Publications
153 results found
Michael DR, Jack AA, Masetti G, et al., 2020, A randomised controlled study shows supplementation of overweight and obese adults with lactobacilli and bifidobacteria reduces bodyweight and improves well-being, Scientific Reports, Vol: 10
Ovadia C, Perdones-Montero A, Fan HM, et al., 2020, Ursodeoxycholic acid enriches intestinal bile salt hydrolase-expressing Bacteroidetes in cholestatic pregnancy, Scientific Reports, Vol: 10
Mullish BH, 2020, FMT for the Treatment of Obesity, Metabolic Syndrome and NAFLD, The 6 Ds of FMT: A Primer for Clinicians from Decision to Discharge and Beyond, Editors: Allegretti, Kassam, ISBN: 9781630917500
Ghani R, Mullish BH, 2020, Decision – Considerations for use of fecal microbiota transplantation in special patient populations, The 6 Ds of FMT: A Primer for Clinicians from Decision to Discharge and Beyond, Editors: Allegretti, Kassam, Publisher: Slack Inc, ISBN: 9781630917500
Ianiro G, Mullish BH, Kelly CR, et al., 2020, Reorganisation of faecal microbiota transplant services during the COVID-19 pandemic, Gut, ISSN: 0017-5749
The COVID-19 pandemic has led to an exponential increase in SARS-CoV-2 infections and associated deaths, and represents a significant challenge to healthcare professionals and facilities. Individual countries have taken several prevention and containment actions to control the spread of infection, including measures to guarantee safety of both healthcare professionals and patients who are at increased risk of infection from COVID-19. Faecal microbiota transplantation (FMT) has a well-established role in the treatment of Clostridioides difficile infection (CDI). In the time of the pandemic, FMT centres and stool banks are required to adopt a workflow that continues to ensure reliable patient access to FMT whilst maintaining safety and quality of procedures. In this position paper, based on the best available evidence, worldwide FMT experts provide guidance on issues relating to the impact of COVID-19 on FMT, including patient selection, donor recruitment and selection, stool manufacturing, FMT procedures, patient follow-up, and research activities.
Ghani R, Mullish BH, McDonald JAK, et al., 2020, Disease prevention not decolonization – a model for fecal microbiota transplantation in patients colonized with multidrug-resistant organisms, Clinical Infectious Diseases, ISSN: 1058-4838
Ianiro G, Mullish BH, Kelley CR, 2020, Correction to Lancet Gastroenterol Hepatol 2020; 5: 430-31, LANCET GASTROENTEROLOGY & HEPATOLOGY, Vol: 5, Pages: E5-E5
Nathwani R, Mukherjee S, Forlano R, et al., 2020, Letter: liver disease and COVID-19 - not the perfect storm, Alimentary Pharmacology and Therapeutics, ISSN: 0269-2813
Segal JP, Mullish BH, Quraishi MN, et al., 2020, Letter: faecal microbiota transplantation for irritable bowel syndrome, Alimentary Pharmacology and Therapeutics, ISSN: 0269-2813
Smith PJ, 2020, GI highlights from the literature, Gut, Vol: 69, Pages: 963-964, ISSN: 0017-5749
Blanco JM, Liu Z, Selvarajah U, et al., 2020, Sa1923 IDENTIFICATION OF NEW ASSOCIATIONS BETWEEN PSORIATIC ARTHRITIS AND THE GUT MICROBIOTA, A PHENOMIC STUDY, Gastroenterology, Vol: 158, Pages: S-481, ISSN: 0016-5085
Monaghan T, Russell L, Rosati E, et al., 2020, Mo1939 TEMPORAL MODULATION OF TCR REPERTOIRE FOLLOWING SEQUENTIAL FMT TREATMENT IN PATIENTS WITH SEVERE OR FULMINANT CLOSTRIDIOIDES DIFFICILE INFECTION, Gastroenterology, Vol: 158, ISSN: 0016-5085
Allegretti JR, Kassam Z, Hurtado J, et al., 2020, Tu1909 IMPACT OF FECAL MICROBIOTA TRANSPLANTATION ON PREVENTION OF METABOLIC SYNDROME AMONG PATIENTS WITH OBESITY, Gastroenterology, Vol: 158, ISSN: 0016-5085
Ghani R, Mullish BH, McDonald JA, et al., 2020, 1144 FECAL MICROBIOTA TRANSPLANT FOR MULTI-DRUG RESISTANT ORGANISMS: IMPROVED CLINICAL OUTCOMES BEYOND INTESTINAL DECOLONISATION, Gastroenterology, Vol: 158, ISSN: 0016-5085
Martinez-Gili L, McDonald JA, Liu Z, et al., 2020, 644 IDENTIFICATION OF NOVEL CHANGES IN MICROBIALLY-DERIVED METABOLITES AFTER FECAL MICROBIOTA TRANSPLANT FOR RECURRENT CLOSTRIDIOIDES DIFFICILE INFECTION, Gastroenterology, Vol: 158, ISSN: 0016-5085
Allegretti JR, Hurtado J, Carrellas M, et al., 2020, 121 ULCERATIVE COLITIS PATIENTS ACHEIVE MORE ROBUST ENGRAFTMENT COMPARED TO PATIENTS WITH CROHN'S DISEASE AFTER FECAL MICROBIOTA TRANSPLANTATION FOR THE TREATMENT OF RECURRENT C. DIFFICLE INFECTION, Gastroenterology, Vol: 158, Pages: S-22, ISSN: 0016-5085
Ianiro G, Mullish BH, Kelly CR, et al., 2020, Screening of faecal microbiota transplant donors during the COVID-19 outbreak: suggestions for urgent updates from an international expert panel, The Lancet Gastroenterology & Hepatology, Vol: 5, Pages: 430-432, ISSN: 2468-1253
