Fecal incontinence is a common condition that can significantly impact patients’quality of life.Obstetric anal sphincter injury and anorectal surgeries are common etiologies.Endoanal ultrasound and anorectal manometr...Fecal incontinence is a common condition that can significantly impact patients’quality of life.Obstetric anal sphincter injury and anorectal surgeries are common etiologies.Endoanal ultrasound and anorectal manometry are important diagnostic tools for evaluating patients.There are various treatment options,including diet,lifestyle modifications,drugs,biofeedback therapy,tibial and sacral nerve neuromodulation therapy,and surgery.In this editorial,we will discuss current controversies and novel approaches to fecal incontinence.Screening for asymptomatic anal sphincter defects after obstetric anal sphincter injury and in patients with inflammatory bowel disease is not generally recommended,but may be helpful in selected patients.The Garg incontinence score is a new score that includes the assessment of solid,liquid,flatus,mucous,stress and urge fecal incontinence.Novel tests such as translumbosacral anorectal magnetic stimulation and novel therapies such as translumbosacral neuromodulation therapy are promising diagnostic and treatment options,for both fecal incontinence and neuropathy.Home biofeedback therapy can overcome some limitations of the office-based therapy.Skeletal muscle-derived cell implantation of the external anal sphincter has been further studied as a possible treatment option.Sacral neuromodulation may be useful in scleroderma,congenital fecal incontinence and inflammatory bowel disease but merits further study.展开更多
Inflammatory bowel disease,particularly Crohn's disease(CD),has been linked to modifications in mesenteric adipose tissue(MAT)and the phenomenon known as"creeping fat"(CrF).The presence of CrF is believe...Inflammatory bowel disease,particularly Crohn's disease(CD),has been linked to modifications in mesenteric adipose tissue(MAT)and the phenomenon known as"creeping fat"(CrF).The presence of CrF is believed to serve as a predictor for early clinical recurrence following surgical intervention in patients with CD.Notably,the incorporation of the mesentery during ileocolic resection for CD has been correlated with a decrease in surgical recurrence,indicating the significant role of MAT in the pathogenesis of CD.While numerous studies have indicated that dysbiosis of the gut microbiota is a critical factor in the development of CD,the functional implications of translocated microbiota within the MAT of CD patients remain ambiguous.This manuscript commentary discusses a recent basic research conducted by Wu et al.In their study,intestinal bacteria from individuals were transplanted into CD model mice,revealing that fecal microbiota trans-plantation(FMT)from healthy donors alleviated CD symptoms,whereas FMT from CD patients exacerbated these symptoms.Importantly,FMT was found to affect intestinal permeability,barrier function,and the levels of proinflammatory factors and adipokines.Collectively,these findings suggest that targeting MAT and CrF may hold therapeutic potential for patients with CD.However,the study did not evaluate the composition of the intestinal microbiota of the donors or the subsequent alterations in the gut microbiota.Overall,the gut microbiota plays a crucial role in the histopathology of CD,and thus,targeting MAT and CrF may represent a promising avenue for treatment in this patient population.展开更多
This study highlights the potential of diatomaceous earth to eliminate pathogenic microorganisms from canal sediments used in agricultural irrigation.The findings demonstrate both technical feasibility and economic be...This study highlights the potential of diatomaceous earth to eliminate pathogenic microorganisms from canal sediments used in agricultural irrigation.The findings demonstrate both technical feasibility and economic benefits for agriculture,particularly in regions where such irrigation practices are common.The research incorporates three distinct projects.The first involved monitoring water and sediment quality in the Xochimilco canal zone in Mexico City.The other two were experimental studies aimed at assessing the efficacy of diatomaceous earth in reducing fecal coliforms in sediments.The first project evaluated the water and sediment quality.Subsequently,an experiment was conducted in the San Gregorio Atlapulco chinampa,where diatomaceous earth was applied to a coriander crop to measure its effectiveness in reducing fecal coliforms.A laboratory experiment at the Institute of Engineering,UNAM,tested the impact of diatomaceous earth on sediments from a Xochimilco canal,focusing on fecal coliform reduction.In all experiments,diatomaceous earth was utilized in its commercial form.The results of the first project identified wastewater discharges as the primary source of pathogenic contamination in the canals.The second demonstrated a significant reduction—over 70%—in fecal coliforms within a crop after the application of diatomaceous earth.Similarly,the third project achieved an average fecal coliform reduction of 70%in sediments during laboratory testing.The study underscores the affordability and accessibility of diatomaceous earth for local agricultural producers.Moreover,its application does not adversely affect soil quality or crop productivity,further supporting its viability as a sustainable solution for improving irrigation water quality.展开更多
Crohn’s disease(CD)is an idiopathic,chronic,and recurrent inflammatory condition of the gastrointestinal tract.Recent studies suggest a potential role of gut microbiota in CD,particularly dysbiosis—an imbalance in g...Crohn’s disease(CD)is an idiopathic,chronic,and recurrent inflammatory condition of the gastrointestinal tract.Recent studies suggest a potential role of gut microbiota in CD,particularly dysbiosis—an imbalance in gut bacteria.While dysbiosis is consistently observed in CD,it remains uncertain whether it is a cause or a consequence of the disease.Given its association with CD,the therapeutic potential of fecal microbiota transplantation(FMT)has been explored.This review examines the role of gut microbiota in CD,evaluates the therapeutic potential of probiotics and FMT,and highlights current research findings and limitations.Key studies on the relationship between gut dysbiosis,probiotics,and FMT in CD were analyzed,with a focus on randomized trials,meta-analyses,and clinical observations.Dysbiosis is a consistent feature of CD,but its causative role remains unclear.Probiotics,prebiotics,and synbiotics have shown no efficacy in inducing or maintaining remission in CD.FMT shows potential as a therapeutic option for CD,but its efficacy remains inconsistent and inconclusive.The variability in outcomes,including diminished effects over time despite repeated FMT,underscores the need for larger,well-controlled trials.Only one randomized controlled trial(RCT)has compared FMT with sham transplantation,but the sample size was very small.Other studies are limited by factors such as small sample sizes,lack of control groups,short follow-up periods,and inconsistent methodologies,making it challenging to draw definitive conclusions.While gut dysbiosis likely plays a role in CD pathogenesis,its causative role remains uncertain.Current evidence does not support FMT as a reliable treatment for inducing or maintaining remission in CD,though it appears generally safe.Larger,standardized,RCTs are necessary to clarify the therapeutic role of FMT in CD management.展开更多
Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascul...Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascular inflammation risk.However,the specific intestinal microbiota alteration contributing to increased inflammation remains unclear.Therefore,the present study investigated the correlation between the intestinal microbiota and inflammation in patients with unstable angina(UA).Methods A cohort of 92 patients with UA was recruited for this study.The plasma hsCRP level was measured via a CardioPhase hsCRP assay,fecal samples were collected after admission,and 16S rRNA sequencing was conducted to identify the fecal microbial profile.The participants were classified into two groups according to the median hsCRP level(1.11 mg/L).The composition of the fecal microbiota was compared between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Additionally,the correlations between the fecal microbiota and clinical characteristics were analyzed.Results A notable reduction in the relative abundance of Akkermansia was observed in patients with hsCRP≥1.11 mg/L,whereas the diversity of the fecal microbiota was not significantly different between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Furthermore,the abundance of Akkermansia was negatively correlated with hsCRP levels.Conclusion This study suggested a significant association between decreased levels of Akkermansia and inflammatory risk in patients with UA.These findings underscore the potential role of the intestinal microbiota in contributing to inflammation in UA patients.Further work is needed on the mechanism by which the microbiota contributes to inflammatory risk.展开更多
