Publications
189 results found
Michael DR, Davies TS, Jack AA, et al., 2021, Daily supplementation with the Lab4P probiotic consortium induces significant weight loss in overweight adults, Scientific Reports, Vol: 11
<jats:title>Abstract</jats:title><jats:p>This 9-month randomised, parallel, double-blind, single-centre, placebo-controlled study (PROBE, ISRCTN18030882) assessed the impact of probiotic supplementation on bodyweight. Seventy overweight Bulgarian participants aged 45–65 years with BMI 25–29.9 kg/m<jats:sup>2</jats:sup> received a daily dose of the Lab4P probiotic comprising lactobacilli and bifidobacteria (50 billion cfu/day). Participants maintained their normal diet and lifestyle over the duration of the study. The primary outcome was change from baseline in body weight and secondary outcomes included changes in waist circumference, hip circumference and blood pressure. A significant between group decrease in body weight (3.16 kg, 95% CI 3.94, 2.38, <jats:italic>p</jats:italic> < 0.0001) was detected favouring the probiotic group. Supplementation also resulted in significant between group decreases in waist circumference (2.58 cm, 95% CI 3.23, 1.94, <jats:italic>p</jats:italic> < 0.0001) and hip circumference (2.66 cm, 95% CI 3.28, 2.05, <jats:italic>p</jats:italic> < 0.0001) but no changes in blood pressure were observed. These findings support the outcomes of a previous shorter-term Lab4P intervention study in overweight and obese participants (PROMAGEN, ISRCTN12562026). We conclude that Lab4P has consistent weight modulation capability in free-living overweight adults.</jats:p>
Mullish BH, Alexander JL, Segal JP, 2021, Microbiota and faecal microbiota transplant, Microbiota in Health and Disease, ISSN: 2704-8845
Smith PJ, 2021, GI highlights from the literature, Gut, Vol: 70, Pages: 803-804, ISSN: 0017-5749
Ianiro G, Mullish BH, Hvas CL, et al., 2021, SARS-CoV-2 vaccines and donor recruitment for FMT, The Lancet Gastroenterology & Hepatology, Vol: 6, Pages: 264-266, ISSN: 2468-1253
Mullish BH, Marchesi JR, McDonald JAK, et al., 2021, Probiotics reduce self-reported symptoms of upper respiratory tract infection in overweight and obese adults: should we be considering probiotics during viral pandemics?, Gut Microbes, ISSN: 1949-0976
Gilca-Blanariu GE, Stefanescu G, Girleanu I, et al., 2021, Romanian National Guideline on Translating Fecal Microbiota Transplantation Applications related to Clostridioides difficile Infections into the Local Clinical Practice, Journal of Gastrointestinal and Liver Diseases, Vol: 30, Pages: 147-163, ISSN: 1841-8724
<jats:p>Fecal microbiota transplantation involves the infusion of intestinal microorganisms via the transfer of a stool from a healthy individual into a diseased individual, with the intent of restoring normal intestinal flora. Fecal transplant is proposed for the treatment of refractory Clostridioides difficile infection. At present, recurrent Clostridioides difficile infection is the only indication supported by solid scientific evidence. Regulations by healthcare authorities vary among different countries. Considering that Romania does not have an available national guideline to offer standardization, this paper aimed to create a national fecal microbiota transplantation guideline concerning indications, techniques and donor screening, developed by international and local scientific working groups.</jats:p>
Nathwani R, Kockerling D, Mullish BH, et al., 2021, Non-selective beta-blocker use in cirrhosis: the additional benefit in preventing secondary infections, Frontline Gastroenterology, ISSN: 2041-4137
Mullish BH, Quraishi MN, Segal JP, et al., 2021, The gut microbiome: what every gastroenterologist needs to know, Frontline Gastroenterology, Vol: 12, Pages: 118-127, 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>
Nathwani R, Mullish BH, Kockerling D, et al., 2021, Review of rifaximin: A summary of the current evidence and its benefits beyond its licensed use, European Medical Journal
NICE, 2021, Faecal microbiota transplant for recurrent or refractory Clostridioides difficile infection, Medtech innovation briefing [MIB247]
