Association of intestinal microecology with the development and progression of autoimmune hepatitis / 临床肝胆病杂志

Autoimmune hepatitis （AIH） is an autoimmune disease characterized by chronic liver inflammation， with a gradually increasing incidence rate， and its social and medical burdens cannot be neglected. Intestinal microecology is becoming a research hotspot in the field of autoimmune disease. In recent years， it has been believed that changes in intestinal microecology can cause changes in autoimmune state， microbial metabolites， and intestinal barrier， which is one of the driving factors for the onset of AIH. Early diagnosis and correct treatment can help to improve the prognosis of AIH patients. This article introduces the characteristics of gut microbiota in AIH patients， elaborates on the impact of intestinal microflora imbalance on the pathogenesis of AIH， and briefly describes related treatment regimens from the perspective of intestinal microecology， so as to comprehensively understand and explain the role of intestinal microecology in AIH and the impact of intestinal microecology balance on the pathogenesis， diagnosis， and treatment of AIH.

Characteristics of the composition of intestinal flora in cirrhotic patients with malnutrition / 临床肝胆病杂志

ObjectiveTo investigate the characteristics of the composition of intestinal flora and the serum level of endotoxin in cirrhotic patients with malnutrition， and to provide new diagnosis and treatment ideas for improving the nutritional status of patients with liver cirrhosis. MethodsA total of 58 patients with liver cirrhosis who were hospitalized in Department of Gastroenterology， People’s Hospital of Zhengzhou， from March 2021 to November 2022 were enrolled as experimental group （LC group）， and according to the Royal Free Hospital-Nutritional Prioritizing Tool， they were divided into low malnutrition risk group （LC-A group with 28 patients） and moderate/high malnutrition risk group （LC-B group with 30 patients）； 25 individuals who underwent physical examination during the same period of time were enrolled as control group （HC group）. Peripheral blood and feces samples were collected from all subjects. The limulus amebocyte lysate gel method was used to measure the concentration of endotoxin in peripheral blood， and high-throughput sequencing and bioinformatics analysis were used to investigate the characteristics of intestinal flora. The independent-samples t test was used for comparison of normally distributed continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test were used for further comparison between two groups. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups. The chi-square test was used for comparison of categorical data between groups. The Spearman test was used for correlation analysis. ResultsThere were significant differences between the three groups in the levels of alanine aminotransferase （H=7.054， P<0.05）， gamma-glutamyl transpeptidase （H=9.644， P<0.05）， albumin （Alb） （F=32.768， P<0.05）， total bilirubin （TBil） （H=20.980， P<0.05）， and serum endotoxin （F=108.672， P<0.05）. There was a significant difference in Chao1 index between the three groups （F=5.110， P=0.008） and between the HC group and the LC-B group （P<0.05）. Compared with the HC group， the LC-A group and the LC-B group had significant reductions in Chao1 index and Shannon index， and there was a significant difference in Chao1 index between the HC group and the LC-B group （P<0.05）. At the phylum level， the intestinal flora in each group was mainly composed of Bacteroidota， Firmicutes， Proteobacteria， and Actinobacteriota， accounting for more than 95% of all phyla， and there was a significant difference in the relative abundance of Firmicutes between the HC group and the LC-B group （P<0.05）. Serum endotoxin was significantly negatively correlated with Ruminococcaceae （r=-0.420， P=0.007）， and spirochete was significantly positively correlated with TBil （r=0.419， P=0.007） and was significantly negatively correlated with Alb （r=-0.492， P=0.001）. ConclusionThere are unique changes in intestinal flora in cirrhotic patients with malnutrition， and differentially expressed flora are associated with endotoxemia. Improving intestinal microecology in liver cirrhosis may help to improve nutritional status.

Insuflación rectal con ozono en infecciones intestinales / Rectal Insufflation with Ozone in Intestinal Infections

Introducción: Las infecciones intestinales se relacionan con trastornos del sistema inmune y de la microbiota intestinal. Pueden ser recurrentes y producir otras alteraciones intestinales y sistémicas, que empeoran con la terapia antimicrobiana. La ozonoterapia ha sido usada en el tratamiento de infecciones intestinales. Objetivos: Recopilar información sobre los efectos biológicos, terapéuticos y la seguridad de la administración del ozono por insuflación rectal en el tratamiento de las infecciones intestinales. Métodos: Para la búsqueda de información se empleó el motor de búsqueda Google Académico. Se consultaron artículos en las bases de datos PubMed y SciELO de la Biblioteca Virtual de Salud. Además, se realizó una búsqueda general en los idiomas español e inglés, a partir de los artículos más relevantes acerca del estudio. Se utilizaron como palabras clave: infecciones, insuflación, microbioma gastrointestinal, ozono como términos más concretos. En el estudio no se aplicó ninguna restricción acerca del ámbito geográfico ni de la edad. Conclusiones: La aplicación rectal de ozono es segura, tiene acciones biológicas y terapéuticas útiles para tratar las infecciones intestinales. Actúa como inmunomodulador y protector de la microbiota intestinal, lo que permite enfrentar esta problemática de salud desde el punto de vista preventivo, curativo y de rehabilitación de los daños causados, tanto por los gérmenes como por los efectos de los antibióticos(AU)