Blueberry anthocyanins(VA)and blackberry anthocyanins(RA)showed benefits on metabolic syndrome(MS)induced by high-fat diet(HFD)in mice.In this study,we investigated whether the therapeutic effects of VA and RA were ac...Blueberry anthocyanins(VA)and blackberry anthocyanins(RA)showed benefits on metabolic syndrome(MS)induced by high-fat diet(HFD)in mice.In this study,we investigated whether the therapeutic effects of VA and RA were achieved by the gut microbiota regulation and whether these effects could be replicated through fecal microbiota transplantation(FMT)using the HFD caused MS model in pseudo-germ-free mice.The results demonstrated that the beneficial effects of VA and RA on MS,including reducing body weight gain and fat accumulation,improving glucose and lipid metabolism,and mitigating intestinal barrier damage,were attributed to the gut microbiota and could be replicated by FMT.16S r RNA sequencing analysis suggested that FMT from donor mice supplemented with VA and RA could regulate the gut microbiota composition.Particularly,FMT from RA supplemented mice displayed the potential to restore the diversity of gut microbiota and the ratio of Firmicutes to Bacteroidetes.Meanwhile,FMT from VA supplemented mice appeared to exert its effects by selectively influencing specific gut microbiota,such as the genus Akkermansia.Furthermore,our analysis identified 10 common differential amplicon sequence variants(ASVs)among groups compared to HFD-HFD group.Notably,ASV_36450 was negatively associated with metabolic parameters,suggesting that Lactobacillus might be the potential bacteria in regulating MS.Overall,our study demonstrated that FMT from VA and RA supplemented mice could ameliorate MS induced by HFD in mice through regulating specific gut microbiota.展开更多
BACKGROUND Hepatocellular carcinoma(HCC),the predominant form of primary liver cancer,is a key contributor to cancer-related deaths globally.However,HCC diagnosis solely based on blood biochemical markers lacks both s...BACKGROUND Hepatocellular carcinoma(HCC),the predominant form of primary liver cancer,is a key contributor to cancer-related deaths globally.However,HCC diagnosis solely based on blood biochemical markers lacks both sensitivity and specificity.AIM To investigate alterations of the fecal metabolome and intestinal bacteria and reveal the correlations among differential metabolites,distinct bacteria,and serum indicators.METHODS To uncover potentially effective therapeutic targets for HCC,we utilized nontargeted liquid chromatography-mass spectrometry and high-throughput DNA sequencing targeting the 16S rRNA gene.This comprehensive approach allowed us to investigate the metabolome and microbial community structure of feces samples obtained from patients with HCC.Furthermore,we conducted an analysis to assess the interplay between the fecal metabolome and intestinal bacterial population.RESULTS In comparison to healthy controls,a notable overlap of 161 differential metabolites and 3 enriched Kyoto Encyclopedia of Genes and Genomes pathways was observed in the HCC12(comprising patients with stage I and II HCC)and HCC34 groups(comprising patients with stage III and IV HCC).Lachnospira,Streptococcus,and Veillonella had significant differences in abundance in patients with HCC.Notably,Streptococcus and Veillonella exhibited significant correlations with serum indicators such as alpha-fetoprotein(AFP).Meanwhile,several differential metabolites[e.g.,4-keto-2-undecylpyrroline,dihydrojasmonic acid,1,8-heptadecadiene-4,6-diyne-3,10-diol,9(S)-HOTrE]also exhibited significant correlations with serum indicators such asγ-glutamyl transferase,total bilirubin,AFP,aspartate aminotransferase,and albumin.Additionally,these two genera also had significant associations with differential metabolites such as 1,2-Dipentadecanoyl-rac-glycerol(15:0/20:0/0:0),arachidoyl ethanolamide,and 4-keto-2-undecylpyrroline.CONCLUSION Our results suggest that the metabolome of fecal samples and the composition of intestinal bacteria hold promise as potential biomarkers for HCC diagnosis.展开更多
OBJECTIVE:To analyze the mechanism of Tongqiao Yizhi decoction(TQYZD,通窍益智颗粒)in treating vascular dementia(VaD)rats using brain tissue untargeted metabonomics and fecal 16S rRNA gene sequencing.METHODS:The chemic...OBJECTIVE:To analyze the mechanism of Tongqiao Yizhi decoction(TQYZD,通窍益智颗粒)in treating vascular dementia(VaD)rats using brain tissue untargeted metabonomics and fecal 16S rRNA gene sequencing.METHODS:The chemical composition of TQYZD was analyzed by ultra-high performance liquid chromatography-high resolution mass spectrometry.The effects of TQYZD on VaD rats were evaluated by water maze test,hematoxylin-eosin staining,enzyme-linked immunosorbent assay and Western blot.Untargeted metabolomics and 16S rRNA sequencing were utilized to explore the relationship between metabolic profiles and the structure and function of intestinal flora.Fecal microbiota transplantation(FMT)was used to validate the role of gut microbiota in VaD.Spearman correlation analysis of differential metabolites and gut microbiota was performed.RESULTS:The results showed that TQYZD improved cognitive function and neuronal damage in VaD rats,and reduced inflammatory response and repaired the intestinal barrier.In addition,TQYZD had the effect of modulating gut microbes in VaD rats,and FMT further confirmed that gut flora plays an important role in TQYZD treatment of VaD.Untargeted metabolomics revealed that VaD could lead to metabolic disorders in brain tissues,and TQYZD significantly altered the metabolites of brain tissues in Middle Cerebral Artery Occlusion rats.The results of spearman correlation analysis showed that there was a significant correlation between intestinal flora and the metabolites of brain tissues.CONCLUSION:In this study,we demonstrated that TQYZD can improve metabolic disorders in vascular dementia rats by acting on intestinal flora.展开更多
Chronic liver disease has become a global health crisis,with increasing incidence and mortality rates placing a substantial burden on healthcare systems worldwide.A key factor in the progression of chronic liver disea...Chronic liver disease has become a global health crisis,with increasing incidence and mortality rates placing a substantial burden on healthcare systems worldwide.A key factor in the progression of chronic liver disease is intestinal microbiota dysbiosis,which influences liver function via the intricate liver-gut axis.This axis plays a central role in various physiological processes,and disruptions in microbial composition can exacerbate liver pathology.Fecal microbiota transplantation(FMT)has emerged as a promising therapeutic strategy,with the potential to restore the composition and metabolic functions of the intestinal microbiota.Supported by encouraging findings from clinical trials and animal studies,FMT has demonstrated therapeutic benefits,including improvements in clinical symptoms,objective indicators,and long-term prognosis.These benefits encompass reductions in hepatic lipid deposition and inflammation,mitigation of complications in advanced liver disease,promotion of hepatitis B e antigen seroconversion,and enhancement of cognitive function.Although clinical evidence remains preliminary,current data underscore the transformative potential of FMT in managing chronic liver diseases.Nonetheless,challenges persist,including the need for standardized procedures,variability among donors,potential risks,and concerns regarding long-term safety.This review provides a comprehensive evaluation of the current literature on the efficacy and safety of FMT,while exploring future research directions to expand its application in liver disease management.展开更多
Objective:To analyze the preventive and management effects of the 4R crisis management theory on incontinence-associated dermatitis(IAD)in ICU patients with fecal incontinence.Methods:A hundred patients with fecal inc...Objective:To analyze the preventive and management effects of the 4R crisis management theory on incontinence-associated dermatitis(IAD)in ICU patients with fecal incontinence.Methods:A hundred patients with fecal incontinence who were admitted to the ICU for treatment between January 2024 and December 2024 were selected and randomly divided into two groups using a random number table.The observation group received 4R crisis management theory,while the control group received routine management.The IAD risk score,incidence of IAD,severity of IAD,and formation and healing time of IAD were compared between the two groups.Results:After management,the IAD risk score of the observation group was lower than that of the control group(P<0.05).The incidence of IAD in the observation group was lower than that in the control group,the proportion of mild IAD was higher than that in the control group,the formation time of IAD was later than that in the control group,and the healing time was shorter than that in the control group(P<0.05).Conclusion:Adopting the 4R crisis management theory for ICU patients with fecal incontinence can reduce the risk of IAD occurrence,effectively prevent IAD,reduce its severity,delay its formation time,and promote good healing.展开更多
BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated wit...BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated with false-positive and false-negative FIT results.METHODS This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020.A total of 4129947 residents aged 40-74 years completed at least one FIT.Of these,24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis.Multivariable logistic regression was performed to identify the factors associated with false FIT results.RESULTS Among the overall screening population,88687(2.15%)participants tested positive for FIT.The sensitivity,specificity,positive predictive value,and negative predictive value of FIT for advanced neoplasms were 58.2%,44.8%,9.7%,and 91.3%,respectively.Older age,female sex,smoking,alcohol consumption,higher body mass index,and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of falsenegative FIT results.Moreover,features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results,while irregular exercise and diverticulum were associated with higher odds of false-positive results.CONCLUSION FIT results may be inaccurate in certain subgroups.Our results provide important evidence for further individualization of screening strategies.展开更多
Objective To investigate the therapeutic efficacy and potential mechanisms of fecal microbiota transplantation(FMT)in patients with type 2 diabetes mellitus(T2DM),and to preliminarily identify the traditional Chinese ...Objective To investigate the therapeutic efficacy and potential mechanisms of fecal microbiota transplantation(FMT)in patients with type 2 diabetes mellitus(T2DM),and to preliminarily identify the traditional Chinese medicine(TCM)syndrome element characteristics of FMT in the treatment of T2DM.Methods Between March 25,2023 and September 30,2024,T2DM patients who met the inclusion and exclusion criteria were enrolled at the Department of Rheumatology and Endocrinology of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine.Participants received oral microbiota capsules as an adjunct to metformin therapy.Information obtained by four diagnostic methods of TCM,along with clinical and laboratory parameters,was collected before and after the intervention.Metagenomic sequencing was employed to analyze the gut microbiota,and Spearman correlation analysis was used to explore the relationship between laboratory indicators and differential bacterial genera.According to the post-treatment reduction in glycosylated hemoglobin(HbA1c),patients were categorized into a response(R)group and a non-response(NR)group.Treatment outcomes,safety indicators,gut microbiota changes,and TCM syndrome element features were compared between the two groups.Results A total of 53 T2DM patients were included in the final analysis,and 30 patients were assigned to R group and 23 to NR group.After treatment,the R group exhibited significant reductions in HbA1c,fasting plasma glucose(FPG),and 2-hour postprandial glucose(2hPG)(P<0.05 or P<0.01).The NR group also showed significant decreases in HbA1c and FPG levels P<0.01 or P<0.05.Compared with the NR group,after treatment,FPG level in the R group demonstrated significant reductions(P<0.01).As compared with before treatment,pancreatic islet function demonstrated enhancement in the R group,a significant increase in the 2-hour pastprandial C-peptide(2hC-P)levels in R group(P<0.05),whereas no marked change was observed in the NR group.Regarding body composition indicators,the R group showed significantly lower waist-hip ratio(WHR),visceral fat(VF),and subcutaneous fat(SF)levels compared with the NR group(P<0.01).After treatment,the NR group exhibited a significant elevation in aspartate aminotransferase(AST)levels(P<0.05).Other safety-related indicators fluctuated within normal reference ranges,and no other adverse events,such as diarrhea,fever,or nausea,were reported.Metagenomic sequencing showed that FMT improved the diversity and richness of the gut microbiota,remodeling its overall structure.At the phylum level,the abundance of p_Firmicutes decreased significantly(P<0.01),while the abundances of p_Bacteroidota and p_Proteobacteria increased significantly(P<0.01).At the family level,among the 125 identified taxa,the abundances of f_Bacteroidaceae,f_Lactobacillaceae,and f_Sutterellaceae were significantly elevated,whereas six families,including f_Lachnospiraceae,f_Ruminococcaceae,and f_Coriobacteriaceae,were significantly decreased(all P<0.05).Among the 367 taxa at the genus level,the top 10 differential genera showed significantly increased abundances of g_Bacteroides and g_Sutterella,and significantly decreased abundances in eight genera,including g_Faecalibacterium,g_Ruminococcus,g_Blautia,and g_Collinsella(all P<0.05).Correlation analysis suggested that the phylum p_Bacillota was positively correlated with improvements in T2DM laboratory parameters,g_norank_f_Prevotellaceae was significantly positively correlated with fasting C-peptide(FC-P)and 2hC-P(P<0.05).HbA1c demonstrated a significantly positive correlation with g_Blautia and g_Gemmiger(P<0.05)and a significantly negative correlation with g_Bacteroides and g_Collinsella(P>0.05).Analysis of syndrome element characteristics revealed that the R group was primarily characterized by pathological patterns of dampness,phlegm,and Yang deficiency.Before treatment,statistically significant reductions in syndrome element scores were observed for dampness,Yang deficiency,spleen,phlegm,Qi deficiency,Qi stagnation,and Yin deficiency(P<0.01),as well as for heat and liver(P<0.05).The NR group was mainly featured with Qi deficiency and Yin deficiency.Statistically significant changes in their syndrome element scores after treatment were noted for Qi deficiency(P<0.01),and for spleen,Qi stagnation,liver,and blood deficiency(P<0.05).In this group,the score changes for Yang deficiency,Yin deficiency,heat,and dampness were not statistically significant(P>0.05).Conclusion The principles of syndrome element differentiation can be effectively applied to predict treatment efficacy and facilitate patient selection for FMT in the treatment of T2DM.Patients with T2DM presented with specific TCM syndrome element characteristics,notably dampness,phlegm,and Yang deficiency,represent a highly responsive population to FMT therapy.展开更多
BACKGROUND Inflammatory bowel disease,particularly Crohn’s disease(CD),has been associated with alterations in mesenteric adipose tissue(MAT)and the phenomenon termed“creeping fat”.Histopathological evaluations sho...BACKGROUND Inflammatory bowel disease,particularly Crohn’s disease(CD),has been associated with alterations in mesenteric adipose tissue(MAT)and the phenomenon termed“creeping fat”.Histopathological evaluations showed that MAT and intestinal tissues were significantly altered in patients with CD,with these tissues characterized by inflammation and fibrosis.AIM To evaluate the complex interplay among MAT,creeping fat,inflammation,and gut microbiota in CD.METHODS Intestinal tissue and MAT were collected from 12 patients with CD.Histological manifestations and protein expression levels were analyzed to determine lesion characteristics.Fecal samples were collected from five recently treated CD patients and five control subjects and transplanted into mice.The intestinal and mesenteric lesions in these mice,as well as their systemic inflammatory status,were assessed and compared in mice transplanted with fecal samples from CD patients and control subjects.RESULTS Pathological examination of MAT showed significant differences between CDaffected and unaffected colons,including significant differences in gut microbiota structure.Fetal microbiota transplantation(FMT)from clinically healthy donors into mice with 2,4,6-trinitrobenzene sulfonic acid(TNBS)-induced CD ameliorated CD symptoms,whereas FMT from CD patients into these mice exacerbated CD symptoms.Notably,FMT influenced intestinal permeability,barrier function,and levels of proinflammatory factors and adipokines.Furthermore,FMT from CD patients intensified fibrotic changes in the colon tissues of mice with TNBS-induced CD.CONCLUSION Gut microbiota play a critical role in the histopathology of CD.Targeting MAT and creeping fat may therefore have potential in the treatment of patients with CD.展开更多
The main aim of this editorial is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593-4603.This original research presents a new scoring system for fecal inco...The main aim of this editorial is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593-4603.This original research presents a new scoring system for fecal incontinence.Fecal incontinence is a chronic disease with a severe impact on the quality of life of the patients.Substantial social stigmatization often leads to significant underreporting of the condition even during visits to a specialist and could lead to further misman-agement or non-existent management of the disease.An important fact is that patients are often unable to describe their condition when not asked precisely defined questions.This problem is partially resolved by scoring questionnaires.Several scoring systems are commonly used;however,each of them has their shortcomings.For example,the absence of different kinds of leakage besides flatus and stool could further lead to underscoring the incontinence severity.Therefore,there has long been a call for a more precise scoring system.The correct identification of the presence and severity of fecal incontinence is paramount for further diagnostic approach and for choosing the appropriate therapy option.This editorial describes fecal incontinence,its effect on quality of life in general and further evaluates the diagnostic approach with a particular focus on symptom scoring systems and their implications for clinical practice.展开更多
