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1.
AAPS J ; 22(1): 3, 2019 11 11.
Artículo en Inglés | MEDLINE | ID: mdl-31712917

RESUMEN

Multiple approaches such as mathematical deconvolution and mechanistic oral absorption models have been used to predict in vivo drug dissolution in the gastrointestinal (GI) tract. However, these approaches are often validated by plasma pharmacokinetic profiles, but not by in vivo drug dissolution due to the limited data available regarding the local GI environment. It is also challenging to predict and validate in vivo dissolution in different regions of the GI tract (stomach, duodenum, jejunum, and ileum). In this study, the dynamic fluid compartment absorption and transport (DFCAT) model was used to predict the in vivo dissolution profiles of ibuprofen, which was administered as an 800-mg immediate-release tablet to healthy subjects, in different regions of the GI tract. The prediction was validated with concentration time-courses of ibuprofen (BCS class 2a) in different regions of the GI tract that we have obtained over the past few years. The computational model predicted that the dissolution of ibuprofen was minimal in the stomach (2%), slightly more in the duodenum (6.3%), and primarily dissolved in the jejunum (63%) and the ileum (25%). The detailed model prediction of drug dissolution in different regions of GI can provide a quantitative reference of in vivo dissolution that may provide valuable insight in developing in vitro tests for drug product optimization and quality.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacocinética , Liberación de Fármacos , Ibuprofeno/farmacocinética , Absorción Intestinal , Modelos Teóricos , Administración Oral , Antiinflamatorios no Esteroideos/administración & dosificación , Tracto Gastrointestinal , Humanos , Ibuprofeno/administración & dosificación , Prueba de Estudio Conceptual
2.
mSphere ; 4(2)2019 03 13.
Artículo en Inglés | MEDLINE | ID: mdl-30867328

RESUMEN

Although the microbiota in the proximal gastrointestinal (GI) tract have been implicated in health and disease, much about these microbes remains understudied compared to those in the distal GI tract. This study characterized the microbiota across multiple proximal GI sites over time in healthy individuals. As part of a study of the pharmacokinetics of oral mesalamine administration, healthy, fasted volunteers (n = 8; 10 observation periods total) were orally intubated with a four-lumen catheter with multiple aspiration ports. Samples were taken from stomach, duodenal, and multiple jejunal sites, sampling hourly (≤7 h) to measure mesalamine (administered at t = 0), pH, and 16S rRNA gene-based composition. We observed a predominance of Firmicutes across proximal GI sites, with significant variation compared to stool. The microbiota was more similar within individuals over time than between subjects, with the fecal microbiota being unique from that of the small intestine. The stomach and duodenal microbiota displayed highest intraindividual variability compared to jejunal sites, which were more stable across time. We observed significant correlations in the duodenal microbial composition with changes in pH; linear mixed models identified positive correlations with multiple Streptococcus operational taxonomic units (OTUs) and negative correlations with multiple Prevotella and Pasteurellaceae OTUs. Few OTUs correlated with mesalamine concentration. The stomach and duodenal microbiota exhibited greater compositional dynamics than the jejunum. Short-term fluctuations in the duodenal microbiota were correlated with pH. Given the unique characteristics and dynamics of the proximal GI tract microbiota, it is important to consider these local environments in health and disease states.IMPORTANCE The gut microbiota are linked to a variety of gastrointestinal diseases, including inflammatory bowel disease. Despite this importance, microbiota dynamics in the upper gastrointestinal tract are understudied. Our article seeks to understand what factors impact microbiota dynamics in the healthy human upper gut. We found that the upper gastrointestinal tract contains consistently prevalent bacterial OTUs that dominate the overall community. Microbiota variability is highest in the stomach and duodenum and correlates with pH.


Asunto(s)
Bacterias/clasificación , Ayuno , Microbioma Gastrointestinal , Intestino Delgado/microbiología , Estómago/microbiología , Administración Oral , Adolescente , Adulto , Bacterias/aislamiento & purificación , Heces/microbiología , Femenino , Firmicutes/clasificación , Firmicutes/aislamiento & purificación , Voluntarios Sanos , Humanos , Concentración de Iones de Hidrógeno , Intubación Gastrointestinal , Modelos Lineales , Masculino , Persona de Mediana Edad , Pasteurellaceae/clasificación , Pasteurellaceae/aislamiento & purificación , ARN Ribosómico 16S/genética , Análisis Espacio-Temporal , Adulto Joven
3.
Mol Pharm ; 15(12): 5468-5478, 2018 12 03.
Artículo en Inglés | MEDLINE | ID: mdl-30417648

