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
The human gut microbiome has primarily been studied through the use of fecal samples,a practice that has generated vital knowledge on the composition and functional capacities of gastrointestinal microbial communities...The human gut microbiome has primarily been studied through the use of fecal samples,a practice that has generated vital knowledge on the composition and functional capacities of gastrointestinal microbial communities.However,this reliance on fecal materials limits the investigation of microbial dynamics in other locations along the gastrointestinal tract(in situ),and the infrequent availability of fecal samples prevents analysis at finer temporal scales(e.g.,hours).In our study,we utilized colonic transendoscopic enteral tubing,a technology originally developed for fecal microbiota transplantation,to sample the ileocecal microbiome twice daily;metagenomic and metatranscriptomic analyses were then conducted on these samples.A total of 43 ileocecal and 28 urine and fecal samples were collected from five healthy volunteers.The ileocecal and fecal microbiomes,as profiled in the five volunteers,were found to be similar in metagenomic profiling,yet their active genes(metatranscriptome)were found to be highly distinct.Both microbiomes were perturbed after laxative exposure;over time,they exhibited reduced dissimilarity to their pre-treatment state,thereby demonstrating resilience as an innate property of the gut microbiome,although they did not fully recover within our observation time window.Sampling of the ileocecal microbiome during the day and at night revealed the existence of diurnal rhythms in a series of bacterial species and functional pathways,particularly those related to short-chain fatty acid production,such as Propionibacterium acnes and coenzyme A biosynthesis Ⅱ.Autocorrelation analysis and fluctuations decomposition further indicated the significant periodicity of the diurnal oscillations.Metabolomic profiling in the fecal and urine samples mirrored the perturbance and recovery in the gut microbiome,indicating the crucial contribution of the gut microbiome to many key metabolites involved in host health.This study provides novel insights into the human gut microbiome and its inner resilience and diurnal rhythms,as well as the potential consequences of these to the host.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
Fecal microbiota transplantation(FMT)has been used as a core therapy for treating dysbiosis-related diseases by remodeling gut microbiota.The methodology and technology for improving FMT are stepping forward,mainly in...Fecal microbiota transplantation(FMT)has been used as a core therapy for treating dysbiosis-related diseases by remodeling gut microbiota.The methodology and technology for improving FMT are stepping forward,mainly including washed microbiota transplantation(WMT),colonic transendoscopic enteral tubing(TET)for microbiota delivery,and purified Firmicutes spores from fecal matter.To improve the understanding of the clinical applications of FMT,we performed a systematic literature review on FMT published from 2011 to 2021.Here,we provided an overview of the reported clinical benefits of FMT,the methodology of processing FMT,the strategy of using FMT,and the regulations on FMT from a global perspective.A total of 782 studies were included for the final analysis.The present review profiled the effectiveness from all clinical FMT uses in 85 specific diseases as eight categories,including infections,gut diseases,microbiotagut-liver axis,microbiotagut-brain axis,metabolic diseases,oncology,hematological diseases,and other diseases.Although many further controlled trials will be needed,the dramatic increasing reports have shown the promising future of FMT for dysbiosis-related diseases in the gut or beyond the gut.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
Dear Editor,Circadian rhythms are the periodic turmover of biological behaviors and physiological functions of many organisms(Allada and Bass,2021).In mammals,circadian rhythms are maintained by the clock system,invol...Dear Editor,Circadian rhythms are the periodic turmover of biological behaviors and physiological functions of many organisms(Allada and Bass,2021).In mammals,circadian rhythms are maintained by the clock system,involving central clock in suprachiasmatic nucleus and peripheral clock in organs like intestine;and at cellular level a cell-autonomous transcriptional and translational feedback loop involving clock genes like BMAL1(brain and muscle ARNT-Like 1,also known as ARNTL),CLOCK(clock circadian regulator),PER1/2/3(period circadian regulator 1/2/3)and CRY1/2(cryptochrome circadian regulator 1/2)(Allada and Bass,2021).展开更多
The gut microbiome has attracted increasing attention over the past 15 years.Along with the fast-growing body of research literature and media reports,the public's opinions on the gut microbiome have begun to appe...The gut microbiome has attracted increasing attention over the past 15 years.Along with the fast-growing body of research literature and media reports,the public's opinions on the gut microbiome have begun to appear polarized.Some believe that the gut microbiome is at the core of human health and is related to every single disease.To the opposite,some people question the scientific basis of gut microbiome studies and criticize that many of them are farfetched;there is even a joke spreading in the biomedical research field—"keeping gut microbiome in mind,no mechanism is hard to find".展开更多