The population of non-alcoholic fatty liver disease(NAFLD)patients along with relevant advanced liver disease is projected to continue growing,because currently no medications are approved for treatment.Fecal microbio...The population of non-alcoholic fatty liver disease(NAFLD)patients along with relevant advanced liver disease is projected to continue growing,because currently no medications are approved for treatment.Fecal microbiota transplantation(FMT)is believed a novel and promising therapeutic approach based on the concept of the gut-liver axis in liver disease.There has been an increase in the number of pre-clinical and clinical studies evaluating FMT in NAFLD treatment,however,existing findings diverge on its effects.Herein,we briefly summarized the mechanism of FMT for NAFLD treatment,reviewed randomized controlled trials for evaluating its efficacy in NAFLD,and proposed the prospect of future trials on FMT.展开更多
Fecal microbiota transplantation(FMT)offers a potential treatment avenue for hepatic encephalopathy(HE)by leveraging beneficial bacterial displacement to restore a balanced gut microbiome.The prevalence of HE varies w...Fecal microbiota transplantation(FMT)offers a potential treatment avenue for hepatic encephalopathy(HE)by leveraging beneficial bacterial displacement to restore a balanced gut microbiome.The prevalence of HE varies with liver disease severity and comorbidities.HE pathogenesis involves ammonia toxicity,gut-brain communication disruption,and inflammation.FMT aims to restore gut microbiota balance,addressing these factors.FMT's efficacy has been explored in various conditions,including HE.Studies suggest that FMT can modulate gut microbiota,reduce ammonia levels,and alleviate inflammation.FMT has shown promise in alcohol-associated,hepatitis B and C-associated,and non-alcoholic fatty liver disease.Benefits include improved liver function,cognitive function,and the slowing of disease progression.However,larger,controlled studies are needed to validate its effectiveness in these contexts.Studies have shown cognitive improvements through FMT,with potential benefits in cirrhotic patients.Notably,trials have demonstrated reduced serious adverse events and cognitive enhancements in FMT arms compared to the standard of care.Although evidence is promising,challenges remain:Limited patient numbers,varied dosages,administration routes,and donor profiles.Further large-scale,controlled trials are essential to establish standardized guidelines and ensure FMT's clinical applications and efficacy.While FMT holds potential for HE management,ongoing research is needed to address these challenges,optimize protocols,and expand its availability as a therapeutic option for diverse hepatic conditions.展开更多
Highland barley(HB)is a high-altitude cereal with rich nutritional components and potential health benefits.To clarify its hypoglycemic effect and mechanism,we investigated the effect of whole grain HB and fecal micro...Highland barley(HB)is a high-altitude cereal with rich nutritional components and potential health benefits.To clarify its hypoglycemic effect and mechanism,we investigated the effect of whole grain HB and fecal microbiota transplantation(FMT)on glucose metabolism and gut microbiota in high-fat diet and streptozotocin(HFD/STZ)-induced diabetic mice.The results showed that HB(40%)significantly decreased fasting blood glucose and the area under the glucose tolerance curve,significantly increased insulin secretion and improved insulin resistance in HFD/STZ-induced diabetic mice(P<0.05).Inflammatory factors and blood lipid indices were also significantly alleviated after 12 weeks of 40%HB intervention(P<0.05).Additionally,beneficial bacteria,such as Bifidobacterium and Akkermansia,were significantly enriched in the gut of diabetic mice after whole grain HB intervention.Meanwhile,the results of further FMT experiments verified that the fecal microbiota after the 40%HB intervention not only significantly increased the relative abundance of Bifidobacterium and Akkermansia but also effectively improved glucose metabolism and alleviated the inflammatory state in HFD/STZ-induced diabetic mice.Collectively,our study confirmed the bridge role of gut microbiota in improving glucose metabolism of whole grain HB,which could promote the development of precision nutrition.展开更多
Managing inflammatory bowel disease(IBD)is becoming increasingly complex and personalized,considering the advent of new advanced therapies with distinct mechanisms of action.Achieving mucosal healing(MH)is a pivotal t...Managing inflammatory bowel disease(IBD)is becoming increasingly complex and personalized,considering the advent of new advanced therapies with distinct mechanisms of action.Achieving mucosal healing(MH)is a pivotal therapeutic goal in IBD management and can prevent IBD progression and reduce flares,hospitalization,surgery,intestinal damage,and colorectal cancer.Employing proactive disease and therapy assessment is essential to achieve better control of intestinal inflammation,even if subclinical,to alter the natural course of IBD.Periodic monitoring of fecal calprotectin(FC)levels and interval endoscopic evaluations are cornerstones for evaluating response/remission to advanced therapies targeting IBD,assessing MH,and detecting subclinical recurrence.Here,we comment on the article by Ishida et al Moreover,this editorial aimed to review the role of FC and endoscopic scores in predicting MH in patients with IBD.Furthermore,we intend to present some evidence on the role of these markers in future targets,such as histological and transmural healing.Additional prospective multicenter studies with a stricter MH criterion,standardized endoscopic and histopathological analyses,and virtual chromoscopy,potentially including artificial intelligence and other biomarkers,are desired.展开更多
In this editorial we comment on the article published in the recent issue of the World journal of Gastroenterology.We focus specifically on the mechanisms underlying the effects of fecal microbiota transplantation(FMT...In this editorial we comment on the article published in the recent issue of the World journal of Gastroenterology.We focus specifically on the mechanisms underlying the effects of fecal microbiota transplantation(FMT)for irritable bowel syndrome(IBS),the factors which affect the outcomes of FMT in IBS patients,and challenges.FMT has emerged as a efficacious intervention for clostridium difficile infection and holds promise as a therapeutic modality for IBS.The utilization of FMT in the treatment of IBS has undergone scrutiny in numerous randomized controlled trials,yielding divergent outcomes.The current frontier in this field seeks to elucidate these variations,underscore the existing knowledge gaps that necessitate exploration,and provide a guideline for successful FMT implementation in IBS patients.At the same time,the application of FMT as a treatment for IBS confronts several challenges.展开更多
Intestinal microbiota imbalance may worsen the progression of ulcerative colitis(UC).Lacticaseibacillus rhamnosus LS8(LR)has the potential ability to regulate microbiota through producing a novel antibacterial substan...Intestinal microbiota imbalance may worsen the progression of ulcerative colitis(UC).Lacticaseibacillus rhamnosus LS8(LR)has the potential ability to regulate microbiota through producing a novel antibacterial substance,cyclic opine:cycloalanopine.This study aimed to investigate whether LR could ameliorate dextran sulfate sodium-induced UC in mice via modulating intestinal microbiota using fecal microbiota transplantation(FMT)experiment.The results showed that both LR and FMT attenuated UC as evidenced by 1)alleviating disease activity index and colonic pathology;2)up-regulating MUCs and tight junction proteins;3)increasing oxidative mediators and decreasing antioxidant mediators;4)down-regulating proinflammatory cytokines and chemokines.These results were mainly attributable to the microbiota-regulating effect of LR,including increasing beneficial bacteria(like Akkermansia)and its related SCFAs,while decreasing harmful bacteria(like Proteobacteria)and its related LPS,thereby suppressing the hyperactivation of TLR4/NF-κB pathway.Consequently,LR can alleviate UC and is a potential dietary supplement to attenuate UC.展开更多
文摘Fecal incontinence is a common condition that can significantly impact patients’quality of life.Obstetric anal sphincter injury and anorectal surgeries are common etiologies.Endoanal ultrasound and anorectal manometry are important diagnostic tools for evaluating patients.There are various treatment options,including diet,lifestyle modifications,drugs,biofeedback therapy,tibial and sacral nerve neuromodulation therapy,and surgery.In this editorial,we will discuss current controversies and novel approaches to fecal incontinence.Screening for asymptomatic anal sphincter defects after obstetric anal sphincter injury and in patients with inflammatory bowel disease is not generally recommended,but may be helpful in selected patients.The Garg incontinence score is a new score that includes the assessment of solid,liquid,flatus,mucous,stress and urge fecal incontinence.Novel tests such as translumbosacral anorectal magnetic stimulation and novel therapies such as translumbosacral neuromodulation therapy are promising diagnostic and treatment options,for both fecal incontinence and neuropathy.Home biofeedback therapy can overcome some limitations of the office-based therapy.Skeletal muscle-derived cell implantation of the external anal sphincter has been further studied as a possible treatment option.Sacral neuromodulation may be useful in scleroderma,congenital fecal incontinence and inflammatory bowel disease but merits further study.