RESUMEN

Exploring the intraluminal behavior of an oral drug product in the human gastrointestinal (GI) tract remains challenging. Many in vivo techniques are available to investigate the impact of GI physiology on oral drug behavior in fasting state conditions. However, little is known about the intraluminal behavior of a drug in postprandial conditions. In a previous report, we described the mean solution and total concentrations of ibuprofen after oral administration of an immediate-release (IR) tablet in fed state conditions. In parallel, blood samples were taken to assess systemic concentrations. The purpose of this work was to statistically evaluate the impact of GI physiology (e.g., pH, contractile events) within and between individuals (intra and intersubject variability) for a total of 17 healthy subjects. In addition, a pharmacokinetic (PK) analysis was performed by noncompartmental analysis, and PK parameters were correlated with underlying physiological factors (pH, time to phase III contractions postdose) and study parameters (e.g., ingested amount of calories, coadministered water). Moreover, individual plasma profiles were deconvoluted to assess the fraction absorbed as a function of time, demonstrating the link between intraluminal and systemic behavior of the drug. The results demonstrated that the in vivo dissolution of ibuprofen depends on the present gastric pH and motility events at the time of administration. Both intraluminal factors were responsible for explaining 63% of plasma Cmax variability among all individuals. For the first time, an in-depth analysis was performed on a large data set derived from an aspiration/motility study, quantifying the impact of physiology on systemic behavior of an orally administered drug product in fed state conditions. The data obtained from this study will help us to develop an in vitro biorelevant dissolution approach and optimize in silico tools in order to predict the in vivo performance of orally administered drug products, especially in fed state conditions.


Asunto(s)
Liberación de Fármacos , Absorción Gástrica/fisiología , Ibuprofeno/farmacocinética , Periodo Posprandial/fisiología , Estómago/fisiología , Administración Oral , Adulto , Área Bajo la Curva , Disponibilidad Biológica , Variación Biológica Individual , Variación Biológica Poblacional/fisiología , Simulación por Computador , Conjuntos de Datos como Asunto , Femenino , Interacciones Alimento-Droga/fisiología , Vaciamiento Gástrico/fisiología , Voluntarios Sanos , Humanos , Concentración de Iones de Hidrógeno , Ibuprofeno/administración & dosificación , Masculino , Persona de Mediana Edad , Modelos Biológicos , Solubilidad , Comprimidos , Adulto Joven
4.
Mol Pharm ; 15(12): 5454-5467, 2018 12 03.
Artículo en Inglés | MEDLINE | ID: mdl-30372084

RESUMEN

The goal of this project was to explore and to statistically evaluate the responsible gastrointestinal (GI) factors that are significant factors in explaining the systemic exposure of ibuprofen, between and within human subjects. In a previous study, we determined the solution and total concentrations of ibuprofen as a function of time in aspirated GI fluids, after oral administration of an 800 mg IR tablet (reference standard) of ibuprofen to 20 healthy volunteers in fasted state conditions. In addition, we determined luminal pH and motility pressure recordings that were simultaneously monitored along the GI tract. Blood samples were taken to determine ibuprofen plasma levels. In this work, an in-depth statistical and pharmacokinetic analysis was performed to explain which underlying GI variables are determining the systemic concentrations of ibuprofen between (inter-) and within (intra-) subjects. In addition, the obtained plasma profiles were deconvoluted to link the fraction absorbed with the fraction dissolved. Multiple linear regressions were performed to explain and quantitatively express the impact of underlying GI physiology on systemic exposure of the drug (in terms of plasma Cmax/AUC and plasma Tmax). The exploratory analysis of the correlation between plasma Cmax/AUC and the time to the first phase III contractions postdose (TMMC-III) explains ∼40% of the variability in plasma Cmax for all fasted state subjects. We have experimentally shown that the in vivo intestinal dissolution of ibuprofen is dependent upon physiological variables like, in this case, pH and postdose phase III contractions. For the first time, this work presents a thorough statistical analysis explaining how the GI behavior of an ionized drug can explain the systemic exposure of the drug based on the individual profiles of participating subjects. This creates a scientifically based and rational framework that emphasizes the importance of including pH and motility in a predictive in vivo dissolution methodology to forecast the in vivo performance of a drug product. Moreover, as no extensive first-pass metabolism is considered for ibuprofen, this study demonstrates how intraluminal drug behavior is reflecting the systemic exposure of a drug.