Introduction: Intestinal infections are related to disorders of the immune system and intestinal microbiota. They can be recurrent and produce other intestinal and systemic alterations, which worsen with antimicrobial therapy. Ozone therapy has been used in the treatment of intestinal infections. Objectives: To compile information on the biological, therapeutic effects and safety of the administration of ozone by rectal insufflation in the treatment of intestinal infections. Methods: Google Scholar search engine was used for searching information. Articles were consulted in PubMed and SciELO databases of the Virtual Health Library. In addition, a general search was carried out in Spanish and English, based on the most relevant articles about the study. The keywords used were infections, insufflation, gastrointestinal microbiome, ozone as more specific terms. No restrictions on geographic area or age were applied in the study. Conclusions: The rectal application of ozone is safe, it has useful biological and therapeutic actions to treat intestinal infections, acting as an immunomodulator and protector of the intestinal microbiota, which allows us to face this health problem from a preventive, curative and rehabilitation point of view of the damage caused, both by germs and by the effects of antibiotics(AU)

The brain-gut-microbiota axis in the treatment of neurologic and psychiatric disorders / O eixo microbiota-intestino-cérebro no tratamento de desordens neurológicas e psiquiátricas

Abstract The human gut microbiota is a complex ecosystem made of trillions of microorganisms. The composition can be affected by diet, metabolism, age, geography, stress, seasons, temperature, sleep, and medications. The increasing evidence about the existence of a close and bi-directional correlation between the gut microbiota and the brain indicates that intestinal imbalance may play a vital role in the development, function, and disorders of the central nervous system. The mechanisms of interaction between the gut-microbiota on neuronal activity are widely discussed. Several potential pathways are involved with the brain-gut-microbiota axis, including the vagus nerve, endocrine, immune, and biochemical pathways. Gut dysbiosis has been linked to neurological disorders in different ways that involve activation of the hypothalamic-pituitary-adrenal axis, imbalance in neurotransmitter release, systemic inflammation, and increase in the permeability of the intestinal and the blood-brain barrier. Mental and neurological diseases have become more prevalent during the coronavirus disease 2019pandemic and are an essential issue in public health globally. Understanding the importance of diagnosing, preventing, and treating dysbiosis is critical because gut microbial imbalance is a significant risk factor for these disorders. This review summarizes evidence demonstrating the influence of gut dysbiosis on mental and neurological disorders.

Resumo A microbiota intestinal humana é um ecossistema complexo feito de trilhões de microrganismos, cuja composição pode ser afetada pela dieta, pelo metabolismo, pela idade, geografia, pelo estresse, pelas estações do ano, pela temperatura, pelo sono e por medicamentos. A crescente evidência sobre a existência de uma correlação estreita e bidirecional entre a microbiota intestinal e o cérebro indica que o desequilíbrio intestinal pode desempenhar um papel vital no desenvolvimento, na função e nos distúrbios do sistema nervoso central. Os mecanismos de interação entre a microbiota intestinal e a atividade neuronal são amplamente discutidos. Várias vias potenciais estão envolvidas com o eixo microbiota-intestino-cérebro, incluindo o nervo vago e as vias endócrinas, imunes e bioquímicas. A disbiose intestinal tem sido associada a distúrbios neurológicos de diferentes maneiras que envolvem a ativação do eixo hipotálamo-hipófise-adrenal, o desequilíbrio na liberação de neurotransmissores, a inflamação sistêmica e o aumento da permeabilidade das barreiras intestinal e hematoencefálica. As doenças mentais e neurológicas tornaram-se mais prevalentes durante a pandemia de coronavirus disease 2019 e são uma questão global essencial na saúde pública. Compreender a importância de diagnosticar, prevenir e tratar a disbiose é fundamental porque o desequilíbrio microbiano intestinal é um fator de risco significativo para esses distúrbios. Esta revisão resume as evidências que demonstram a influência da disbiose intestinal em distúrbios mentais e neurológicos.