文摘Inflammatory bowel disease,particularly Crohn's disease(CD),has been linked to modifications in mesenteric adipose tissue(MAT)and the phenomenon known as"creeping fat"(CrF).The presence of CrF is believed to serve as a predictor for early clinical recurrence following surgical intervention in patients with CD.Notably,the incorporation of the mesentery during ileocolic resection for CD has been correlated with a decrease in surgical recurrence,indicating the significant role of MAT in the pathogenesis of CD.While numerous studies have indicated that dysbiosis of the gut microbiota is a critical factor in the development of CD,the functional implications of translocated microbiota within the MAT of CD patients remain ambiguous.This manuscript commentary discusses a recent basic research conducted by Wu et al.In their study,intestinal bacteria from individuals were transplanted into CD model mice,revealing that fecal microbiota trans-plantation(FMT)from healthy donors alleviated CD symptoms,whereas FMT from CD patients exacerbated these symptoms.Importantly,FMT was found to affect intestinal permeability,barrier function,and the levels of proinflammatory factors and adipokines.Collectively,these findings suggest that targeting MAT and CrF may hold therapeutic potential for patients with CD.However,the study did not evaluate the composition of the intestinal microbiota of the donors or the subsequent alterations in the gut microbiota.Overall,the gut microbiota plays a crucial role in the histopathology of CD,and thus,targeting MAT and CrF may represent a promising avenue for treatment in this patient population.
文摘This study highlights the potential of diatomaceous earth to eliminate pathogenic microorganisms from canal sediments used in agricultural irrigation.The findings demonstrate both technical feasibility and economic benefits for agriculture,particularly in regions where such irrigation practices are common.The research incorporates three distinct projects.The first involved monitoring water and sediment quality in the Xochimilco canal zone in Mexico City.The other two were experimental studies aimed at assessing the efficacy of diatomaceous earth in reducing fecal coliforms in sediments.The first project evaluated the water and sediment quality.Subsequently,an experiment was conducted in the San Gregorio Atlapulco chinampa,where diatomaceous earth was applied to a coriander crop to measure its effectiveness in reducing fecal coliforms.A laboratory experiment at the Institute of Engineering,UNAM,tested the impact of diatomaceous earth on sediments from a Xochimilco canal,focusing on fecal coliform reduction.In all experiments,diatomaceous earth was utilized in its commercial form.The results of the first project identified wastewater discharges as the primary source of pathogenic contamination in the canals.The second demonstrated a significant reduction—over 70%—in fecal coliforms within a crop after the application of diatomaceous earth.Similarly,the third project achieved an average fecal coliform reduction of 70%in sediments during laboratory testing.The study underscores the affordability and accessibility of diatomaceous earth for local agricultural producers.Moreover,its application does not adversely affect soil quality or crop productivity,further supporting its viability as a sustainable solution for improving irrigation water quality.
文摘Crohn’s disease(CD)is an idiopathic,chronic,and recurrent inflammatory condition of the gastrointestinal tract.Recent studies suggest a potential role of gut microbiota in CD,particularly dysbiosis—an imbalance in gut bacteria.While dysbiosis is consistently observed in CD,it remains uncertain whether it is a cause or a consequence of the disease.Given its association with CD,the therapeutic potential of fecal microbiota transplantation(FMT)has been explored.This review examines the role of gut microbiota in CD,evaluates the therapeutic potential of probiotics and FMT,and highlights current research findings and limitations.Key studies on the relationship between gut dysbiosis,probiotics,and FMT in CD were analyzed,with a focus on randomized trials,meta-analyses,and clinical observations.Dysbiosis is a consistent feature of CD,but its causative role remains unclear.Probiotics,prebiotics,and synbiotics have shown no efficacy in inducing or maintaining remission in CD.FMT shows potential as a therapeutic option for CD,but its efficacy remains inconsistent and inconclusive.The variability in outcomes,including diminished effects over time despite repeated FMT,underscores the need for larger,well-controlled trials.Only one randomized controlled trial(RCT)has compared FMT with sham transplantation,but the sample size was very small.Other studies are limited by factors such as small sample sizes,lack of control groups,short follow-up periods,and inconsistent methodologies,making it challenging to draw definitive conclusions.While gut dysbiosis likely plays a role in CD pathogenesis,its causative role remains uncertain.Current evidence does not support FMT as a reliable treatment for inducing or maintaining remission in CD,though it appears generally safe.Larger,standardized,RCTs are necessary to clarify the therapeutic role of FMT in CD management.
基金supported by the National Natural Science Foundation of China(No.82030016,No 82230011 and No.82200533).
文摘Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascular inflammation risk.However,the specific intestinal microbiota alteration contributing to increased inflammation remains unclear.Therefore,the present study investigated the correlation between the intestinal microbiota and inflammation in patients with unstable angina(UA).Methods A cohort of 92 patients with UA was recruited for this study.The plasma hsCRP level was measured via a CardioPhase hsCRP assay,fecal samples were collected after admission,and 16S rRNA sequencing was conducted to identify the fecal microbial profile.The participants were classified into two groups according to the median hsCRP level(1.11 mg/L).The composition of the fecal microbiota was compared between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Additionally,the correlations between the fecal microbiota and clinical characteristics were analyzed.Results A notable reduction in the relative abundance of Akkermansia was observed in patients with hsCRP≥1.11 mg/L,whereas the diversity of the fecal microbiota was not significantly different between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Furthermore,the abundance of Akkermansia was negatively correlated with hsCRP levels.Conclusion This study suggested a significant association between decreased levels of Akkermansia and inflammatory risk in patients with UA.These findings underscore the potential role of the intestinal microbiota in contributing to inflammation in UA patients.Further work is needed on the mechanism by which the microbiota contributes to inflammatory risk.
