Clostridioides difficile(C.difficile)is one of the major causes of nosocomial infections.Pregnant women,who are generally considered at low risk for C.difficile infection(CDI),have attracted attention because of an in...Clostridioides difficile(C.difficile)is one of the major causes of nosocomial infections.Pregnant women,who are generally considered at low risk for C.difficile infection(CDI),have attracted attention because of an increasing number of reports.Oral vancomycin,the only first-line treatment for pregnant women infected with C.difficile,has been associated with increasing strain resistance,leading to decreased efficacy.Fecal microbiota transplantation(FMT)is recommended for severe,fulminant,and recurrent CDI;however,it is generally avoided in pregnant women because of safety concerns.We report a case of a pregnant woman with a primary ribotype 027 CDI who experienced a successful outcome with washed microbiota transplantation(WMT),an improved form of FMT,via enema.The specific strain of ribotype 027 is related to severe outcomes but has not previously been reported in pregnant women.The follow-up lasted for two years,during which the patient's diarrhea was fully alleviated without recurrence.The baby showed normal growth and development,and no adverse events were recorded for either.This case provides evidence for the efficacy and safety of WMT in pregnant women infected with C.difficile,indicating that WMT via enema may be a viable therapeutic strategy for this population for treating CDI.展开更多
Viral myocarditis is a rare but life-threatening complication in patients with ulcerative colitis.Management of myocarditis is primarily supportive,because there are currently no established targeted therapies.Recent ...Viral myocarditis is a rare but life-threatening complication in patients with ulcerative colitis.Management of myocarditis is primarily supportive,because there are currently no established targeted therapies.Recent studies have increasingly highlighted the association between the gut microbiota and myocarditis.Here,we report a case of acute severe ulcerative colitis complicated by cytomegalovirus and Epstein-Barr virus co-infections that led to viral myocarditis.The patient experienced rapid remission of both intestinal and cardiac symptoms following washed microbiota transplantation,suggesting this intervention may serve as a potential alternative treatment for these life-threatening conditions.展开更多
Amyotrophic lateral sclerosis(ALS) is known as a progressive paralysis disorder characterized by degeneration of upper and lower motor neurons, and has an average survival time of three to five years. Growing evidence...Amyotrophic lateral sclerosis(ALS) is known as a progressive paralysis disorder characterized by degeneration of upper and lower motor neurons, and has an average survival time of three to five years. Growing evidence has suggested a bidirectional link between gut microbiota and neurodegeneration. Here we aimed to report one female case with ALS, who benefited from washed microbiota transplantation(WMT), an improved fecal microbiota transplantation(FMT), through a transendoscopic enteral tube during a 12-month follow-up. Notedly, the accidental scalp trauma the patient suffered later was treated with prescribed antibiotics that caused ALS deterioration. The subsequent rescue WMTs successfully stopped the progression of the disease with a quick improvement. The plateaus and reversals occurred during the whole course of WMT. The stool and blood samples from the first WMT to the last were collected for dynamic microbial and metabolomic analysis. We observed the microbial and metabolomic changing trend consistent with the disease status. This case report for the first time shows the direct clinical evidence on using WMT for treating ALS, indicating that WMT may be the novel treatment strategy for controlling this so-called incurable disease.展开更多
Fecal microbiota transplantation(FMT)by manual preparation has been applied to treat diseases for thousands of years.However,this method still endures safety risks and challenges the psychological endurance and accept...Fecal microbiota transplantation(FMT)by manual preparation has been applied to treat diseases for thousands of years.However,this method still endures safety risks and challenges the psychological endurance and acceptance of doctors,patients and donors.Population evidence showed the washed microbiota preparation with microfiltration based on an automatic purification system followed by repeated centrifugation plus suspension for three times significantly reduced FMT-related adverse events.This washing preparation makes delivering a precise dose of the enriched microbiota feasible,instead of using the weight of stool.Intraperitoneal injection in mice with the fecal microbiota supernatant obtained after repeated centrifugation plus suspension for three times induced less toxic reaction than that by the first centrifugation following the microfiltration.The toxic reactions that include death,the change in the level of peripheral white blood cells,and the proliferation of germinal center in secondary lymphoid follicles in spleen were noted.The metagenomic next-generation sequencing(NGS)indicated the increasing types and amount of viruses could be washed out during the washing process.Metabolomics analysis indicated metabolites with pro-inflammatory effects in the fecal microbiota supernatant such as leukotriene B4,corticosterone,and prostaglandin G2 could be removed by repeated washing.Near-infrared absorption spectroscopy could be served as a rapid detection method to control the quality of the washingprocess.In conclusion,this study for the first time provides evidence linking clinical findings and animal experiments to support that washed microbiota transplantation(WMT)is safer,more precise and more quality-controllable than the crude FMT by manual.展开更多
