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      Manipulation of the intestinal microbiome-a slow journey to primetime

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          Abstract

          The gut microbiota has important functions in the regulation of normal body functions. Alterations of the microbiota are being increasingly linked to various disease states. The microbiome has been manipulated via the administration of stool from animals or humans, for more than 1000 years. Currently, fecal microbiota transplantation can be performed via endoscopic administration of fecal matter to the duodenum or colon or via capsules of lyophilized stools. More recently fecal microbial transplantation has been shown to be very effective for recurrent Clostridoides difficile infection (CDI). In addition there is some evidence of efficacy in the metabolic syndrome and its hepatic manifestation, metabolic associated fatty liver disease (MAFLD), irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). We review the current literature regarding the microbiome and the pathogenesis and treatment of CDI, MAFLD, IBS and IBD.

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          Diversity of the human intestinal microbial flora.

          Paul Eckburg, Elisabeth Bik, Charles Bernstein … (2005)
          The human endogenous intestinal microflora is an essential "organ" in providing nourishment, regulating epithelial development, and instructing innate immunity; yet, surprisingly, basic features remain poorly described. We examined 13,355 prokaryotic ribosomal RNA gene sequences from multiple colonic mucosal sites and feces of healthy subjects to improve our understanding of gut microbial diversity. A majority of the bacterial sequences corresponded to uncultivated species and novel microorganisms. We discovered significant intersubject variability and differences between stool and mucosa community composition. Characterization of this immensely diverse ecosystem is the first step in elucidating its role in health and disease.
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            The gut microbiota shapes intestinal immune responses during health and disease.

            June Round, Sarkis Mazmanian (2009)
            Immunological dysregulation is the cause of many non-infectious human diseases such as autoimmunity, allergy and cancer. The gastrointestinal tract is the primary site of interaction between the host immune system and microorganisms, both symbiotic and pathogenic. In this Review we discuss findings indicating that developmental aspects of the adaptive immune system are influenced by bacterial colonization of the gut. We also highlight the molecular pathways that mediate host-symbiont interactions that regulate proper immune function. Finally, we present recent evidence to support that disturbances in the bacterial microbiota result in dysregulation of adaptive immune cells, and this may underlie disorders such as inflammatory bowel disease. This raises the possibility that the mammalian immune system, which seems to be designed to control microorganisms, is in fact controlled by microorganisms.
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              Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis.

              Rebecca M. Lovell, Alexander Ford (2012)
              Many cross-sectional surveys have reported the prevalence of irritable bowel syndrome (IBS), but there have been no recent systematic review of data from all studies to determine its global prevalence and risk factors. MEDLINE, EMBASE, and EMBASE Classic were searched (until October 2011) to identify population-based studies that reported the prevalence of IBS in adults (≥15 years old); IBS was defined by using specific symptom-based criteria or questionnaires. The prevalence of IBS was extracted for all studies and based on the criteria used to define it. Pooled prevalence, according to study location and certain other characteristics, odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. Of the 390 citations evaluated, 81 reported the prevalence of IBS in 80 separate study populations containing 260,960 subjects. Pooled prevalence in all studies was 11.2% (95% CI, 9.8%-12.8%). The prevalence varied according to country (from 1.1% to 45.0%) and criteria used to define IBS. The greatest prevalence values were calculated when ≥3 Manning criteria were used (14%; 95% CI, 10.0%-17.0%); by using the Rome I and Rome II criteria, prevalence values were 8.8% (95% CI, 6.8%-11.2%) and 9.4% (95% CI, 7.8%-11.1%), respectively. The prevalence was higher for women than men (OR, 1.67; 95% CI, 1.53-1.82) and lower for individuals older than 50 years, compared with those younger than 50 (OR, 0.75; 95% CI, 0.62-0.92). There was no effect of socioeconomic status, but only 4 studies reported these data. The prevalence of IBS varies among countries, as well as criteria used to define its presence. Women are at slightly higher risk for IBS than men. The effects of socioeconomic status have not been well described. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Ofra Kriger-Sharabi
                Stephen D H Malnick
                David Fisher
                Journal
                Journal ID (nlm-ta): World J Clin Cases
                Journal ID (publisher-id): WJCC
                Title: World Journal of Clinical Cases
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 2307-8960
                Publication date (Print): 26 July 2023
                Publication date (Electronic): 26 July 2023
                Volume: 11
                Issue: 21
                Pages: 4975-4988
                Affiliations
                Institute of Gastroenterology, Assuta Medical Center, Ashdod 7747629, Israel
                Department of Internal Medicine, Kaplan Medical Center, Rehovot 76100, Israel. steve_m@ 123456clalit.org.il
                Department of Endocrinology, Soroka Medical Center, Beer Sheva POB 151, Israel
                Author notes

                Author contributions: Each author contributed equally to the writing of the manuscript.

                Corresponding author: Stephen D H Malnick, MD, Doctor, Department of Internal Medicine, Kaplan Medical Center, Derech Pasternak 1, Rehovot 76100, Israel. steve_m@ 123456clalit.org.il

                Article
                Other ID: jWJCC.v11.i21.pg4975
                DOI: 10.12998/wjcc.v11.i21.4975
                PMC ID: 10424025
                PubMed ID: 37583860
                SO-VID: 4cd88f26-ddda-443b-9ed1-663b5dc78cfa
                Copyright © ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

                History
                Date received : 23 March 2023
                Date revision received : 17 May 2023
                Date accepted : 30 June 2023
                Categories
                Subject: Review

                Keywords: gut microbiota,fecal microbiota transplantation,clostridoides difficile,metabolic associated fatty liver disease,irritable bowel syndrome,inflammatory bowel disease
                Data availability:
                Keywords: gut microbiota, fecal microbiota transplantation, clostridoides difficile, metabolic associated fatty liver disease, irritable bowel syndrome, inflammatory bowel disease

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