ABSTRACT
When refractory diarrhea comes on,it greatly affects the life and daily work of patients,and there is no unified treatment.Patients with refractory diarrhea have varying degrees of intestinal flora disorder,so rebuilding the intestinal micro ecosystem may be an effective way to treat refractory diarrhea.Fecal microbiota transplantation(FMT)has the potential to be an effective treatment for refractory diarrhea as a therapy that reconstructs normal intestinal flora.In recent years,FMT has been applied to the treatment of some refractory diarrhea related to intestinal flora imbalance,such as recurrent clostridium difficile infection,inflammatory bowel disease,irritable bowel syndrome,and has achieved good results,but some problems have not been properly solved so far.This article reviews the mechanism of action of FMT in the treatment of refractory diarrhea,its clinical application,research progress and current problems.
ABSTRACT
Objective:To evaluate the efficacy of esketamine combined with propofol for colonic transendoscopic enteral tubing (TET) in pediatric patients with autism.Methods:Sixty pediatric patients with autism of both sexes, aged 3-12 yr, weighing 15-45 kg, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent painless transendoscopic enteral tubing (TET) from October 2022 to August 2023, were selected and divided into 2 groups ( n=30 each) by a random number table method: normal saline + propofol group (group NP) and esketamine + propofol group (group EP). In group NP, normal saline 10 ml was intravenously injected, and 30 s later propofol 2.0 mg/kg was given. In group EP, esketamine 0.3 mg/kg (diluted to 10 ml in normal saline) was intravenously injected, and 30 s later propofol 2.0 mg/kg was given. TET was performed when the Modified Observer′s Assessment of Alertness/Sedation Scale score ≤2. Propofol 0.5-1.0 mg/kg was added if the sedation depth was not enough, and the Modified Observer′s Assessment of Alertness/Sedation Scale score was maintained ≤2 until the end of surgery. The degree of body movement during TET was observed and recorded. The injection pain during induction, total consumption of propofol, operation time, spontaneous emergence time, and completion of operation were recorded. Adverse reactions such as respiratory depression, nausea and vomiting, hypotension, bradycardia, and postoperative agitation were recorded during operation and in the emergence period. Results:Compared with group NP, the degree of intraoperative body movement was significantly lighter, the total consumption of propofol and incidence of injection pain and intraoperative hypotension were significantly lower, and no significant change was found in the spontaneous emergence time and incidence of adverse reactions during recovery in group EP ( P<0.05). Conclusions:Esketamine (0.3 mg/kg) combined with propofol (2.0 mg/kg) can be safely and effectively used for colonic TET in pediatric patients with autism, and esketamine does not increase the risk of adverse reactions during resuscitation in a resuscitation strategy without early awakening.
ABSTRACT
ObjectiveTo clarify the relationship between intestinal flora and intestinal motility in rats with slow transit constipation （STC） and qi stagnation syndrome by conducting a pseudo-sterile experiment and fecal microbiota transplantation （FMT） technology. MethodsTwenty-four Wistar rats were randomly divided into normal group （n=6）， STC with qi stagnation pattern group （n=6） and pseudo-sterile group （n=12）. In the STC group with qi stagnation pattern， 3 mg/kg of loperamide suspension by intragastric administration combined with tail clamping stimulation were performed to establish the rat model of STC with qi stagnation pattern. After successful modeling， fresh feces from the rats in the STC with qi stagnation pattern group and the normal group were collected to prepare 100 mg/ml of fecal bacterial suspension. In the pseudo-sterile group， the antibiotic cocktail method was used （a mixed antibiotic suspension containing bacitracin， streptomycin sulfate， and neomycin sulfate at 20 mg/ml each was administered intragastrically） to establish pseudo-sterile rats model. After successful modeling， the rats were randomly divided into normal fecal bacterial liquid group and STC with qi stagnation pattern fecal bacterial liquid group， with six rats in each group， and then were given 10 ml/kg of the prepared corresponding rat fecal bacterial suspension by gavage. Rats in STC with qi stagnation pattern group were given an equal volume of sterile water by gavage. All groups were administered once a day for 7 consecutive days. The small intestinal propulsion rate of the STC with qi stagnation pattern group， the normal fecal bacterial liquid group， and STC with qi stagnation pattern fecal bacterial liquid group were compared. ELISA method was used to detect serum 5-hydroxytryptamine （5-HT） levels. Immunohistochemistry was used to detect the positive expression levels of 5-hydroxytryptamine 3 receptor （5-HT3R） and 5-hydroxytryptamine 4 receptor （5-HT4R） in colon tissue. Western blot method was used to detect the protein expression levels of tryptophan hydroxylase 1 （TPH1）， tryptophan hydroxylase 2 （TPH2）， serotonin transporter （SERT）， and monoamine oxidase A （MAO-A） in colon tissue. ResultsCompared to those in the normal fecal bacterial liquid group， the small intestinal propulsion rate， serum 5-HT level， positive expression of 5-HT3R and 5-HT4R in colon tissue， and protein expression of TPH1， TPH2， SERT and MAO-A significantly decreased in the STC with qi stagnation pattern group and STC with qi stagnation pattern fecal bacterial liquid group （P＜0.05）. There was no statistically significant difference in the indicators between the STC with qi stagnation pattern group and STC with qi stagnation pattern fecal bacterial liquid group （P＞0.05）. ConclusionThe intestinal flora in STC rats with qi stagnation pattern can lead to a slowdown in intestinal transmission function， whose mechanism may be related to intestinal motility disorders affected by the synthesis， transport， metabolism and other pathways of 5-HT.
