Microbiota composition effect on immunotherapy outcomes in colorectal cancer patients: A systematic review.

BACKGROUND: Immune checkpoint inhibitors (ICIs) have emerged as an effective treatment for colorectal cancer (CRC). Studies indicate that the composition of gut microbiota could potentially serve as a biomarker for predicting the clinical effectiveness of immune checkpoint inhibitors. METHODS: Following PRISMA guidelines, the review was conducted after registering the protocol with PROSPERO. A comprehensive literature search was carried out across five databases: PubMed, Scopus, Web of Science, Embase, and Cochrane Library. Assessment tools from the National Institutes of Health (NIH) were used to gauge the quality of the studies. RESULTS: A total of 5,132 papers were identified, and three studies and one conference abstract published between 2017-2022 met the inclusion criteria and were summarized in a descriptive synthesis table. These four studies were in accord with the following findings, four main phyla, Firmicutes, Bacteroidata, Actinobacteria, and Verrucomicrobiota were associated with CRC patients' clinical response toward ICIs treatment. Ruminococcaceae was predominantly related to CRC patients responding to therapy, while the Micrococcaceae family was more common among the non-responders. Bacterial taxa such as Faecalibacterium and Prevotellaceae were associated with better responses to ICIs and could be predictive biomarkers. The signature of fecal microbiota with Akkermansia muciniphila and Eubacterium rectale enrichment, and Rothia mucilaginosa depletion could independently predict better response to ICIs in patients with CRC. CONCLUSION: The findings have brought attention to the notable differences in terms of richness and composition of microbiota between patients who responded positively to the treatment and those who did not. Bacterial species and families, such as Faecalibacterium, Bifidobacterium, Lachnospiraceae, Akkermansia sp., Ruminococcaceae, and Prevotellaceae, have consistently surfaced as potential indicators of immunotherapeutic responses. Furthermore, this review also emphasizes the need for additional comprehensive, multi-center studies with larger sample sizes to validate reported microbiota and expand our understanding of the role of gut microbiota in CRC ICIs therapy. PROSPERO ID: CRD42021277691.

The associated risk of Blastocystis infection in cancer: A case control study.

Background: Blastocystis is an anaerobic intestinal protozoan. Nine Blastocystis subtypes (STs) were detected in humans. A subtype-dependent association between Blastocystis and different cancer types has been debated in many studies. Thus, this study aims to assess the possible association between Blastocystis infection and cancer, especially colorectal cancer (CRC). We also screened the presence of gut fungi and their association with Blastocystis. Methods: We used a case-control design; cancer patients and cancer-free (CF) participants. The cancer group was further sub-group into CRC group and cancers outside the gastrointestinal tract (COGT) group. Macroscopic and microscopic examinations were performed to identify intestinal parasites in participants' stool samples. Molecular and phylogenetic analyses were conducted to identify and subtype Blastocystis. Furthermore, gut fungi were investigated molecularly. Results: 104 stool samples were collected and matched between CF (n=52) and cancer patients (n=52); CRC (n=15) and COGT (n=37). As anticipated, Blastocystis prevalence was significantly higher among CRC patients (60%, P=0.002) and insignificant in COGT patients (32.4%, P=0.161) compared to CF group (17.3%). The most common subtypes were ST2 among cancer group and ST3 in the CF group. Conclusion: Cancer patients have a higher risk of Blastocystis infection compared to CF individuals (OR=2.98, P=0.022). Increased risk of Blastocystis infection was associated with CRC patients (OR=5.66, P=0.009). Nevertheless, further studies are required to understand the underlying mechanisms of Blastocystis and cancer association.

The role of microbiota in immunotherapy outcomes in colorectal cancer patients: A protocol for a systematic review.

In the human gut, there are many microbes, including bacteria, viruses and parasites. The imbalance in the numbers of each type of these microbes can translate into gastrointestinal disorders. Lately, different microbiota patterns have been associated with the levels of efficacy of immunotherapy in multiple cancer conditions. Studies have shown that patients with a more diverse gut microbiome respond better to immunotherapy than those with a homogeneous microbiome. This systematic review aims to identify and assess the available evidence on the efficacy of immunotherapy in treating colorectal cancer (CRC) patients and the effect of their microbiota on their treatment outcomes. The researchers will study the literature regarding CRC and immunotherapy outcomes to survey the different approaches employed to assess the treatment outcomes. A systematic search will be performed in five biomedical databases (PubMed, Scopus, Web of Science, Embase, and the Cochrane Library) in June-July, 2022. Also, open-access registers of clinical trials will be trawled. The search will be conducted without geographical or publication date restrictions; however, only papers published in the English language will be sought. Details regarding patients' diets, lifestyles, and characteristics will be assessed. We will define the primary outcome to compare CRC patients' immunotherapy responses with their gut microbiota composition. The systematic review methodology does not require ethics approval due to the nature of the study design. The systematic review results will be published in an open-access peer-reviewed journal. PROSPERO ID: CRD42021277691.

Epidemiology of asymptomatic and symptomatic Coronavirus Disease 2019 confirmed cases in the Emirate of Abu Dhabi, United Arab Emirates: Observational study.

