Fecal bacteria from 33 infants (aged 1 to 6 months) were tested for growth on commercial prebiotics. The children were born vaginally (20) or by caesarean section (13). Bifidobacteria, lactobacilli, gram-negative bacteria, Escherichia coli, and total anaerobes in fecal samples were enumerated by selective agars and fluorescence in situ hybridization. The total fecal bacteria were inoculated into cultivation media containing 2 % Vivinal® (galactooligosaccharides-GOS) or Raftilose® P95 (fructooligosaccharides-FOS) as a single carbon source and bacteria were enumerated again after 24 h of anaerobic cultivation. Bifidobacteria dominated, reaching counts of 9-10 log colony-forming units (CFU)/g in 17 children born vaginally and in seven children delivered by caesarean section. In these infants, lactobacilli were more frequently detected and a lower number of E. coli and gram-negative bacteria were determined compared to bifidobacteria-negative infants. Clostridia dominated in children without bifidobacteria, reaching counts from 7 to 9 log CFU/g. Both prebiotics supported all groups of bacteria tested. In children with naturally high counts of bifidobacteria, bifidobacteria dominated also after cultivation on prebiotics, reaching counts from 8.23 to 8.77 log CFU/mL. In bifidobacteria-negative samples, clostridia were supported by prebiotics, reaching counts from 7.17 to 7.69 log CFU/mL. There were no significant differences between bacterial growth on Vivinal® and Raftilose® P95 and counts determined by cultivation and FISH. Prebiotics should selectively stimulate the growth of desirable bacteria such as bifidobacteria and lactobacilli. However, our results showed that commercially available FOS and GOS may stimulate also other fecal bacteria.
- MeSH
- Bacteria growth & development isolation & purification MeSH
- Feces microbiology MeSH
- Infant MeSH
- Humans MeSH
- Prebiotics analysis MeSH
- Check Tag
- Infant MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Fekálna mikrobiálna terapia (FMT) je liečebná metóda, pri ktorej sa prenesie fekálna mikroflóra chorému jedincovi od zdravého darcu, a tým sa obnoví normálne mikrobiálne zloženie čreva. V súčasnosti vzrastá záujem o využitie FMT pri liečbe rôznych chorôb, avšak neexistujú štandardné terapeutické protokoly. Postupy pri realizácii FMT sa líšia vo viacerých aspektoch, ako je výber darcu, príprava fekálnych materiálov, príprava príjemcu a spôsob aplikácie. FMT sa zdá byť najúspešnejšia v liečbe rekurentnej infekcie Clostridium difficile, randomizované kontrolované štúdie dokázali úspešnosť približne 90 %. Existujú aj obmedzené výsledky pre liečbu ulceróznej kolitídy, publikované boli malé série prípadov, ktorých výsledky však nie sú jednotné. Využitie FMT sa skúma aj v liečbe iných chorôb, pri ktorých je narušená črevná mikroflóra, ako sú napr. kardiovaskulárne, autoimunitné a metabolické ochorenia. Nateraz je pri FMT veľa nezodpovedaných otázok, a preto je nevyhnutný ďalší výskum v tejto oblasti.
Fecal microbiota transplantation (FMT) is a therapeutic method, in which the fecal microflora from healthy donors is transmitted to the patient to restore the healthy microbial composition of the gut. In the recent years, there is a growing interest in the therapeutic potential of FMT in various diseases. The standard FMT protocols do not exist. Procedures of FMT vary in several aspects such as donor selection, preparation of fecal material, preparation of the recipient and administration way. FMT appears to be the most successful in the treatment of recurrent Clostridium difficile infection (CDI), randomized controlled studies reported 90 % success rate. There is a limited evidence for FMT as a treatment of ulcerative colitis. FMT has been also studied as treatment of diseases with impaired gut microbiota, such as cardiovascular, autoimmune and metabolic diseases. Many unanswered questions with regard to FMT remain and further research is needed.