Morgan A, Vander Broek C, 2021, Microbiome Strategic Roadmap, Publisher: KTN
Allegretti JR, Kassam Z, Hurtado J, et al., 2021, Impact of fecal microbiota transplantation with capsules on the prevention of metabolic syndrome among patients with obesity, HORMONES-INTERNATIONAL JOURNAL OF ENDOCRINOLOGY AND METABOLISM, Vol: 20, Pages: 209-211, ISSN: 1109-3099
Huus KE, Frankowski M, Pučić-Baković M, et al., 2021, Changes in IgA-targeted microbiota following fecal transplantation for recurrent Clostridioides difficile infection, Gut Microbes, Vol: 13, Pages: 1-12, ISSN: 1949-0976
Forlano R, Mullish BH, Maurice JB, et al., 2021, NAFLD: Time to apply quantitation in liver biopsies as endpoints in clinical trials, Journal of Hepatology, Vol: 74, Pages: 241-242, ISSN: 0168-8278
Mullish BH, Michael DR, McDonald JA, et al., 2021, Identifying the factors influencing outcome in probiotic studies in overweight and obese patients: host or microbiome?, Gut, Vol: 70, Pages: 225-226
Forlano R, Mullish BH, Nathwani R, et al., 2020, Non-Alcoholic Fatty Liver Disease and Vascular Disease, Current Vascular Pharmacology, Vol: 19, Pages: 269-279, ISSN: 1570-1611
<jats:sec><jats:title /><jats:p>Non-Alcoholic Fatty Liver Disease (NAFLD) represents an increasing cause of liver diseaseworldwide. However, notably, the primary cause of morbidity and mortality in patients with NAFLD iscardiovascular disease (CVD), with fibrosis stage being the strongest disease-specific predictor. It isglobally projected that NAFLD will become increasingly prevalent, especially among children andyounger adults. As such, even within the next few years, NAFLD will contribute considerably to theoverall CVD burden.</jats:p></jats:sec><jats:sec><jats:title /><jats:p>In this review, we discuss the role of NAFLD as an emerging risk factor for CVD. In particular, thisarticle 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 andclinical CVD will be discussed. Finally, the review illustrates current and potential future perspectivesto screen for CVD in this high-risk population.</jats:p></jats:sec>
Innes AJ, Ghani R, Mullish BH, et al., 2020, O105. Faecal microbiota transplant (FMT) can reduce the high NRM associated with multi-drug resistant organism (MDRO) colonisation prior to allogeneic HCT., The 46th Annual Meeting of the European Society for Blood and Marrow Transplantation, Publisher: Springer Nature [academic journals on nature.com], Pages: 122-122, ISSN: 0268-3369
Smith PJ, 2020, GI highlights from the literature, Gut, Vol: 69, Pages: 2256-2257, ISSN: 0017-5749
Baunwall SMD, Lee MM, Eriksen MK, et al., 2020, Faecal microbiota transplantation for recurrent Clostridioides difficile infection: An updated systematic review and meta-analysis, EClinicalMedicine, Vol: 29-30, Pages: 100642-100642, ISSN: 2589-5370
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
<jats:title>Abstract</jats:title><jats:p>Ursodeoxycholic acid (UDCA) treatment can reduce itch and lower endogenous serum bile acids in intrahepatic cholestasis of pregnancy (ICP). We sought to determine how it could influence the gut environment in ICP to alter enterohepatic signalling. The gut microbiota and bile acid content were determined in faeces from 35 pregnant women (14 with uncomplicated pregnancies and 21 with ICP, 17 receiving UDCA). Faecal bile salt hydrolase activity was measured using a precipitation assay. Serum fibroblast growth factor 19 (FGF19) and 7α-hydroxy-4-cholesten-3-one (C4) concentrations were measured following a standardised diet for 21 hours. Women with a high ratio of <jats:italic>Bacteroidetes</jats:italic> to <jats:italic>Firmicutes</jats:italic> were more likely to be treated with UDCA (Fisher’s exact test p = 0.0178) than those with a lower ratio. Bile salt hydrolase activity was reduced in women with low <jats:italic>Bacteroidetes</jats:italic>:<jats:italic>Firmicutes</jats:italic>. Women taking UDCA had higher faecal lithocholic acid (p < 0.0001), with more unconjugated bile acids than women with untreated ICP or uncomplicated pregnancy. UDCA-treatment increased serum FGF19, and reduced C4 (reflecting lower bile acid synthesis). During ICP, UDCA treatment can be associated with enrichment of the gut microbiota with <jats:italic>Bacteroidetes</jats:italic>. These demonstrate high bile salt hydrolase activity, which deconjugates bile acids enabling secondary modification to FXR agonists, enhancing enterohepatic feedback via FGF19.</jats:p>