Mullish BH, Michael DR, McDonald JA, et al., 2020, Identifying the factors influencing outcome in probiotic studies in overweight and obese patients: host or microbiome?, Gut
Allegretti JR, Kassam Z, Mullish BH, et al., 2020, Effects of fecal microbiota transplantation with oral capsules in obese patients, Clinical Gastroenterology and Hepatology, Vol: 18, Pages: 855-863.e2, ISSN: 1542-3565
Background & AimsStudies in mice have shown that the intestinal microbiota can contribute to obesity via the anorexigenic gut hormone glucagon-like peptide 1 (GLP1) and bile acids, which affect lipid metabolism. We performed a randomized, placebo-controlled pilot study of the effects of fecal microbiota transplantation (FMT) in obese, metabolically uncompromised patients.MethodsWe performed a double-blind study of 22 obese patients (body mass index [BMI] ≥ 35kg/m2) without a diagnosis of diabetes, non-alcoholic steatohepatitis, or metabolic syndrome. Participants were randomly assigned (1:1) to groups that received FMT by capsules (induction dose of 30 capsules at week 4 and maintenance dose of 12 capsules at week 8) or placebo capsules. FMT capsules were derived from a single, lean donor (BMI, 17.5 kg/m2). Patients were followed through week 26; the primary outcome was safety. Stool and serum samples were collected from patients at baseline and at weeks 1, 4, 6, 8 and 12 after administration of the first dose of FMT or placebo and analyzed by 16S RNA gene sequencing. Stool and serum samples were analyzed for metabolomics by liquid chromatography-mass spectrometry. Additional outcomes were change in area under the curve for GLP1 at week 12.ResultsWe observed no significant differences in adverse events between patients who received FMT vs placebo. There was no increase in the area under the curve of GLP1 in either group. Patients who received FMT had sustained shifts in microbiomes associated with obesity toward those of the donor (P<.001). Patients who received FMT had a sustained decrease in stool levels of taurocholic acid (P<.05), compared with baseline; bile acid profiles began to more closely resemble those of the donor. We did not observe significant changes in mean BMI at week 12 in either group.ConclusionsIn a placebo-controlled pilot study, we found that FMT capsules (derived from a lean donor) were safe but did not reduce BMI in obese metabol
Smith PJ, 2020, GI highlights from the literature, Gut, Vol: 69, Pages: 781-782, ISSN: 0017-5749
Manousou P, Forlano R, Mullish BH, et al., 2020, Non-Alcoholic Fatty Liver Disease and Vascular Disease, Current Vascular Pharmacology, Vol: 18, ISSN: 1570-1611
<jats:sec><jats:title>:</jats:title><jats:p>Non-Alcoholic Fatty Liver Disease (NAFLD) represents an increasing cause of liver disease worldwide. However, notably, the primary cause of morbidity and mortality in patients with NAFLD is cardiovascular disease (CVD), with fibrosis stage being the strongest disease-specific predictor. It is globally-projected that NAFLD will become increasingly prevalent, especially among children and younger adults. As such, even within the next few years, NAFLD will contribute considerably to the overall CVD burden.In this review, we discuss the role of NAFLD as an emerging risk factor for CVD. In particular, this article aims to provide an overview of pathological drivers of vascular damage in patients with NAFLD. Moreover, the impact of NAFLD on the development, severity and the progression of subclinical and clinical CVD will be discussed. Finally, the review illustrates current and potential future perspectives for screening for CVD in this high-risk population.</jats:p></jats:sec>
Mullish BH, Quraishi MN, Segal JP, et al., 2020, The gut microbiome: what every gastroenterologist needs to know, Frontline Gastroenterology, ISSN: 2041-4137
<jats:p>The mucosal surfaces of the body are characterised by complex, specialised microbial communities, often referred to as the <jats:italic>microbiome</jats:italic>. However, only much more recently—with the development of technologies allowing exploration of the composition and functionality of these communities—has meaningful research in this area become feasible. Over the past few years, there has been rapid growth in interest in the gut microbiome in particular, and its potential contribution to gastrointestinal and liver disease. This interest has already extended beyond clinicians to pharmaceutical companies, medical regulators and other stakeholders, and is high profile among patients and the lay public in general. Such expansion of knowledge holds the intriguing potential for translation into novel diagnostics and therapeutics; however, being such a nascent field, there remain many uncertainties, unanswered questions and areas of debate.</jats:p>
