Gastrointestinal Microbiome - What We Need to Know in Clinical Practice

被引:16
作者
Ortigao, Raquel [1 ]
Pimentel-Nunes, Pedro [1 ,2 ]
Dinis-Ribeiro, Mario [1 ,2 ]
Libanio, Diogo [1 ,2 ]
机构
[1] Portuguese Oncol Inst Porto, Dept Gastroenterol, Porto, Portugal
[2] Univ Porto, Fac Med, MEDCIDS Dept Community Med Informat & Decis Hlth, Porto, Portugal
关键词
Microbiota; Dysbiosis; Dysbiosis-associated diseases; Probiotics; Fecal microbiota transplantation; IRRITABLE-BOWEL-SYNDROME; CLOSTRIDIUM-DIFFICILE INFECTION; FATTY LIVER-DISEASE; RANDOMIZED CONTROLLED-TRIALS; HUMAN GUT MICROBIOME; FECAL MICROBIOTA; HELICOBACTER-PYLORI; ULCERATIVE-COLITIS; COLORECTAL-CANCER; INTESTINAL MICROBIOTA;
D O I
10.1159/000505036
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Human gut microbiota plays an important role in individual health. When the balance between host and gut microbiota is disrupted, changes in microbiota composition and function occur, which is referred as dysbiosis. Environmental factors as diet, proton pump inhibitors, and antibiotics can lead to a permanent dysbiotic disruption. Clarification of these imbalances was made possible by recent advances in genome sequencing methods that supported acknowledgment of the interplay between microbiome and intestinal and extraintestinal disorders. This review focuses on the microbiota impact in inflammatory bowel disease, gastric cancer, colorectal cancer, nonalcoholic fatty liver disease (NAFLD), irritable bowel syndrome (IBS), and Clostridium difficile infection (CDI). Furthermore, novel therapies are summarized. Fecal microbiota transplant (FMT) is a successful and established therapy in recurrent CDI, and its application in other dysbiosis-related diseases is attracting enormous interest. Pre- and probiotics target microbial rebalance and have positive effects mainly in NAFLD, ulcerative colitis, IBS, and CDI patients. Promising anticarcinogenic effects have also been demonstrated in animal models. The literature increasingly describes microbial changes in many dysbiotic disorders and shows what needs to be treated. However, probiotics and FMT application in clinical practice suffers from a shortage of randomized controlled trials with standardized therapy regimens to support their recommendation.
引用
收藏
页码:336 / 351
页数:16
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