- MeSH
- Clostridioides difficile MeSH
- Crohn Disease therapy MeSH
- Tissue Donors MeSH
- Feces * microbiology MeSH
- Fecal Microbiota Transplantation * MeSH
- Inflammatory Bowel Diseases * therapy MeSH
- Clostridium Infections therapy MeSH
- Humans MeSH
- Gastrointestinal Microbiome * MeSH
- Colitis, Ulcerative therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Problematika střevní dysbiózy je v současnosti předmětem intenzivního výzkumu, alterace mikrobioty je dávána do souvislosti s patogenezí řady chorobných stavů. Určitým prototypem nemoci, u které hraje narušení přirozené rovnováhy mikrobiálního ekosystému střeva klíčovou roli, je rekurentní klostridiová kolitida. Velmi nadějnou metodou mající potenciál terapeuticky zasáhnout právě na úrovni alterované intestinální mikrobioty je fekální bakterioterapie. Jedná se dnes již o globálně plně etablovanou metodu, která má za cíl dosáhnout obnovy přirozené mikrobiální homeostázy ve střevě pomocí stolice od zdravého dárce, která je přenesena do střeva pacienta. Obnovením kolonizační rezistence tlustého střeva dokáže transplantace střevní mikrobioty prolomit pomyslný bludný kruh opakovaných atak klostridiové kolitidy. V rámci sekundární profylaxe rekurentní klostridiové kolitidy je fekální bakterioterapie metodou velmi efektivní, bezpečnou a pacienty dobře tolerovanou. Její budoucnost vidíme jednak ve zdokonalování způsobu podání fekálního transplantátu (včetně enterosolventních kapslí), jednak v cílenější manipulaci s intestinální mikrobiotou, což povede k rozšíření indikací o řadu dalších onemocnění.
The problematic of intestinal dysbiosis is currently an object of intensive research, alteration of microbiota is related to pathogenesis of a whole array of disease states. A certain prototype of illness at which disruption of natural balance of intestinal microbial ecosystem plays a key role is recurrent Clostridium difficile colitis. A very hopeful method having the potential to therapeutically intervene exactly at the level of altered intestinal microbiota is fecal bacteriotherapy. It is already globally established method with aim to achieve the restoration of natural microbial homeostasis in the intestine using stool of healthy donor which is transplanted into the intestines of a patient. By restoring the colonization resistance of large intestine, the transplantation of intestinal microbiota can break an imaginary vicious cycle of repeated attacks of Clostridium difficile colitis. Within secondary prophylaxis of recurrent Clostridium difficile colitis, fecal bacteriotherapy is a very effective, safe, and by patients well-tolerated method. We can see its future in both improvement of the fecal transplant administration method (including enteric capsules) and more targeted manipulation with intestinal microbiota which will lead to extension of indications by an array of other illnesses.
- Keywords
- intestinální dysbióza,
- MeSH
- Clostridioides difficile MeSH
- Dysbiosis therapy MeSH
- Fecal Microbiota Transplantation * methods MeSH
- Clostridium Infections therapy MeSH
- Humans MeSH
- Enterocolitis, Pseudomembranous * therapy MeSH
- Gastrointestinal Microbiome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Fekální transplantace se stala preferovanou léčebnou modalitou u nemocných s recidivujícími infekcemi bakterií Clostridium difficile. Postavení této léčebné metody u jiných poruch trávicího ústrojí, jako jsou idiopatické střevní záněty nebo syndrom dráždivého tračníku, je stále předmětem klinického výzkumu. V přehledném článku je zmíněn potenciální význam fekální transplantace u pacientů s mírně až středně aktivní ulcerózní kolitidou. Na rozdíl od výsledků zjištěných u klostridiové infekce, je nutné v případě pacientů s ulcerózní kolitidou k dosažení klinického účinku transplantaci opakovat a užívat transplantát získaný od více nepříbuzenských dárců. Jednoznačné místo v terapii ulcerózní kolitidy musí určit až výsledky probíhajících kontrolovaných klinických studií.