Asunto(s)
Liberación de Fármacos , Ayuno/fisiología , Absorción Gastrointestinal/fisiología , Tracto Gastrointestinal/fisiología , Ibuprofeno/farmacocinética , Administración Oral , Adulto , Área Bajo la Curva , Disponibilidad Biológica , Variación Biológica Individual , Variación Biológica Poblacional/fisiología , Conjuntos de Datos como Asunto , Femenino , Voluntarios Sanos , Humanos , Concentración de Iones de Hidrógeno , Ibuprofeno/administración & dosificación , Masculino , Persona de Mediana Edad , Modelos Biológicos , Solubilidad , Comprimidos , Adulto Joven
5.
Cell Host Microbe ; 24(3): 364-378.e6, 2018 09 12.
Artículo en Inglés | MEDLINE | ID: mdl-30212649

RESUMEN

In addition to high-fat diet (HFD) and inactivity, inflammation and microbiota composition contribute to obesity. Inhibitory immune receptors, such as NLRP12, dampen inflammation and are important for resolving inflammation, but their role in obesity is unknown. We show that obesity in humans correlates with reduced expression of adipose tissue NLRP12. Similarly, Nlrp12-/- mice show increased weight gain, adipose deposition, blood glucose, NF-κB/MAPK activation, and M1-macrophage polarization. Additionally, NLRP12 is required to mitigate HFD-induced inflammasome activation. Co-housing with wild-type animals, antibiotic treatment, or germ-free condition was sufficient to restrain inflammation, obesity, and insulin tolerance in Nlrp12-/- mice, implicating the microbiota. HFD-fed Nlrp12-/- mice display dysbiosis marked by increased obesity-associated Erysipelotrichaceae, but reduced Lachnospiraceae family and the associated enzymes required for short-chain fatty acid (SCFA) synthesis. Lachnospiraceae or SCFA administration attenuates obesity, inflammation, and dysbiosis. These findings reveal that Nlrp12 reduces HFD-induced obesity by maintaining beneficial microbiota.


Asunto(s)
Microbioma Gastrointestinal , Péptidos y Proteínas de Señalización Intracelular/inmunología , Obesidad/inmunología , Obesidad/microbiología , Tejido Adiposo/inmunología , Adulto , Anciano , Animales , Bacterias/clasificación , Bacterias/genética , Bacterias/aislamiento & purificación , Bacterias/metabolismo , Femenino , Homeostasis , Humanos , Inmunidad Innata , Péptidos y Proteínas de Señalización Intracelular/genética , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Persona de Mediana Edad , Obesidad/genética , Obesidad/metabolismo
6.
Eur J Pharm Biopharm ; 129: 162-174, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29857136

RESUMEN

The goal of this study was to create a mass transport model (MTM) model for gastric emptying and upper gastrointestinal (GI) appearance that can capture the in vivo concentration-time profiles of the nonabsorbable drug phenol red in solution in the stomach and upper small intestine by direct luminal measurement while simultaneously recording the contractile activity (motility) via manometry. We advanced from a one-compartmental design of the stomach to a much more appropriate, multi-compartmental 'mixing tank' gastric model that reflects drug distribution along the different regions of the stomach as a consequence of randomly dosing relative to the different contractile phases of the migrating motor complex (MMC). To capture the intraluminal phenol red concentrations in the different segments of the GI tract both in fasted and fed state conditions, it was essential to include a bypass flow compartment ('magenstrasse') to facilitate the transport of the phenol red solution directly to the duodenum (fasted state) or antrum (fed state). The fasted and fed state models were validated with external reference data from an independent aspiration study using another nonabsorbable marker (paromomycin). These results will be essential for the development and optimization of computational programs for GI simulation and absorption prediction, providing a realistic gastric physiologically-based pharmacokinetic (PBPK) model based on direct measurement of gastric concentrations of the drug in the stomach.


Asunto(s)
Vaciamiento Gástrico/efectos de los fármacos , Absorción Intestinal , Intestino Delgado/efectos de los fármacos , Modelos Biológicos , Estómago/fisiología , Administración Oral , Adulto , Ayuno , Femenino , Voluntarios Sanos , Humanos , Intestino Delgado/fisiología , Masculino , Persona de Mediana Edad , Paromomicina/farmacología , Fenolsulfonftaleína/farmacología , Periodo Posprandial , Solubilidad , Estómago/efectos de los fármacos , Adulto Joven
8.
Mol Pharm ; 14(12): 4295-4304, 2017 12 04.
Artículo en Inglés | MEDLINE | ID: mdl-28937221