ABSTRACT
Objective To analyze the clinical characteristics and treatment of clostridium difficile infection(CDI)in children.Methods The clinical data of 159 children with CDI admitted to the Department of Gastroenterology and Hepatology,Shanghai Children's Hospital,School of Medicine,Shanghai Jiao Tong University from September 2014 to October 2022 were retrospectively analyzed.All ini-tial CDI patients were divided into vancomycin treatment group and metronidazole treatment group according to different treatment meth-ods,Children with recurrent CDI(RCDI)were divided into two groups according to vancomycin or FMT treatment.Results A total of 159 children with initial CDI were included,including 93 males and 66 females,the age of these children was 4.3(1.7,8.0)years.109 children(68.55％)were treated with metronidazole,and 50 children(31.45％)were treated with vancomycin.Recurrence occurred in 51 children after antibiotic treatment,37 children(33.94％)of them treated with metronidazole,and 14 children(28.00％)of them treated with vancomycin,there was no significant difference(P＞0.05).Among RCDI children,21 cases were treated with vancomycin and 30 were treated with FMT.The cure rate of FMT was 90.00％,and the cure rate of vancomycin was 57.14％.The cure rate of FMT was significantly higher than that of vancomycin.There were no serious adverse events reported after two months of FMT treatment.Conclusion Metronidazole can be used as the drug of choice for initial CDI in children.The cure rate of FMT for RCDI is superior to vancomycin treatment.
ABSTRACT
Intestinal flora plays an important role in the process of resisting infectious diseases.Fecal microbiota transplantation(FMT)is an important method for reconstructing intestinal microbiota,mainly includes washed mi-crobiota transplantation,transendoscopic enteral tubing,and spore group transplantation.In 2022,the Standardiza-tion Administration of China released the technical standards for Quality control of fecal microbiota washing and grading of fecal microbiota specimens,aiming to reduce adverse events related to FMT and improve the acceptance of FMT by patients and medical personnel.After the success of FMT in the treatment of recurrent Clostridioides difficile infection,its application in the treatment of other infectious diseases has also become a global research hotspot.This paper reviews the development of FMT and its application in various infectious diseases.
ABSTRACT
La infección por Clostridioides difficile es una amenaza para la salud pública, está asociada a la atención médica, cuya complicación más frecuente es la infección recurrente, con tasas de hasta el 60% después del tercer episodio. Las opciones de tratamiento para la recurrencia de esta infección son limitadas. Una gran paradoja es tratar una infección asociada a antibióticos con más antibióticos, por ello, la piedra angular en el manejo de esta infección es la restauración de la microbiota intestinal mediante el trasplante de microbiota fecal. Objetivo. Determinar la eficacia y seguridad del trasplante de microbiota fecal para el tratamiento de la infección recurrente por Clostridioides difficile. Metodología. Se realizó una revisión bibliográfica narrativa de la literatura científica en las bases de datos PubMed y Cochrane Library empleando los Descriptores en Ciencias de la Salud (DeCS) y Medical Subject Headings (MeSH), junto con los operadores booleanos "AND/Y", "OR/O"; donde se recopilaron los estudios que cumplieron con los criterios de inclusión. Conclusión. Se concluyó que el trasplante de microbiota fecal en la infección recurrente por Clostridioides difficile es un tratamiento eficaz y seguro, con eventos adversos mínimos, aunque la seguridad a largo plazo no está bien establecida.
Clostridioides difficile infection is a public health threat, is associated with health care, the most common complication of which is recurrent infection, with rates of up to 60% after the third episode. Treatment options for recurrence of this infection are limited. A great paradox is to treat an antibiotic-associated infection with more antibiotics; therefore, the cornerstone in the management of this infection is the restoration of the intestinal microbiota by fecal microbiota transplantation. Objective. To determine the efficacy and safety of fecal microbiota transplantation for the treatment of recurrent Clostridioides difficile infection. Methodology. A narrative bibliographic review of the scientific literature was carried out in the PubMed and Cochrane Library databases using the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH), together with the Boolean operators "AND/Y", "OR/O"; where the studies that met the inclusion criteria were collected. Conclusion. It was concluded that fecal microbiota transplantation in recurrent Clostridioides difficile infection is an effective and safe treatment, with minimal adverse events, although long-term safety is not well established.