Use of probiotics in patients with chronic kidney disease on hemodialysis: a randomized clinical trial / Uso de probióticos em pacientes com doença renal crônica em hemodiálise: um ensaio clínico randomizado

ABSTRACT Introduction: Supplementation with probiotics for patients with chronic kidney disease (CKD) may be associated with decreased systemic inflammation. Objective: To assess the impact of oral supplementation with probiotics for patients with CKD on hemodialysis. Method: This double-blind randomized clinical trial included 70 patients on hemodialysis; 32 were given oral supplementation with probiotics and 38 were in the placebo group. Blood samples were collected at the start of the study and patients were given oral supplementation with probiotics or placebo for three months. The probiotic supplement comprised four strains of encapsulated Gram-positive bacteria: Lactobacillus Plantarum A87, Lactobacillus rhamnosus, Bifidobacterium bifidum A218 and Bifidobacterium longum A101. Patients were given one capsule per day for 3 months. Blood samples were taken throughout the study to check for inflammatory biomarkers. Non-traditional biomarkers Syndecan-1, IFN-y, NGAL, and cystatin C were measured using an ELISA kit, along with biochemical parameters CRP, calcium, phosphorus, potassium, PTH, GPT, hematocrit, hemoglobin, glucose, and urea. Results: Patients given supplementation with probiotics had significant decreases in serum levels of syndecan-1 (239 ± 113 to 184 ± 106 ng/mL, p = 0.005); blood glucose levels also decreased significantly (162 ± 112 to 146 ± 74 mg/dL, p = 0.02). Conclusion: Administration of probiotics to patients with advanced CKD was associated with decreases in syndecan-1 and blood glucose levels, indicating potential improvements in metabolism and decreased systemic inflammation.

Resumo Introdução: A suplementação com probióticos na doença renal crônica (DRC) pode estar associada à redução do processo inflamatório sistêmico. Objetivo: Avaliar a suplementação oral com probióticos em pacientes com DRC em hemodiálise. Método: Ensaio clínico, duplo cego, randomizado com 70 pacientes em hemodiálise, sendo 32 do grupo que recebeu o suplemento de probióticos e 38 do grupo placebo. Inicialmente ocorreu a coleta de sangue e suplementação oral com probióticos ou placebo durante três meses. O suplemento probiótico foi composto pela combinação de 4 cepas de bactérias Gram-positivas encapsuladas: Lactobacillus Plantarum A87, Lactobacillus rhamnosus, Bifidobacterium bifidum A218 e Bifidobacterium longum A101, sendo 1 cápsula do suplemento ao dia, durante 3 meses. Após esse período foram feitas novas coletas de sangue para dosagem dos biomarcadores inflamatórios. Foram analisados os biomarcadores não tradicionais: Syndecan-1, IFN-y, NGAL e cistatina C pelo método ELISA, e os seguintes parâmetros bioquímicos: PCR, cálcio, fósforo, potássio, PTH, TGP, hematócrito, hemoglobina, glicose e ureia. Resultados: Os pacientes que receberam suplemento tiveram diminuição significativa dos níveis séricos de syndecan-1 (de 239 ± 113 para 184 ± 106 ng/mL, p = 0,005). Outro parâmetro que diminuiu significativamente nos pacientes que receberam suplemento foi a glicemia (de 162 ± 112 para 146 ± 74 mg/dL, p = 0,02). Conclusão: O uso de probióticos na DRC avançada esteve associado à redução dos níveis de syndecan-1 e glicemia, sinalizando possível melhora no metabolismo e redução do processo inflamatório sistêmico.

Relação entre hábitos alimentares, peso corporal e saúde intestinal em indivíduos adultos / Relationship between eating habits, body weight, and intestinal health in adults

Introdução: A disbiose pode estar relacionada à hábitos alimentares ruins e alterações metabólicas que podem contribuir para o excesso de peso. Objetivo: Avaliar as escolhas alimentares que modulam a microbiota intestinal e a associação entre a saúde intestinal e o peso corporal de indivíduos adultos. Método: Estudo analítico, correlacional-descritivo e transversal realizado com 99 participantes, adultos, de ambos os sexos. Utilizou-se um Questionário Sociodemográfico e de Frequência Alimentar para coletar dados sociodemográficos, peso corporal, altura, frequência de consumo de alimentos fontes de prebióticos e probióticos e o Questionário de Rastreamento Metabólico (QRM), para investigar a saúde intestinal. O estudo ocorreu de forma online, via Google forms, sendo divulgado através das redes sociais (Facebook, Instagram, WhatsApp). Realizou-se uma análise descritiva dos dados e para associação entre variáveis empregou-se o teste Qui-quadrado de Pearson. Resultados: Do total de participantes, 74,7% eram mulheres. Quanto à classificação do Índice de Massa Corporal (IMC), 60,6% apresentaram eutrofia 24,2% sobrepeso e 9,1% algum grau de obesidade. Os alimentos fontes de probióticos e prebióticos mais consumidos foram queijo, iogurte, leites fermentados e banana, maçã, aveia, respectivamente. Porém, são alimentos que não fazem parte do consumo diário para a maioria dos participantes. Não houve diferença significativa entre a associação com IMC com sexo, escore final do QRM e somatório final dos sintomas gastrointestinais (p=0,76, p=0,29, p=0,70), respectivamente. Conclusão: Nota-se uma baixa frequência de consumo de alimentos que auxiliam na saúde intestinal. No entanto, não foi constatado que o peso corporal exerce influência na composição da microbiota intestinal.

