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Irritable bowel syndrome (IBS) is a common gut brain interaction disorder that is diagnosed via patient-reported symptoms and various diagnostic criteria. Multiple factors, such as visceral hypersensitivity, gut dysbiosis, dysmotility, gut-brain dysregulation, lifestyle, and dietary habits, are involved in the development of IBS and manifestation of its symptoms of abdominal pain, bloating, and abnormal bowel movements. Lifestyle modifications and dietary changes, behavioral therapy, and pharmacological treatments, namely antispasmodics and antianxiety drugs, are commonly prescribed for IBS management. Pinaverium bromide is a selective calcium channel blocker that acts locally in the gastrointestinal tract and relieves spasms making it an effective agent for the treatment of IBS. This review provides a background on the diagnostic criteria and pathogenic mechanisms of IBS from an Indian clinician standpoint and provides an in-depth overview on clinical studies of pinaverium emphasizing its role in IBS treatment.
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Type 2 diabetes mellitus (T2DM) represents a significant global health burden, necessitating innovative therapeutic approaches. Recent research has increasingly recognized the role of gut microbiota modulation in T2DM management, offering promising avenues for intervention. This systematic review synthesizes current literature investigating the impact of modulating gut microbiota on T2DM management. A comprehensive search of databases yielded studies examining various strategies, including probiotics, prebiotics, dietary interventions, and facal microbiota transplantation. Analysis of these interventions revealed their potential to improve glycemic control, insulin sensitivity, and inflammation markers in individuals with T2DM. Mechanistic insights elucidate how gut microbiota modulation influences metabolic pathways, immune function, and gut barrier integrity, thereby contributing to T2DM pathophysiology. Furthermore, studies highlight the interplay between gut microbiota composition and host factors such as diet, lifestyle, and genetics, underscoring the complexity of this relationship. Modulating gut microbiota presents a promising therapeutic approach in T2DM management, with potential benefits in glycemic control and metabolic health. However, further research is warranted to optimize intervention strategies, elucidate mechanistic pathways, and explore long-term effects. The aim of this review was to underscores the importance of considering gut microbiota modulation as a complementary approach in the multifaceted management of T2DM.
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Abstract Introduction: This review article develops the basic principles for the use and action mechanisms of neuromodulators applied in clinical practice and their role in treating different disorders of gutbrain interaction (DGBI), particularly, esophageal disorders in part I. Materials and methods: The working group reviewed the most frequent pathologies and medications used according to the most recent literature and presented those with the best clinical evidence in each case. Results: Due to the diversity of disorders, types of studies, and therapeutic options, we decided to present the evidence with the best results for each case. We determined the doses used, their results, and the side effects of each one. Conclusions: The basic principles of the use and mechanisms of action of the main neuromodulators were reviewed, including their use in this section in the main esophageal gastrointestinal functional disorders. Given that the available evidence is not definitive, more controlled clinical trials are needed for each condition to confirm the effectiveness and safety of neuromodulators.
Resumen Introducción: En este artículo de revisión se desarrollan los principios básicos para el uso y los mecanismos de acción de los neuromoduladores utilizados en la práctica clínica y su papel en el tratamiento de los diferentes trastornos de la interacción cerebro-intestino (TICI), particularmente los esofágicos en la parte I. Materiales y métodos: El grupo de trabajo revisó las patologías más frecuentes y los medicamentos utilizados según la bibliografía más reciente, y presenta a los que tienen la mejor evidencia clínica en cada caso. Resultados: Debido a la diversidad de trastornos, tipos de estudios y opciones terapéuticas, se decide presentar las evidencias con los mejores resultados para cada caso, y en cada uno se determinan las dosis utilizadas, sus resultados y efectos colaterales. Conclusiones: Se revisan los principios básicos del uso y mecanismos de acción de los principales neuromoduladores, así como la utilización de los mismos en esta sección en los principales trastornos funcionales gastrointestinales esofágicos. Dado que la evidencia disponible no resulta definitiva, para cada condición se requieren más experimentos clínicos controlados que puedan confirmar la efectividad y seguridad de los neuromoduladores.