RESUMEN

In vivo drug dissolution in the gastrointestinal (GI) tract is largely unmeasured. The purpose of this clinical study was to evaluate the in vivo drug dissolution and systemic absorption of the BCS class IIa drug ibuprofen under fed and fasted conditions by direct sampling of stomach and small intestinal luminal content. Expanding current knowledge of drug dissolution in vivo will help to establish physiologically relevant in vitro models predictive of drug dissolution. A multilumen GI catheter was orally inserted into the GI tract of healthy human subjects. Subjects received a single oral dose of ibuprofen (800 mg tablet) with 250 mL of water under fasting and fed conditions. The GI catheter facilitated collection of GI fluid from the stomach, duodenum, and jejunum. Ibuprofen concentration in GI fluid supernatant and plasma was determined by LC-MS/MS. A total of 23 subjects completed the study, with 11 subjects returning for an additional study visit (a total of 34 completed study visits). The subjects were primarily white (61%) and male (65%) with an average age of 30 years. The subjects had a median [min, max] weight of 79 [52, 123] kg and body mass index of 25.7 [19.4, 37.7] kg/m2. Ibuprofen plasma levels were higher under fasted conditions and remained detectable for 28 h under both conditions. The AUC0-24 and Cmax were lower in fed subjects vs fasted subjects, and Tmax was delayed in fed subjects vs fasted subjects. Ibuprofen was detected immediately after ingestion in the stomach under fasting and fed conditions until 7 h after dosing. Higher levels of ibuprofen were detected in the small intestine soon after dosing in fasted subjects compared to fed. In contrast to plasma drug concentration, overall gastric concentrations remained higher under fed conditions due to increased gastric pH vs fasting condition. The gastric pH increased to near neutrality after feedingbefore decreasing to acidic levels after 7 h. Induction of the fed state reduced systemic levels but increased gastric levels of ibuprofen, which suggest that slow gastric emptying and transit dominate the effect for plasma drug concentration. The finding of high levels of ibuprofen in stomach and small intestine 7 h post dosing was unexpected. Future work is needed to better understand the role of various GI parameters, such as motility and gastric emptying, on systemic ibuprofen levels in order to improve in vitro predictive models.


Asunto(s)
Absorción Fisiológica/fisiología , Liberación de Fármacos/fisiología , Tracto Gastrointestinal/fisiología , Ibuprofeno/farmacocinética , Administración Oral , Adulto , Disponibilidad Biológica , Biofarmacia , Ayuno/fisiología , Femenino , Vaciamiento Gástrico/fisiología , Voluntarios Sanos , Humanos , Absorción Intestinal/fisiología , Masculino , Persona de Mediana Edad , Periodo Posprandial , Solubilidad , Comprimidos , Adulto Joven
9.
Mol Pharm ; 14(12): 4281-4294, 2017 12 04.
Artículo en Inglés | MEDLINE | ID: mdl-28737409

RESUMEN

In this study, we determined the pH and buffer capacity of human gastrointestinal (GI) fluids (aspirated from the stomach, duodenum, proximal jejunum, and mid/distal jejunum) as a function of time, from 37 healthy subjects after oral administration of an 800 mg immediate-release tablet of ibuprofen (reference listed drug; RLD) under typical prescribed bioequivalence (BE) study protocol conditions in both fasted and fed states (simulated by ingestion of a liquid meal). Simultaneously, motility was continuously monitored using water-perfused manometry. The time to appearance of phase III contractions (i.e., housekeeper wave) was monitored following administration of the ibuprofen tablet. Our results clearly demonstrated the dynamic change in pH as a function of time and, most significantly, the extremely low buffer capacity along the GI tract. The buffer capacity on average was 2.26 µmol/mL/ΔpH in fasted state (range: 0.26 and 6.32 µmol/mL/ΔpH) and 2.66 µmol/mL/ΔpH in fed state (range: 0.78 and 5.98 µmol/mL/ΔpH) throughout the entire upper GI tract (stomach, duodenum, and proximal and mid/distal jejunum). The implication of this very low buffer capacity of the human GI tract is profound for the oral delivery of both acidic and basic active pharmaceutical ingredients (APIs). An in vivo predictive dissolution method would require not only a bicarbonate buffer but also, more significantly, a low buffer capacity of dissolution media to reflect in vivo dissolution conditions.