Introducción: La disbiosis puede estar relacionada con malos hábitos alimentarios y alteraciones metabólicas que pueden contribuir al sobrepeso. Objetivo: Evaluar las elecciones alimentarias que modulan la microbiota intestinal y la asociación entre la salud intestinal y el peso corporal en personas adultas. Método: Estudio analítico, correlacional-descriptivo y transversal realizado con 99 personas participantes adultas de ambos sexos. Se utilizó un cuestionario sociodemográfico y de frecuencia alimentaria para recoger datos sociodemográficos, peso corporal, altura, frecuencia de consumo de fuentes alimentarias de prebióticos y probióticos y el Cuestionario de Seguimiento Metabólico para investigar la salud intestinal. El estudio se realizó online, a través de formularios de Google, siendo difundido a través de redes sociales (Facebook, Instagram, WhatsApp). Se realizó un análisis descriptivo de los datos y para la asociación entre variables se empleó el test Chi-cuadrado de Pearson. Resultados: Del total de participantes, el 74.7 % fueron mujeres. En cuanto a la clasificación del Índice de Masa Corporal, el 60.6 % eran personas eutróficas, el 24.2 % con sobrepeso y el 9.1% personas obesas. Los alimentos fuente de probióticos y prebióticos más consumidos fueron el queso, el yogur, las leches fermentadas, el plátano, la manzana y la avena. Sin embargo, se trata de alimentos que no forman parte del consumo diario de la mayoría de los participantes. No hubo diferencias significativas entre la asociación del Índice de Masa Corporal con el sexo, la puntuación final del Cuestionario de Seguimiento Metabólico y la suma final de síntomas gastrointestinales (p=0.76, p=0.29, p=0.70), respectivamente. Conclusiones: Se observa una baja frecuencia de consumo de alimentos que ayudan a la salud intestinal. Sin embargo, no se encontró que el peso corporal ejerza influencia sobre la composición de la microbiota intestinal.

Introduction: Dysbiosis may be related to poor eating habits and metabolic changes that can contribute to being overweight. Objective: To evaluate the food choices that modulate the gut microbiota and the association between gut health and body weight in adult individuals. Method: Analytical, correlational-descriptive, cross-sectional study conducted with 99 adult participants of both sexes. A Sociodemographic and Food Frequency Questionnaire was used to collect sociodemographic data, body weight, height, and frequency of consumption of food sources of prebiotics and probiotics; and the Metabolic Tracking Questionnaire was applied to investigate gut health. The study took place online, via Google Forms, and was disseminated through social media (Facebook, Instagram, WhatsApp). A descriptive analysis of the data was performed and for association between variables, the Pearson's Chi-square test was used. Results: Of the total number of participants, 74.7% were women. As for the classification of Body Mass Index, 60.6% were eutrophic, 24.2% were overweight, and 9.1% were somewhat obese. The most consumed probiotic and prebiotic food sources were cheese, yogurt, fermented kinds of milk; and banana, apple, and oatmeal, respectively. However, these are foods that are not part of the daily consumption for most participants. There was no significant difference between the association of the Body Mass Index with the sex of the participants or the final Metabolic Tracking Questionnaire score and the final sum of gastrointestinal symptoms (p=0.76, p=0.29, p=0.70). Conclusion: A low frequency of consumption of foods that aid intestinal health is noted. However, body weight was not found to influence the composition of the gut microbiota.

Proceso de atención de enfermería en el cuidado al paciente COVID-19 / Nursing process of care in patient care COVID-19 / Processo de cuidados de enfermagem no cuidado ao paciente COVID-19

El microbiota intestinal se encuentra constituida por más un millón de microorganismos entre los cuales las bacterias son de mayor prevalencia. Esta microbiota depende directamente de la localización exacta a lo largo del tubo digestivo, siendo la porción del colon la que alberga la mayor cantidad del microorganismo de la flora. El microbiota de la piel guarda relación directa con el microbiota del intestino por los diversos mecanismos existentes en la formación de la misma. El objetivo del presente estudio fue analizar el uso de probióticos y prebióticos en tratamiento de patología cutáneas y la relación entre la microbiota intestinal y enfermedades de la piel. Se realizó una revisión bibliográfica narrativa de la literatura científica de la relación del microbiota intestinal en patologías cutáneas. Se concluyó que el uso de probióticos y prebióticos juegan un papel importante en enfermedad cutáneas es especial de tipo inflamatoria.