Ghani R, Mullish B, Thursz M, et al., 2020, Case-control study of recurrent Extended-Spectrum Beta Lactamase Enterobacteriaceae Urinary Tract Infections (ESBL UTIs): the management challenges, Access Microbiology, Vol: 2
Ghani R, Mullish B, Mcdonald J, et al., 2020, Cohort study of Faecal Microbiota Transplantation for patient’s colonised with MDROs - successful prevention of invasive disease despite low decolonisation rates, Access Microbiology, Vol: 2
Fessas P, Possamai LA, Clark J, et al., 2020, Immunotoxicity from checkpoint inhibitor therapy: clinical features and underlying mechanisms., Immunology, Vol: 159, Pages: 167-177
Immune checkpoint inhibition with monoclonal antibodies is becoming increasingly commonplace in cancer medicine, having contributed to a widening of therapeutic options across oncological indications. Disruption of immune tolerance is the key mechanism of action of checkpoint inhibitors and although immune-related adverse events are a typical class effect of these compounds, the relationship between toxicity and response is not fully understood. Awareness and vigilance are paramount in recognizing potentially life-threatening toxicities and managing them in a timely manner. In this review article, we provide an overview of the clinical features, pathological findings and management principles of common immune-related toxicities, attempting to provide mechanistic insight into an increasingly common complication of cancer therapy.
Segal J, Mullish B, Clark S, et al., 2020, P844 Higher proportions of genera and species in the Firmicutes phylum are associated with a healthy pouch compared with patients with chronic pouchitis, Journal of Crohn's and Colitis, Vol: 14, Pages: S652-S652, ISSN: 1873-9946
<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Studies highlighting changes in bacterial composition in the ileoanal pouch are limited by heterogeneity in analysis techniques and sampling strategies Therefore, caution must be used when interpreting microbiota data. Similar to findings in IBD, a decrease in bacterial diversity and ‘dysbiosis’ are associated with acute and chronic inflammation in the pouch. Changes in Clostridium spp. and E. coli are associated with inflamed pouches and treatment response. This study aimed to compare the bacterial microbiota composition in patients with chronic pouchitis who responded to antibiotics vs. those who did not.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Patients with confirmed chronic pouchitis defined by a pouch disease activity score ≥ 7 were treated with antibiotics. If patients were already on antibiotics, they were offered the opportunity to stop. Follow up was at 4 weeks to check clinical status. Patients who came off antibiotics who flared were given the opportunity to restart the antibiotics to prevent deterioration. Patients were analysed as either on antibiotics if they received antibiotics 2 weeks prior to the clinic or off antibiotics if they had stopped all antibiotics 2 weeks prior to follow-up. Stool was collected from patients on follow-up and DNA was extracted from this stool. Sequencing was performed on an Illumina platform. Statistical analysis was performed using STAMP 2.1.3 software with Welch’s two-sided t-test for comparing two groups with false discovery rate correction.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <j
Allegretti JR, Mullish BH, 2020, Faecal microbiota transplantations and urinary tract infections – Authors' reply, The Lancet, Vol: 395, Pages: 271-271, ISSN: 0140-6736
McSweeney B, Allegretti JR, Fischer M, et al., 2020, In search of stool donors: a multicenter study of prior knowledge, perceptions, motivators, and deterrents among potential donors for fecal microbiota transplantation., Gut Microbes, Vol: 11, Pages: 51-62
Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridioides difficile infection. Stool donors are essential, but difficult to recruit and retain. We aimed to identify factors influencing willingness to donate stool. This multi-center study with a 32-item questionnaire targeted young adults and health care workers via social media and university email lists in Edmonton and Kingston, Canada; London and Nottingham, England; and Indianapolis and Boston, USA. Items included baseline demographics and FMT knowledge and perception. Investigated motivators and deterrents included economic compensation, screening process, time commitment, and stool donation logistics. Logistic regression and linear regression models estimated associations of study variables with self-assessed willingness to donate stool. 