Asunto(s)
Líquidos Corporales/química , Motilidad Gastrointestinal/fisiología , Tracto Gastrointestinal/fisiología , Ibuprofeno/farmacocinética , Absorción Intestinal/fisiología , Absorción Fisiológica , Administración Oral , Adulto , Líquidos Corporales/fisiología , Tampones (Química) , Liberación de Fármacos , Voluntarios Sanos , Humanos , Concentración de Iones de Hidrógeno , Mucosa Intestinal/fisiología , Manometría , Persona de Mediana Edad , Solubilidad , Comprimidos , Equivalencia Terapéutica , Factores de Tiempo , Adulto Joven
11.
Nat Immunol ; 18(5): 541-551, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28288099

RESUMEN

Inflammatory bowel diseases involve the dynamic interaction of host genetics, the microbiome and inflammatory responses. Here we found lower expression of NLRP12 (which encodes a negative regulator of innate immunity) in human ulcerative colitis, by comparing monozygotic twins and other patient cohorts. In parallel, Nlrp12 deficiency in mice caused increased basal colonic inflammation, which led to a less-diverse microbiome and loss of protective gut commensal strains (of the family Lachnospiraceae) and a greater abundance of colitogenic strains (of the family Erysipelotrichaceae). Dysbiosis and susceptibility to colitis associated with Nlrp12 deficency were reversed equally by treatment with antibodies targeting inflammatory cytokines and by the administration of beneficial commensal Lachnospiraceae isolates. Fecal transplants from mice reared in specific-pathogen-free conditions into germ-free Nlrp12-deficient mice showed that NLRP12 and the microbiome each contributed to immunological signaling that culminated in colon inflammation. These findings reveal a feed-forward loop in which NLRP12 promotes specific commensals that can reverse gut inflammation, while cytokine blockade during NLRP12 deficiency can reverse dysbiosis.


Asunto(s)
Clostridiales/fisiología , Colitis Ulcerosa/inmunología , Colon/fisiología , Firmicutes/fisiología , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Microbiota , ARN Ribosómico 16S/análisis , Animales , Biodiversidad , Colitis Ulcerosa/inducido químicamente , Colitis Ulcerosa/microbiología , Colon/microbiología , Sulfato de Dextran , Heces/microbiología , Interacción Gen-Ambiente , Humanos , Inmunidad Innata/genética , Péptidos y Proteínas de Señalización Intracelular/genética , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Microbiota/genética , Microbiota/inmunología , Simbiosis , Gemelos Monocigóticos
12.
Nat Microbiol ; 2: 16267, 2017 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-28112760

RESUMEN

Mesalamine serves as the gold standard in treating ulcerative colitis. However, its precise mechanism(s) of action remains unclear. Here, we show that mesalamine treatment rapidly decreases polyphosphate levels in diverse bacteria, including members of the human gut microbiome. This decrease sensitizes bacteria towards oxidative stress, reduces colonization and attenuates persister cell and biofilm formation, suggesting that mesalamine aids in diminishing the capacity of bacteria to persist within chronically inflamed environments.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacología , Microbioma Gastrointestinal/efectos de los fármacos , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Gramnegativas/fisiología , Mesalamina/farmacología , Polifosfatos/metabolismo , Animales , Antiinflamatorios no Esteroideos/administración & dosificación , Antiinflamatorios no Esteroideos/uso terapéutico , Biopelículas/efectos de los fármacos , Ciego/microbiología , Colitis Ulcerosa/tratamiento farmacológico , Colitis Ulcerosa/microbiología , Escherichia coli/efectos de los fármacos , Heces/microbiología , Bacterias Gramnegativas/genética , Humanos , Mesalamina/administración & dosificación , Mesalamina/uso terapéutico , Ratones , Estrés Oxidativo/efectos de los fármacos
13.
Mol Pharm ; 14(2): 345-358, 2017 02 06.
Artículo en Inglés | MEDLINE | ID: mdl-28009518