A infecção por Clostridioides difficile é uma ameaça à saúde pública associada ao cuidado com a saúde, cuja complicação mais comum é a infecção recorrente, com taxas de até 60% após o terceiro episódio. As opções de tratamento para infecções recorrentes são limitadas. Um grande paradoxo é tratar uma infecção associada a antibióticos com mais antibióticos, portanto, a pedra fundamental no manejo desta infecção é a restauração da microbiota intestinal através do transplante da microbiota fecal. Objetivo. Determinar a eficácia e segurança do transplante de microbiota fecal para o tratamento de infecções recorrentes por Clostridioides difficile. Metodologia. Uma revisão bibliográfica narrativa da literatura científica foi realizada nas bases de dados da Biblioteca PubMed e Cochrane utilizando os Descritores de Ciências da Saúde (DeCS) e os Títulos de Assuntos Médicos (MeSH), juntamente com os operadores booleanos "AND/Y", "OR/O"; onde foram compilados os estudos que preenchiam os critérios de inclusão. Conclusão. Concluiu-se que o transplante de microbiota fecal em infecção recorrente por Clostridioides difficile é um tratamento eficaz e seguro com o mínimo de eventos adversos, embora a segurança a longo prazo não esteja bem estabelecida.
ABSTRACT
Objective: To explore the effects of fecal microbiota transplantation (FMT) on neurobehavior and gut microbiota of arsenic-exposed offspring rats. Methods: In April 2021, Thirty-six SPF SD rats aged 8 weeks were seleted, rats were ranked by weight and divided into four groups according to randomized block design, namely control group, arsenic exposure group (As group) , arsenic+normal saline group (As+NaCl group) and As+FMT group, 6 females and 3 males in each group. Fecal microbiota fluid were provided by feces of rats in control group. Rats drank tap water containing 75 mg/L sodium arsenite for one week and then were caged together. The arsenic exposure was terminated until the pups were born. Female rats with vaginal plug were treated with fecal microbiota fluid via gavage during neurodevelopmental teratogenic window period. The volume of gavage was 1 ml/100 g with once every two days, for a total of three times. Weight alterations of offspring rats were recorded every week after weaning, and when offspring rats grew up for 6 weeks, Morris test and open field experiment was used to observe learning and memory abilities, as well as neurobehavioral performance of autonomous exploration and tension, respectively. 16S rDNA sequencing technology was used to detect microbiota diversities in fecal samples of rats in As group and As+FMT group. Results: Compared with the control group, the ratio of swimming distance and staying time in the target quadrant and the times of crossing the platform of rats in As group decreased significantly, and the motor distance, times entering central zone and the number of grid crossing of rats decreased significantly (P<0.05) . Compared with As group, the ratio of swimming distance in target quadrant, the motor distance in central zone and times entering central zone of rats in As+FMT group were evidently increased (P<0.05) . The analysis of fecal microbiota diversities showed that, at the phyla level, the relative abundance of Bacteroidetes in feces of rats in As+FMT group was higher than that in As group (68.34% vs 60.55%) , while the relative abundance of Firmicutes was lower than that in As group (28.02% vs 33.48%) . At the genus level, the relative abundance of Prevotella in As+FMT group was significantly higher than that in As group, becoming the dominant genus (42.08% vs 21.78%) . Additionally, compared with As group, a total of 22 genus were increased with 21 decreased genus in As+FMT group (P<0.05) . LEfSe analysis showed that dominant genuses in As+FMT group were Prevotella and UCG_005, and their relative abundance was significantly higher than that of As group (P<0.05) . Conclusion: FMT may alleviate the impaired learning and memory ability and anxiety like behavior of the offspring rats exposed to arsenic, and improve the disrupted gut microbiota.
Subject(s)
Male , Rats , Animals , Female , Fecal Microbiota Transplantation , Gastrointestinal Microbiome , Arsenic , Rats, Sprague-Dawley , FecesABSTRACT
Background:The morbidity of ulcerative colitis(UC)is high,and is easily recurrent.A number of systematic review/meta-analysis have explored the efficacy and safety of fecal microbiota transplantation(FMT)in the treatment of UC with varying conclusions,however,the quality of these studies has not yet been adequately assessed.Aims:To overview the systematic review/meta-analysis of FMT for UC.Methods:Systematic review/meta-analysis of FMT in the treatment of UC were retrieved from PubMed,Cochrane Library,Embase,Web of Science,CNKI,CBM,Wanfang,VIP and other databases from the date of database establishment to May 2023,while gray literatures were searched and experts were consulted.Literature screening and extract information were performed by two researchers.The PRISMA checklist,AMSTAR-2 tool was used to assess the reporting quality and methodological quality,respectively,as well as to grade the quality of evidence for outcome measurements based on the GRADE system.Results:Seventeen systematic review/meta-analysis were finally included.The original studies included randomized controlled trials and observational studies.Most of the studies drew positive conclusions about the efficacy and safety of FMT in the treatment of UC.The PRISMA checklist score was 12.5-22.5,and the mean score was 17.68.Three studies reported relative completeness;ten had some deficiencies;and four had relatively serious report deficiencies.AMSTAR-2 tool showed that two were of intermediate quality,three were of low quality,and twelve were of very low quality.GRADE system ratings showed that six of the eight outcome measurements were of intermediate quality and two were of low quality.Conclusions:FMT may be a safe and effective treatment for UC,but the quality of the current evidence is low and users of clinical evidence need to treat the above evidence with caution.