Fecal microbiota transplantation （FMT） has become a research focus of biomedicine and clinical medicine in recent years. The clinical response from FMT for different diseases provided evidence for microbiota-host in...Fecal microbiota transplantation （FMT） has become a research focus of biomedicine and clinical medicine in recent years. The clinical response from FMT for different diseases provided evidence for microbiota-host interactions associated with various disorders, including Clostridium difficile infection, inflammatory bowel disease, diabetes mellitus, cancer, liver cirrhosis, gut- brain disease and others. To discuss the experiences of using microbes to treat human diseases from ancient China to current era should be important in moving standardized FMT forward and achieving a better future. Here, we review the changing concept of microbiota transplantation from FMT to selective microbiota transplantation, methodology development of FMT and step- up FMT strategy based on literature and state experts＇ perspectives.展开更多
The exposure to either medical sources or accidental radiation can cause varying degrees of radiation injury(RI).RI is a common disease involving multiple human body parts and organs,yet effective treatments are curre...The exposure to either medical sources or accidental radiation can cause varying degrees of radiation injury(RI).RI is a common disease involving multiple human body parts and organs,yet effective treatments are currently limited.Accumulating evidence suggests gut microbiota are closely associated with the development and prevention of various RI.This article summarizes 10 common types of RI and their possible mechanisms.It also highlights the changes and potential microbiota-based treatments for RI,including probiotics,metabolites,and microbiota transplantation.Additionally,a 5P-Framework is proposed to provide a comprehensive strategy for managing RI.展开更多
To the Editor:Female patients with inflammatory bowel disease(IBD)have lower fertility rates and take longer time to conceive than the healthy population.How to improve the fertility in patients with IBD is a critical...To the Editor:Female patients with inflammatory bowel disease(IBD)have lower fertility rates and take longer time to conceive than the healthy population.How to improve the fertility in patients with IBD is a critical challenge.展开更多
基金supported by the Nanjing Medical University Fan Daiming Research Funds for Holistic Integrative Medicine(Grant No.2023-3HIM).
文摘Clostridioides difficile(C.difficile)is one of the major causes of nosocomial infections.Pregnant women,who are generally considered at low risk for C.difficile infection(CDI),have attracted attention because of an increasing number of reports.Oral vancomycin,the only first-line treatment for pregnant women infected with C.difficile,has been associated with increasing strain resistance,leading to decreased efficacy.Fecal microbiota transplantation(FMT)is recommended for severe,fulminant,and recurrent CDI;however,it is generally avoided in pregnant women because of safety concerns.We report a case of a pregnant woman with a primary ribotype 027 CDI who experienced a successful outcome with washed microbiota transplantation(WMT),an improved form of FMT,via enema.The specific strain of ribotype 027 is related to severe outcomes but has not previously been reported in pregnant women.The follow-up lasted for two years,during which the patient's diarrhea was fully alleviated without recurrence.The baby showed normal growth and development,and no adverse events were recorded for either.This case provides evidence for the efficacy and safety of WMT in pregnant women infected with C.difficile,indicating that WMT via enema may be a viable therapeutic strategy for this population for treating CDI.
文摘Viral myocarditis is a rare but life-threatening complication in patients with ulcerative colitis.Management of myocarditis is primarily supportive,because there are currently no established targeted therapies.Recent studies have increasingly highlighted the association between the gut microbiota and myocarditis.Here,we report a case of acute severe ulcerative colitis complicated by cytomegalovirus and Epstein-Barr virus co-infections that led to viral myocarditis.The patient experienced rapid remission of both intestinal and cardiac symptoms following washed microbiota transplantation,suggesting this intervention may serve as a potential alternative treatment for these life-threatening conditions.