RESUMEN

As an orally administered, locally acting gastrointestinal drug, mesalamine products are designed to achieve high local drug concentration in the gastrointestinal (GI) tract for the treatment of ulcerative colitis. The aim of this study was to directly measure and compare drug dissolution of three mesalamine formulations in human GI tract and to correlate their GI concentration with drug concentration in plasma. Healthy human subjects were orally administered Pentasa, Apriso, or Lialda. GI fluids were aspirated from stomach, duodenum, proximal jejunum, mid jejunum, and distal jejunum regions. Mesalamine (5-ASA) and its primary metabolite acetyl-5-mesalamine (Ac-5-ASA) were measured using LC-MS/MS. GI tract pH was measured from each GI fluid sample, which averaged 1.82, 4.97, 5.67, 6.17, and 6.62 in the stomach, duodenum, proximal jejunum, middle jejunum, and distal jejunum, respectively. For Pentasa, high levels of 5-ASA in solution were observed in the stomach, duodenum, proximal jejunum, mid jejunum, and distal jejunum from 1 to 7 h. Apriso had minimal 5-ASA levels in stomach, low to medium levels of 5-ASA in duodenum and proximal jejunum from 4 to 7 h, and high levels of 5-ASA in distal jejunum from 3 to 7 h. In contrast, Lialda had minimal 5-ASA levels from stomach and early small intestine. A composite appearance rate (CAR) was calculated from the deconvolution of individual plasma concentration to reflect drug release, dissolution, transit, and absorption in the GI tract. Individuals dosed with Pentasa had high levels of CAR from 1 to 10 h; individuals dosed with Apriso had low levels of CAR from 1 to 4 h and high levels of CAR from 5 to 10 h; Lialda showed minimal levels of CAR from 0 to 5 h, then increased to medium levels from 5 to 12 h, and then decreased to further lower levels after 12 h. In the colon region, Pentasa and Apriso showed similar levels of accumulated 5-ASA excreted in the feces, while Lialda showed slightly higher 5-ASA accumulation in feces. However, all three formulations showed similar levels of metabolite Ac-5-ASA in the feces. These results provide direct measurement of drug dissolution in the GI tract, which can serve as a basis for investigation of bioequivalence for locally acting drug products.


Asunto(s)
Liberación de Fármacos/fisiología , Tracto Gastrointestinal/metabolismo , Mesalamina/metabolismo , Administración Oral , Adolescente , Adulto , Química Farmacéutica/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Solubilidad , Adulto Joven
14.
Infect Immun ; 83(3): 934-41, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25534943

RESUMEN

Clostridium difficile infection (CDI) following antibiotic therapy is a major public health threat. While antibiotic disruption of the indigenous microbiota underlies the majority of cases of CDI, the early dynamics of infection in the disturbed intestinal ecosystem are poorly characterized. This study defines the dynamics of infection with C. difficile strain VPI 10463 throughout the gastrointestinal (GI) tract using a murine model of infection. After inducing susceptibility to C. difficile colonization via antibiotic administration, we followed the dynamics of spore germination, colonization, sporulation, toxin activity, and disease progression throughout the GI tract. C. difficile spores were able to germinate within 6 h postchallenge, resulting in the establishment of vegetative bacteria in the distal GI tract. Spores and cytotoxin activity were detected by 24 h postchallenge, and histopathologic colitis developed by 30 h. Within 36 h, all infected mice succumbed to infection. We correlated the establishment of infection with changes in the microbiota and bile acid profile of the small and large intestines. Antibiotic administration resulted in significant changes to the microbiota in the small and large intestines, as well as a significant shift in the abundance of primary and secondary bile acids. Ex vivo analysis suggested the small intestine as the site of spore germination. This study provides an integrated understanding of the timing and location of the events surrounding C. difficile colonization and identifies potential targets for the development of new therapeutic strategies.


Asunto(s)
Clostridioides difficile/patogenicidad , Infecciones por Clostridium/patología , Colitis/patología , Tracto Gastrointestinal/patología , Animales , Antibacterianos/efectos adversos , Ácidos y Sales Biliares/química , Clostridioides difficile/crecimiento & desarrollo , Clostridioides difficile/metabolismo , Infecciones por Clostridium/etiología , Infecciones por Clostridium/microbiología , Infecciones por Clostridium/mortalidad , Colitis/etiología , Colitis/microbiología , Colitis/mortalidad , Progresión de la Enfermedad , Enterotoxinas/biosíntesis , Enterotoxinas/metabolismo , Heces/microbiología , Femenino , Tracto Gastrointestinal/efectos de los fármacos , Tracto Gastrointestinal/microbiología , Masculino , Ratones , Ratones Endogámicos C57BL , Microbiota/efectos de los fármacos , Esporas Bacterianas/crecimiento & desarrollo , Esporas Bacterianas/metabolismo , Esporas Bacterianas/patogenicidad , Análisis de Supervivencia , Factores de Tiempo
15.
Nat Commun ; 5: 3114, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24445449

RESUMEN

Antibiotics can have significant and long-lasting effects on the gastrointestinal tract microbiota, reducing colonization resistance against pathogens including Clostridium difficile. Here we show that antibiotic treatment induces substantial changes in the gut microbial community and in the metabolome of mice susceptible to C. difficile infection. Levels of secondary bile acids, glucose, free fatty acids and dipeptides decrease, whereas those of primary bile acids and sugar alcohols increase, reflecting the modified metabolic activity of the altered gut microbiome. In vitro and ex vivo analyses demonstrate that C. difficile can exploit specific metabolites that become more abundant in the mouse gut after antibiotics, including the primary bile acid taurocholate for germination, and carbon sources such as mannitol, fructose, sorbitol, raffinose and stachyose for growth. Our results indicate that antibiotic-mediated alteration of the gut microbiome converts the global metabolic profile to one that favours C. difficile germination and growth.