ABSTRACT
Background:Ulcerative colitis(UC)is highly prevalent and recurrent.A number of systematic review/meta-analysis have explored the efficacy and safety of fecal microbiota transplantation(FMT)in the treatment of UC with varying conclusions,however,the quality of these studies has not yet been adequately assessed.Aims:To overview of systematic review/meta-analysis of FMT for UC.Methods:Systematic review/meta-analysis of FMT for the treatment of UC were retrieved from PubMed,Cochrane Library,Embase,Web of Science,CNKI,CBM,Wanfang,VIP and other databases from the date of database establishment to May 2023,while gray literature was searched manually and experts were consulted.Literature screening and extract information were performed by two researchers.The PRISMA checklist,AMSTAR-2 tool was used to assess the reporting quality and methodological quality,respectively,as well as to grade the quality of evidence for outcome measurements based on the GRADE system.Results:Seventeen systematic review/meta-analysis were finally included.The original studies included randomized controlled trials and observational studies.Most of the studies drew positive conclusions about the effectiveness and safety of FMT in the treatment of UC,but some of them only made inferences about possible effectiveness.The PRISMA checklist score was 12-22.5,and the mean score was 17.68.Four studies(23.5%)reported relative completeness;nine(52.9%)had some deficiencies;and four(23.5%)had relatively serious information deficiencies.AMSTAR-2 score showed that two were of intermediate quality,three were of low quality,and twelve were of very low quality.GRADE ratings showed that five of the eight outcome measurements were of intermediate quality and three were of low quality.Conclusions:FMT may be a safe and effective treatment for UC,but the quality of the current evidence is low and users of clinical evidence need to treat the above evidence with caution.
ABSTRACT
Objective:To explore the effect of fecal microbiota transplantation (FMT) on the formation of renal calcium oxalate crystals in SD rats induced by oxalate mixed diet.Methods:Six male guinea pigs were fed with standard guinea pig chow for 1 month and then given a 5% oxalate diet for 14 d. The guinea pigs on the standard chow were labeled as the standard chow guinea pig (GSC group) and those on the high oxalate diet for 14 d were labeled as the guinea pig group on the high oxalate diet (GOD group). The feces of guinea pigs in the GSC and GOD groups were collected using metabolic cages. Twenty-four male SD rats were randomly divided into standard chow (SC) group, oxalate diet(OD)+ phosphate buffered saline gavage group (OD+ PBS group), OD+ FMT group and SC+ FMT group. Among them, the SC group and SC+ FMT group were fed with standard chow. The OD+ PBS group and OD+ FMT group were fed with 5% oxalate content chow. The OD+ FMT and SC+ FMT groups were given GOD group guinea pig fecal filtrate gavage for 7 days. The 24 h urine and feces of rats in each group were collected, and the intestinal microbiota of rats and guinea pigs were detected by 16sRNA detection. The urinary oxalate excretion was detected by high performance liquid chromatography. The rats and kidneys were weighed and the renal index was calculated. HE staining was used to observe the histological morphological changes of rat kidney tissue, the calcium oxalate crystal deposition in renal tissues was detected by Pizzolato staining.Results:The relative abundance of bacteria from a total of 11 families, including Muribaculaceae family and Bifidobacteriaceae family, was significantly increased in the intestinal tract of guinea pigs (GOD) from the high oxalate diet group compared to guinea pigs (GSC) from the standard chow group. The microbial diversity of the intestinal microbiota of the rats in the OD+ PBS group was reduced compared to the SC group, and the microbial diversity of the intestinal microbiota of the rats in the OD+ FMT group was restored compared to the OD+ PBS group. When given a standard chow, the intestinal microbiota of rats receiving FMT deviated from that of normal rats and was more similar to that of guinea pigs fed a high oxalate diet. In the OD+ FMT group, bacteria from a total of 18 families, including Muribaculaceae family, Erysipelotrichaceae family and Bifidobacteriaceae family, were significantly enriched, and FMT activated the intestinal microbial network represented by bacteria from Muribaculaceae family. The renal index of rats in the OD+ PBS group was significantly increased compared to the SC group (7.63±0.67 vs. 6.12±0.53, P<0.05), whereas the renal index of rats in the OD+ FMT group was significantly decreased in comparison to the OD+ PBS group (6.53±0.64 vs. 7.63±0.67, P<0.05). Urinary oxalate excretion of rats in the SC group, the OD+ PBS group, and the OD+ FMT group were (0.61±0.05), (0.89±0.04) and (0.72±0.04) μmol/ml, respectively. In the rats of the SC group no calcium oxalate crystals were seen in the kidney (0 score) and more calcium oxalate crystals were detected in the OD+ PBS group (4.83±0.41 score). The OD+ FMT group showed significantly lower calcium oxalate crystallization scores (3.17 ± 0.75 score, P<0.01) compared to the OD+ PBS group. Conclusions:FMT activated the microbial network represented by bacteria from the family Muribaculaceae in the rat intestine, significantly reduced urinary oxalate excretion and renal calcium oxalate crystal deposition in rats on a high oxalate diet.
