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Li RM, Long Z, Ding XY, Duan L. Oral microbiota imbalance: A predisposing factor for Henoch-Schönlein Purpura in children. Heliyon 2024; 10:e28826. [PMID: 38596127 PMCID: PMC11002595 DOI: 10.1016/j.heliyon.2024.e28826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
Oral microecological dysregulation has been shown to be associated with various immune system disorders. Henoch-schonlein purpura (HSP) is an autoimmune small vessel inflammatory disease in children of uncertain etiology, and studies have suggested that streptococcal infection may be an influential factor in its development. However, the relationship between oral microecological dysregulation and HSP has not been clearly studied so far. In this study, an epidemiological survey on the oral health status of children with HSP was investigated in this paper, and collected dental plaque from four groups of children for 16SrDNA high-throughput sequencing to analyze the composition and changes of oral microbial diversity among different groups. The results showed that the oral health status of children with HSP was poor, except for the incidence of caries in the 5-year-old group, the caries rate and dmfs/DMFS in the 3,4 and 5-year-old groups were higher than the same age in the fourth Chinese Oral Health Epidemiological Survey. Moreover, the development of HSP is accompanied by disturbances in the oral microbiota; a decrease in the number of Firmicutes which producing butyric acid may be closely associated with the development of HSP; changes in the abundance of Streptococcus and Neisseria may be a risk factor for the development of HSP.
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Affiliation(s)
- Rui min Li
- Department of Operative Dentistry and Endodontics, Stomatology Hospital of General Hospital, Ningxia Medical University, China
- Ningxia Medical University, China
- Ningxia Key Laboratory of Oral Disease Research, China
| | - Zhe Long
- Ningxia Medical University, China
- Ningxia Key Laboratory of Oral Disease Research, China
| | - Xiao yan Ding
- Ningxia Medical University, China
- Ningxia Key Laboratory of Oral Disease Research, China
| | - Li Duan
- Ningxia Medical University, China
- Ningxia Key Laboratory of Oral Disease Research, China
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2
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Xie Z, Zhou J, Zhang X, Li Z. Clinical potential of microbiota in thyroid cancer therapy. Biochim Biophys Acta Mol Basis Dis 2024; 1870:166971. [PMID: 38029942 DOI: 10.1016/j.bbadis.2023.166971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 12/01/2023]
Abstract
Thyroid cancer is one of the most common tumors of the endocrine system because of its rapid and steady increase in incidence and prevalence. In recent years, a growing number of studies have identified a key role for the gut, thyroid tissue and oral microbiota in the regulation of metabolism and the immune system. A growing body of evidence has conclusively demonstrated that the microbiota influences tumor formation, prevention, diagnosis, and treatment. We provide extensive information in which oral, gut, and thyroid microbiota have an effect on thyroid cancer development in this review. In addition, we thoroughly discuss the various microbiota species, their potential functions, and the underlying mechanisms for thyroid cancer. The microbiome offers a unique opportunity to improve the effectiveness of immunotherapy and radioiodine therapy thyroid cancer by maintaining the right type of microbiota, and holds great promise for improving clinical outcomes and quality of life for thyroid cancer patients.
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Affiliation(s)
- Zilan Xie
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410078, PR China; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, PR China; National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, Hunan, PR China
| | - Jiating Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410078, PR China; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, PR China; National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, Hunan, PR China
| | - Xuan Zhang
- Department of General Surgery, The Second People's Hospital of Hunan, Furong Middle Road, Changsha 410078, PR China
| | - Zhi Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410078, PR China; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, PR China; National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, Hunan, PR China.
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3
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Gorini F, Tonacci A. Tumor Microbial Communities and Thyroid Cancer Development-The Protective Role of Antioxidant Nutrients: Application Strategies and Future Directions. Antioxidants (Basel) 2023; 12:1898. [PMID: 37891977 PMCID: PMC10604861 DOI: 10.3390/antiox12101898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/11/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Thyroid cancer (TC), the most frequent malignancy of the endocrine system, has recorded an increasing incidence in the last decades. The etiology of TC remains at least partly unknown and, among modifiable risk factors, the gut microbiota and dietary nutrients (vitamins, essential microelements, polyphenols, probiotics) have been recognized to not only influence thyroid function, but exert critical effects on TC development and progression. Recent discoveries on the existence of tumor microbiota also in the TC microenvironment provide further evidence for the essential role of tumor microorganisms in TC etiology and severity, as well as acting as prognostic markers and as a potential target of adjuvant care in the treatment of TC patients. Therefore, in this review, we summarize current knowledge on the relationship of the tumor microbiome with the clinical tumor characteristics and TC progression, also illustrating the molecular mechanisms underlying this association, and how antioxidant nutrients may be used as a novel strategy to both control gut health and reduce the risk for TC. Furthermore, we discuss how new technologies might be exploited for the development of new foods with high nutritional values, antioxidant capability, and even attractiveness to the individual in terms of sensory and emotional features.
