Imperial College London

Dr Benjamin Mullish

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

NIHR Clinical Lecturer
 
 
 
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b.mullish

 
 
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Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Publication Type
Year
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148 results found

Mullish BH, Quraishi MN, Segal JP, McCune VL, Baxter M, Marsden GL, Moore DJ, Colville A, Bhala N, Iqbal TH, Settle C, Kontkowski G, Hart AL, Hawkey PM, Goldenberg SD, Williams HRTet al., 2018, The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridium difficile infection and other potential indications: joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines., Gut, Vol: 67, Pages: 1920-1941

Interest in the therapeutic potential of faecal microbiota transplant (FMT) has been increasing globally in recent years, particularly as a result of randomised studies in which it has been used as an intervention. The main focus of these studies has been the treatment of recurrent or refractory Clostridium difficile infection (CDI), but there is also an emerging evidence base regarding potential applications in non-CDI settings. The key clinical stakeholders for the provision and governance of FMT services in the UK have tended to be in two major specialty areas: gastroenterology and microbiology/infectious diseases. While the National Institute for Health and Care Excellence (NICE) guidance (2014) for use of FMT for recurrent or refractory CDI has become accepted in the UK, clear evidence-based UK guidelines for FMT have been lacking. This resulted in discussions between the British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS), and a joint BSG/HIS FMT working group was established. This guideline document is the culmination of that joint dialogue.

Journal article

McDonald JAK, Mullish BH, Pechlivanis A, Liu Z, Brignardello J, Kao D, Holmes E, Li JV, Clarke TB, Thursz MR, Marchesi JRet al., 2018, Inhibiting Growth of Clostridioides difficile by Restoring Valerate, Produced by the Intestinal Microbiota., Gastroenterology, Vol: 155, Pages: 1495-1507.e15

BACKGROUND & AIMS: Fecal microbiota transplantation (FMT) is effective for treating recurrent Clostridioides difficile infection (CDI), but there are concerns about its long-term safety. Understanding the mechanisms of the effects of FMT could help us design safer, targeted therapies. We aimed to identify microbial metabolites that are important for C difficile growth. METHODS: We used a CDI chemostat model as a tool to study the effects of FMT in vitro. The following analyses were performed: C difficile plate counts, 16S rRNA gene sequencing, proton nuclear magnetic resonance spectroscopy, and ultra-performance liquid chromatography and mass spectrometry bile acid profiling. FMT mixtures were prepared using fresh fecal samples provided by donors enrolled in an FMT program in the United Kingdom. Results from chemostat experiments were validated using human stool samples, C difficile batch cultures, and C57BL/6 mice with CDI. Human stool samples were collected from 16 patients with recurrent CDI and healthy donors (n = 5) participating in an FMT trial in Canada. RESULTS: In the CDI chemostat model, clindamycin decreased valerate and deoxycholic acid concentrations and increased C difficile total viable counts and valerate precursors, taurocholic acid, and succinate concentrations. After we stopped adding clindamycin, levels of bile acids and succinate recovered, whereas levels of valerate and valerate precursors did not. In the CDI chemostat model, FMT increased valerate concentrations and decreased C difficile total viable counts (94% decrease), spore counts (86% decrease), and valerate precursor concentrations; concentrations of bile acids were unchanged. In stool samples from patients with CDI, valerate was depleted before FMT but restored after FMT. Clostridioides difficile batch cultures confirmed that valerate decreased vegetative growth, and that taurocholic acid was required for germination but had no effect on vegetative growth. Clost

Journal article

Mullish BH, Quraishi MN, Segal J, Williams HRT, Goldenberg SDet al., 2018, Introduction to the joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) faecal microbiota transplant guidelines, Journal of Hospital Infection, Vol: 100, Pages: 130-132, ISSN: 0195-6701

Journal article

Ghani R, Mookerjee S, Mullish BH, Thursz M, Marchesi J, Pavlu J, Davies Fet al., 2018, Impact on Length of Stay and Antibiotic Use in Allogenic and Autologous Stem Cell Transplant Patients Colonized with Carbapenemase-producing Enterobacteriaceae, IDWeek, Publisher: Oxford University Press, ISSN: 2328-8957