The intestinal microbiota is constituted by more than one million microorganisms among which bacteria are the most prevalent. This microbiota is directly dependent on the exact location along the digestive tract, with the colon portion harboring the largest amount of the microorganism flora. The skin microbiota is directly related to the gut microbiota by the various mechanisms involved in its formation. The aim of the present study was to analyze the use of probiotics and prebiotics in the treatment of skin pathology and the relationship between the intestinal microbiota and skin diseases. A narrative bibliographic review of the scientific literature on the relationship between the intestinal microbiota and skin pathologies was carried out. It was concluded that the use of probiotics and prebiotics play an important role in skin diseases, especially inflammatory ones.

A microbiota intestinal é formada por mais de um milhão de microorganismos entre os quais as bactérias são as mais prevalentes. Esta microbiota depende diretamente da localização exata ao longo do trato gastrointestinal, sendo que a porção de cólon abriga a maior quantidade da flora de microorganismos. A microbiota da pele está diretamente relacionada à microbiota intestinal pelos diversos mecanismos envolvidos em sua formação. O objetivo deste estudo foi analisar o uso de probióticos e prebióticos no tratamento da patologia da pele e a relação entre a microbiota intestinal e as doenças de pele. Foi realizada uma revisão narrativa da literatura científica sobre a relação entre microbiota intestinal e patologias da pele. Concluiu-se que o uso de probióticos e prebióticos desempenha um papel importante nas doenças de pele, especialmente nas doenças inflamatórias da pele.

O impacto da pandemia da covid-19 na microbiota intestinal do lactente / The impact of the covid-19 pandemic on the infant gut microbiota / El impacto de la pandemia de covid-19 en la microbiota intestinal del lactante

A COVID-19 resultou em milhares de óbitos e até o presente momento assola diversos pacientes com as suas implicações. Uma das consequências da doença foi o isolamento social, realizado por quase todos os países, o que configurou a alteração de diversos padrões de convivência e principalmente de exposição a outros agentes não patogênicos e patogênicos essenciais para o desenvolvimento da microbiota. Com isso, o seguinte projeto tem como objetivo a descrição dos impactos da pandemia da COVID-19 na microbiota intestinal de lactentes do período pandêmico e as consequências geradas no sistema imunológico imaturo, prejudicando seu desenvolvimento e maturação. A metodologia consiste na análise e seleção de artigos científicos publicados nos últimos 10 anos com auxílio de Descritores em Ciências da Saúde (DeCS) específicos nas línguas inglesa e portuguesa para o tema da pesquisa, sendo a combinação dos descritores feita por meio de operadores booleanos. Conclui-se que a composição da microbiota intestinal é iniciada intraútero e influenciada pela via de parto, contato pele a pele após o nascimento e pela presença da amamentação materna. A modificação das práticas durante a pandemia da COVID-19, pode alterar a microbiologia neonatal, assim como impactar na maturação do sistema imunológico do lactente, predispondo futuramente à doenças gastrointestinais, metabólicas e atópicas, como asma.

COVID-19 has resulted in thousands of deaths and until now is affecting many patients with its implications. One of the consequences of the disease was social isolation, carried out by almost all countries, which resulted in changes in different patterns of coexistence and mainly exposure to other non-pathogenic and pathogenic agents essential for the development of the microbiota. Therefore, the following project aims to describe the impacts of the COVID-19 pandemic on the microbiota of infants during the pandemic period and the consequences generated on the immature immune system, damaging its development and maturation and relating microbiology, essentially intestinal, throughout the project. The methodology consists of the analysis and selection of scientific articles published in the last 10 years with the help of specific Health Sciences Descriptors in English and Portuguese for the research topic, with the combination of descriptors made using Boolean operators. It is concluded that the composition of the intestinal microbiota begins in utero and is influenced by the mode of delivery, skin-to- skin contact after birth, and the presence of maternal breastfeeding. Modifying practices during the COVID-19 pandemic may alter neonatal microbiology and impact the maturation of the infant's immune system, potentially predisposing them to future gastrointestinal, metabolic, and atopic diseases such as asthma.

El COVID-19 ha provocado miles de muertes y todavía afecta a muchos pacientes con sus implicaciones. Una de las consecuencias de la enfermedad fue el aislamiento social, llevado a cabo por casi todos los países, que resultó en cambios en diferentes patrones de convivencia y principalmente exposición a otros agentes patógenos y no patógenos esenciales para el desarrollo de la microbiota. Com eso, el siguiente proyecto tiene como objetivo describir los impactos de la pandemia de COVID-19 en la microbiota de los lactantes durante el periodo pandémico y las consecuencias generadas sobre el sistema inmunológico inmaduro, perjudicando su desarrollo y maduración y relacionando la microbiología, fundamentalmente intestinal, a lo largo del proyecto. La metodología consiste en el análisis y selección de artículos científicos publicados en los últimos 10 años con la ayuda de Descriptores en Ciencias de la Salud específicos en inglés y portugués para el tema de investigación, con la combinación de descriptores realizada mediante operadores booleanos. Se concluye que la composición de la microbiota intestinal comienza intraútero y está influenciada por la vía de parto, el contacto piel a piel después del nacimiento y la presencia de la lactancia materna. La modificación de las prácticas durante la pandemia de COVID-19 puede alterar la microbiología neonatal y afectar la maduración del sistema inmunológico del lactante, predisponiéndolo potencialmente a enfermedades gastrointestinales, metabólicas y atópicas en el futuro, como la asma.