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Affiliation(s)
- Francesca Gorini
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy;
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4
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Sharma BR, Jaiswal S, Ravindra PV. Modulation of gut microbiota by bioactive compounds for prevention and management of type 2 diabetes. Biomed Pharmacother 2022; 152:113148. [PMID: 35665671 DOI: 10.1016/j.biopha.2022.113148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/10/2022] [Accepted: 05/15/2022] [Indexed: 01/08/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia and insulin resistance. Gut microbiota (GM) are specific groups of microbes colonized in the gastrointestinal (GI) tract. They profoundly influence health, disease protection, and associated with metabolic activities, and play a vital role in the production of functional metabolites from dietary substances. Dysbiosis of GM has been linked to the onset of T2DM and can be altered to attain eubiosis by intervention with various nutritional bioactive compounds such as polyphenols, prebiotics, and probiotics. This review presents an overview of the evidence and underlying mechanisms by which bioactive compounds modulate the GM for the prevention and management of T2DM.
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Affiliation(s)
- Basista Rabina Sharma
- Department of Biochemistry, CSIR-Central Food Technological Research Institute (CFTRI), KRS Road, Opp. Rail Museum, Mysuru 570020, India
| | - Swarna Jaiswal
- School of Food Science and Environmental Health, College of Sciences and Health, Technological University Dublin - City Campus, Central Quad, Grangegorman, Dublin D07 ADY7, Ireland; Environmental Sustainability and Health Institute, Technological University Dublin - City Campus, Grangegorman, Dublin D07 H6K8, Ireland
| | - P V Ravindra
- Department of Biochemistry, CSIR-Central Food Technological Research Institute (CFTRI), KRS Road, Opp. Rail Museum, Mysuru 570020, India.
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5
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Ai X, Wu C, Yin T, Zhur O, Liu C, Yan X, Yi C, Liu D, Xiao L, Li W, Xie B, He H. Antidiabetic Function of Lactobacillus fermentum MF423-Fermented Rice Bran and Its Effect on Gut Microbiota Structure in Type 2 Diabetic Mice. Front Microbiol 2021; 12:682290. [PMID: 34248898 PMCID: PMC8266379 DOI: 10.3389/fmicb.2021.682290] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/10/2021] [Indexed: 01/10/2023] Open
Abstract
Rice bran is an industrial byproduct that exerts several bioactivities despite its limited bioavailability. In this study, rice bran fermented with Lactobacillus fermentum MF423 (FLRB) had enhanced antidiabetic effects both in vitro and in vivo. FLRB could increase glucose consumption and decrease lipid accumulation in insulin resistant HepG2 cells. Eight weeks of FLRB treatment significantly reduced the levels of blood glucose and lipids and elevated antioxidant activity in type 2 diabetic mellitus (T2DM) mice. H&E staining revealed alleviation of overt lesions in the livers of FLRB-treated mice. Moreover, high-throughput sequencing showed notable variation in the composition of gut microbiota in FLRB-treated mice, especially for short-chain fatty acids (SCFAs)-producing bacteria such as Dubosiella and Lactobacillus. In conclusion, our results suggested that rice bran fermentation products can modulate the intestinal microbiota and improve T2DM-related biochemical abnormalities, so they can be applied as potential probiotics or dietary supplements.
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Affiliation(s)
- Xiaojuan Ai
- School of Life Sciences, Central South University, Changsha, China
| | - Cuiling Wu
- Department of Biochemistry, Changzhi Medical College, Changzhi, China
| | - Tingting Yin
- School of Life Sciences, Central South University, Changsha, China
| | - Olena Zhur
- School of Life Sciences, Central South University, Changsha, China
| | - Congling Liu
- School of Life Sciences, Central South University, Changsha, China
| | - Xiaotao Yan
- School of Life Sciences, Central South University, Changsha, China
| | - CuiPing Yi
- School of Chemistry and Biology Engineering, Changsha University of Science and Technology, Changsha, China
| | - Dan Liu
- Department of Biochemistry and Molecular Biology, School of Preclinical Medicine, Guangxi Medical University, Nanning, China
| | - Linhu Xiao
- School of Life Sciences, Central South University, Changsha, China
| | - Wenkai Li
- School of Life Sciences, Central South University, Changsha, China
| | - Binbin Xie
- Microbial Technology Institute and State Key Laboratory of Microbial Technology, Shandong University, Qingdao, China
| | - Hailun He
- School of Life Sciences, Central South University, Changsha, China
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6
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Brereton N, Pitre F, Gonzalez E. Reanalysis of the Mars500 experiment reveals common gut microbiome alterations in astronauts induced by long-duration confinement. Comput Struct Biotechnol J 2021; 19:2223-2235. [PMID: 33995915 PMCID: PMC8099722 DOI: 10.1016/j.csbj.2021.03.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 12/16/2022] Open
Abstract
Maintaining astronaut health throughout long-duration spaceflight is essential to the feasibility of a manned mission to Mars. The ground-based Mars500 experiment investigated long-duration health by isolating six astronauts for 520 days, the longest controlled human confinement study conducted to date. After 520 days, astronauts had uniform strength and lean body mass losses, and increased fasting plasma glucose, calprotectin, and neutrophil levels characteristic of intestinal inflammation but previous analyses revealed no common significant changes in gut microbiota. This study reanalysed data from early (days 7–45) and late (days 420–520) faecal samples and identified 408 exact sequence variants (ESVs), including 213 shared by all astronauts. Thirty-two ESVs were significantly differentially abundant over time, including depletion of keystone resistant starch degrading, anti-inflammatory and insulin sensitivity-associated species, such as Faecalibacterium prausnitzii, Ruminococcus bromii, Blautia luti, Anaerostipes hadrus, Roseburia faecis, and Lactobacillus rogosae, and enrichment of yet-to-be-cultured bacteria. Additionally, the extraordinary experimental confinement allowed observation of microbiota potentially shared between astronauts and their habitat. Forty-nine species were shared, representing 49% and 12% of the human and environmental microbiome diversity, respectively. These findings reveal the microbiota which significantly altered in relative abundance throughout confinement, including species known to influence inflammation and host glucose homeostasis consistent with astronaut symptoms. Identification of microbiome alterations after 520 days of isolation represents a missing piece connecting Mars500 astronaut physiological studies. Knowledge of the impact of long-term confinement upon the human microbiome helps to improve our understanding of how humans interact with their habitats and is a valuable step forward towards enabling long-duration spaceflight.