ABSTRACT: This study was conducted to describe demographics, clinical features, and outcomes of 3827 confirmed cases of Coronavirus Disease 2019 between March 12 and April 22, 2020 in the Emirates of Abu Dhabi, United Arab Emirates (UAE).Data were extracted from the Infectious Diseases Notification Surveillance System of the Department of Health. The descriptive analysis was done using Statistical Package for Social Sciences v26 and reported according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.We analyzed 3827 cases; 82% were men, 18% women, 14% UAE citizens, and 86% were of other nationalities. Most cases (72%) had lower exposure to low-risk occupations of infectious disease as per the classification of the department of health while high exposure risk occupations, which included healthcare worker accounts only for 3%. While 43% of cases were asymptomatic, 57% displayed symptoms, which were mostly mild. Only 12% of patients had comorbidities, which were significantly higher in men (9%) than women (3%). Among those who have comorbid conditions; hypertension (27%) and diabetes (21%) were the most common comorbidities. Viral pneumonia (11%) was the most common sequela documented in records. Only 51 patients (4%) required admission to the intensive care units, and 4 patients died (0.1%).The significant number of asymptomatic patients was identified by active case finding and contact tracing from the early period of the epidemic. A small percentage of severe, critical cases, and death reported in the Emirate of Abu Dhabi which may have been due to public health measures implemented for early detection, contact tracing, and treatment.

COVID-19 knowledge, attitudes, and practices of United Arab Emirates medical and health sciences students: A cross sectional study.

The COVID-19 pandemic is the largest viral pandemic of the 21st century. We aimed to study COVID-19 knowledge, attitudes, and practices (KAP) among medical and health sciences students in the United Arab Emirates (UAE). We performed a cross-sectional study between 2 June and 19 August 2020. The survey was distributed online using Survey Monkey. It was conducted in English and comprised two parts: socio-demographic characteristics, and KAP towards COVID-19. 712 responses to the questionnaire were collected. 90% of respondents (n = 695) were undergraduate students, while 10% (n = 81) were postgraduates. The majority (87%, n = 647) stated that they obtained COVID-19 information from multiple reliable sources. They were highly knowledgeable about the COVID-19 pandemic, but 76% (n = 539) did not recognize its routes of transmission. Medical students were significantly more knowledgeable compared with allied health students (P<0.0001, Mann Whitney U test) but there was no difference in knowledge between undergraduate and postgraduate students (P = 0.14, Mann Whitney U test). Medical students thought that more could be done to mitigate the COVID-19 situation compared with the allied health students (66.2% compared with 51.6%, p = 0.002 Fisher's Exact test). 63% (n = 431) were worried about getting COVID-19 infection, while 92% (n = 633)) were worried that a family member could be infected with the virus. 97% (n = 655) took precautions when accepting home deliveries, 94% (n = 637) had been washing their hands more frequently, and 95% (n = 643) had been wearing face masks. In conclusion, medical and health sciences students in the UAE showed high levels of knowledge and good attitudes and practices towards the COVID-19 pandemic. Nevertheless, they were worried about themselves or their family members becoming infected. Medical students had more knowledge about COVID-19 pandemic which was reflected in their opinion that more can be done to mitigate its effects.

Occupational Health of Frontline Healthcare Workers in the United Arab Emirates during the COVID-19 Pandemic: A Snapshot of Summer 2020.

The study aim was to understand the availability of personal protective equipment (PPE) and the levels of anxiety, depression, and burnout of healthcare workers (HCWs) in the United Arab Emirates (UAE). This study was an online-based, cross-sectional survey during July and August 2020. Participants were eligible from the entire country, and 1290 agreed to participate. The majority of HCWs were females aged 30-39 years old, working as nurses, and 80% considered PPE to be available. Twelve percent of respondents tested positive for SARS-CoV-2. Half of HCWs considered themselves physically tired (52.2%), reported musculoskeletal pain or discomfort (54.2%), and perceived moderate-to-high levels of burnout on at least one of three burnout domains (52.8%). A quarter of HCWs reported anxiety (26.3%) or depression (28.1%). HCWs reporting not having musculoskeletal pain, having performed physical activity, and higher scores of available PPE reported lower scores of anxiety, depression, and burnout. UAE HCWs experienced more access to PPE and less anxiety, depression, and burnout compared with HCWs in other countries. Study findings can be used by healthcare organizations and policymakers to ensure adequate measures are implemented to maximize the health and wellbeing of HCWs during the current COVID-19 and future pandemics.

Prevalence of, and Factors Associated with Intestinal Parasites in Multinational Expatriate Workers in Al Ain City, United Arab Emirates: An Occupational Cross-Sectional Study.

To estimate the prevalence of, and identify factors associated with intestinal parasites (IPs) in expatriate workers in the United Arab Emirates (UAE). All expatriate workers (N = 115) in a conveniently selected workplace in the industrial district of Al Ain city were invited to participate in a cross-sectional study. Consenting workers completed an interviewer-led questionnaire and self-collected stool samples. Stool samples were microscopically and molecularly screened for the presence of IPs. Univariate and multivariate analyses were conducted. Overall, 102 (88.7%) workers participated in the survey and 84.3% provided stool samples. Over three-quarters (79.4%) of workers were living in labour accommodation, 76.0% were sharing a bedroom with ≥ 4 workers, 80.2% were sharing a toilet with > 5 other people. Fifteen species of IPs were identified. Microscopically, 17.4% of the screened stool samples were positive for at least one parasite. Entamoeba species was the most common (8.1%) followed by Cryptosporidium species (3.5%). Thirty-six (41.8%) of the tested stool samples were positive for at least one parasite by molecular testing. The most prevalent parasite was Cryptosporidium species (16.3%) followed by Enterobius vermicularis (14.0%) and Ascaris lumbricoides (5.8%). Overall, 47.8% of the tested expatriate workers were positive for at least one IP, microscopically or molecularly. Educational attainment was negatively associated with being positive for at least one IP. IPs were very common amongst expatriate workers in Al Ain city. Efficacious and cost-effective public health interventions are required to reduce the burden of, and prevent the onward transmission of IPs in the UAE.