Conference paper

Allegretti JR, Mullish B, Kassam Z, Carrellas M, Marchesi J, Smith M, Geradin Y, Timberlake S, Pratt D, Korzenik Jet al., 2018, Bile Acid Profiles are Not Altered by Fecal Microbiota Transplantation for the Treatment of Primary Sclerosing Cholangitis: Category Award (Liver): Presidential Poster Award, Publisher: Ovid Technologies (Wolters Kluwer Health), Pages: S574-S576, ISSN: 0002-9270

Conference paper

Mullish BH, Pechlivanis A, Barker GF, Thursz MR, Marchesi JR, McDonald JAKet al., 2018, Functional microbiomics: Evaluation of gut microbiota-bile acid metabolism interactions in health and disease., Methods (San Diego, Calif.), Vol: 149, Pages: 49-58, ISSN: 1046-2023

There is an ever-increasing recognition that bile acids are not purely simple surfactant molecules that aid in lipid digestion, but are a family of molecules contributing to a diverse range of key systemic functions in the host. It is now also understood that the specific composition of the bile acid milieu within the host is related to the expression and activity of bacterially-derived enzymes within the gastrointestinal tract, as such creating a direct link between the physiology of the host and the gut microbiota. Coupled to the knowledge that perturbation of the structure and/or function of the gut microbiota may contribute to the pathogenesis of a range of diseases, there is a high level of interest in the potential for manipulation of the gut microbiota-host bile acid axis as a novel approach to therapeutics. Much of the growing understanding of the biology of this area reflects the recent development and refinement of a range of novel techniques; this study applies a number of those techniques to the analysis of human samples, aiming to illustrate their strengths, drawbacks and biological significance at all stages. Specifically, we used microbial profiling (using 16S rRNA gene sequencing), bile acid profiling (using liquid chromatography-mass spectrometry), bsh and baiCD qPCR, and a BSH enzyme activity assay to demonstrate differences in the gut microbiota and bile metabolism in stool samples from healthy and antibiotic-exposed individuals.

Journal article

Segal J, Penez L, Mohsen S, Worley G, McLaughlin S, Mullish BH, Quraishi MN, Ding N, Glyn T, Kandiah K, Samaan MA, Irving PM, Faiz OD, Clark SK, Hart ALet al., 2018, Long term outcomes of initial Infliximab therapy for inflammatory pouch pathology: a multi-centre retrospective study, Scandinavian Journal of Gastroenterology, Vol: 53, Pages: 1051--1058, ISSN: 0036-5521

Background: Restorative proctocolectomy with ileal pouch-anal anastomosis is considered the procedure of choice in patients with ulcerative colitis refractory to medical therapy. Subsequent inflammation of the pouch is a common complication and in some cases pouchitis fails to respond to antibiotics, the mainstay of treatment. In such cases, corticosteroids, immunomodulatory or biologic treatments are options. However, our understanding of the efficacy of anti-tumour necrosis factor medications in both chronic pouchitis and Crohn’s-like inflammation are based on studies that include relatively small numbers of patients. Methods: This was an observational, retrospective, multi-centre study to assess the long-term effectiveness and safety of infliximab for inflammatory disorders related to the ileoanal pouch. The primary outcome was the development of infliximab failure defined by early failure to infliximab or secondary loss of response to infliximab. Results: Thirty-four patients met the inclusion criteria; 18/34 (53%) who were initiated on infliximab for inflammatory disorders of the pouch had infliximab failure, 3/34 (8%) had early failure, and 15/34 (44%) had secondary loss of response with a median follow-up of 280 days (range 3-47 months). In total, 24/34 (71%) avoided an ileostomy by switching to other medical therapies at a median follow-up of follow-up of 366 days (1-130 months). Conclusions:Initial infliximab therapy for pouch inflammatory conditions is associated with Infliximab failure in just over half of all patients. Despite a high failure rate, an ileostomy can be avoided in almost three quarters of patients at four years by using other medical therapies.