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Affiliation(s)
- N.J.B. Brereton
- Institut de Recherche en Biologie Végétale, University of Montreal, Montreal, QC H1X 2B2, Canada
- Corresponding author.
| | - F.E. Pitre
- Institut de Recherche en Biologie Végétale, University of Montreal, Montreal, QC H1X 2B2, Canada
| | - E. Gonzalez
- Canadian Centre for Computational Genomics (C3G), Department of Human Genetics, McGill University, 740 Dr. Penfield Avenue, Montréal, QC H3A 0G1, Canada
- Microbiome Research Platform, McGill Interdisciplinary Initiative in Infection and Immunity (MI4), Genome Centre, McGill University, Montréal, QC, Canada
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7
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Wang S, Dhital S, Wang K, Fu X, Zhang B, Huang Q. Side-by-side and exo-pitting degradation mechanism revealed from in vitro human fecal fermentation of granular starches. Carbohydr Polym 2021; 263:118003. [PMID: 33858585 DOI: 10.1016/j.carbpol.2021.118003] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/08/2021] [Accepted: 03/25/2021] [Indexed: 12/16/2022]
Abstract
The in vitro fecal fermentation characteristics and microbiota responses to A- and B-type polymorphic starches as model (whole) foods enriched with resistant starch was investigated. Marked difference in fermentation rate as well as microbial genera was observed during fermentation, the degradation pattern as well as structural evolution during fermentation was almost similar. The final butyrate concentrations of both HAMS and PS (ca. 38 mM) were significantly higher than that of WMS (23 mM) and NMS (33 mM), which was associated with the increase of the relative abundance of Roseburia, Blautia, and Lachnospiraceae. A-type polymorphic starches, on the other hand had remarkably faster fermentation rate and promoted Megamonas. X-ray diffraction and size-exclusion chromatography of residual starch during the fermentation course demonstrated the "side-by-side" fermentation pattern. Based on the structural changes observed, we conclude that in vitro fecal fermentation of starch granules predominantly controlled by the surface features rather than the molecular and supra-molecular structure.
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Affiliation(s)
- Shaokang Wang
- School of Food Science and Engineering, Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, South China University of Technology, Guangzhou, 510640, China; Sino-Singapore International Research Institute, Guangzhou, 510555, China
| | - Sushil Dhital
- Department of Chemical Engineering, Monash University, Clayton Campus, VIC, 3800, Australia
| | - Kai Wang
- School of Food Science, South China Agricultural University, Guangzhou, 510642, China
| | - Xiong Fu
- School of Food Science and Engineering, Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, South China University of Technology, Guangzhou, 510640, China; Sino-Singapore International Research Institute, Guangzhou, 510555, China; Overseas Expertise Introduction Center for Discipline Innovation of Food Nutrition and Human Health (111 Center), Guangzhou, 510640, China
| | - Bin Zhang
- School of Food Science and Engineering, Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, South China University of Technology, Guangzhou, 510640, China; Sino-Singapore International Research Institute, Guangzhou, 510555, China; Overseas Expertise Introduction Center for Discipline Innovation of Food Nutrition and Human Health (111 Center), Guangzhou, 510640, China.
| | - Qiang Huang
- School of Food Science and Engineering, Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, South China University of Technology, Guangzhou, 510640, China; Sino-Singapore International Research Institute, Guangzhou, 510555, China; Overseas Expertise Introduction Center for Discipline Innovation of Food Nutrition and Human Health (111 Center), Guangzhou, 510640, China.