ABSTRACT
Chronic kidney disease (CKD) is a serious health problem worldwide, whereas there is still no efficient cure. The gut microbiota plays a crucial role in maintaining human health and disease resistance, and multiple studies have confirmed that the gut microbiota is closely related to the occurrence and development of CKD. Starting from the "gut-kidney axis" theory, this article provides a systematic review of the changes in gut microbiota composition and function in patients with CKD, such as a decrease in the abundance of butyrate-producing bacteria Roseburia and Faecalibacterium prausnitzii. Besides that, the article explores the mechanisms by which the gut microbiota affects CKD progression, such as inflammation and immunity, and also describes the application methods of using the gut microbiota as a therapeutic target for CKD, such as fecal microbiota transplantation, microecologics, and dietary therapy, in order to provide microbial- based targets for the clinical diagnosis and treatment of CKD.
ABSTRACT
Objective: To investigate the clinical efficacy of fecal microbiota transplantation (FMT) for treating steroid-refractory gastrointestinal acute graft-versus-host disease (GI-aGVHD) . Methods: This analysis included 29 patients with hematology who developed steroid-refractory GI-aGVHD after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in Huaian Hospital Affiliated to Xuzhou Medical University from March 2017 to March 2022. Among them, 19 patients underwent FMT treatment (the FMT group) and 10 patients did not (the control group). The efficacy and safety of FMT were assessed, as well as the changes in intestinal microbiota abundance, lymphocyte subpopulation ratio, peripheral blood inflammatory cytokines, and GVHD biomarkers before and after FMT treatment. Results: ① Complete remission of clinical symptoms after FMT was achieved by 13 (68.4%) patients and 2 (20.0%) controls, with a statistically significant difference (P<0.05). Intestinal microbiota diversity increased and gradually recovered to normal levels after FMT and FMT-related infections did not occur. ②The proportion of CD3(+) and CD8(+) cells in the FMT group after treatment decreased compared with the control group, and the ratio of CD4(+), regulatory T cells (Treg), and CD4(+)/CD8(+) cells increased (all P< 0.05). The interleukin (IL) -6 concentration in the FMT group was lower than that in the control group [4.15 (1.91-5.71) ng/L vs 6.82 (2.40-8.91) ng/L, P=0.040], and the IL-10 concentration in the FMT group was higher than that in the control group [12.11 (5.69-20.36) ng/L vs 7.51 (4.10-9.58) ng/L, P=0.024]. Islet-derived protein 3α (REG3α) was significantly increased in patients with GI-aGVHD, and the REG3α level in the FMT group was lower than that in the control group after treatment [30.70 (10.50-105.00) μg/L vs 74.35 (33.50-139.50) μg/L, P=0.021]. Conclusion: FMT is a safe and effective method for the treatment of steroid-refractory GI-aGVHD by restoring intestinal microbiota diversity, regulating inflammatory cytokines, and upregulating Treg cells.
Subject(s)
Humans , Fecal Microbiota Transplantation/methods , Treatment Outcome , Graft vs Host Disease/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , SteroidsABSTRACT
Metabolic associated fatty liver disease (MAFLD) is a cluster of chronic, progressive diseases with an increasing prevalence rate worldwide. MAFLD has become the leading cause of chronic liver disease around the world, for which approved therapy is currently lacking. In recent years, growing evidence has demonstrated the close link between gut microbiome dysbiosis and MAFLD. The generation of pro-inflammatory bacterial components and metabolites is susceptible to the changes in the abundance, diversity, and ratio of intestinal bacteria, which could accelerate the progress of MAFLD through the gut-liver axis. As a new therapeutic strategy, fecal microbiota transplantation (FMT) is the transplantation of flora from the intestines of healthy people into the gastrointestinal tract of patients, to directly correct intestinal flora disorders and alter bacterial metabolites. FMT has been widely used in the treatment of Clostridium difficile infections and inflammatory bowel disease. The role of FMT in the treatment of MAFLD has also been explored. However, studies about FMT in MAFLD are overall scarce and the mechanism of action and the therapeutic effect of FMT on MAFLD remains ambiguous. We summarized the existing evidence on the potential molecular mechanism and effectiveness related to FMT in MAFLD.