基金financially supported by grants from the National Natural Science Foundation of China(32170377,81973463)the Primary Research&Development Plan of Jiangsu Province(BE2020344,BE2022371)。
文摘Blueberry anthocyanins(VA)and blackberry anthocyanins(RA)showed benefits on metabolic syndrome(MS)induced by high-fat diet(HFD)in mice.In this study,we investigated whether the therapeutic effects of VA and RA were achieved by the gut microbiota regulation and whether these effects could be replicated through fecal microbiota transplantation(FMT)using the HFD caused MS model in pseudo-germ-free mice.The results demonstrated that the beneficial effects of VA and RA on MS,including reducing body weight gain and fat accumulation,improving glucose and lipid metabolism,and mitigating intestinal barrier damage,were attributed to the gut microbiota and could be replicated by FMT.16S r RNA sequencing analysis suggested that FMT from donor mice supplemented with VA and RA could regulate the gut microbiota composition.Particularly,FMT from RA supplemented mice displayed the potential to restore the diversity of gut microbiota and the ratio of Firmicutes to Bacteroidetes.Meanwhile,FMT from VA supplemented mice appeared to exert its effects by selectively influencing specific gut microbiota,such as the genus Akkermansia.Furthermore,our analysis identified 10 common differential amplicon sequence variants(ASVs)among groups compared to HFD-HFD group.Notably,ASV_36450 was negatively associated with metabolic parameters,suggesting that Lactobacillus might be the potential bacteria in regulating MS.Overall,our study demonstrated that FMT from VA and RA supplemented mice could ameliorate MS induced by HFD in mice through regulating specific gut microbiota.
基金Supported by the Department of Science and Technology of Shanxi Province,No.20210302124369the Health Commission of Shanxi Province,No.2021116Shanxi Administration of Traditional Chinese Medicine,No.2024ZYY2C054.
文摘BACKGROUND Hepatocellular carcinoma(HCC),the predominant form of primary liver cancer,is a key contributor to cancer-related deaths globally.However,HCC diagnosis solely based on blood biochemical markers lacks both sensitivity and specificity.AIM To investigate alterations of the fecal metabolome and intestinal bacteria and reveal the correlations among differential metabolites,distinct bacteria,and serum indicators.METHODS To uncover potentially effective therapeutic targets for HCC,we utilized nontargeted liquid chromatography-mass spectrometry and high-throughput DNA sequencing targeting the 16S rRNA gene.This comprehensive approach allowed us to investigate the metabolome and microbial community structure of feces samples obtained from patients with HCC.Furthermore,we conducted an analysis to assess the interplay between the fecal metabolome and intestinal bacterial population.RESULTS In comparison to healthy controls,a notable overlap of 161 differential metabolites and 3 enriched Kyoto Encyclopedia of Genes and Genomes pathways was observed in the HCC12(comprising patients with stage I and II HCC)and HCC34 groups(comprising patients with stage III and IV HCC).Lachnospira,Streptococcus,and Veillonella had significant differences in abundance in patients with HCC.Notably,Streptococcus and Veillonella exhibited significant correlations with serum indicators such as alpha-fetoprotein(AFP).Meanwhile,several differential metabolites[e.g.,4-keto-2-undecylpyrroline,dihydrojasmonic acid,1,8-heptadecadiene-4,6-diyne-3,10-diol,9(S)-HOTrE]also exhibited significant correlations with serum indicators such asγ-glutamyl transferase,total bilirubin,AFP,aspartate aminotransferase,and albumin.Additionally,these two genera also had significant associations with differential metabolites such as 1,2-Dipentadecanoyl-rac-glycerol(15:0/20:0/0:0),arachidoyl ethanolamide,and 4-keto-2-undecylpyrroline.CONCLUSION Our results suggest that the metabolome of fecal samples and the composition of intestinal bacteria hold promise as potential biomarkers for HCC diagnosis.
基金Supported by the Southwest Medical University Project:Exploring the Neuroprotective Mechanism of Tongqiao Yizhi Decoction on Vascular Dementia Rats Based on the Brain Gut Axis(southwest Medical University[2021]No.1)。
文摘OBJECTIVE:To analyze the mechanism of Tongqiao Yizhi decoction(TQYZD,通窍益智颗粒)in treating vascular dementia(VaD)rats using brain tissue untargeted metabonomics and fecal 16S rRNA gene sequencing.METHODS:The chemical composition of TQYZD was analyzed by ultra-high performance liquid chromatography-high resolution mass spectrometry.The effects of TQYZD on VaD rats were evaluated by water maze test,hematoxylin-eosin staining,enzyme-linked immunosorbent assay and Western blot.Untargeted metabolomics and 16S rRNA sequencing were utilized to explore the relationship between metabolic profiles and the structure and function of intestinal flora.Fecal microbiota transplantation(FMT)was used to validate the role of gut microbiota in VaD.Spearman correlation analysis of differential metabolites and gut microbiota was performed.RESULTS:The results showed that TQYZD improved cognitive function and neuronal damage in VaD rats,and reduced inflammatory response and repaired the intestinal barrier.In addition,TQYZD had the effect of modulating gut microbes in VaD rats,and FMT further confirmed that gut flora plays an important role in TQYZD treatment of VaD.Untargeted metabolomics revealed that VaD could lead to metabolic disorders in brain tissues,and TQYZD significantly altered the metabolites of brain tissues in Middle Cerebral Artery Occlusion rats.The results of spearman correlation analysis showed that there was a significant correlation between intestinal flora and the metabolites of brain tissues.CONCLUSION:In this study,we demonstrated that TQYZD can improve metabolic disorders in vascular dementia rats by acting on intestinal flora.
基金Supported by National Key R&D Program of China,No.2022YFC2304505 and No.2021YFC2301801the Beijing Municipal of Science and Technology Major Project,No.Z221100007422002+1 种基金the Capital Funds for Health Improvement and Research,No.CFH-2024-1-2181Beijing Igandan Foundation,No.iGandanF-1082023-GSH011.
文摘Chronic liver disease has become a global health crisis,with increasing incidence and mortality rates placing a substantial burden on healthcare systems worldwide.A key factor in the progression of chronic liver disease is intestinal microbiota dysbiosis,which influences liver function via the intricate liver-gut axis.This axis plays a central role in various physiological processes,and disruptions in microbial composition can exacerbate liver pathology.Fecal microbiota transplantation(FMT)has emerged as a promising therapeutic strategy,with the potential to restore the composition and metabolic functions of the intestinal microbiota.Supported by encouraging findings from clinical trials and animal studies,FMT has demonstrated therapeutic benefits,including improvements in clinical symptoms,objective indicators,and long-term prognosis.These benefits encompass reductions in hepatic lipid deposition and inflammation,mitigation of complications in advanced liver disease,promotion of hepatitis B e antigen seroconversion,and enhancement of cognitive function.Although clinical evidence remains preliminary,current data underscore the transformative potential of FMT in managing chronic liver diseases.Nonetheless,challenges persist,including the need for standardized procedures,variability among donors,potential risks,and concerns regarding long-term safety.This review provides a comprehensive evaluation of the current literature on the efficacy and safety of FMT,while exploring future research directions to expand its application in liver disease management.
基金Exploration of the Preventive Effect of Skin Management Program Based on 4R Crisis Management Theory on Incontinence-Associated Dermatitis in ICU Patients with Fecal Incontinence(Project No.:YK202335)。
文摘Objective:To analyze the preventive and management effects of the 4R crisis management theory on incontinence-associated dermatitis(IAD)in ICU patients with fecal incontinence.Methods:A hundred patients with fecal incontinence who were admitted to the ICU for treatment between January 2024 and December 2024 were selected and randomly divided into two groups using a random number table.The observation group received 4R crisis management theory,while the control group received routine management.The IAD risk score,incidence of IAD,severity of IAD,and formation and healing time of IAD were compared between the two groups.Results:After management,the IAD risk score of the observation group was lower than that of the control group(P<0.05).The incidence of IAD in the observation group was lower than that in the control group,the proportion of mild IAD was higher than that in the control group,the formation time of IAD was later than that in the control group,and the healing time was shorter than that in the control group(P<0.05).Conclusion:Adopting the 4R crisis management theory for ICU patients with fecal incontinence can reduce the risk of IAD occurrence,effectively prevent IAD,reduce its severity,delay its formation time,and promote good healing.