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8
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Lee JHJ, Zhu J. Optimizing Secondary Electrospray Ionization High-Resolution Mass Spectrometry (SESI-HRMS) for the Analysis of Volatile Fatty Acids from Gut Microbiome. Metabolites 2020; 10:E351. [PMID: 32872254 PMCID: PMC7570293 DOI: 10.3390/metabo10090351] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/19/2020] [Accepted: 08/26/2020] [Indexed: 12/19/2022] Open
Abstract
Gut microbiota plays essential roles in maintaining gut homeostasis. The composition of gut microbes and their metabolites are altered in response to diet and remedial agents such as antibiotics. However, little is known about the effect of antibiotics on the gut microbiota and their volatile metabolites. In this study, we evaluated the impact of a moderate level of ampicillin treatment on volatile fatty acids (VFAs) of gut microbial cultures using an optimized real-time secondary electrospray ionization coupled with high-resolution mass spectrometry (SESI-HRMS). To evaluate the ionization efficiency, different types of electrospray solvents and concentrations of formic acid as an additive (0.01, 0.05, and 0.1%, v/v) were tested using VFAs standard mixture (C2-C7). As a result, the maximum SESI-HRMS signals of all studied m/z values were observed from water with 0.01% formic acid than those from the aqueous methanolic solutions. Optimal temperatures of sample inlet and ion chamber were set at 130 °C and 85 °C, respectively. SESI spray pressure at 0.5 bar generated the maximum intensity than other tested values. The optimized SESI-HRMS was then used for the analysis of VFAs in gut microbial cultures. We detected that the significantly elevated C4 and C7 VFAs in the headspace of gut microbial cultures six hours after ampicillin treatment (1 mg/L). In conclusion, our results suggested that the optimized SESI-HRMS method can be suitable for the analysis of VFAs from gut microbes in a rapid, sensitive, and non-invasive manner.
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Affiliation(s)
- Jisun H. J. Lee
- Department of Human Sciences, The Ohio State University, Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210, USA;
- James Comprehensive Cancer Center, The Ohio State University, Wiseman Hall, 400 W 12th Ave, Columbus, OH 43210, USA
| | - Jiangjiang Zhu
- Department of Human Sciences, The Ohio State University, Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210, USA;
- James Comprehensive Cancer Center, The Ohio State University, Wiseman Hall, 400 W 12th Ave, Columbus, OH 43210, USA
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9
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Cassotta M, Forbes-Hernández TY, Calderón Iglesias R, Ruiz R, Elexpuru Zabaleta M, Giampieri F, Battino M. Links between Nutrition, Infectious Diseases, and Microbiota: Emerging Technologies and Opportunities for Human-Focused Research. Nutrients 2020; 12:E1827. [PMID: 32575399 PMCID: PMC7353391 DOI: 10.3390/nu12061827] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023] Open
Abstract
The interaction between nutrition and human infectious diseases has always been recognized. With the emergence of molecular tools and post-genomics, high-resolution sequencing technologies, the gut microbiota has been emerging as a key moderator in the complex interplay between nutrients, human body, and infections. Much of the host-microbial and nutrition research is currently based on animals or simplistic in vitro models. Although traditional in vivo and in vitro models have helped to develop mechanistic hypotheses and assess the causality of the host-microbiota interactions, they often fail to faithfully recapitulate the complexity of the human nutrient-microbiome axis in gastrointestinal homeostasis and infections. Over the last decade, remarkable progress in tissue engineering, stem cell biology, microfluidics, sequencing technologies, and computing power has taken place, which has produced a new generation of human-focused, relevant, and predictive tools. These tools, which include patient-derived organoids, organs-on-a-chip, computational analyses, and models, together with multi-omics readouts, represent novel and exciting equipment to advance the research into microbiota, infectious diseases, and nutrition from a human-biology-based perspective. After considering some limitations of the conventional in vivo and in vitro approaches, in this review, we present the main novel available and emerging tools that are suitable for designing human-oriented research.
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Affiliation(s)
- Manuela Cassotta
- Centre for Nutrition and Health, Universidad Europea del Atlántico (UEA), 39001 Santander, Spain; (M.C.); (R.C.I.); (R.R.)
| | - Tamara Yuliett Forbes-Hernández
- Department of Analytical and Food Chemistry, Nutrition and Food Science Group, CITACA, CACTI, University of Vigo, 36310 Vigo, Spain;
| | - Ruben Calderón Iglesias
- Centre for Nutrition and Health, Universidad Europea del Atlántico (UEA), 39001 Santander, Spain; (M.C.); (R.C.I.); (R.R.)
| | - Roberto Ruiz
- Centre for Nutrition and Health, Universidad Europea del Atlántico (UEA), 39001 Santander, Spain; (M.C.); (R.C.I.); (R.R.)