ABSTRACT
Objective:To understand the current status of nursing for chronic constipation patients accepted fecal microbiota transplantation and provide reference basis for constructing clinical nursing plan.Methods:From April to August 2021, a field research was conducted in the Tenth People′s Hospital of Tongji University. Data was collected by field observation and informal interview for 13 nurses and analyzed by three-level coding method of qualitative research.Results:The work content of the observation subjects could be divided into 3 items including entrance health education, donor management, bacterial fluid management and clinical nursing. It still needed being improved in donor management, health education, nursing of naso-jejunal tube, intestinal preparation, infusion of bacterial fluid, observation of complications and follow-up.Conclusions:It still needs further development in nursing for chronic constipation with fecal microbiota transplantation. It is urgent to establish donor follow-up team, conduct professional training for nurses, rely on mobile medical platform to improve quality of fecal microbiota transplantation, so as to promote the recovery of patients.
ABSTRACT
Objective:To evaluate the effects of whole brain irradiation (WBI) and fecal microbiota transplantation (FMT) on hippocampal neurogenesis and the composition of gut microbiota in mice.Methods:Forty specific pathogen free ICR male mice (8-week-old, weighed 30 g) were divided into four groups by simple random sample method: control group (group C), radiation group (group R), group C+FMT and group R+FMT, 10 in each group. Animal models were established by WBI at a dose of 10 Gy by 4 MeV electron beam. In group C+FMT and group R+FMT, mice were gavaged with normal fecal bacteria suspension on day 2 post-irradiation, while those in group C and group R were gavaged with phosphate buffered saline as alternative. Hippocampal tissues and feces in four groups were collected on day 15 post-irradiation. 16S rRNA sequencing was used to detect the species and abundance of fecal flora. BrdU +/NeuN + immunofluorescence staining was performed to observe the neurogenesis in hippocampus of mice. Results:WBI and FMT had no effect on survival rate and body weight of mice. WBI induced the inhibition of hippocampal neurogenesis and flora disorder. The quantity of Bacteroideae and Rumen bacteria was increased by 28.6% and 102.9%, whereas that of Lactobacillus was significantly decreased by 70.6% ( P<0.05). FMT regulated the abundance of bacteria. The abundance of Enterobacteriaceae was significantly declined by 65.1% ( P=0.028), while that of Lactobacillus was increased by 58.2% ( P=0.015). FMT also promoted hippocampal neurogenesis to some extent after WBI. Conclusions:This preliminary study demonstrates that FMT alleviates the inhibition of hippocampal neurogenesis and flora disorder induced by WBI in mice. Ionizing radiation directly acting on the whole brain of mice indirectly disturbs the composition of gut microbiota, which in turn affects the degree of hippocampal neurogenesis in the brain of mice. There is a bidirectional interaction between gut microbiota and brain.
ABSTRACT
With the decline in male fertility in recent years, infertility has become an urgent global problem to be solved. Existing evidence shows that gut microbiota has an important impact on male reproductive health, and gut microbiota disorder can affect spermatogenesis by inducing inflammation, metabolic disorder and endocrine disruption. This paper systematically reviews the relevant research progress in this field, focusing on the impact of gut microbiota disorder on male reproductive ability from the aspects of gut microbiota and spermatogenesis, gut microbiota and sex hormone metabolism, effects of fecal microbiota transplantation and dietary regulation on male reproductive function, and discusses the future research directions of gut micro-biota and male infertility.
ABSTRACT
Male infertility is a significant cause of psychosocial and marital distress in approximately 50% of couples who are unable to conceive, with male factors being the underlying cause. Guijiajiao (Colla Carapacis et Plastri, CCP) is a Traditional Chinese Medicine commonly used to treat male infertility. The present study aimed to investigate the potential mechanisms underlying the preventive effects of CCP on male infertility. An infertile male rat model was established using cyclophosphamide (CTX), and CCP was administered for both treatment and prevention. Fecal microbiota transplantation (FMT) was also performed to explore the role of gut microbiota in the CCP-mediated prevention of male infertility in rats. Sperm motility and concentration were determined using a semi-automatic sperm classification analyzer. Subsequently, histopathological analysis using HE staining was performed to examine the changes in the small intestine and testis. Moreover, the serum levels of lipopolysaccharide (LPS) and testosterone were measured by ELISA. In addition, immunohistochemistry was conducted to detect CD3 expression in the small intestine, while RT-qPCR was employed to assess the expressions of interleukin-1 beta (IL-1β), cluster of differentiation 3 (CD3), Monocyte chemoattractant protein-1 (MCP-1), and C-X-C motif chemokine ligand 10 (CXCL-10) in the small intestine and epididymis. Finally, gut microbiota was analyzed by 16S rRNA sequencing. CCP improved sperm motility, number, and concentration in CTX-induced infertile male rats. CCP increased the serum testosterone level, inhibited the immune cell infiltration of the intestinal lamina propria, and promoted the aggregation of CD3+ T cells in CTX-induced male infertility rats. CCP also inhibited the expressions of MCP-1, CXCL-10, and IL-1β in the epididymis of male infertility rats. At the genus level, CTX led to a reduction in the abundance of Lactobacillus, Clostridia_UCG.014, and Romboutsia in the intestinal tract of rats. In contrast, CCP decreased the abundance of Ruminococcus and increased the abundance of Romboutsia in infertile male rats. Additionally, FMT experiments proved that the gut microbiota of CCP-treated rats facilitated testicular tissue recovery and spermatogenesis while also reducing the serum LPS level in infertile male rats. CCP improves the spermatogenic ability of infertile male rats by restoring gut microbiota diversity and inhibiting epididymal inflammation.
