Gastrointestinal Microbiome – What We Need to Know in Clinical Practice

Abstract

Human gut microbiota plays an important role in individual health. When the balance between host and gut microbiota is disrupted, changes in microbiota composition and function occur, which is referred as dysbiosis. Environmental factors as diet, proton pump inhibitors, and antibiotics can lead to a permanent dysbiotic disruption. Clarification of these imbalances was made possible by recent advances in genome sequencing methods that supported acknowledgment of the interplay between microbiome and intestinal and extraintestinal disorders. This review focuses on the microbiota impact in inflammatory bowel disease, gastric cancer, colorectal cancer, nonalcoholic fatty liver disease (NAFLD), irritable bowel syndrome (IBS), and Clostridium difficile infection (CDI). Furthermore, novel therapies are summarized. Fecal microbiota transplant (FMT) is a successful and established therapy in recurrent CDI, and its application in other dysbiosis-related diseases is attracting enormous interest. Pre-and probiotics target microbial rebalance and have positive effects mainly in NAFLD, ulcerative colitis, IBS, and CDI patients. Promising anticarcinogenic effects have also been demonstrated in animal models. The literature increasingly describes microbial changes in many dysbiotic disorders and shows what needs to be treated. However, probiotics and FMT application in clinical practice suffers from a shortage of randomized controlled trials with standardized therapy regimens to support their recommendation.

Proton Pump Inhibitors Increase the Risk of Autoimmune Diseases: A Nationwide Cohort Study

“…The administration of PPIs induced gut dysbiosis or disruption of the microbial balance. The alteration of the gut microbiota early in the course of PPI use was discovered in previous study (13). Alteration of the microbiome causes changes of the host immune system and then induces the development of AD.…”

“…Bacterial overgrowth in the small intestine is closely related to dysbiosis ( 12 ). Moreover, the dysbiotic disruption caused by administration of PPIs is permanent ( 13 ). The dysbiosis was found most often at 4 to 8 weeks after PPIs treatment in patients ( 14 ).…”

Insight into the Antifungals Used to Address Human Infection Due to Trichosporon Spp.: A Scoping Review

“…The in vitro results with this compound were comparable to AMB, the most efficient antimycotic agent [ 72 ]. Such antifungal action could be added to a nutritional effect, recomposing the endogenous intestinal microbiota, and thereby avoiding the dysbiosis, a relevant point today [ 84 ].…”

Selective Antimicrobial Therapies for Periodontitis: Win the “Battle and the War”

“…Antibiotics influence the community composition of the gut [ 18 ] and oral microbiomes [ 19 ]. Broad-spectrum antibiotics are contraindicated in patients with a history of Clostridium difficile -positive ulcerative colitis [ 20 ].…”

“…Probiotics are a well-accepted approach to treating dysbiotic conditions of the gut, such as Clostridium difficile infection. Fecal microbiota transplants from healthy patients can restore microbial homeostasis in the gut by replacing pathogens with commensal microbiota [ 20 ]. However, the application of probiotics for gingivitis and PD is presently in its infancy, with long-term studies yet to be carried out.…”