Fighting on the frontlines against the coronavirus disease 2019(COVID-19)pandemic,health workers are at high risk of virus infection and overwork-related sudden death and disorders including cardiovascular diseases an...Fighting on the frontlines against the coronavirus disease 2019(COVID-19)pandemic,health workers are at high risk of virus infection and overwork-related sudden death and disorders including cardiovascular diseases and stress.When we noted the increase of overwork-related sudden deaths in physicians and nurses in the first 2 weeks after lockdown of Wuhan,we organized the‘Touching Your Heart’program by remote monitoring,aiming to protect health workers from overwork-related disorders through integrated volunteer work by physicians and medical engineering researchers from Wuhan Huoshenshan Hospital,Nanjing Medical University,and Tiangong University.By remotely monitoring the health conditions of the medical aid team working atWuhan Huoshenshan Hospital,the programsuccessfully helped in avoiding severe overwork-related events.The results from our program should be used to remind frontline health workers around the world to take precautions against overworked-related severe events,and showthat precision monitoring is effective in improving work efficiency and maintaining a sustainable workforce during emergency situations like a pandemic.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
Concern about health risks associated with rising obesity has become nearly universal, with the mean body mass index （BMI） and the prevalence of obese and overweight individuals increasing substantially worldwide du...Concern about health risks associated with rising obesity has become nearly universal, with the mean body mass index （BMI） and the prevalence of obese and overweight individuals increasing substantially worldwide during the previous three decades. Unfortunately, prevention and treatment of obesity and related complications have proven complex, and successful strategies to tackle this pathology remain limited. Epidemiological studies have highlighted potential environmental exposures, including diet, energy expenditure, early life influences, sleep deprivation, endocrine disruptors, chronic inflammation, and microbiome sta- tus, contributing to higher risk of obesity （Franks and McCarthy, 2016）. Among these, the microbiome has received extensive attention during the previous decade.展开更多
Colonic transendoscopic enteral tubing(TET)is an interventional intestine therapeutic procedure.The colonic TET technique represents a novel drug delivery route,interventional diagnosis and therapy,and paradigm for co...Colonic transendoscopic enteral tubing(TET)is an interventional intestine therapeutic procedure.The colonic TET technique represents a novel drug delivery route,interventional diagnosis and therapy,and paradigm for concept validation,showing broad prospects in research and practice.Since its first meeting at the China Gut Conference in 2023,our panel of experts has held a series of discussions on TET’s concept,breakthroughs,and future.We strive to lay the groundwork for further establishing the TET Study Group for designing multicenter studies and developing relevant consensus or guidelines.展开更多
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supported by the National Key Research and Development Program of China(2018YFC2000500)the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB29020000)+2 种基金the National Natural Science Foundation of China(31771481,91857101,and 81873548)the Primary Research&Development Plan of Jiangsu Province(BE2018751)the Jiangsu Provincial Medical Innovation Team(F.Zhang)。
文摘The human gut microbiome has primarily been studied through the use of fecal samples,a practice that has generated vital knowledge on the composition and functional capacities of gastrointestinal microbial communities.However,this reliance on fecal materials limits the investigation of microbial dynamics in other locations along the gastrointestinal tract(in situ),and the infrequent availability of fecal samples prevents analysis at finer temporal scales(e.g.,hours).In our study,we utilized colonic transendoscopic enteral tubing,a technology originally developed for fecal microbiota transplantation,to sample the ileocecal microbiome twice daily;metagenomic and metatranscriptomic analyses were then conducted on these samples.A total of 43 ileocecal and 28 urine and fecal samples were collected from five healthy volunteers.The ileocecal and fecal microbiomes,as profiled in the five volunteers,were found to be similar in metagenomic profiling,yet their active genes(metatranscriptome)were found to be highly distinct.Both microbiomes were perturbed after laxative exposure;over time,they exhibited reduced dissimilarity to their pre-treatment state,thereby demonstrating resilience as an innate property of the gut microbiome,although they did not fully recover within our observation time window.Sampling of the ileocecal microbiome during the day and at night revealed the existence of diurnal rhythms in a series of bacterial species and functional pathways,particularly those related to short-chain fatty acid production,such as Propionibacterium acnes and coenzyme A biosynthesis Ⅱ.Autocorrelation analysis and fluctuations decomposition further indicated the significant periodicity of the diurnal oscillations.Metabolomic profiling in the fecal and urine samples mirrored the perturbance and recovery in the gut microbiome,indicating the crucial contribution of the gut microbiome to many key metabolites involved in host health.This study provides novel insights into the human gut microbiome and its inner resilience and diurnal rhythms,as well as the potential consequences of these to the host.
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 a grant from the National Natural Science Foundation of China(No. 81873548)the Nanjing Medical University Fan Daiming Research Funds for Holistic Integrative Medicine.