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
<jats:title>Abstract</jats:title><jats:p>In an exploratory, block-randomised, parallel, double-blind, single-centre, placebo-controlled superiority study (ISRCTN12562026, funded by Cultech Ltd), 220 Bulgarian participants (30 to 65 years old) with BMI 25–34.9 kg/m<jats:sup>2</jats:sup> received Lab4P probiotic (50 billion/day) or a matched placebo for 6 months. Participants maintained their normal diet and lifestyle. Primary outcomes were changes in body weight, BMI, waist circumference (WC), waist-to-height ratio (WtHR), blood pressure and plasma lipids. Secondary outcomes were changes in plasma C-reactive protein (CRP), the diversity of the faecal microbiota, quality of life (QoL) assessments and the incidence of upper respiratory tract infection (URTI). Significant between group decreases in body weight (1.3 kg, <jats:italic>p</jats:italic> < 0.0001), BMI (0.045 kg/m<jats:sup>2</jats:sup>, <jats:italic>p</jats:italic> < 0.0001), WC (0.94 cm, <jats:italic>p</jats:italic> < 0.0001) and WtHR (0.006, <jats:italic>p</jats:italic> < 0.0001) were in favour of the probiotic. Stratification identified greater body weight reductions in overweight subjects (1.88%, <jats:italic>p</jats:italic> < 0.0001) and in females (1.62%, <jats:italic>p</jats:italic> = 0.0005). Greatest weight losses were among probiotic hypercholesterolaemic participants (−2.5%, <jats:italic>p</jats:italic> < 0.0001) alongside a significant between group reduction in small dense LDL-cholesterol (0.2 mmol/L, <jats:italic>p</jats:italic> = 0.0241). Improvements in QoL and the incidence rate ratio of URTI (0.60, <jats:italic>p</jats:italic> <&thins
Miguens Blanco J, Selvarajah U, Liu Z, et al., 2020, Identification of New Associations Between Psoriatic Arthritis and the Gut Microbiota. the Mi-PART, a Phenomic Study, ACR Convergence 2020, Publisher: Wiley, ISSN: 2326-5205
Martinez-Gili L, McDonald JAK, Liu Z, et al., 2020, Understanding the mechanisms of efficacy of fecal microbiota transplant in treating recurrent Clostridioides difficile infection and beyond: the contribution of gut microbial-derived metabolites, Gut Microbes, Vol: 12, Pages: 1810531-1810531, ISSN: 1949-0976
Allegretti JR, Kelly CR, Grinspan A, et al., 2020, Inflammatory Bowel Disease Outcomes Following Fecal Microbiota Transplantation for Recurrent C. difficile Infection, Inflammatory Bowel Diseases, ISSN: 1078-0998
<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Recurrent Clostridioides difficile infection (CDI) in patients with inflammatory bowel disease (IBD) is a clinical challenge. Fecal microbiota transplantation (FMT) has emerged as a recurrent CDI therapy. Anecdotal concerns exist regarding worsening of IBD activity; however, prospective data among IBD patients are limited.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Secondary analysis from an open-label, prospective, multicenter cohort study among IBD patients with 2 or more CDI episodes was performed. Participants underwent a single FMT by colonoscopy (250 mL, healthy universal donor). Secondary IBD-related outcomes included rate of de novo IBD flares, worsening IBD, and IBD improvement—all based on Mayo or Harvey-Bradshaw index (HBI) scores. Stool samples were collected for microbiome and targeted metabolomic profiling.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Fifty patients enrolled in the study, among which 15 had Crohn’s disease (mean HBI, 5.8 ± 3.4) and 35 had ulcerative colitis (mean partial Mayo score, 4.2 ± 2.1). Overall, 49 patients received treatment. Among the Crohn’s disease cohort, 73.3% (11 of 15) had IBD improvement, and 4 (26.6%) had no disease activity change. Among the ulcerative colitis cohort, 62% (22 of 34) had IBD improvement, 29.4% (11 of 34) had no change, and 4% (1 of 34) experienced a de novo flare. Alpha diversity significantly increased post-FMT, and ulcerative colitis patients became more similar to the donor than Crohn’s disease patients (P = 0.04).</jats:p>