| | - Maria Elexpuru Zabaleta
- Dipartimento di Scienze Cliniche e Molecolari, Facoltà di Medicina, Università Politecnica delle Marche, 60131 Ancona, Italy;
| | - Francesca Giampieri
- Department of Analytical and Food Chemistry, Nutrition and Food Science Group, CITACA, CACTI, University of Vigo, 36310 Vigo, Spain;
- Department of Clinical Sciences, Faculty of Medicine, Polytechnic University of Marche, 60131 Ancona, Italy
- College of Food Science and Technology, Northwest University, Xi’an 710069, China
| | - Maurizio Battino
- Department of Analytical and Food Chemistry, Nutrition and Food Science Group, CITACA, CACTI, University of Vigo, 36310 Vigo, Spain;
- Department of Clinical Sciences, Faculty of Medicine, Polytechnic University of Marche, 60131 Ancona, Italy
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China
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Li Y, Su X, Zhang L, Liu Y, Shi M, Lv C, Gao Y, Xu D, Wang Z. Dysbiosis of the gut microbiome is associated with CKD5 and correlated with clinical indices of the disease: a case-controlled study. J Transl Med 2019; 17:228. [PMID: 31315634 PMCID: PMC6637476 DOI: 10.1186/s12967-019-1969-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/05/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a universal chronic disease in China. The balance of the gut microbiome is highly crucial for a healthy human body, especially for the immune system. However, the relationship between the gut microbiome and CKD has not yet been clarified. METHODS A total of 122 patients were recruited for this study. Among them, 24 patients were diagnosed with CKD5 but did not receive hemodialysis therapy, 29 patients were diagnosed with CKD5 and received hemodialysis therapy and 69 were matched healthy controls. The gut microbiome composition was analyzed by a 16S rRNA (16S ribosomal RNA) gene-based sequencing protocol. High-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (HPLC/ESI-MS/MS) technology was used to evaluate the levels of microbiome-related protein-binding uremic toxins level, indoxyl sulfate (IS) and p-cresyl sulfate (PCS), in the patients. RESULTS We compared the gut microbiome results of 122 subjects and established a correlation between the gut microbiome and IS and PCS levels. The results indicated that alpha and beta diversity were different in patients with CKD5 than in the healthy controls (p < 0.01). In comparison to healthy controls, CKD5 patients exhibited a significantly higher relative abundance of Neisseria (p < 0.001), Lachnoclostridium (p < 0.001) and Bifidobacterium (p < 0.001). Faecalibacterium (p < 0.001) displayed a notably lower relative abundance for CKD5 patients both with and without hemodialysis than for controls. It was also found that the concentrations of IS and PCS were correlated with the gut microbiome. CONCLUSIONS Our results indicate that CKD5 patients both with and without hemodialysis had dysbiosis of the gut microbiome and that this dysbiosis was associated with an accumulation of IS and PCS. These results may support further clinical diagnosis to a great extent and help in developing potential probiotics to facilitate the treatment of CKD5.
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Affiliation(s)
- Yang Li
- Department of Nephrology, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Xinhuan Su
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| | - Lei Zhang
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Chemistry and Environment, Beihang University, Beijing, 100191, China
- Shandong Children's Microbiome Center, Qilu Children's Hospital of Shandong University, Jinan, 250022, China
| | - Yanwei Liu
- Department of Nephrology, Feicheng Mining Center Hospital, Feicheng High-Tech Development Zone, Taian, 271600, Shandong, China
| | - Min Shi
- Jinan Center for Food and Drug Control, Jinan, 250102, China
| | - Chenxiao Lv
- Department of Nephrology, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250014, Shandong, China
- Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, Shandong, China
| | - Ying Gao
- Department of Nephrology, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250014, Shandong, China
- Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, Shandong, China
| | - Dongmei Xu
- Department of Nephrology, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250014, Shandong, China.
| | - Zunsong Wang
- Department of Nephrology, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250014, Shandong, China.
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11
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Zhang J, Zhang F, Zhao C, Xu Q, Liang C, Yang Y, Wang H, Shang Y, Wang Y, Mu X, Zhu D, Zhang C, Yang J, Yao M, Zhang L. Dysbiosis of the gut microbiome is associated with thyroid cancer and thyroid nodules and correlated with clinical index of thyroid function. Endocrine 2019; 64:564-574. [PMID: 30584647 DOI: 10.1007/s12020-018-1831-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 12/12/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE Thyroid cancer and thyroid nodules are the most prevalent form of thyroid endocrine disorder. The balance of gut microbiome is highly crucial for a healthy human body, especially for the immune and endocrine system. However, the relationship between gut microbiome and the thyroid endocrine disorders such as thyroid cancer and thyroid nodules has not been reported yet. METHODS A cohort of 74 patients was recruited for this study. Among them, 20 patients had thyroid cancer, 18 patients had thyroid nodules, and 36 were matched healthy controls. Gut microbiome composition was analyzed by 16S rRNA (16S ribosomal RNA) gene-based sequencing protocol. RESULTS We compared the gut microbiome results of 74 subjects and established the correlation between gut microbiome and thyroid endocrine function for both thyroid cancer and thyroid nodules. The results inferred that alpha and beta diversity were different for patients with thyroid tumor than the healthy controls (p < 0.01). In comparison to healthy controls, the relative abundance of Neisseria (p < 0.001) and Streptococcus (p < 0.001) was significantly higher for thyroid cancer and thyroid nodules. Butyricimonas (p < 0.001) and Lactobacillus (p < 0.001) displayed notably lower relative abundance for thyroid cancer and thyroid nodules, respectively. It was also found that the clinical indexes were correlated with gut microbiome. CONCLUSION Our results indicate that both thyroid cancer and thyroid nodules are associated with the composition of gut microbiome. These results may support further clinical diagnosis to a great extent and help in developing potential probiotics to facilitate the treatment of thyroid cancer and thyroid nodules.