Journal article

Mullish BH, Osborne LS, Marchesi JR, McDonald JAKet al., 2018, The implementation of omics technologies in cancer microbiome research, Ecancermedicalscience, Vol: 12, Pages: 1-11, ISSN: 1754-6605

Whilst the interplay between host genetics and the environment plays a pivotal role in the aetiopathogenesis of cancer, there are other key contributors of importance as well. One such factor of central and growing interest is the contribution of the microbiota to cancer. Even though the field is only a few years old, investigation of the ’cancer microbiome’ has already lead to major advances in knowledge of the basic biology of cancer risk and progression, opened novel avenues for biomarkers and diagnostics, and given better understanding of mechanisms underlying response to therapy. Recent developments in microbial DNA sequencing techniques (and the bioinformatics required for analysis of these datasets) has allowed much more in-depth profiling of the structure of microbial communities than was previously possible. However, for more complete assessment of the functional implications of microbial changes, there is a growing recognition of the importance of the integration of microbial profiling with other ‘omics modalities, with metabonomics (metabolite profiling) and proteomics (protein profiling) both gaining particular recent attention. In this review, we give an overview of some of the key scientific techniques being used to unravel the role of the cancer microbiome. We have aimed to highlight practical aspects related to sample collection and preparation, choice of modality of analysis, and examples of where different ‘omics technologies have been complementary to each other to highlighting the significance of the cancer microbiome.

Journal article

Mullish BH, Quraishi MN, Segal JP, McCune VL, Baxter M, Marsden GL, Moore D, Colville A, Bhala N, Iqbal TH, Settle C, Kontkowski G, Hart AL, Hawkey PM, Williams HR, Goldenberg SDet al., 2018, The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridium difficile infection and other potential indications: joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines., J Hosp Infect, Vol: 100 Suppl 1, Pages: S1-S31

Journal article

Forlano R, Giannakeas N, Mullish BH, Tsipouras M, Tzallas A, Yee M, Lloyd J, Goldin RD, Thursz MR, Manousou Pet al., 2018, Automated Quantitation of Steatosis, Fibrosis and Ballooning Using Machine Learning in Routine Histological Images of Liver Biopsies of Patients with NAFLD, The Liver Meeting, American Association for the Study of Liver Diseases (AASLD), Publisher: Wiley, Pages: 971A-972A, ISSN: 0270-9139

Conference paper

Segal J, Penez L, Elkady S, Worley G, McLaughlin S, Mullish BH, Quraishi M, Ding N, Glyn T, Kandiah K, Samaan M, Irving P, Faiz O, Clark S, Hart Aet al., 2018, IDDF2018-ABS-0056 Long term outcomes of initial infliximab therapy for inflammatory pouch pathology: a multi-centre retrospective study, International Digestive Disease Forum 2018, Publisher: BMJ Publishing Group, Pages: A41-A41, ISSN: 0017-5749

Conference paper

Segal J, Penez L, Elkady SM, Worley G, McLaughlin S, Mullish BH, Quraishi M, Ding N, Glyn T, Kandiah K, Samaan M, Irving P, Faiz O, Clark S, Hart Aet al., 2018, PWE-052 Long term outcomes of initial IFX therapy for inflammatory pouch pathology: a multi-centre retrospective study, British Society of Gastroenterology, Annual General Meeting, Publisher: BMJ Publishing Group, Pages: A93-A93, ISSN: 0017-5749

Conference paper

Mullish BH, Williams HR, 2018, Clostridium difficile infection and antibiotic-associated diarrhoea., Clin Med (Lond), Vol: 18, Pages: 237-241

Antibiotic-associated diarrhoea is among the most common adverse events related to antibiotic use. Most cases are mild, but Clostridium difficile infection causes a spectrum of disease, ranging from occasional diarrhoea to colitis, toxic megacolon, and potentially death. Recent developments in our understanding of the biology of the gut microbiota have provided new insights into the pathogenesis of these conditions, and have revealed a role for manipulation of the gut microbiota as a novel therapeutic approach. This review will give an overview of the assessment of these conditions, before focusing on the rapidly developing area of their treatment.

Journal article

McDonald JAK, Mullish BH, Pechlivanis A, Liu Z, Brignardello J, Kao D, Holmes E, Li JV, Clarke TB, Thursz MR, Marchesi JRet al., A novel route for controlling Clostridioides difficile growth via bile acid and short chain fatty acid modulation, ISME17

Conference paper

Allegretti JR, Mullish BH, Bogart E, Shu E, Dong X, McDonald JAK, Pechlivanis A, Marchesi JR, Gerber G, Bry Let al., 2018, 25 - Microbiome and metabolic markers of Clostridium Difficile recurrance, Digestive Diseases Week, Publisher: Elsevier, Pages: S8-S9, ISSN: 0016-5085

