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ReportMorgan A, Vander Broek C, 2021,
Microbiome Strategic Roadmap
, Publisher: KTN -
Conference paperMonaghan T, Russell L, Rosati E, et al., 2021,
P307 FMT-associated alterations in the TCR repertoire of patients with severe or fulminant Clostridioides difficile infection
, BSG Campus, Publisher: BMJ Publishing Group, Pages: A199-A200, ISSN: 0017-5749 -
Journal articleMichael DR, Davies TS, Jack AA, et al., 2020,
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>
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Journal articleHuus KE, Frankowski M, Pučić-Baković M, et al., 2021,
Changes in IgA-targeted microbiota following fecal transplantation for recurrent <i>Clostridioides difficile</i> infection
, Gut Microbes, Vol: 13, ISSN: 1949-0976 -
Journal articleMullish BH, Allegretti JR, 2021,
The contribution of bile acid metabolism to the pathogenesis of <i>Clostridioides difficile</i> infection
, Therapeutic Advances in Gastroenterology, Vol: 14, Pages: 175628482110177-175628482110177, ISSN: 1756-2848<jats:p> Clostridioides difficile infection (CDI) remains a major global cause of gastrointestinal infection, with significant associated morbidity, mortality and impact upon healthcare system resources. Recent antibiotic use is a key risk factor for the condition, with the marked antibiotic-mediated perturbations in gut microbiome diversity and composition that underpin the pathogenesis of CDI being well-recognised. However, only relatively recently has further insight been gained into the specific mechanistic links between these gut microbiome changes and CDI, with alteration of gut microbial metabolites – in particular, bile acid metabolism – being a particular area of focus. A variety of in vitro, ex vivo, animal model and human studies have now demonstrated that loss of gut microbiome members with bile-metabolising capacity (including bile salt hydrolases, and 7-α-dehydroxylase) – with a resulting alteration of the gut bile acid milieu – contributes significantly to the disease process in CDI. More specifically, this microbiome disruption results in the enrichment of primary conjugated bile acids (including taurocholic acid, which promotes the germination of C. difficile spores) and loss of secondary bile acids (which inhibit the growth of C. difficile, and may bind to and limit activity of toxins produced by C. difficile). These bile acid changes are also associated with reduced activity of the farnesoid X receptor pathway, which may exacerbate C. difficile colitis throughout its impact upon gut barrier function and host immune/inflammatory response. Furthermore, a key mechanism of efficacy of faecal microbiota transplant (FMT) in treating recurrent CDI has been shown to be restoration of gut microbiome bile metabolising functionality; ensuring the presence of this functionality among defined microbial communities (and other ‘next generation’ FMT products) designed to treat CDI may be critical to their success. &
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Conference paperInnes 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 -
Journal articleMullish BH, Michael DR, McDonald JAK, et al., 2020,
Identifying the factors influencing outcome in probiotic studies in overweight and obese patients – host or microbiome?
, Gut, Vol: 70, Pages: 225-226, ISSN: 0017-5749 -
Journal articleBaunwall 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: 1-12, ISSN: 2589-5370BackgroundFaecal microbiota transplantation (FMT) is effective for recurrent Clostridioides difficile infection (CDI), but inconsistent effect rates and uncertain evidence levels have warranted caution. To clarify, we aimed to establish the evidence of FMT for recurrent CDI, updated across different delivery methods, treatment regimens, and in comparison with standard antibiotics.MethodsIn this updated systematic review and meta-analysis, we searched PubMed, Scopus, Embase, Web of Science, Clinical Key, and Svemed+ for FMT literature published in English until November 11, 2019. We included observational and clinical trials with or without antibiotic comparators and excluded studies with below 8 weeks follow-up and fewer than 15 patients. The primary outcome was clinical outcome by week 8. We comprehensively extracted patient and procedural data. In a random-effects meta-analysis, we estimated the clinical effect for repeat or single FMT, different delivery methods, and versus antibiotics. We rated the evidence according to the Cochrane and GRADE methods. The PROSPERO preregistration number is CRD42020158112.FindingsOf 1816 studies assessed, 45 studies were included. The overall clinical effect week 8 following repeat FMT (24 studies, 1855 patients) was 91% (95% CI: 89–94%, I2=53%) and 84% (80–88%, I2=86%) following single FMT (43 studies, 2937 patients). Delivery by lower gastrointestinal endoscopy was superior to all other delivery methods, and repeat FMT significantly increased the treatment effect week 8 (P<0·001). Compared with vancomycin, the number needed to treat (NNT) for repeat FMT was 1·5 (1·3–1·9, P<0·001) and 2.9 (1·5–37·1, P=0·03) for single FMT. Repeat FMT had high quality of evidence.InterpretationHigh-quality evidence supports FMT is effective for recurrent CDI, but its effect varies with the delivery method and the number of administrations. The superior NNT for F
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Journal articleSegal JP, Mak JWY, Mullish BH, et al., 2020,
The gut microbiome: an under-recognised contributor to the Covid-19 pandemic?
, Therapeutic Advances in Gastroenterology, Vol: 13, Pages: 1-14, ISSN: 1756-2848The novel Coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus, Covid-19 has rapidly spread across the globe, culminating in major global morbidity and mortality. As such, there has been a rapid escalation in scientific and clinical activity aimed at increasing our comprehension of this virus. This volume of work has led to early insights into risk factors associated with severity of disease, and mechanisms that underpin the virulence and dynamics involved in viral transmission. These insights ultimately may help guide potential therapeutics to reduce the human, economic and social impact of this pandemic. Importantly, the gastrointestinal (GI) tract has emerged as an important organ for propensity to and severity of Covid-19 infection. Furthermore, the gut microbiome has been linked to a variety of diseases and manipulation of the gut microbiome is an attractive potential therapeutic target for a number of diseases. While the data profiling the gut microbiome in Covid-19 infection to date are limited, they support the possibility of several routes of interaction between Covid-19, the gut microbiome, ACE2 expression in the small bowel and colon and gut inflammation. This article will explore the evidence that implicates the gut microbiome as a contributing factor to the pathogenesis, severity and disease course of Covid-19 and speculate about the gut microbiome’s capability as a therapeutic avenue against Covid-19.
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Journal articleMolinaro A, Bel Lassen P, Henricsson M, et al., 2020,
Imidazole propionate is increased in diabetes and associated with dietary patterns and altered microbial ecology
, Nature Communications, Vol: 11, ISSN: 2041-1723Microbiota-host-diet interactions contribute to the development of metabolic diseases. Imidazole propionate is a novel microbially produced metabolite from histidine, which impairs glucose metabolism. Here, we show that subjects with prediabetes and diabetes in the MetaCardis cohort from three European countries have elevated serum imidazole propionate levels. Furthermore, imidazole propionate levels were increased in subjects with low bacterial gene richness and Bacteroides 2 enterotype, which have previously been associated with obesity. The Bacteroides 2 enterotype was also associated with increased abundance of the genes involved in imidazole propionate biosynthesis from dietary histidine. Since patients and controls did not differ in their histidine dietary intake, the elevated levels of imidazole propionate in type 2 diabetes likely reflects altered microbial metabolism of histidine, rather than histidine intake per se. Thus the microbiota may contribute to type 2 diabetes by generating imidazole propionate that can modulate host inflammation and metabolism.
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