Asunto(s)
Antibacterianos/farmacología , Clostridioides difficile/fisiología , Infecciones por Clostridium/metabolismo , Infecciones por Clostridium/microbiología , Tracto Gastrointestinal/microbiología , Metaboloma/efectos de los fármacos , Microbiota/efectos de los fármacos , Animales , Clostridioides difficile/efectos de los fármacos , Clostridioides difficile/crecimiento & desarrollo , Susceptibilidad a Enfermedades/metabolismo , Susceptibilidad a Enfermedades/microbiología , Femenino , Masculino , Metabolómica , Ratones Endogámicos C57BL
16.
Curr Opin Gastroenterol ; 29(6): 628-32, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24100717

RESUMEN

PURPOSE OF REVIEW: The use of faecal microbiota transplantation (FMT) as treatment for recurrent Clostridium difficile infection (CDI) has increased rapidly over the past few years. In this review, we highlight clinical studies of FMT for treatment of recurrent CDI and discuss the safety, standardization and future of this treatment option. The major risk factor for CDI is prior antibiotic use, which results in an altered state of the gut microbiota characterized by decreased microbial diversity. This altered gut microbiota increases the patient's susceptibility to CDI. In patients with recurrent CDI, the microbiota remains in a state with decreased diversity, and FMT from a healthy individual restores the gut microbiota and subsequently colonization resistance against the pathogen. RECENT FINDINGS: Recent studies have shown the success rate for FMT as treatment for recurrent CDI being greater than 90%. Standardized, frozen preparations of faeces can be used, which increases the availability of faeces for FMT and decreases the cost of screening individual donors. In addition, there have been recent advances in identifying a defined microbial community isolated from faeces that can restore colonization resistance against C. difficile. SUMMARY: The use of FMT is a successful treatment for recurrent CDI when primary treatment options have failed. However, more work needs to define potential long-term consequences of this treatment and understand how specific members of the gut microbiota can restore colonization resistance against C. difficile.


Asunto(s)
Terapia Biológica/métodos , Enterocolitis Seudomembranosa/terapia , Heces/microbiología , Microbiota , Terapia Biológica/efectos adversos , Terapia Biológica/normas , Enterocolitis Seudomembranosa/microbiología , Humanos , Intestinos/microbiología , Ensayos Clínicos Controlados Aleatorios como Asunto , Recurrencia
17.
PLoS One ; 7(10): e48207, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23133571

RESUMEN

Phosphoribosylamine (PRA) is an intermediate in the biosynthetic pathway that is common to thiamine and purines. Glutamine phosphoribosyl pyrophosphate (PRPP) amidotransferase is the product of the purF gene in Salmonella enterica and catalyzes the synthesis of PRA from PRPP and glutamine. Strains lacking PurF require exogenous addition of purines for growth. However, under some growth conditions or with specific secondary mutations these strains grow in the absence of exogenous thiamine. Mutant alleles of hisA, which encodes 1-(5-phosphoribosyl)-5-[(5-phosphoribosylamino) methylideneamino] imidazole-4-carboxamide (ProFAR) isomerase, allowed PurF-independent PRA formation. The alleles of hisA that suppressed the requirement for exogenous thiamine resulted in proteins with reduced enzymatic activity. Data presented here showed that decreased activity of HisA altered metabolite pools and allowed PRA formation from ProFAR. Possible mechanisms of this conversion were proposed. The results herein emphasize the plasticity of the metabolic network and specifically highlight the potential for chemical syntheses to contribute to network robustness.


Asunto(s)
Amidofosforribosiltransferasa/genética , Histidina/metabolismo , Salmonella enterica/metabolismo , Alelos , Amidofosforribosiltransferasa/metabolismo , Cromatografía Líquida de Alta Presión/métodos , ADN/metabolismo , Histidina/química , Redes y Vías Metabólicas/fisiología , Modelos Químicos , Modelos Genéticos , Mutación , Operón , Purinas/metabolismo , Tiamina/metabolismo
18.
Infect Immun ; 80(11): 3786-94, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22890996