基金funded by the National Natural Science Foundation of China (Grant No. 81873548)the Nanjing Medical University Fan Daiming Research Funds for Holistic Integrative Medicine。
文摘Amyotrophic lateral sclerosis(ALS) is known as a progressive paralysis disorder characterized by degeneration of upper and lower motor neurons, and has an average survival time of three to five years. Growing evidence has suggested a bidirectional link between gut microbiota and neurodegeneration. Here we aimed to report one female case with ALS, who benefited from washed microbiota transplantation(WMT), an improved fecal microbiota transplantation(FMT), through a transendoscopic enteral tube during a 12-month follow-up. Notedly, the accidental scalp trauma the patient suffered later was treated with prescribed antibiotics that caused ALS deterioration. The subsequent rescue WMTs successfully stopped the progression of the disease with a quick improvement. The plateaus and reversals occurred during the whole course of WMT. The stool and blood samples from the first WMT to the last were collected for dynamic microbial and metabolomic analysis. We observed the microbial and metabolomic changing trend consistent with the disease status. This case report for the first time shows the direct clinical evidence on using WMT for treating ALS, indicating that WMT may be the novel treatment strategy for controlling this so-called incurable disease.
基金This work was supported by publicly donated Intestine Initiative FoundationPrimary Research&Development Plan of Jiangsu Province(BE2018751)+1 种基金Jiangsu Provincial Medical Innovation Team(Zhang F),National Natural Science Foundation of China(81600417,81670495 and 81873548)China National Center for Clinical Research of Digestive Diseases(201502026).
文摘Fecal microbiota transplantation(FMT)by manual preparation has been applied to treat diseases for thousands of years.However,this method still endures safety risks and challenges the psychological endurance and acceptance of doctors,patients and donors.Population evidence showed the washed microbiota preparation with microfiltration based on an automatic purification system followed by repeated centrifugation plus suspension for three times significantly reduced FMT-related adverse events.This washing preparation makes delivering a precise dose of the enriched microbiota feasible,instead of using the weight of stool.Intraperitoneal injection in mice with the fecal microbiota supernatant obtained after repeated centrifugation plus suspension for three times induced less toxic reaction than that by the first centrifugation following the microfiltration.The toxic reactions that include death,the change in the level of peripheral white blood cells,and the proliferation of germinal center in secondary lymphoid follicles in spleen were noted.The metagenomic next-generation sequencing(NGS)indicated the increasing types and amount of viruses could be washed out during the washing process.Metabolomics analysis indicated metabolites with pro-inflammatory effects in the fecal microbiota supernatant such as leukotriene B4,corticosterone,and prostaglandin G2 could be removed by repeated washing.Near-infrared absorption spectroscopy could be served as a rapid detection method to control the quality of the washingprocess.In conclusion,this study for the first time provides evidence linking clinical findings and animal experiments to support that washed microbiota transplantation(WMT)is safer,more precise and more quality-controllable than the crude FMT by manual.
基金This work was supported by publicaUy donated Intestine Initiative Jiangsu Province Medicine Creation Team and Leading Talents project （Faming Zhang） National Natural Science Foundation of China （Grant Nos. 81670495 and 81600417） and National Center for Clinical Research of Digestive System Diseases （2015BAI13B07）.
文摘Fecal microbiota transplantation （FMT） has become a research focus of biomedicine and clinical medicine in recent years. The clinical response from FMT for different diseases provided evidence for microbiota-host interactions associated with various disorders, including Clostridium difficile infection, inflammatory bowel disease, diabetes mellitus, cancer, liver cirrhosis, gut- brain disease and others. To discuss the experiences of using microbes to treat human diseases from ancient China to current era should be important in moving standardized FMT forward and achieving a better future. Here, we review the changing concept of microbiota transplantation from FMT to selective microbiota transplantation, methodology development of FMT and step- up FMT strategy based on literature and state experts＇ perspectives.
基金supported by the National Key Research and Development Program of China (2021YFA0717004)Nanjing Medical University Fan Daiming Research Funds for Holistic Integrative Medicine.
文摘The exposure to either medical sources or accidental radiation can cause varying degrees of radiation injury(RI).RI is a common disease involving multiple human body parts and organs,yet effective treatments are currently limited.Accumulating evidence suggests gut microbiota are closely associated with the development and prevention of various RI.This article summarizes 10 common types of RI and their possible mechanisms.It also highlights the changes and potential microbiota-based treatments for RI,including probiotics,metabolites,and microbiota transplantation.Additionally,a 5P-Framework is proposed to provide a comprehensive strategy for managing RI.
基金This study was funded by the Nanjing Medical University Fan Daiming Research Funds for Holistic Integrative Medicine.
文摘To the Editor:Female patients with inflammatory bowel disease(IBD)have lower fertility rates and take longer time to conceive than the healthy population.How to improve the fertility in patients with IBD is a critical challenge.