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Affiliation(s)
- Jiaming Zhang
- Qingdao Human Microbiome Center, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
- College of Life Science, Shandong Normal University, Shandong Province, Jinan, 250014, China
| | - Fanghua Zhang
- Qingdao Human Microbiome Center, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
- Department of Endocrinology, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
| | - Changying Zhao
- Qingdao Human Microbiome Center, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
- College of Life Science, Shandong Normal University, Shandong Province, Jinan, 250014, China
| | - Qian Xu
- Department of Endocrinology, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
| | - Cheng Liang
- School of Information Science and Engineering, Shandong Normal University, Shandong Province, Jinan, 250014, China
| | - Ying Yang
- Department of Endocrinology, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
| | - Huiling Wang
- Department of Endocrinology, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
| | - Yongfang Shang
- Department of Endocrinology, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
| | - Ye Wang
- Department of Endocrinology, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
- Clinical Laboratory and Core Research Laboratory, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao 266042, China
| | - Xiaofeng Mu
- Department of Endocrinology, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
- Clinical Laboratory and Core Research Laboratory, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao 266042, China
| | - Dequan Zhu
- Microbiological Laboratory, Lin Yi People's Hospital, Shandong Province, Linyi 276003, China
| | - Chunling Zhang
- Qingdao Human Microbiome Center, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China
| | - Junjie Yang
- Qingdao Human Microbiome Center, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China.
- College of Life Science, Qilu Normal University, Shandong Province, Jinan, 250200, China.
| | - Minxiu Yao
- Qingdao Human Microbiome Center, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China.
- Department of Endocrinology, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China.
| | - Lei Zhang
- Qingdao Human Microbiome Center, The Affiliated Central Hospital of Qingdao University, Shandong Province, Qingdao, 266042, China.
- Microbiological Laboratory, Lin Yi People's Hospital, Shandong Province, Linyi 276003, China.
- Shandong Children's Microbiome Center, Qilu Children's Hospital of Shandong University, Jinan, 250022, China.
- Shandong Institutes for Food and Drug Control, Xinluo Street 2749, Jinan, Shandong Province, 250101, China.
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Chemistry and Environment, Beihang University, Beijing, 100191, China.
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Mills S, Stanton C, Lane JA, Smith GJ, Ross RP. Precision Nutrition and the Microbiome, Part I: Current State of the Science. Nutrients 2019; 11:nu11040923. [PMID: 31022973 PMCID: PMC6520976 DOI: 10.3390/nu11040923] [Citation(s) in RCA: 158] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/10/2019] [Accepted: 04/17/2019] [Indexed: 12/11/2022] Open
Abstract
The gut microbiota is a highly complex community which evolves and adapts to its host over a lifetime. It has been described as a virtual organ owing to the myriad of functions it performs, including the production of bioactive metabolites, regulation of immunity, energy homeostasis and protection against pathogens. These activities are dependent on the quantity and quality of the microbiota alongside its metabolic potential, which are dictated by a number of factors, including diet and host genetics. In this regard, the gut microbiome is malleable and varies significantly from host to host. These two features render the gut microbiome a candidate ‘organ’ for the possibility of precision microbiomics—the use of the gut microbiome as a biomarker to predict responsiveness to specific dietary constituents to generate precision diets and interventions for optimal health. With this in mind, this two-part review investigates the current state of the science in terms of the influence of diet and specific dietary components on the gut microbiota and subsequent consequences for health status, along with opportunities to modulate the microbiota for improved health and the potential of the microbiome as a biomarker to predict responsiveness to dietary components. In particular, in Part I, we examine the development of the microbiota from birth and its role in health. We investigate the consequences of poor-quality diet in relation to infection and inflammation and discuss diet-derived microbial metabolites which negatively impact health. We look at the role of diet in shaping the microbiome and the influence of specific dietary components, namely protein, fat and carbohydrates, on gut microbiota composition.
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Affiliation(s)
- Susan Mills
- APC Microbiome Ireland, University College Cork, Cork T12 K8AF, Ireland.
| | - Catherine Stanton
- APC Microbiome Ireland, Teagasc Food Research Centre, Fermoy P61 C996, Co Cork, Ireland.
| | - Jonathan A Lane
- H&H Group, Technical Centre, Global Research and Technology Centre, Cork P61 C996, Ireland.
| | - Graeme J Smith
- H&H Group, Technical Centre, Global Research and Technology Centre, Cork P61 C996, Ireland.
| | - R Paul Ross
- APC Microbiome Ireland, University College Cork, Cork T12 K8AF, Ireland.
