The Gut Microbiome and Digestive Health - A New Frontier

Bibliometric and visual analysis of fecal microbiota transplantation research from 2012 to 2021

BACKGROUND

Fecal microbiota transplantation (FMT) is an emerging therapy for diseases associated with intestinal flora imbalance that has attracted increasing attention in recent years. This study aims to provide an overview of research trends in the field, and act as a reference point for future scientific research by analyzing the state of current research, identifying hotspots, and potential frontiers of FMT.

METHODS

Articles relating to FMT that were published between the years 2012 and 2021 were retrieved from the Web of Science Core Collection. Bibliometric analysis was performed using Microsoft Excel and CiteSpace.

RESULTS

A total of 2,403 English language articles relating to FMT research were published over the last ten years. Most of this research was carried out in the United States of America, with Harvard Medical school being the most productive institution. Much of the research was published in the PLoS One journal. Alexander Khoruts was identified as a prominent, productive researcher in the field. Keyword analysis revealed that research hot spots included gut microbiota, Clostridium difficile infection (CDI), and diseases. Burst detection indicated that future research frontiers include clinical practice guidelines and strategies.

CONCLUSION

Our analysis explored hot spots and emerging trends in the FMT field. Indications for use of FMT extended from digestive system diseases to other systemic diseases. Additionally, areas such as risk assessment and control, along with application methods were also a focus of current research. Moreover, research relating to optimization of clinical practice has excellent prospects.

Antibiotics as Major Disruptors of Gut Microbiota

Advances in culture-independent research techniques have led to an increased understanding of the gut microbiota and the role it plays in health and disease. The intestine is populated by a complex microbial community that is organized around a network of metabolic interdependencies. It is now understood that the gut microbiota is vital for normal development and functioning of the human body, especially for the priming and maturation of the adaptive immune system. Antibiotic use can have several negative effects on the gut microbiota, including reduced species diversity, altered metabolic activity, and the selection of antibiotic-resistant organisms, which in turn can lead to antibiotic-associated diarrhea and recurrent Clostridioides difficile infections. There is also evidence that early childhood exposure to antibiotics can lead to several gastrointestinal, immunologic, and neurocognitive conditions. The increase in the use of antibiotics in recent years suggests that these problems are likely to become more acute or more prevalent in the future. Continued research into the structure and function of the gut microbiota is required to address this challenge.

Editorial: The Promise of Psychiatric Translational Research: Exploring How the Gut Can Influence Brain Development

How the gastrointestinal (GI) tract can influence the development and functioning of the central nervous system is one of the hottest translational research topics today. In animal studies, GI infections have been linked to enteric inflammation, disrupted intestinal permeability, and changes in diversity in the gut microbiome as well as brain dysfunction.¹ In humans, infectious gastroenteritis has been associated with modified composition of the gut microbiome and systemic inflammation.² Although gastroenteritis has not been causally linked to dysregulation of the brain in humans, it has been associated with later chronic GI conditions such as irritable bowel syndrome, which is often accompanied by anxiety and depression.^2-4 In other human studies, microbiome dysbiosis has been associated with significantly increased the risk for later systemic inflammation and brain dysfunction manifested as changes in emotions, behaviors, pain perception, and cognitions.^5,6 Most studies investigating these relationships have focused on adult cohorts and are often cross-sectional in design nature. The study by Parent et al.⁷ is the first longitudinal study to evaluate whether repeated episodes of gastroenteritis during early childhood predicts behavioral problems in later childhood and mental illness during adolescence. In addition, it has an exploratory mechanistic objective: whether systemic inflammation in later childhood and adolescence moderates this brain-gut relationship.