Fecal transplantation has become a preferring therapeutic method in patients with recurrent Clostridium difficile infection. Positioning of the fecal transplantation in other gastrointestinal disorders, like inflammatory bowel disease and irritable bowel syndrome, remains in the focus on the clinical research. In the review article a therapeutic potential of fecal transplantation in patients with mild to moderate ulcerative colitis is discussed. In the difference from recurrent Clostridium difficile infection a patient with ulcerative colitis require a repetitive fecal transplantations procedure and to use a multidonor fecal material from un-relationship donors. The clear position of the fecal transplantation must be clarified on the ongoing clinical studies.
- MeSH
- Bacteria classification MeSH
- Clostridioides difficile pathogenicity MeSH
- Double-Blind Method MeSH
- Dysbiosis therapy MeSH
- Fecal Microbiota Transplantation * methods MeSH
- Inflammatory Bowel Diseases * therapy MeSH
- Remission Induction MeSH
- Clostridium Infections therapy MeSH
- Humans MeSH
- Microbiota physiology MeSH
- Multicenter Studies as Topic MeSH
- Randomized Controlled Trials as Topic MeSH
- Gastrointestinal Microbiome * physiology immunology MeSH
- Colitis, Ulcerative * therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
Narušení mikrobiálního ekosystému střeva dnes představuje významný patogenetický faktor řady onemocnění. Známá je úloha alterace intestinální mikrobioty u rekurentní klostridiové kolitidy (rCDI – recurent Clostridioides difficile infection). Přenosem stolice od zdravého dárce do zažívacího traktu nemocného dokážeme navrátit přirozenou homeostázu střevní mikrobioty, a tím efektivně přerušit "bludný kruh“ chronicky relabující klostridiové infekce. Do budoucna očekáváme dominantně perorální způsob podání fekálního transplantátu v podobě enterosolventních kapslí či komerčně vyráběných fekálních derivátů. Tato cesta podání minimalizuje riziko nežádoucích komplikací, které vzácně pozorujeme při administraci suspenze stolice nazoenterální sondou, endoskopicky nebo rektálním klyzmatem. V posledních letech je transplantace střevní mikrobioty testována i u dalších chorobných stavů, jejichž patogeneze je pravděpodobně asociována s intestinální dysbiózou. V tomto smyslu jsou nejčastěji diskutovány idiopatické střevní záněty, syndrom dráždivého tračníku, jaterní encefalopatie a v posledních letech i "civilizační nemoci“, jako jsou diabetes mellitus 2. typu, roztroušená skleróza, Parkinsonova nemoc či metabolický syndrom. Efekt fekální bakterioterapie je pozorován i při eradikaci multirezistentních bakteriálních kmenů kolonizujících střevo pacientů. U rCDI je dnes v rámci medicíny založené na důkazech fekální bakterioterapie celosvětově akceptovaným a doporučovaným terapeutickým postupem. U ostatních onemocnění se jedná stále o metodu experimentální, na přesvědčivé výsledky randomizovaných kontrolovaných studií prozatím čekáme.
Distortions in intestinal microbial ecosystems are important pathogenetic factors of numerous diseases. The role of alterations in intestinal microbiota in the pathogenesis of recurrent clostridium colitis is well known. A fecal transfer from a healthy donor can restore natural homeostasis in intestinal microbiota and thus disrupt a "vicious circle“ of chronic relapsing clostridium infection. In the future, it should be possible to perform peroral fecal microbiota transplantations using enterosolvent tablets or commercially produced fecal derivatives. This administration route minimises the risk of adverse complications, which are rarely observed when fecal suspensions are administered via a nasoenteral probe, endoscopy, or by rectal clysma. In the past few years, intestinal microbiota transplantation has been used for the treatment of other diseases, the pathogenesis of which is probably associated with intestinal dysbiosis. In this respect, the most discussed issues are idiopathic intestinal inflammations, irritable bowel syndrome, liver encephalopathy and recently, "civilisation diseases“ such as diabetes mellitus type 2, multiple sclerosis, Parkinson‘s disease, and metabolic syndrome. The fecal bacteriotherapy effect is observed also during the eradication of multi-resistant bacterial strains that colonise patients‘ intestines. At present, fecal bacteriotherapy for recurrent clostridium colitis, as a proved medical method, is an accepted and world-wide recommended therapy. As for other diseases, this method is still in the experimental stage. Conclusive results of randomised control trials are expected.