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Argüello H, Estellé J, Leonard FC, Crispie F, Cotter PD, O’Sullivan O, Lynch H, Walia K, Duffy G, Lawlor PG, Gardiner GE. Influence of the Intestinal Microbiota on Colonization Resistance to Salmonella and the Shedding Pattern of Naturally Exposed Pigs. mSystems 2019; 4:e00021-19. [PMID: 31020042 PMCID: PMC6478965 DOI: 10.1128/msystems.00021-19] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/01/2019] [Indexed: 12/11/2022] Open
Abstract
Salmonella colonization and infection in production animals such as pigs are a cause for concern from a public health perspective. Variations in susceptibility to natural infection may be influenced by the intestinal microbiota. Using 16S rRNA compositional sequencing, we characterized the fecal microbiome of 15 weaned pigs naturally infected with Salmonella at 18, 33, and 45 days postweaning. Dissimilarities in microbiota composition were analyzed in relation to Salmonella infection status (infected, not infected), serological status, and shedding pattern (nonshedders, single-point shedders, intermittent-persistent shedders). Global microbiota composition was associated with the infection outcome based on serological analysis. Greater richness within the microbiota postweaning was linked to pigs being seronegative at the end of the study at 11 weeks of age. Members of the Clostridia, such as Blautia, Roseburia, and Anaerovibrio, were more abundant and part of the core microbiome in nonshedder pigs. Cellulolytic microbiota (Ruminococcus and Prevotella) were also more abundant in noninfected pigs during the weaning and growing stages. Microbial profiling also revealed that infected pigs had a higher abundance of Lactobacillus and Oscillospira, the latter also being part of the core microbiome of intermittent-persistent shedders. These findings suggest that a lack of microbiome maturation and greater proportions of microorganisms associated with suckling increase susceptibility to infection. In addition, the persistence of Salmonella shedding may be associated with an enrichment of pathobionts such as Anaerobiospirillum. Overall, these results suggest that there may be merit in manipulating certain taxa within the porcine intestinal microbial community to increase disease resistance against Salmonella in pigs. IMPORTANCE Salmonella is a global threat for public health, and pork is one of the main sources of human salmonellosis. However, the complex epidemiology of the infection limits current control strategies aimed at reducing the prevalence of this infection in pigs. The present study analyzes for the first time the impact of the gut microbiota in Salmonella infection in pigs and its shedding pattern in naturally infected growing pigs. Microbiome (16S rRNA amplicon) analysis reveals that maturation of the gut microbiome could be a key consideration with respect to limiting the infection and shedding of Salmonella in pigs. Indeed, seronegative animals had higher richness of the gut microbiota early after weaning, and uninfected pigs had higher abundance of strict anaerobes from the class Clostridia, results which demonstrate that a fast transition from the suckling microbiota to a postweaning microbiota could be crucial with respect to protecting the animals.
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Affiliation(s)
- Héctor Argüello
- Teagasc, Food Research Centre, Ashtown, Dublin, Ireland
- Grupo de Genómica y Mejora Animal, Departamento de Genética, Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | - Jordi Estellé
- GABI, INRA, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Finola C. Leonard
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Fiona Crispie
- Teagasc, Food Research Centre, Fermoy, Cork, Ireland
- APC Microbiome Ireland, Cork, Ireland
| | - Paul D. Cotter
- Teagasc, Food Research Centre, Fermoy, Cork, Ireland
- APC Microbiome Ireland, Cork, Ireland
| | - Orla O’Sullivan
- Teagasc, Food Research Centre, Fermoy, Cork, Ireland
- APC Microbiome Ireland, Cork, Ireland
| | - Helen Lynch
- Teagasc, Food Research Centre, Ashtown, Dublin, Ireland
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Kavita Walia
- Teagasc, Food Research Centre, Ashtown, Dublin, Ireland
- Department of Science, Waterford Institute of Technology, Waterford, Ireland
| | | | - Peadar G. Lawlor
- Teagasc, Pig Development Department, Animal and Grassland Research and Innovation Centre, Moorepark, Fermoy, Cork, Ireland
| | - Gillian E. Gardiner
- Department of Science, Waterford Institute of Technology, Waterford, Ireland
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Response of intestinal metabolome to polysaccharides from mycelia of Ganoderma lucidum. Int J Biol Macromol 2019; 122:723-731. [DOI: 10.1016/j.ijbiomac.2018.10.224] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/30/2018] [Accepted: 10/31/2018] [Indexed: 12/20/2022]
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15
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16
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Zhang B, Sun W, Yu N, Sun J, Yu X, Li X, Xing Y, Yan D, Ding Q, Xiu Z, Ma B, Yu L, Dong Y. Anti-diabetic effect of baicalein is associated with the modulation of gut microbiota in streptozotocin and high-fat-diet induced diabetic rats. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.04.070] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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17