Subject(s)
Humans , Rats , Male , Animals , Gastrointestinal Microbiome , Lipopolysaccharides/pharmacology , RNA, Ribosomal, 16S , Semen , Sperm Motility , Infertility, Male/prevention & control , TestosteroneABSTRACT
Abstract Introduction The relationship between humidity and systemic lupus erythematosus (SLE) has yielded inconsistent results in prior research, while the effects of humidity on lupus in animal experiments and its underlying mechanism remain inadequately explored. Methods The present study aimed to investigate the impact of high humidity (80 ± 5%) on lupus using female and male MRL/lpr mice, with a particular focus on elucidating the role of gut microbiota in this process. To this end, fecal microbiota transplantation (FMT) was employed to transfer the gut microbiota of MRL/lpr mice under high humidity to blank MRL/lpr mice under normal humidity (50 ± 5%), allowing for an assessment of the effect of FMT on lupus. Results The study revealed that high humidity exacerbated lupus indices (serum anti-dsDNA, ANA, IL-6, and IFN- g, and renal pathology) in female MRL/lpr mice but had no significant effect on male MRL/lpr mice. The aggravation of lupus caused by high humidity may be attributed to the increased abundances of the Rikenella, Romboutsia, Turicibacter, and Escherichia-Shigella genera in female MRL/lpr mice. Furthermore, FMT also exacerbated lupus in female MRL/lpr mice but not in male MRL/lpr mice. Conclusion In summary, this study has demonstrated that high humidity exacerbated lupus by modulating gut microbiota in female MRL/lpr mice. The findings underscore the importance of considering environmental factors and gut microbiota in the development and progression of lupus, particularly among female patients.
ABSTRACT
Objetivo: Oferecer uma visão geral sobre os efeitos que as intervenções com o uso de probióticos, prebióticos ou Transplante de Microbiota Fecal (TMF) e suas combinações provocam nos sintomas neurocomportamentais e gastrointestinais (GI) em indivíduos com Transtorno do Espectro Autista (TEA). Metodologia: Foi realizada uma revisão integrativa (RI) da literatura nas plataformas PubMed, SciELO, LILACS e Scopus, a partir dos descritores "autistic disorder", "autism", "prebiotics", "probiotics", "fecal microbiota transplantation" e "fecal transplantation", utilizando os operadores booleanos "AND" e "OR". Foram selecionados apenas artigos dos anos de 2013 a 2022, publicados em português, inglês ou espanhol e que possuíam relação direta com o tema. Resultados: Foram analisados 24 artigos na íntegra, dos quais 14 obedeciam aos critérios de inclusão e tiveram seus resultados analisados na presente revisão. Desses, dois relataram melhora dos sintomas GI com uso de probiótico, prebiótico e/ou TMF, nove mencionaram melhora tanto dos sintomas GI como dos neurocomportamentais com as terapias utilizadas e os outros três avaliaram a mudança dos sintomas neurocomportamentais. Conclusão: As terapias com probióticos, prebióticos e TMF possuem um efeito promissor na modificação da microbiota e na melhora dos sintomas neurocomportamentais e GI em pessoas com TEA.
Objective: To provide an overview of the effects that interventions with the use of probiotics, prebiotics, or fecal microbiota transplantation and their combinations have on neurobehavioral and gastrointestinal (GI) symptoms in individuals with Autism Spectrum Disorder (ASD). Methodology: An integrative review of the literature was conducted on the PubMed, SciELO, LILACS, and Scopus platforms using the descriptors "autistic disorder", "autism", "prebiotics", "probiotics", "fecal microbiota transplantation", and "fecal transplantation", using the Boolean operators "AND" and "OR". Only articles published between 2013 and 2022 in Portuguese, English, or Spanish and directly related to the topic were selected. Results: Twenty-four articles were fully analyzed, of which fourteen met the inclusion criteria and had their results analyzed in this review. Of these, two reported improvement in GI symptoms with the use of probiotics, prebiotics, and/or fecal microbiota transplantation, nine mentioned improvement in both GI and neurobehavioral symptoms with the therapies used, and the other three evaluated the change in neurobehavioral symptoms. Conclusion: Probiotic, prebiotic, and fecal microbiota transplantation therapies have a promising effect on modifying the microbiota and improving neurobehavioral and GI symptoms in individuals with ASD.