基金Supported by Natural Science Foundation of Tianjin,No.21JCZDJC00060 and No.21JCYBJC00180Tianjin Health and Medical Science and Technology Project,No.TJWJ2023QN040National Key Research and Development Program,No.2017YFC1700606 and No.2017YFC1700604.
文摘BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated with false-positive and false-negative FIT results.METHODS This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020.A total of 4129947 residents aged 40-74 years completed at least one FIT.Of these,24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis.Multivariable logistic regression was performed to identify the factors associated with false FIT results.RESULTS Among the overall screening population,88687(2.15%)participants tested positive for FIT.The sensitivity,specificity,positive predictive value,and negative predictive value of FIT for advanced neoplasms were 58.2%,44.8%,9.7%,and 91.3%,respectively.Older age,female sex,smoking,alcohol consumption,higher body mass index,and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of falsenegative FIT results.Moreover,features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results,while irregular exercise and diverticulum were associated with higher odds of false-positive results.CONCLUSION FIT results may be inaccurate in certain subgroups.Our results provide important evidence for further individualization of screening strategies.
基金National Natural Science Foundation of Joint Fund in China (U22A20376)。
文摘Objective To investigate the therapeutic efficacy and potential mechanisms of fecal microbiota transplantation(FMT)in patients with type 2 diabetes mellitus(T2DM),and to preliminarily identify the traditional Chinese medicine(TCM)syndrome element characteristics of FMT in the treatment of T2DM.Methods Between March 25,2023 and September 30,2024,T2DM patients who met the inclusion and exclusion criteria were enrolled at the Department of Rheumatology and Endocrinology of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine.Participants received oral microbiota capsules as an adjunct to metformin therapy.Information obtained by four diagnostic methods of TCM,along with clinical and laboratory parameters,was collected before and after the intervention.Metagenomic sequencing was employed to analyze the gut microbiota,and Spearman correlation analysis was used to explore the relationship between laboratory indicators and differential bacterial genera.According to the post-treatment reduction in glycosylated hemoglobin(HbA1c),patients were categorized into a response(R)group and a non-response(NR)group.Treatment outcomes,safety indicators,gut microbiota changes,and TCM syndrome element features were compared between the two groups.Results A total of 53 T2DM patients were included in the final analysis,and 30 patients were assigned to R group and 23 to NR group.After treatment,the R group exhibited significant reductions in HbA1c,fasting plasma glucose(FPG),and 2-hour postprandial glucose(2hPG)(P<0.05 or P<0.01).The NR group also showed significant decreases in HbA1c and FPG levels P<0.01 or P<0.05.Compared with the NR group,after treatment,FPG level in the R group demonstrated significant reductions(P<0.01).As compared with before treatment,pancreatic islet function demonstrated enhancement in the R group,a significant increase in the 2-hour pastprandial C-peptide(2hC-P)levels in R group(P<0.05),whereas no marked change was observed in the NR group.Regarding body composition indicators,the R group showed significantly lower waist-hip ratio(WHR),visceral fat(VF),and subcutaneous fat(SF)levels compared with the NR group(P<0.01).After treatment,the NR group exhibited a significant elevation in aspartate aminotransferase(AST)levels(P<0.05).Other safety-related indicators fluctuated within normal reference ranges,and no other adverse events,such as diarrhea,fever,or nausea,were reported.Metagenomic sequencing showed that FMT improved the diversity and richness of the gut microbiota,remodeling its overall structure.At the phylum level,the abundance of p_Firmicutes decreased significantly(P<0.01),while the abundances of p_Bacteroidota and p_Proteobacteria increased significantly(P<0.01).At the family level,among the 125 identified taxa,the abundances of f_Bacteroidaceae,f_Lactobacillaceae,and f_Sutterellaceae were significantly elevated,whereas six families,including f_Lachnospiraceae,f_Ruminococcaceae,and f_Coriobacteriaceae,were significantly decreased(all P<0.05).Among the 367 taxa at the genus level,the top 10 differential genera showed significantly increased abundances of g_Bacteroides and g_Sutterella,and significantly decreased abundances in eight genera,including g_Faecalibacterium,g_Ruminococcus,g_Blautia,and g_Collinsella(all P<0.05).Correlation analysis suggested that the phylum p_Bacillota was positively correlated with improvements in T2DM laboratory parameters,g_norank_f_Prevotellaceae was significantly positively correlated with fasting C-peptide(FC-P)and 2hC-P(P<0.05).HbA1c demonstrated a significantly positive correlation with g_Blautia and g_Gemmiger(P<0.05)and a significantly negative correlation with g_Bacteroides and g_Collinsella(P>0.05).Analysis of syndrome element characteristics revealed that the R group was primarily characterized by pathological patterns of dampness,phlegm,and Yang deficiency.Before treatment,statistically significant reductions in syndrome element scores were observed for dampness,Yang deficiency,spleen,phlegm,Qi deficiency,Qi stagnation,and Yin deficiency(P<0.01),as well as for heat and liver(P<0.05).The NR group was mainly featured with Qi deficiency and Yin deficiency.Statistically significant changes in their syndrome element scores after treatment were noted for Qi deficiency(P<0.01),and for spleen,Qi stagnation,liver,and blood deficiency(P<0.05).In this group,the score changes for Yang deficiency,Yin deficiency,heat,and dampness were not statistically significant(P>0.05).Conclusion The principles of syndrome element differentiation can be effectively applied to predict treatment efficacy and facilitate patient selection for FMT in the treatment of T2DM.Patients with T2DM presented with specific TCM syndrome element characteristics,notably dampness,phlegm,and Yang deficiency,represent a highly responsive population to FMT therapy.
基金Supported by the National Natural Science Foundation of China,No.82270590.
文摘BACKGROUND Inflammatory bowel disease,particularly Crohn’s disease(CD),has been associated with alterations in mesenteric adipose tissue(MAT)and the phenomenon termed“creeping fat”.Histopathological evaluations showed that MAT and intestinal tissues were significantly altered in patients with CD,with these tissues characterized by inflammation and fibrosis.AIM To evaluate the complex interplay among MAT,creeping fat,inflammation,and gut microbiota in CD.METHODS Intestinal tissue and MAT were collected from 12 patients with CD.Histological manifestations and protein expression levels were analyzed to determine lesion characteristics.Fecal samples were collected from five recently treated CD patients and five control subjects and transplanted into mice.The intestinal and mesenteric lesions in these mice,as well as their systemic inflammatory status,were assessed and compared in mice transplanted with fecal samples from CD patients and control subjects.RESULTS Pathological examination of MAT showed significant differences between CDaffected and unaffected colons,including significant differences in gut microbiota structure.Fetal microbiota transplantation(FMT)from clinically healthy donors into mice with 2,4,6-trinitrobenzene sulfonic acid(TNBS)-induced CD ameliorated CD symptoms,whereas FMT from CD patients into these mice exacerbated CD symptoms.Notably,FMT influenced intestinal permeability,barrier function,and levels of proinflammatory factors and adipokines.Furthermore,FMT from CD patients intensified fibrotic changes in the colon tissues of mice with TNBS-induced CD.CONCLUSION Gut microbiota play a critical role in the histopathology of CD.Targeting MAT and creeping fat may therefore have potential in the treatment of patients with CD.
