A Physician’s Guide to Use of Actinobacteria Indices

A Physician’s Guide to Use of Actinobacteria Indices

7/7/2021

Ritchie C. Shoemaker, MD

In the newest report from EnviroBiomics, Actinomycetales, also called Actinobacteria, are now reported with an additional factor called an Actino Index. We look at a Dominance Index (DI) and a Prevalence Index (PI) to assist physicians in making clinical decisions. Dominance is the ratio of human habitat-derived actinos (HH) to soil habitat-derived actinos (SH), using appearance in a group of 33 species of HH compared to 13 species of SH. For the DI, number of Bacterial Equivalents/mg (BE) is not factored into the ratio. DI is correlated with upregulation of genes that code for MAPKs. Here is where dysfunctional immunoregulation caused by actino exposure begins.

PI is the ratio of the average BE. in the top 5 HH organisms to the average BE for the top 5 SH organisms. PI is correlated with genes for TGF beta-1 signaling (TGFBR 1, 2, 3). As published, here is where precise, specific causation of immunoreactivity caused by actinos begins.

EACH INDEX IS UNIQUE AND IS NOT RELATED TO THE OTHER. Said another way, we are trying to maximize the transcriptomic implications of presence of abnormalities in environmental sampling. This concept of direct linkage of exposure to gene abnormalities has been used and published before.

There are a couple of methodological elements that now are of greater importance given a greater specificity that the index brings. We need to know where the Actinobacteria dust sample was taken from. Sample location is a short section on page one of the EBI report but is probably the most important duty for the individual obtaining the dust sample to let the lab and the physician know where the dust comes from. The reason this is important is because outdoors, basement and crawlspace samples are very different in the predicted makeup of normal flora of bacteria compared to the “inner sanctum” of the house to include bedrooms and bathrooms. We find different organisms there. Please be specific.

Please notice on page 3 that the EBI actinos score has been changed slightly to make it easier to understand. The score is not an index, however.

The Actinos Index box is printed on page 5 together with a brief discussion about the role of Actinobacteria from HH or Actinobacteria from SH. The different species of actinos found that are printed for you on page 7 in Table 2 of Pathogenic Actinomycetes are ones that are the master group from which the extracted group of actinos sampled from human versus soil organisms are based.

If the DI is greater than 2.0, then there are more HH species than SH. If the PI is greater than 2.0, the number of HH organisms will be greater than the number of SH organisms. There has been a lot of calculation, correlation and statistics involved in generation of these numbers.

If you want a breakout score for the AI, this added service is available from EBI.

Both indices are correlated with specific abnormalities of immunoreactivity seen on GENIE. If GENIE is not done with the actinos index testing, we simply can’t access that information but if the AI is done simultaneously with GENIE, then the most sophisticated role of causation of actinos in human illness is unveiled. Even without GENIE, the AI is a stand-alone measurement of tremendous importance. Only EBI has this function now available from a commercial laboratory to be accessed by patients.

Please pay close attention to the DI and PI when they are lower than 2.0. To date, they have been correlated with absence of Actinobacteria-associated illness for patients with CIRS, but we all know that CIRS is a complex illness; AI will not indicate fungal contamination or growth of bacteria making endotoxins. I expect that as our research data set expands, there will be new findings in patients with low AI.

We hope that the indices will eventually lead to greater sophistication in remediation efforts, as it is clear that remediation using just fungal measurements alone has been well established in peer-reviewed literature to not be reliable as shown by many publications. We don’t know yet that use of indices will make remediation more accurate and less expensive, but we are hopeful that there will be expansion of use of precipitation techniques as well as filtration, based on before remediation and after indices studies in anecdotal cases.

These are exciting times in CIRS. We hope to have regularly updated information on AI on the survivingmold website.

To calculate the indices use the following formula:

Dominance Index

1. Take sum of HH actinos and divide by 33.
2. Now take sum of SH actinos and divide by 13.
3. Now divide HH/33 by SH/13.
4. The result is the DI.

Prevalence Index

Take the average of the first five species listed in Human and divide that number by the average of the first five SH. These species are identified by an * for both HH and SH.

Human Habitat derived Actinobacteria

• Propionibacterium acnes*
• Corynebacterium tuberculostearicum *
• C. xerosis*
• C. amycolatum*
• C. simulans*
• Actinomadura chibensis
• Actinomyces canis
• Actinomyces europaeus
• Actinomyces meyeri
• Actinomyces neuii
• Actinomyces odontolyticus
• Actinomyces turicensis
• Corynebacterium accolens
• C. argentoratense
• C. coyleae
• C. falsenii
• C. glucuronolyticum
• C. hansenii
• C. imitans
• C. jeikeium
• C. kroppenstedtii
• C. matruchotii
• C. minutissimum
• C. propinquum
• C. resistens
• C. riegelii
• C. striatum
• C. sundsvallense
• C. ureicelerivorans
• Dermatophilus congolensis
• Propionibacterium avidum
• Propionibacterium granulosum
• Rothia mucilaginosa

Soil Habitat derived Actinobacteria

• Rathayibacter tritici*
• Brevibacterium mcbrelneri*
• Curtobacterium flaccumfaciens*
• Rhodococcus fascians*
• Saccharopolyspora rectivirgula*
• Arthrobacter creatinolyticus
• Arthobacter crystallopoietes
• Brevibacterium paucivorans
• Clavibacter michiganensis
• Gordonia terrae
• Nocardia higoensis
• Rhodococcus equi
• Sanguibacter suarezii

Should you have questions, or wish to obtain a AI consult, please contact Debbie Waidner info@survivingmold.com.