Conference paper

McDonald JAK, Mullish BH, Pechlivanis A, Li JV, Nicholson JK, Holmes E, Thursz MR, Marchesi JRet al., 2018, 24 - A novel route to controlling Clostridioides Difficile growth via short chain fatty acid and bile acid modulation, Digestive Diseases Week, Publisher: Elsevier, Pages: S8-S8, ISSN: 0016-5085

Conference paper

McSweeney B, Allegretti JR, Fischer M, Monaghan T, Mullish BH, Petrof EO, Phelps EL, Wong K, Xu H, Chis R, Kao DHet al., 2018, Tu1894 - Potential Motivators and Deterents for Stool Donors: A Multicenter Study, Digestive Diseases Week, Publisher: Elsevier, Pages: S1051-S1051, ISSN: 0016-5085

Conference paper

Forlano R, Mullish BH, Katertsidis N, Giannakeas N, Tzallas A, Tsipouras M, Yee M, Taylor-Robinson S, Thursz M, Manousou Pet al., 2018, A mobile application for the management and follow-up of patients with Non-Alcoholic Fatty Liver Disease, International Liver Congress (ILC), Publisher: ELSEVIER SCIENCE BV, Pages: S819-S819, ISSN: 0168-8278

Conference paper

Forlano R, Mullish BH, Katertsidis N, Giannakeas N, Tzallas A, Tsipouras M, Yee M, Taylor-Robinson S, Thursz M, Manousou Pet al., 2018, A mobile application for the management and follow-up of patients with Non-Alcoholic Fatty Liver Disease, Journal of Hepatology, Vol: 68, Pages: S819-S819, ISSN: 0168-8278

Journal article

Segal J, McLaughlin S, Penez L, Mullish BH, Quraishi M, Ding N, Kandiah K, Samaan M, Irving P, Faiz O, Clark S, Hart Aet al., 2018, P141 Infliximab therapy for inflammatory pouch pathology: a multi-centre retrospective study, 13th Congress of ECCO – European Crohn’s and Colitis Organisation, Publisher: Oxford University Press (OUP), Pages: S167-S167, ISSN: 1873-9946

Conference paper

Ding NS, Mullish BH, McLaughlin J, Hart A, Marchesi JRet al., 2018, Meeting update: faecal microbiota transplantation--bench, bedside, courtroom?, Frontline Gastroenterol, Vol: 9, Pages: 45-48, ISSN: 2041-4137

Journal article

Forlano R, Manousou P, Mullish BH, Olaoke A, Khelifa MZ, Tsipouras MG, Yee M, Taylor-Robinson S, Lloyd J, Goldin RD, Thursz MR, Khan SAet al., 2017, Assessment of non invasive markers of fibrosis against collagen quantitation and NASH-CRN scoring in liver biopsies of NAFLD patients, The AASLD Liver Meeting 2017, Publisher: Wiley, Pages: 334A-334A, ISSN: 0270-9139

Conference paper

King A, Mullish BH, Williams HRT, Aylin Pet al., 2017, Comparative epidemiology of Clostridium difficile infection: England and the USA, International Journal for Quality in Health Care, Vol: 29, Pages: 785-791, ISSN: 1353-4505

Journal article

Mullish B, Forlano R, Yee M, Giannakeas N, Goldin RD, Taylor-Robinson SD, Khan SA, Thursz MR, Manousou Pet al., 2017, Development of an algorithm for the prediction of cardiovascular events in patients with NAFLD: the role of mean platelet volume, 68th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases (AASLD) / Liver Meeting, Publisher: WILEY, Pages: 1175A-1176A, ISSN: 0270-9139

Conference paper

Innes AJ, Mullish BH, Fernando F, Adams G, Marchesi JR, Apperley JF, Brannigan E, Davies F, Pavlů Jet al., 2017, Faecal microbiota transplant: a novel biological approach to extensively drug-resistant organism-related non-relapse mortality., Bone Marrow Transplant, Vol: 52, Pages: 1452-1454

Journal article

Mullish BH, McDonald JAK, Thursz MR, Marchesi JRet al., 2017, Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial., Hepatology, Vol: 66, Pages: 1354-1355

Journal article

Mullish BH, Forlano R, Yee M, Giannakeas N, Goldin R, Taylor-Robinson S, Khan S, Thursz M, Manousou Pet al., 2017, Development Of An Algorithm For The Prediction Of Cardiovascular Events In Patients With NAFLD: The Role Of Mean Platelet Volume., BASL 2017 Annual Meeting

Conference paper

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