Purpose: To highlight the role of atopobiosis and dysbiosis in the pathomechanism of autoimmune uveitis, therefore supporting fecal microbiota transplant (FMT) and probiotics as potential targeted-treatment for uveitis. Methods: This review synthesized literatures upon the relation between gut microbiota, autoimmune uveitis, FMT, and probiotics, published from January 2001 to March 2021 and indexed in PubMed, Google Scholar, CrossRef. Results: The basis of the gut–eye axis revolves around occurrences of molecular mimicry, increase in pro-inflammatory cytokines, gut epithelial barrier disruption, and translocation of microbes to distant sites. In patients with autoimmune uveitis, an increase of gut Fusobacterium and Enterobacterium were found. With current knowledge of aforementioned mechanisms, studies modifying the gut microbiome and restoring the physiologic gut barrier has been the main focus for pathomechanism-based therapy. In mice models, FMT and probiotics targeting repopulation of gut microbiota has shown significant improvement in clinical manifestations of uveitis. Consequently, a better understanding in the homeostasis of gut microbiome along with their role in the gut–eye axis is needed to develop practical targeted treatment. Conclusion: Current preliminary studies are promising in establishing a causative gut–eye axis relationship and the possibility of conducting FMT and probiotics as targeted treatment to mitigate autoimmune uveitis, to shorten disease duration, and to prevent further complications.
: Polycystic ovary syndrome (PCOS) occurs in 1 of 10 women of reproductive age. This syndrome is highly associated with obesity. Therefore, many of the patients face weight loss challenges. Given that many patients find it rather difficult to change their lifestyle, medicamentous intervention poses an option. Orlistat is an inhibitor of carboxyl ester lipase which inhibits the hydrolysis of dietary triglycerides that decreases the absorption of fatty acids and monoglyceride. The purpose of this study is to determine whether administration of orlistat can improve diet and exercise-induced body weight reduction in PCOS patients with obesity. Literature searching was done in 3 databases: PubMed, Cochrane Library, and Embase which yielded 141 articles. Findings were narrowed down using duplicate removal, inclusion and exclusion criteria into two relevant articles of randomized controlled trials. One randomized clinical trial showed a greater percentage in weight loss in PCOS patients BMI>23 kg/m2 administered with orlistat and lifestyle modification in comparison to lifestyle modification alone (7.81% (6.51-9.11%) vs 4.7% (4.19-5.21%) ; p<0.001). Similar body weight reduction was also found by another randomized clinical trial in PCOS patients BMI>25 kg/m2 with orlistat treatment (from 81.5 kg (80.3-82.7) to 76.2 kg (74.92-77.48) vs from 80.91 kg (79.65-82.17) to 79.15 kg (77.8-80.5) ; p<0.01). It was concluded that a considerable reduction of weight in obese and overweight PCOS patients was found when given orlistat with exercise and dietary interventions compared to exercise and dietary interventions alone.
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