Cambios en la microbiota durante el embarazo: revisión narrativa / Changes in the microbiota during pregnancy: a narrative review

OBJETIVO: Evaluar la evidencia científica de los cambios en la microbiota durante el embarazo. METODOLOGÍA: Revisión de la bibliografía publicada entre el 2013 y el 2022 efectuada mediante la búsqueda de artículos científicos escritos en español e inglés resguardados en las bases de datos bibliográficas NICE, CENETEC-SALUD, BIREME y Portal OMS, OPS, Portal de Evidencias de la Biblioteca Virtual de Salud - BVS, LILACS, BIREME, EVIPNET, PubMed y Cochrane. La selección de artículos se basó en los descriptores: microbiota; embarazo-pregnancy; microbiota, gut microbiome, fetus-feto; microbiota, placenta; microbiota, combinadas entre sí con el operador boleano "and". RESULTADOS: Se identificaron 3038 posibles artículos y 137 se encontraron adecuados para el objetivo de la revisión en virtud de estar relacionados directamente con el embarazo y la microbiota. Se revisaron estudios transversales, ensayos, revisiones, cohortes, casos y controles, revisiones sistemáticas o matanálisis. CONCLUSIONES: La microbiota se encuentra en diversos tejidos u órganos que anteriormente se creían estériles durante el embarazo. Se sugiere que todos los cambios que implica esta etapa pueden influir en la microbiota de la madre y el feto. A pesar de las crecientes investigaciones en el área aún quedan preguntas por contestar para ayudar a solucionar el enigma de los cambios en la diversidad en las diferentes complicaciones del embarazo y saber si los probióticos tendrían efecto o no en la disminución del riesgo a padecerlas.

Abstract OBJECTIVE: to evaluate the scientific evidence on changes in the microbiota during pregnancy. METHODOLOGY: A review of the literature published between 2013 and 2022 was carried out through the search of scientific articles in Spanish and English in the bibliographic databases NICE, CENETEC-SALUD, BIREME AND PORTAL WHO, PAHO, Portal of Evidence of the Virtual Health Library - BVS, LILACS, BIREME, EVIPNET, PUBMED and COCHRANE. The selection of articles was based on the descriptors: Microbiota, pregnancy, Gut microbiome, Fetus-Microbiota, Placenta - Microbiota, combined with each other with the Boolean "and". RESULTS: A total of 3,038 possible articles were identified and 137 were found suitable for the objective of the review because they were directly related to pregnancy and microbiota. Cross-sectional studies, trials, reviews, cohorts, case-controls, systematic review, or meta-analysis were reviewed. CONCLUSIONS: Microbiota has been found in various tissues or organs that were previously believed to be sterile during pregnancy, and with this, it is suggested that all the changes that this stage entails can influence the maternal and fetal microbiota. However, despite the growing research in the area, there are still questions to be resolved to help solve the enigma of the changes in diversity in the different complications of pregnancy and whether the use of probiotics would influence reducing the risk to present them.

Gut-liver axis： Intestinal microbial homeostasis and hepatocellular carcinoma / 临床肝胆病杂志

Intestinal microbiota plays an important role in maintaining liver metabolic homeostasis and affects the development and progression of hepatocellular carcinoma by participating in bile acid metabolism. Gut-liver axis plays an important role in the pathogenesis of liver diseases， and it might be one of the effective methods to prevent the progression of hepatocellular carcinoma by correcting intestinal ecological imbalance to restore normal bile acid level. This article summarizes the mechanism of bile acid receptor affecting hepatocellular carcinoma and the latest therapeutic targets， in order to provide a reference for the early prevention and treatment of hepatocellular carcinoma.