RESUMEN

The indigenous microbial community of the gastrointestinal (GI) tract determines susceptibility to Clostridium difficile colonization and disease. Previous studies have demonstrated that antibiotic-treated mice challenged with C. difficile either developed rapidly lethal C. difficile infection or were stably colonized with mild disease. The GI microbial community of animals with mild disease was dominated by members of the bacterial family Lachnospiraceae, while the gut community in moribund animals had a predominance of Escherichia coli. We investigated the roles of murine Lachnospiraceae and E. coli strains in colonization resistance against C. difficile in germfree mice. Murine Lachnospiraceae and E. coli isolates were cultured from wild-type mice. The ability of each of these isolates to interfere with C. difficile colonization was tested by precolonizing germfree mice with these bacteria 4 days prior to experimental C. difficile challenge. Mice precolonized with a murine Lachnospiraceae isolate, but not those colonized with E. coli, had significantly decreased C. difficile colonization, lower intestinal cytotoxin levels and exhibited less severe clinical signs and colonic histopathology. Infection of germfree mice or mice precolonized with E. coli with C. difficile strain VPI 10463 was uniformly fatal by 48 h, but only 20% mortality was seen at 2 days in mice precolonized with the Lachnospiraceae isolate prior to challenge with VPI 10463. These findings confirm that a single component of the GI microbiota, a murine Lachnospiraceae isolate, could partially restore colonization resistance against C. difficile. Further study of the members within the Lachnospiraceae family could lead to a better understanding of mechanisms of colonization resistance against C. difficile and novel therapeutic approaches for the treatment and prevention of C. difficile infection.


Asunto(s)
Clostridioides difficile/patogenicidad , Tracto Gastrointestinal/microbiología , Animales , Clostridioides difficile/genética , Recuento de Colonia Microbiana , Escherichia coli/genética , Escherichia coli/aislamiento & purificación , Vida Libre de Gérmenes , Bacilos Grampositivos Formadores de Endosporas/genética , Bacilos Grampositivos Formadores de Endosporas/aislamiento & purificación , Metagenoma , Ratones , Ratones Endogámicos C57BL , Filogenia , ARN Ribosómico 16S
19.
Trends Microbiol ; 18(6): 240-7, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20382023

RESUMEN

The emergence of systems biology has re-emphasized the advantages of understanding biological processes with a global perspective. One biological process amenable to global approaches is microbial metabolism. This review describes a model system that contributes to the goals of systems biology by experimentally defining metabolic integration found in a bacterial cell and thus providing data needed for implementation and interpretation of systems approaches. We have taken a largely unbiased in vivo approach centered on thiamine biosynthesis to identify new metabolic components and connections, and to explore uncharacterized paradigms of the integration between them. This article summarizes recent results from this approach that include the identification of the function of unknown genes, connections between cofactors biosynthesis and thiamine biosynthesis, and how metabolites from one biosynthetic pathway can be used in thiamine biosynthesis.


Asunto(s)
Bacterias/metabolismo , Salmonella enterica/metabolismo , Tiamina/biosíntesis , Bacterias/genética , Vías Biosintéticas , Genes Bacterianos , Genes Reguladores , Modelos Biológicos , Ribosa-Fosfato Pirofosfoquinasa/metabolismo , Salmonella enterica/genética , Biología de Sistemas/métodos , Tiamina/metabolismo
20.
Microbiology (Reading) ; 156(Pt 3): 950-959, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19959576

RESUMEN

Phosphoribosylamine (PRA) is the first intermediate in the common purine/thiamine biosynthetic pathway and is primarily synthesized by the product of the purF gene, glutamine phosphoribosylpyrophosphate (PRPP) amidotransferase (E.C. 2.4.2.14). Past genetic and biochemical studies have shown that multiple mechanisms for the synthesis of PRA independent of PurF are present in Salmonella enterica. Here, we describe mutant alleles of the essential prsA gene, which encodes PRPP synthetase (E.C. 2.7.6.1), that allow PurF-independent thiamine synthesis. The mutant alleles resulted in reduced PrsA activity in extracts, caused nutritional requirements indicative of PRPP limitation and allowed non-enzymic formation of PRA due to a build-up of ribose 5-phosphate (R5P). These results emphasize the balance that must be reached between pathways competing for the same substrate to maintain robustness of the metabolic network.


Asunto(s)
Proteínas Bacterianas/metabolismo , Lipoproteínas/metabolismo , Proteínas de la Membrana/metabolismo , Ribosamonofosfatos/metabolismo , Salmonella enterica/enzimología , Tiamina/biosíntesis , Transaminasas/metabolismo , Alelos , Proteínas Bacterianas/genética , Medios de Cultivo , Lipoproteínas/genética , Proteínas de la Membrana/genética , Redes y Vías Metabólicas , Mutación , Salmonella enterica/genética , Salmonella enterica/crecimiento & desarrollo
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