Capturing and concentrating environmental nutrients
• Being shielded from host defense mechanisms – the EPS matrix acts like a force field and it is too large to be engulfed by immune cells
• Antibiotic resistance – biofilm bacteria can resist up to 5000 times the antibiotic concentration that would normally be needed to resolve an  infection⁴

In the last stage of development, dispersion, some cells of the mature biofilm start to detach and disperse into the environment as free-floating cells. During the dispersion stage, negative symptoms often resurface while the free-floating cells travel to other areas of the body to form a new biofilm and reseed infections.

How to stop the cycle? 

Biofilms – with their ability to resist antibiotics and antimicrobial agents – create a barrier to optimal health. The treatment of biofilm-associated conditions is complicated. Fortunately, there are several herbal extracts and essential oils you can consider to dismantle biofilms and support microbial balance. 

 The following lifestyle recommendations will also support the disruption of biofilms: 

• Apple Cider Vinegar. One tablespoon daily can help dissolve biofilms. A quick shot is the best option, but if you prefer to mix it with water, drink it with a straw. The acidic pH of apple cider vinegar can erode dental enamel. 
• Raw Garlic. Long revered for its nutritional value, raw garlic also aids in dissolving biofilms. One to two cloves a couple of times a week is helpful; daily is ideal. Garlic salt and powder do not count!
• Evaluate Lifestyle Habits. Smoking, alcohol, simple carbohydrates, and sugar all increase your susceptibility to biofilm formation. 
• Address Oral Biofilms. What grows in the mouth will grow in the gut! Be vigilant about oral health, including regular visits to your dental hygienist.

Understanding biofilms – what they are, how they form, and how they impact health – is especially important for people who experience conditions that just won’t go away. Is that you? Perhaps it’s time to talk to your healthcare professional about whether biofilms might play a role and how you might go about busting them!

References:

1. Joo, H. S., & Otto, M. (2012). Molecular basis of in vivo biofilm formation by bacterial pathogens. Chemistry & biology, 19(12), 1503–1513. https://doi.org/10.1016/j.chembiol.2012.10.022
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312881
3. Hall-Stoodley L, Stoodley P. Biofilm formation and dispersal and the transmission of human pathogens. Trends Microbiol. 2005 Jan;13(1):7-10. doi: 10.1016/j.tim.2004.11.004. 
4. Petrova, O. E., & Sauer, K. (2012). Sticky situations: key components that control bacterial surface attachment. Journal of bacteriology, 194(10), 2413–2425. https://doi.org/10.1128/JB.00003-12