The human gut microbiota consists of bacteria, archaea, fungi, and viruses. It is a dynamic ecosystem shaped by several factors that play an essential role in both healthy and diseased states of humans. A disturbance of the gut microbiota, also termed "dysbiosis", is associated with increased host susceptibility to a range of diseases. Because of splanchnic ischemia, exposure to antibiotics, and/or the underlying disease, critically ill patients loose 90% of the commensal organisms in their gut within hours after the insult. This is followed by a rapid overgrowth of potentially pathogenic and pro-inflammatory bacteria that alter metabolic, immune, and even neurocognitive functions and that turn the gut into the driver of systemic inflammation and multiorgan failure. Indeed, restoring healthy microbiota by means of fecal microbiota transplantation (FMT) in the critically ill is an attractive and plausible concept in intensive care. Nonetheless, available data from controlled studies are limited to probiotics and FMT for severe C. difficile infection or severe inflammatory bowel disease. Case series and observational trials have generated hypotheses that FMT might be feasible and safe in immunocompromised patients, refractory sepsis, or severe antibiotic-associated diarrhea in ICU. There is a burning need to test these hypotheses in randomized controlled trials powered for the determination of patient-centered outcomes.
- MeSH
- Dysbiosis epidemiology microbiology therapy MeSH
- Feces microbiology MeSH
- Fecal Microbiota Transplantation methods MeSH
- Inflammatory Bowel Diseases epidemiology microbiology therapy MeSH
- Critical Illness epidemiology MeSH
- Humans MeSH
- Diarrhea epidemiology microbiology therapy MeSH
- Gastrointestinal Microbiome genetics MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Flavonoids, including anthocyanins, are polyphenolic compounds present in fruits, vegetables and dietary supplements. They can be absorbed from the intestine to the bloodstream or pass into the large intestine. Various bacterial species and enzymes are present along the entire intestine. The aim of the present work was to investigate the intestinal metabolism of selected dietary polyphenol and polyphenol glycosides (quercetin, cyanidin-3-O-glucoside, cyanidin-3-O-galactoside, and delphinidin-3-O-galactoside) by human fecal bacteria. Moreover, the metabolism of metabolites formed from these compounds in human colon carcinoma cells (Caco-2) was also point of the interest. Test compounds were added to fresh human stool in broth or to Caco-2 cells in medium and then incubated for 6 or 20 h at 37°C. After incubation, samples were prepared for LC/MS determination. Main metabolic pathways were deglycosylation, hydrogenation, methylation, hydroxylation, and decomposition. 2,4,5-trihydroxybenzaldehyde, as a metabolite of cyanidin glycosides, was detected after incubation for the first time. Metabolites formed by fecal bacteria were further glucuronidated or methylated by intestinal enzymes. This metabolite profiling of natural compounds has helped to better understand the complex metabolism in the human intestine and this work also has shown the connection of metabolism of natural substances by intestinal bacteria followed by metabolism in intestinal cells.
- MeSH
- Bacteria metabolism MeSH
- Caco-2 Cells MeSH
- Feces microbiology MeSH
- Flavonoids metabolism MeSH
- Glycosides metabolism MeSH
- Humans MeSH
- Metabolic Networks and Pathways MeSH
- Metabolome * MeSH
- Colonic Neoplasms metabolism MeSH
- Polyphenols metabolism MeSH
- Intestinal Mucosa metabolism MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