文摘Fecal microbiota transplantation(FMT)has been used as a core therapy for treating dysbiosis-related diseases by remodeling gut microbiota.The methodology and technology for improving FMT are stepping forward,mainly including washed microbiota transplantation(WMT),colonic transendoscopic enteral tubing(TET)for microbiota delivery,and purified Firmicutes spores from fecal matter.To improve the understanding of the clinical applications of FMT,we performed a systematic literature review on FMT published from 2011 to 2021.Here,we provided an overview of the reported clinical benefits of FMT,the methodology of processing FMT,the strategy of using FMT,and the regulations on FMT from a global perspective.A total of 782 studies were included for the final analysis.The present review profiled the effectiveness from all clinical FMT uses in 85 specific diseases as eight categories,including infections,gut diseases,microbiotagut-liver axis,microbiotagut-brain axis,metabolic diseases,oncology,hematological diseases,and other diseases.Although many further controlled trials will be needed,the dramatic increasing reports have shown the promising future of FMT for dysbiosis-related diseases in the gut or beyond the gut.
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supported by the National Key Research and Development Program of China(2018YFC2000500)the National Natural Science Foundation of China(91857101)+2 种基金the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB29020000)the National Natural Science Foundation of China(81922027,81870228,and 81921006)Beijing Natural Science Foundation(Q20031)and the State Key Laboratory of Membrane Biology.
文摘Dear Editor,Circadian rhythms are the periodic turmover of biological behaviors and physiological functions of many organisms(Allada and Bass,2021).In mammals,circadian rhythms are maintained by the clock system,involving central clock in suprachiasmatic nucleus and peripheral clock in organs like intestine;and at cellular level a cell-autonomous transcriptional and translational feedback loop involving clock genes like BMAL1(brain and muscle ARNT-Like 1,also known as ARNTL),CLOCK(clock circadian regulator),PER1/2/3(period circadian regulator 1/2/3)and CRY1/2(cryptochrome circadian regulator 1/2)(Allada and Bass,2021).
基金This work was supported by National Key Research and Development Program of China(2018YFC2000500)the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB29020000)+1 种基金the National Natural Science Foundation of China(31771481,91857101)the National Social Science Foundation of China(16CZX064).We thank Prof.Liping Zhao from Shanghai Jiao Tong University for insightful advice and the many researchers,clinicians and industry specialists who participated in the discussion and provided valuable suggestions.
文摘The gut microbiome has attracted increasing attention over the past 15 years.Along with the fast-growing body of research literature and media reports,the public's opinions on the gut microbiome have begun to appear polarized.Some believe that the gut microbiome is at the core of human health and is related to every single disease.To the opposite,some people question the scientific basis of gut microbiome studies and criticize that many of them are farfetched;there is even a joke spreading in the biomedical research field—"keeping gut microbiome in mind,no mechanism is hard to find".
基金This programwas partially supported by Tianjin Science and Technology Plan Project(Grant No.18ZXRHSY00200)and Jiangsu Provincial Medical Innovation Team(Zhang F).
文摘Fighting on the frontlines against the coronavirus disease 2019(COVID-19)pandemic,health workers are at high risk of virus infection and overwork-related sudden death and disorders including cardiovascular diseases and stress.When we noted the increase of overwork-related sudden deaths in physicians and nurses in the first 2 weeks after lockdown of Wuhan,we organized the‘Touching Your Heart’program by remote monitoring,aiming to protect health workers from overwork-related disorders through integrated volunteer work by physicians and medical engineering researchers from Wuhan Huoshenshan Hospital,Nanjing Medical University,and Tiangong University.By remotely monitoring the health conditions of the medical aid team working atWuhan Huoshenshan Hospital,the programsuccessfully helped in avoiding severe overwork-related events.The results from our program should be used to remind frontline health workers around the world to take precautions against overworked-related severe events,and showthat precision monitoring is effective in improving work efficiency and maintaining a sustainable workforce during emergency situations like a pandemic.
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.
文摘Concern about health risks associated with rising obesity has become nearly universal, with the mean body mass index （BMI） and the prevalence of obese and overweight individuals increasing substantially worldwide during the previous three decades. Unfortunately, prevention and treatment of obesity and related complications have proven complex, and successful strategies to tackle this pathology remain limited. Epidemiological studies have highlighted potential environmental exposures, including diet, energy expenditure, early life influences, sleep deprivation, endocrine disruptors, chronic inflammation, and microbiome sta- tus, contributing to higher risk of obesity （Franks and McCarthy, 2016）. Among these, the microbiome has received extensive attention during the previous decade.
基金supported by the National Key Research and Development Program(No.2021YFA0717004).
文摘Colonic transendoscopic enteral tubing(TET)is an interventional intestine therapeutic procedure.The colonic TET technique represents a novel drug delivery route,interventional diagnosis and therapy,and paradigm for concept validation,showing broad prospects in research and practice.Since its first meeting at the China Gut Conference in 2023,our panel of experts has held a series of discussions on TET’s concept,breakthroughs,and future.We strive to lay the groundwork for further establishing the TET Study Group for designing multicenter studies and developing relevant consensus or guidelines.