Objetivo: Proporcionar una visión general de los efectos que las intervenciones con el uso de probióticos, prebióticos o trasplante de microbiota fecal y sus combinaciones tienen sobre los síntomas neuroconductuales y gastrointestinales (GI) en individuos con Trastorno del Espectro Autista (TEA). Metodología: Se realizó una revisión integradora de la literatura en las plataformas PubMed, SciELO, LILACS y Scopus utilizando los descriptores "autistic disorder", "autism", "prebiotics", "probiotics", "fecal microbiota transplantation" y "fecal transplantation", utilizando los operadores booleanos "AND" y "OR". Solo se seleccionaron artículos publicados entre 2013 y 2022 en portugués, inglés o español y directamente relacionados con el tema. Resultados: Veinticuatro artículos fueron analizados en su totalidad, de los cuales catorce cumplieron los criterios de inclusión y sus resultados fueron analizados en esta revisión. De estos, dos reportaron mejoría en los síntomas GI con el uso de probióticos, prebióticos y/o trasplante de microbiota fecal, nueve mencionaron mejoría tanto en los síntomas GI como neuroconductuales con las terapias utilizadas, y los otros tres evaluaron el cambio en los síntomas neuroconductuales. Conclusiones: Las terapias con probióticos, prebióticos y trasplante de microbiota fecal tienen un efecto prometedor en la modificación de la microbiota y la mejora de los síntomas neuroconductuales y GI en individuos con TEA. PALABRAS CLAVE: Autismo; Microbiota; Prebióticos; Probióticos; Trasplante de Microbiota Fecal.
ABSTRACT
ABSTRACT Introduction: despite being extremely effective in some cases, up to 70% of patients with melanoma do not respond to anti-PD-1/PD-L1 (primary resistance) and many of the responders eventually progress (secondary resistance). Extensive efforts are being made to overcome this resistance through new strategies, especially aimed at modulating the intestinal microbiota. Objective: to assess whether fecal microbiota transplantation (FMT), associated with immunotherapy, is beneficial in the clinical course of patients with refractory melanoma. Methods: this is a scope review, based on studies collected on the MEDLINE, ScienceDirect, The Cochrane Library, Embase and BMJ Journals; using the terms: "Antibodies, Monoclonal"; "Drug Resistance, Neoplasm"; "Fecal Microbiota Transplantation"; "Host Microbial Interactions"; "Immunotherapy"; "Melanoma"; and "Microbiota". Clinical trials, in English, with relevant data on the subject and fully available were included. A cut-off period was not determined, due to the limited amount of evidence on the topic. Results: crossing the descriptors allowed the identification of 342 publications and, after applying the eligibility criteria, allowed the selection of 4 studies. From the analyses, it was observed that a considerable part of those studied overcame resistance to immune checkpoint inhibitors after FMT, with better response to treatment, less tumor growth and increased beneficial immune response. Conclusion: it is noted that FMT favors the response of melanoma to immunotherapy, translated into significant clinical benefit. However, further studies are necessary for the complete elucidation of the bacteria and the mechanisms involved, as well as for the translation of new evidence to oncological care practice.
RESUMO Introdução: apesar de extremamente eficaz em alguns casos, até 70% dos pacientes com melanoma não respondem aos anti-PD-1/PD-L1 (resistência primária) e muitos dos respondedores, eventualmente, acabam progredindo (resistência secundária). Extensos esforços estão sendo realizados para superar esta resistência através de novas estratégias, sobretudo, visando a modulação da microbiota intestinal. Objetivo: avaliar se o transplante de microbiota fecal (TMF), associado à imunoterapia, é benéfico no curso clínico do paciente com melanoma refratário. Métodos: trata-se de uma revisão de escopo, baseada em estudos coletados nas plataformas MEDLINE, ScienceDirect, The Cochrane Library, Embase e BMJ Journals; utilizando os descritores: "Antibodies, Monoclonal"; "Drug Resistance, Neoplasm"; "Fecal Microbiota Transplantation"; "Host Microbial Interactions"; "Immunotherapy"; "Melanoma"; e "Microbiota". Foram incluídos ensaios clínicos, na língua inglesa, com dados relevantes sobre a temática e disponíveis integralmente. Não foi determinado um período de corte temporal, devido à quantidade limitada de evidências sobre o tema. Resultados: o cruzamento dos descritores permitiu a identificação de 342 publicações e, após a aplicação dos critérios de elegibilidade, permitiu a seleção de 4 estudos. A partir das análises, observou-se que grande parte dos estudados superaram a resistência aos inibidores do checkpoint imunológico pós-TMF, com melhor resposta ao tratamento, menor crescimento tumoral e aumento da resposta imunológica benéfica. Conclusão: nota-se que o TMF favorece a resposta do melanoma à imunoterapia, traduzido por benefício clínico significativo. Entretanto, novos estudos são necessários para a completa elucidação das bactérias e mecanismos envolvidos, bem como para que haja a translação das novas evidências para a prática assistencial oncológica.