802 respondents completed our questionnaire: 387 (48.3%) age 21-30 years, 573 (71.4%) female, 323 (40%) health care workers. Country of residence, age and occupation were not associated with willingness to donate stool. Factors increasing willingness to donate were: already a blood donor (OR 1.64), male, altruism, economic benefit, knowledge of how FMT can help patients (OR 1.32), and positive attitudes towards FMT (OR 1.39). Factors decreasing willingness to donate were: stool collection unpleasant (OR 0.92), screening process invasive (OR 0.92), higher stool donation frequency, negative social perception of stool, and logistics of collection/transporting feces. We conclude that 1) blood donors and males are more willing to consider stool donation; 2) altruism, economic compensation, and positive feedback are motivators; and 3) screening process, high donation frequency, logistics of collection/transporting feces, lack of public awareness, and negative social perception are deterrents. Considering these variables could maximize donor recruitment and retention.
Cammarota G, Ianiro G, Kelly CR, et al., 2019, International consensus conference on stool banking for faecal microbiota transplantation in clinical practice, Gut, Vol: 68, Pages: 2111-2121, ISSN: 0017-5749
<jats:p>Although faecal microbiota transplantation (FMT) has a well-established role in the treatment of recurrent <jats:italic>Clostridioides difficile</jats:italic> infection (CDI), its widespread dissemination is limited by several obstacles, including lack of dedicated centres, difficulties with donor recruitment and complexities related to regulation and safety monitoring. Given the considerable burden of CDI on global healthcare systems, FMT should be widely available to most centres.</jats:p><jats:p>Stool banks may guarantee reliable, timely and equitable access to FMT for patients and a traceable workflow that ensures safety and quality of procedures. In this consensus project, FMT experts from Europe, North America and Australia gathered and released statements on the following issues related to the stool banking: general principles, objectives and organisation of the stool bank; selection and screening of donors; collection, preparation and storage of faeces; services and clients; registries, monitoring of outcomes and ethical issues; and the evolving role of FMT in clinical practice,</jats:p><jats:p>Consensus on each statement was achieved through a Delphi process and then in a plenary face-to-face meeting. For each key issue, the best available evidence was assessed, with the aim of providing guidance for the development of stool banks in order to promote accessibility to FMT in clinical practice.</jats:p>
Nathwani R, Mullish BH, Kockerling D, et al., 2019, A review of liver fibrosis and emerging therapies, European Medical Journal Gastroenterology, Vol: 4, Pages: 105-116, ISSN: 2054-6203
With an increasing burden of liver cirrhosis, the most advanced stage of hepatic fibrosis, there is an emphasis to better understand the pathological processes and mechanisms to target specific treatments to reverse or cease fibrosis progression. Antiviral therapy for hepatitis B and C has effectively treated underlying causes of chronic liver disease and has induced fibrosis reversal in some however, this has not been targeted for the majority of aetiologies for cirrhosis including alcohol or non-alcoholic steatohepatitis. Fibrosis, characterized by the accumulation of extracellular matrix proteins, occurs due to chronic injury from toxic, infectious or metabolic causes. The primary event of fibrogenesis is increased matrix production and scar formation mediated by the hepatic stellate cell, the principal cell type involved. Experimental models using rodent and human cell lines of liver injury have assisted in better understanding fibrogenesis especially in recognising the role of procoagulant factors. This has led to interventional studies using anticoagulants in animal models with reversal of fibrosis as the primary endpoint. Though these trials have been encouraging, no antifibrotic therapies are currently licenced for human use. This literature review discusses current knowledge in the pathophysiology of hepatic fibrosis, including characteristics of the extracellular matrix, signalling pathways and hepatic stellate cells. We also review current types of experimental models used to induce fibrosis and up-to46 date anticoagulant therapies and agents targeting the hepatic stellate cell that have been trialled in animal and human studies with anti-fibrotic properties.
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