Relationship between intestinal microbiota heterogeneity and acquired myasthenia in septic mice / 中华麻醉学杂志

Objective:To evaluate the relationship between intestinal microbiota heterogeneity and acquired myasthenia in septic mice.Methods:Eighty SPF healthy male C57BL/6 mice, weighing 18-20 g, aged 6-8 weeks, were included. Forty mice were selected to prepare a sepsis model by intraperitoneal injection of lipopolysaccharide (LPS) 10 mg/kg. Sepsis-sensitive mice (state of dying or even death within 24 h after developing the model) and sepsis-resistant mice (survival for 7 days and recovery) were screened. The feces from donor mice were collected to make fecal bacteria fluid. Forty mice were selected and divided into 4 groups ( n=10 each) by the random number table method: control group (C group), antibiotic group (ABX group), resistant group (Res group), and sensitive group (Sen group). Group C received no treatment. In ABX group, compound antibiotics were given by intragastric gavage once a day for 5 consecutive days. In Res group, the fecal solution from sepsis-resistant mice 150 μl was given by gavage once a day for 3 consecutive days starting from 5 days after gavage administration of compound antibiotics, and then LPS 15 mg/kg was intraperitoneally injected. In Sen group, the fecal solution from sepsis-sensitive mice was given by gavage for 3 days (using the same method as previously described in Res group) starting from 5 days after gavage administration of compound antibiotics, and then LPS 15 mg/kg was intraperitoneally injected. The severity of sepsis was assessed and scored at 24 h after developing the model. The four limb grip strength was measured after fecal bacteria transplantation and at 24 h after developing the sepsis model. The Compound Muscle Action Potential (CMAP) of the gastrocnemius was measured at 24 h after developing the sepsis model. Then blood samples were collected for determination of the levels of interleukin-1 (IL-1), IL-6 and tumor necrosis factor α (TNF-α) in serum by enzyme-linked immunosorbent assay. The tissues of anterior tibial muscle and gastrocnemius muscle were obtained for determination of the expression of muscle-specific ring finger protein 1 (MuRF-1) and muscle atrophy box F protein (MAFbx) by Western blot. The diameter and cross-sectional area of gastrocnemius muscle fibers were measured after HE staining. The feces of mice were collected at 3 days after fecal bacteria transplantation, and DNA was extracted from mouse fecal samples for 16S rDNA sequencing and untargeted metabolomics analysis. Results:Compared with C group, the score for severity of sepsis was significantly increased, the four limb grip strength was decreased after developing the sepsis model, the serum IL-6 concentration was increased, and the diameter and cross-sectional area of gastnemius muscle fibers were decreased ( P<0.05), and no statistically significant changes were found in the other parameters in Res group, and no statistically significant changes were found in the indexes mentioned above in ABX group ( P>0.05). Compared with C group and Res group, the score for severity of sepsis was significantly increased, the four limb grip strength was decreased, the latency of CMAP was prolonged, and the amplitude of CMAP was decreased, the serum concentrations of IL-1, IL-6 and TNF-α were increased, the diameter and cross-sectional area of gastrocnemius muscle fibers were decreased, and the expression of MuRF-1 and MAFbx in anterior tibial muscle was up-regulated after developing the sepsis model in Sen group ( P<0.05). 16S rDNA sequencing of intestinal flora: Compared with Sen group, no significant change was found in Chao1 index, Good-coverage index and Simpson index in Res group ( P>0.05), Shannon index was increased ( P<0.05), and no significant change was found in β diversity in Res group ( P>0.05). LDA analysis showed that f_Akkermarisiaceae, o_Verrucomicrobiales, g_Akmansia, c_Verrucomicrobiae and p_Verrucomicrobiota were significantly enriched in Sen group, and g_Enterococcus and f_Enterococcaceae were significantly enriched in Res group ( P<0.05). Nontargeted metabolic analysis: The metabolite profiles in Res group and Sen group suggested that the model was well developed (R2Y>Q2Y). Compared with Sen group, 90 metabolites was significantly up-regulated and 88 down-regulated, significantly up-regulated metabolic substances including vitamin K1, gamma-tocopherol, and taurine in Res group ( P<0.05). The differential metabolite KEGG enrichment pathway included 2-oxocarboxylic acid metabolism and ubiquinone and other terpenoid-quinone biosynthesis ( P<0.05). Conclusions:Intestinal flora heterogeneity may be involved in the pathogenesis of acquired myasthenia in septic mice.

Research progress on the relationship between pancreatic exocrine insufficiency and intestinal microbiota in aging individuals / 中华肝胆外科杂志

Pancreatic exocrine insufficiency (PEI) refers to insufficient or non-synchronous secretion of trypsin caused by various reasons, resulting in dyspepsia and other symptoms. Intestinal microbiota is a large number of microbiota on the surface of intestinal mucosa. Its main functions include intestinal immune function, forming intestinal biological barrier and participating in the regulation of nutrition and metabolism. Due to aging, some elderly people often have unexplained chronic pancreatic insufficiency, which is often characterized by unexplained weight loss and malnutrition. Several studies have shown that the composition of intestinal microbiota changes significantly with age. This article focuses on aging and its related PEI and then reviews its possible effects on intestinal microbiota, in order to provide a reference basis for individualized prevention and treatment strategies according to the changes of pancreatic exocrine function and microbiota in the elderly.