Allegretti JR, Kelly CR, Grinspan A, et al., 2020, Outcomes of Fecal Microbiota Transplantation in Patients With Inflammatory Bowel Diseases and Recurrent Clostridioides difficile Infection, Gastroenterology, Vol: 159, Pages: 1982-1984, ISSN: 0016-5085
Craven LJ, McIlroy JR, Mullish BH, et al., 2020, Letter: Intestinal microbiota transfer – Updating the nomenclature to increase acceptability, Alimentary Pharmacology and Therapeutics, Vol: 52, Pages: 1622-1623, ISSN: 0269-2813
This article is linked to Lai et al paper. To view this article, visit https://doi.org/10.1111/apt.15116
Ghani R, Mullish BH, 2020, Decision: Considerations for Use of Fecal Microbiota Transplantation in Special Patient Populations, The 6 Ds of Fecal Microbiota Transplantation: A Primer from Decision to Discharge and Beyond, Editors: Allegretti, Kassam, Publisher: Slack Incorporated, ISBN: 9781630917500
Mullish BH, 2020, The Role of Fecal Microbiota Transplantation in the Treatment of Obesity, Metabolic Syndrome, and Nonalcoholic Fatty Liver Disease, The 6 Ds of Fecal Microbiota Transplantation: A Primer from Decision to Discharge and Beyond, Editors: Allegretti, Kassam, Publisher: Slack Incorporated, ISBN: 9781630917500
Gupta S, Mullish BH, Allegretti JR, 2020, Fecal microbiota transplantation: the evolving risk landscape, American Journal of Gastroenterology, ISSN: 0002-9270
Fecal microbiota transplantation (FMT) has been recommended in clinical guidelines for the treatment for recurrent Clostridioides difficile infection (CDI). However, it is considered investigational by most regulatory agencies. As the adoption of FMT increased from a small group of CDI experts alone to more widespread use, there has been a corresponding increase in concern regarding potential risk. FMT is largely considered a safe procedure, though risks described range from mild gastrointestinal symptoms to serious infection. Currently, there is variability in how ‘FMT’ is characterized specifically with regards to testing approach, which, in turn, impacts the risk profile. This has been highlighted by the rare cases of multidrug-resistant organisms, Shiga toxin-producing E. coli and enteropathogenic E. coli recently reported, where these organisms were not screened. These cases have prompted additional screening mandates from the FDA, which has maintained its policy of enforcement discretion for the use of FMT for CDI not responding to standard therapy. Here, we examine the evolving risk landscape of FMT.
Alexander JL, Mullish BH, 2020, A Guide to the Gut Microbiome and its Relevance to Critical Care, British Journal of Nursing, Vol: 29, Pages: 1106-1112, ISSN: 0966-0461
<jats:p> Although it is well-established that particular bacteria may cause gastroenteritis and other infections when present in the gut, it is only recently that scientists have made significant inroads into understanding the huge number of other bacteria and additional microbes that live within the gastrointestinal tract, referred to as the gut microbiome. In particular, it is now recognised that bacteria within the gut microbiome have a wide variety of roles in maintaining different aspects of human health, and that disturbances of these bacteria may potentially cause or contribute to a number of different medical conditions, including particular infections, certain cancers, and chronic conditions, including inflammatory bowel disease. Moreover, there is increasing awareness that these bacteria help determine how the body responds to medication, including antibiotics and chemotherapy. There has been growing interest in different approaches to alter the gut microbiome as a novel approach to medical therapy. This article provides an overview of the importance of the gut microbiome, with a particular focus on critical care. </jats:p>
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