文摘The main aim of this editorial is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593-4603.This original research presents a new scoring system for fecal incontinence.Fecal incontinence is a chronic disease with a severe impact on the quality of life of the patients.Substantial social stigmatization often leads to significant underreporting of the condition even during visits to a specialist and could lead to further misman-agement or non-existent management of the disease.An important fact is that patients are often unable to describe their condition when not asked precisely defined questions.This problem is partially resolved by scoring questionnaires.Several scoring systems are commonly used;however,each of them has their shortcomings.For example,the absence of different kinds of leakage besides flatus and stool could further lead to underscoring the incontinence severity.Therefore,there has long been a call for a more precise scoring system.The correct identification of the presence and severity of fecal incontinence is paramount for further diagnostic approach and for choosing the appropriate therapy option.This editorial describes fecal incontinence,its effect on quality of life in general and further evaluates the diagnostic approach with a particular focus on symptom scoring systems and their implications for clinical practice.
基金the National Natural Science Foundation of China,No.82104525the Natural Science Foundation of the Jiangsu Higher Education Institutions of China,No.21KJB360009Health Commission of Zhejiang Province Scientific Research Foundation,No.2024KY247.
文摘The population of non-alcoholic fatty liver disease(NAFLD)patients along with relevant advanced liver disease is projected to continue growing,because currently no medications are approved for treatment.Fecal microbiota transplantation(FMT)is believed a novel and promising therapeutic approach based on the concept of the gut-liver axis in liver disease.There has been an increase in the number of pre-clinical and clinical studies evaluating FMT in NAFLD treatment,however,existing findings diverge on its effects.Herein,we briefly summarized the mechanism of FMT for NAFLD treatment,reviewed randomized controlled trials for evaluating its efficacy in NAFLD,and proposed the prospect of future trials on FMT.
文摘Fecal microbiota transplantation(FMT)offers a potential treatment avenue for hepatic encephalopathy(HE)by leveraging beneficial bacterial displacement to restore a balanced gut microbiome.The prevalence of HE varies with liver disease severity and comorbidities.HE pathogenesis involves ammonia toxicity,gut-brain communication disruption,and inflammation.FMT aims to restore gut microbiota balance,addressing these factors.FMT's efficacy has been explored in various conditions,including HE.Studies suggest that FMT can modulate gut microbiota,reduce ammonia levels,and alleviate inflammation.FMT has shown promise in alcohol-associated,hepatitis B and C-associated,and non-alcoholic fatty liver disease.Benefits include improved liver function,cognitive function,and the slowing of disease progression.However,larger,controlled studies are needed to validate its effectiveness in these contexts.Studies have shown cognitive improvements through FMT,with potential benefits in cirrhotic patients.Notably,trials have demonstrated reduced serious adverse events and cognitive enhancements in FMT arms compared to the standard of care.Although evidence is promising,challenges remain:Limited patient numbers,varied dosages,administration routes,and donor profiles.Further large-scale,controlled trials are essential to establish standardized guidelines and ensure FMT's clinical applications and efficacy.While FMT holds potential for HE management,ongoing research is needed to address these challenges,optimize protocols,and expand its availability as a therapeutic option for diverse hepatic conditions.
基金funded by the National Natural Science Foundation of China(32101876)the Discipline ConstructionFood Science and Engineering(SPKX-202202)grants。
文摘Highland barley(HB)is a high-altitude cereal with rich nutritional components and potential health benefits.To clarify its hypoglycemic effect and mechanism,we investigated the effect of whole grain HB and fecal microbiota transplantation(FMT)on glucose metabolism and gut microbiota in high-fat diet and streptozotocin(HFD/STZ)-induced diabetic mice.The results showed that HB(40%)significantly decreased fasting blood glucose and the area under the glucose tolerance curve,significantly increased insulin secretion and improved insulin resistance in HFD/STZ-induced diabetic mice(P<0.05).Inflammatory factors and blood lipid indices were also significantly alleviated after 12 weeks of 40%HB intervention(P<0.05).Additionally,beneficial bacteria,such as Bifidobacterium and Akkermansia,were significantly enriched in the gut of diabetic mice after whole grain HB intervention.Meanwhile,the results of further FMT experiments verified that the fecal microbiota after the 40%HB intervention not only significantly increased the relative abundance of Bifidobacterium and Akkermansia but also effectively improved glucose metabolism and alleviated the inflammatory state in HFD/STZ-induced diabetic mice.Collectively,our study confirmed the bridge role of gut microbiota in improving glucose metabolism of whole grain HB,which could promote the development of precision nutrition.
文摘Managing inflammatory bowel disease(IBD)is becoming increasingly complex and personalized,considering the advent of new advanced therapies with distinct mechanisms of action.Achieving mucosal healing(MH)is a pivotal therapeutic goal in IBD management and can prevent IBD progression and reduce flares,hospitalization,surgery,intestinal damage,and colorectal cancer.Employing proactive disease and therapy assessment is essential to achieve better control of intestinal inflammation,even if subclinical,to alter the natural course of IBD.Periodic monitoring of fecal calprotectin(FC)levels and interval endoscopic evaluations are cornerstones for evaluating response/remission to advanced therapies targeting IBD,assessing MH,and detecting subclinical recurrence.Here,we comment on the article by Ishida et al Moreover,this editorial aimed to review the role of FC and endoscopic scores in predicting MH in patients with IBD.Furthermore,we intend to present some evidence on the role of these markers in future targets,such as histological and transmural healing.Additional prospective multicenter studies with a stricter MH criterion,standardized endoscopic and histopathological analyses,and virtual chromoscopy,potentially including artificial intelligence and other biomarkers,are desired.
文摘In this editorial we comment on the article published in the recent issue of the World journal of Gastroenterology.We focus specifically on the mechanisms underlying the effects of fecal microbiota transplantation(FMT)for irritable bowel syndrome(IBS),the factors which affect the outcomes of FMT in IBS patients,and challenges.FMT has emerged as a efficacious intervention for clostridium difficile infection and holds promise as a therapeutic modality for IBS.The utilization of FMT in the treatment of IBS has undergone scrutiny in numerous randomized controlled trials,yielding divergent outcomes.The current frontier in this field seeks to elucidate these variations,underscore the existing knowledge gaps that necessitate exploration,and provide a guideline for successful FMT implementation in IBS patients.At the same time,the application of FMT as a treatment for IBS confronts several challenges.
基金supported by the National Natural Science Foundation of China(32001652)Chinese Universities Scientific Fund(2452018062)Keypoint Research and Invention Program of Shannxi Province(2021ZDLNY05-06)。
文摘Intestinal microbiota imbalance may worsen the progression of ulcerative colitis(UC).Lacticaseibacillus rhamnosus LS8(LR)has the potential ability to regulate microbiota through producing a novel antibacterial substance,cyclic opine:cycloalanopine.This study aimed to investigate whether LR could ameliorate dextran sulfate sodium-induced UC in mice via modulating intestinal microbiota using fecal microbiota transplantation(FMT)experiment.The results showed that both LR and FMT attenuated UC as evidenced by 1)alleviating disease activity index and colonic pathology;2)up-regulating MUCs and tight junction proteins;3)increasing oxidative mediators and decreasing antioxidant mediators;4)down-regulating proinflammatory cytokines and chemokines.These results were mainly attributable to the microbiota-regulating effect of LR,including increasing beneficial bacteria(like Akkermansia)and its related SCFAs,while decreasing harmful bacteria(like Proteobacteria)and its related LPS,thereby suppressing the hyperactivation of TLR4/NF-κB pathway.Consequently,LR can alleviate UC and is a potential dietary supplement to attenuate UC.