A preliminary study of fecal microbiota transplantation alleviating inhibition of radiation-induced hippocampal neurogenesis in mice / 中华放射肿瘤学杂志

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.

Research progress in characteristics of intestinal flora and intestinal flora-targeted therapeutic methods in patients with spinal cord injury / 中华创伤杂志

Patients with spinal cord injury is associated with seriously affected gastrointestinal function and imbalance of intestinal flora, leading to increased inflammation of spinal cord nerves. With the proposal of the theory of gut microbiota-gut-brain axis in recent years, the regulatory role of gut microbiota in the central nervous system and gastrointestinal system has gradually attracted attention. Although a considerable number of studies have focused on the effects of intestinal flora characteristics on spinal cord nerve function repair in patients with spinal cord injury from different perspectives, there are numerous research models for treating spinal cord injury with intestinal flora as intervention targets and remains a lack of unified and effective clinical treatment methods. In this paper, the authors review the research progress in characteristics of intestinal microflora and intestinal microflora-targeted therapeutic methods in patients with spinal cord injury, hoping to provide a reference for the clinical treatment and basic research of spinal cord injury.

The role of antibiotics in the treatment of Crohn′s disease / 中国医师杂志

Crohn′s disease (CD) is a chronic, progressive and destructive inflammatory disease affecting the entire digestive tract. Changes in the intestinal microbiota, particularly a decrease in gut microbiome diversity, are thought to be associated with chronic intestinal inflammation of CD. As for the mechanism of antibiotics in CD treatment, some scholars believe that antibiotics can affect the course of disease by reducing the concentration of intestinal bacteria and changing the composition of intestinal microbiota. Different antibiotics, including ciprofloxacin, metronidazole and rifaximin, have been proved to have certain therapeutic effect on some patients with CD in clinical practice, but there are still limitations in the use of antibiotics.In this review, the relationship between intestinal flora and the incidence of CD and the application of antibiotics in CD were reviewed, providing reference and help for the standardized application of antibiotics in CD.

Gut microbiome and tumor immunotherapy / 国际肿瘤学杂志

Neoplasms immunotherapy has made a major breakthrough in the clinical practice of refractory tumor. However, there are still individual differences in treatment results and drug resistance in clinical application. Gastrointestinal microbiome is gradually recognized as an immunoregulatory factor in recent years, and more and more studies have focused on its influences on the efficacy of tumor immunotherapy. Targeting gastrointestinal microbiota to improve the response of tumor patients to immunotherapy has potential clinical application value.

Gut flora and cervical cancer / 国际肿瘤学杂志

The occurrence and progression of cervical cancer are influenced by gut flora. Patients with cervical cancer have different gut flora from healthy women, and the detection and evaluation of gut flora can help in the diagnosis, immunotherapy, assessment of radiotherapy efficacy and prognosis prediction of cervical cancer. Regulation of gut flora is of great clinical value in enhancing response to anti-tumor therapy, improving patients' quality of life and improving prognosis.

Research progress on the interaction between gut microbiota and radiation enteritis / 国际肿瘤学杂志

Radiotherapy is an important treatment for abdominal and pelvic tumors, but it has a high incidence of the adverse reaction radiation enteritis. Abdominal and pelvic radiotherapy can induce apoptosis of intestinal crypt cells, destroy the intestinal barrier and change the composition of gut microbiota. Dysbiosis of gut microbiota can aggravate radiation enteritis. Fecal flora transplantation, as well as the use of probiotics, prebiotics and antibiotics can regulate gut microbiota, which is an effective method to prevent and treat radiation enteritis.

Gut microbiota and cerebral vessel diseases / 国际脑血管病杂志

Gut microbiota is involved in maintaining intestinal homeostasis. The bidirectional communication between intestinal flora and brain can also be conducted through the neuro-immune-endocrine network, namely, the "microbiota-gut-brain axis". A number of studies have shown that the "microbiota-gut-brain axis" disorder plays an important role in the occurrence, development and prognosis of some cerebrovascular diseases, such as cerebral small vessel disease and stroke. This article introduces the latest research progress of the relationship between gut microbiota and cerebrovascular diseases, so as to provide more ideas and options for the treatment of cerebrovascular diseases.

Changes in intestinal microbiota and application of probiotics in patients with acute pancreatitis / 临床肝胆病杂志

Intestinal microbiota is the most complex and important microecosystem in the human body， and gut microbiota dysbiosis is closely associated with the development and progression of acute pancreatitis. Targeted regulation of intestinal microecology in assisting the treatment of acute pancreatitis has attracted more attention in recent years. This article describes the changes in intestinal microbiota and related mechanisms in patients with acute pancreatitis， summarizes the current research status of the use of probiotics， points out the research direction of probiotics as the adjuvant treatment regime， and proposes a new method for predicting the dominant flora in patients with acute pancreatitis， in order to bring new ideas for the treatment of acute pancreatitis.