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Dong D, Ni Q, Wang C, Zhang L, Li Z, Jiang C, EnqiangMao, Peng Y. Effects of intestinal colonization by Clostridium difficile and Staphylococcus aureus on microbiota diversity in healthy individuals in China. BMC Infect Dis 2018; 18:207. [PMID: 29724187 PMCID: PMC5934869 DOI: 10.1186/s12879-018-3111-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/25/2018] [Indexed: 12/16/2022] Open
Abstract
Background Intestinal colonization by pathogenic bacteria is a risk factor for infection, and contributes to environmental contamination and disease dissemination. Alteration of gut microbiota also plays a pivotal role in the development of disease. Although Clostridium difficile and Staphylococcus aureus are well-recognized pathogens causing nosocomial and community infections, the intestinal colonization was not fully investigated. Herein, we explored their overall carriage rates in healthy adults from the community, and characterized the gut microbiomes of C. difficile and S. aureus carriers. Methods Fecal samples were collected from 1709 healthy volunteers from communities in Shanghai, China, and tested for the presence of C. difficile, methicillin-sensitive S. aureus (MSSA), and methicillin-resistant S. aureus (MRSA) using culture-based techniques. To explore differences in the gut microbiome, 16S rRNA gene sequencing was conducted using samples from non-carriers (CH), C. difficile carriers (CCD), MRSA carriers (CM), and MSSA carriers (CS). Results Overall, we detected 12 C. difficile and 60 S. aureus isolates, accounting for 0.70% and 3.51% of total isolates, respectively. Eight isolates were determined to be MRSA, accounting for 13.3% of the S. aureus population. Sequencing data revealed that the microbial diversity and richness were similar among the four groups. However, at the phylum level, carriage of C. difficile or MRSA was associated with a paucity of Bacteroidetes and an overabundance of Proteobacteria compared with non-carriers. At the genus level, the prevalence of the genera Bacteroides, Prevotella, Faecalibacterium, and Roseburia was decreased in C. difficile-positive samples compared with the controls, while the proportion of Clostridium cluster XIVa species was increased. MRSA carriers exhibited a higher proportion of the genera Parasutterella and Klebsiella, but a decreased prevalence of Bacteroides. Compared with MSSA carriers, Klebsiella was the only genus found to be significantly enriched in MRSA carriers. Conclusions In healthy adults, colonization by C. difficile or S. aureus did not significantly affect gut microbiota diversity. However, the alteration of the gut microbiota composition in C. difficile carriers could indicate a predisposition to further infection. Our study provides essential data on the prevalence and effects of C. difficile and S. aureus colonization on gut microbiota composition in healthy adults. Electronic supplementary material The online version of this article (10.1186/s12879-018-3111-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Danfeng Dong
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197 Ruijin ER Road, Shanghai, 200025, China
| | - Qi Ni
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197 Ruijin ER Road, Shanghai, 200025, China
| | - Chen Wang
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197 Ruijin ER Road, Shanghai, 200025, China
| | - Lihua Zhang
- Department of Laboratory Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, No. 1665 Kongjiang Road, Shanghai, 200092, China
| | - Zhen Li
- Department of Laboratory Medicine, Longhua Hospital, Shanghai University of Traditional Medicine, No725 South Wanping Road, Shanghai, 200032, China
| | - Cen Jiang
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197 Ruijin ER Road, Shanghai, 200025, China
| | - EnqiangMao
- Department of Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197 Ruijin ER Road, Shanghai, 200025, China.
| | - Yibing Peng
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No.197 Ruijin ER Road, Shanghai, 200025, China.
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Perna canaliculus and the Intestinal Microbiome. Mar Drugs 2017; 15:md15070207. [PMID: 28665349 PMCID: PMC5532649 DOI: 10.3390/md15070207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 06/21/2017] [Accepted: 06/26/2017] [Indexed: 12/28/2022] Open
Abstract
Natural medicines are often an attractive option for patients diagnosed with chronic conditions. Three main classes of bioactives that have been reported from marine mussel extracts include proteins, lipids and carbohydrates. Commercially, the most relevant species of marine mollusks belong to two genera, Perna and Mytilus. Specifically, the Perna canaliculus species has been repeatedly demonstrated to harbor anti-inflammatory compounds such as omega-3 polyunsaturated fatty acids (ω-3 PUFAs) that can ameliorate pro-inflammatory conditions, or proteins that can promote thrombin inhibitory activity. Recent clinical studies have posited that extracts from green-lipped mussels may lead to prebiotic activity in the intestinal microbiome that in turn has been reported to improve symptoms of osteoarthritis of the knee. Prebiotics have been reported to favorably interact with the intestinal microbiome through the proliferation of beneficial bacteria in the gut, suppressing exogenous and endogenous intestinal infections and promoting homeostasis by balancing local pro- and anti-inflammatory actions. Bioactive compounds from Perna canaliculus are functional foods and, in this regard, may positively interact with the intestinal microbiome and provide novel therapeutic solutions for intra-intestinal and extra-intestinal inflammatory conditions.
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