Advanced Gut & Microbiome Research

More focus is being paid to the relationship between gastrointestinal microbiota and human health. The microbiota-gut-brain axis was created as a result of the intricate networks and connections between the gastrointestinal bacteria and the host, highlighting the significant impact that this environment may have on brain health and central nervous system problems. To communicate with the central nervous system, the gastrointestinal, autonomic, immune, neuroendocrine, and neuroendocrine systems engage in a bidirectional interaction with the microbiota. Through a number of neurological processes, including stimulation of the altered neurotransmitter function, hypothalamic-pituitary-adrenal axis, and immune system activity, changes in this network may have an impact on both health and sickness. Anxiety and sadness are two neuropsychiatric conditions that may be impacted by the microbiota-gut-brain axis, according to a recent study. Numerous host disorders, including obesity, diabetes, and inflammation, have already been related to alterations in the gut microbiota’s makeup. In this article, the effects of the gut microbiota on the functioning of the central nervous system are examined, with a focus on the symptoms of anxiety and depression. After examining how stress affects the autonomic, neuroendocrine, immunological, and neurotransmitter systems, modern gastrointestinal-based therapies stress the importance of the microbiome in the prevention and treatment of brain-based diseases including anxiety and depression.

Drug-related liver injury (DILI) is increasing in the incidence of liver injury due to nonviral liver disease and has become a health problem that should not be underestimated. As a hot research topic in recent years, gut microbiota have been studied in various tumors, cardiovascular metabolic diseases, and human immunity. However, there is still a lack of research related to gut microbiota and DILI. It is known that they can influence each other through the regulation of the “gut-liver axis,” and the relationship between them and the possible mechanisms of action are still at the research stage. Human leukocyte antigen (HLA) gene polymorphisms are closely related to the development of DILI, and the gene can also affect changes in the composition of gut microbes. In this paper, we review the possible relationships and mechanisms between DILI and gut microbiota in order to provide new research directions for the prevention and treatment of DILI in the future. In the future, untargeted therapies using antibiotics, probiotics, or FMT will be replaced by personalised and precision medicine approaches, such as bioengineered bacterial strains or drugs that modulate specific bacterial enzymes and metabolic pathways.

Gastrointestinal disease is characterized by gastrointestinal dysfunction with dysbiosis of the microbiome. Probiotics may act as biological agents in treating gastrointestinal diseases through modifying gut microbiota. However, several challenges, including safety, stress resistance, postcolonization quantification, and evaluation models, may hinder the application of probiotics in gastrointestinal diseases. This review introduces the emerging methods for delivering probiotics as well as available materials. Furthermore, we elucidated bacteriocins and their role in helping probiotics obtain a competitive advantage over other strains and challenges of large-scale application. Bacteriocins produced by probiotics also showed promising efficacy in gastrointestinal diseases including the capacity of immune stimulation, intestinal barrier protection, and cytotoxicity against intestinal tumorigenesis. For the quantification of probiotics in complex microbiomes and evaluation methods of probiotic encapsulated delivery systems, recent fluorescent labeling technology and various in vitro and in vivo models were also reviewed. Given the widespread use of probiotic agents in the microecological therapy of gastrointestinal diseases, further understanding of the multiple challenges of probiotic application and the updated methods to improve the colonization and evaluation system of probiotics is of great significance for probiotics as live biotherapeutics.

Emerging evidence highlights the role in the gut microbiota (GM), integral parts of the gut-brain axis, and plays in developing various complications in patients with acute ischemic stroke (AIS). The link between the GM and disease can be actively utilized in the diagnosis of poststroke complications. AIS-GM cohort is a prospective study focusing on the link between gut microbial signature and adverse outcomes in patients with AIS. From September 2020 to July 2021, a total of 507 AIS patients were enrolled, their clinical baseline data and faeces samples during hospitalization were collected, and poststroke outcomes were evaluated by a variety of questionnaires. At present, 395 faeces samples of AIS patients completed were collected, analyzed the composition of microbiota, and tracked the prognosis and neuropsychiatric complications of AIS patients. After the patient was discharged, the out-of-hospital follow up was conducted on the 90^th days, then repeated once a year, which included the collections of fecal and blood samples and measurements of poststroke outcomes. AIS-GM cohort could provide an opportunity to observe the dynamic changes of GM after stroke. AIS-GM cohort contributes to deep understanding of risk factors for AIS and the relationship between GM and AIS outcomes. AIS-GM cohort can be used as a new tool to assess the prognosis of stroke and further predict the development of disease.

Objectives. There are no detailed reports on the long-term outcome of patients treated with tenofovir disoproxil fumarate (TDF) compared with entecavir (ENT) following liver transplantation. We aimed to assess the association between TDF use and long-term outcome compared to recipients using ENT. Methods. This retrospective observational study included patients who underwent liver transplantation between January 2015 and May 2019 at the First Affiliated Hospital of Zhejiang University School of Medicine and Hangzhou Shulan Hospital. Cox regression, propensity score matching (PSM), and inverse probability of treatment weighting (IPTW) were performed to assess HBV recurrence, renal dysfunction, and patient survival in liver transplant patients treated with TDF compared with ENT. Results. A total of 907 patients met the inclusion criteria and were included in the final analysis, among which, there were 109 (12.0%) patients treated with TDF and 798 (88.0%) patients treated with ENT. During the follow-up period, 166 patients died, 15 (13.8%) in the TDF group, and 151 (18.9%) in the ENT group. No significant association was found between TDF or ENT use and patient survival (HR, 0.72, 95% CI 0.41-1.23; ) by PSM analysis. Similarly, differences in the antiviral agents were not significantly associated with hepatitis B recurrence (HR, 1.19, 95% CI 0.62-2.28; ), but TDF use was significantly related to renal dysfunction after liver transplantation (HR 1.70, 95% CI, 1.21-2.37; ). Similar results were obtained in subsequent sensitivity analyses. Conclusions. In this study, the results showed that the use of TDF after liver transplantation is as safe and effective as the use of ENT in preventing hepatitis B recurrence. However, renal function in recipients treated with TDF requires careful monitoring.

Background and Aims. This study was conducted to investigate intestinal parasitic infections among diabetes patients compared to nondiabetic (control) individuals and examine the intensity of parasitosis in both groups. Even though diabetes poses a risk for parasitic infections, similarly, few recent studies suggest that parasitic infections, especially toxoplasmosis, and cysticercosis affecting pancreatic cells, can cause a decrease in insulin secretion, thus leading to diabetes. A retrospective study was carried out to find intestinal parasite infections among diabetics and nondiabetics in tertiary care hospitals. The records were collected from Microbiology Laboratory for five years. Out of 625 patients included in the study, two hundred twenty-seven (36.7%) were diabetic. Of these, most of the intestinal infections were caused by Hookworm (26.58%), followed by Blastocystis hominis (23.2%), and Entamoeba histolytica (12.23%). The risk factors involved in increased intestinal parasitosis were HIV and anemia. The most common parasite isolated among HIV patients was Isospora belli (30.23%). In anemic patients, Hookworm (4.04%) was the most frequently isolated parasite. This study also highlights the risk factors for acquiring intestinal parasites in diabetic patients, especially among patients with other comorbidities such as HIV.