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The field of psychology has advanced over the years in treating psychiatric disorders such as major depressive disorder (MDD), Schizophrenia, and Alzheimer's disease (AD). Depression or clinical depression is a major mental health issue characterized by chronic sadness, hopelessness, and emptiness, which diminishes the patient's quality of life. According to WHO, an estimated 3.8% of the world's population experience depression, in which 15% of depressed patients eventually die by suicide. Recent studies in treating depressive patients have progressed with the usage of psychobiotics. Psychobiotics contain both probiotics and prebiotics, meaning psychobiotics possess the ability to introduce beneficial bacteria in the gut as well as support the growth of existing bacteria in the human gut. The gut-brain axis, which mediates the mechanism of action of psychobiotics in treating clinical depression, has been cleverly studied, and it provides promising results in the improvement of a patient's mental health status. Psychobiotics have proven their worth not only in upgrading the patient's mental health in psychological disorders but also in the enhancement of overall patient health by improving one's gut health.
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Abstract In the human gut, there is a metabolically active microbiome whose metabolic products reach various organs and are used in the physiological activities of the body. When dysbiosis of intestinal microbial homeostasis occurs, pathogenic metabolites may increase and one of them is trimethyl amine-N-oxide (TMAO). TMAO is thought to have a role in the pathogenesis of insulin resistance, diabetes, hyperlipidemia, atherosclerotic heart diseases, and cerebrovascular events. TMAO level is also associated with renal inflammation, fibrosis, acute kidney injury, diabetic kidney disease, and chronic kidney disease. In this review, the effect of TMAO on various kidney diseases is discussed.
Resumo No intestino humano, existe um microbioma metabolicamente ativo cujos produtos metabólicos alcançam diversos órgãos e são utilizados nas atividades fisiológicas do corpo. Quando ocorre disbiose da homeostase microbiana intestinal, os metabólitos patogênicos podem aumentar, e um deles é o N-óxido de trimetilamina (TMAO). Acredita-se que o TMAO tenha um papel na patogênese da resistência à insulina, diabetes, hiperlipidemia, doenças cardíacas ateroscleróticas e eventos cerebrovasculares. O nível de TMAO também está associado à inflamação renal, fibrose, lesão renal aguda, doença renal diabética e doença renal crônica. Nesta revisão, discute-se o efeito do TMAO em diversas doenças renais.
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Resumen: La microbiota intestinal tiene un impacto bien documentado en diversos aspectos de la salud. En este estudio se recoge la evidencia disponible acerca de la repercusión de la dieta individual y de la microbiota en la percepción del dolor visceral.
Abstract: The gut microbiota has a well-documented impact on various aspects of health. In this study we review the available evidence on the impact of individual diet and microbiota on visceral pain perception.
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Chronic obstructive pulmonary disease （COPD） is a heterogeneous lung condition characterized by persistent and often progressive airflow obstruction， including airway abnormalities （e.g.， bronchitis and bronchiolitis） and chronic respiratory symptoms （e.g.， dyspnea， cough， and expectoration）. It is one of the leading causes of death worldwide. According to the theory of traditional Chinese medicine （TCM）， the lung and large intestine are interior-exterior related. Therefore， COPD can be treated from both the lung and intestine by the methods of tonifying and invigorating lung， spleen， and kidney， dispelling phlegm， and expelling stasis. Gut microbiota plays a key role in human immunity， nerve， and metabolism and may act on COPD by affecting the structures and functions of lung and intestine tissue and regulating lung inflammation and immunity. TCM can restore the balance of gut microbiota， which is conducive to the recovery from COPD. For example， the treatment method of tonifying lung and invigorating kidney can regulate gut microbiota， alleviate pulmonary and intestinal injuries， and improve lung immunity. The treatment methods of dispelling phlegm and expelling stasis can regulate gut microbiota and reduce pulmonary inflammation. According to the TCM theory of lung and large intestine being interior-exterior related， this review elaborates on the connotation of TCM in the treatment of COPD by regulating gut microbiota， aiming to provide new ideas for the clinical treatment of COPD via gut microbiota.
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Colorectal cancer is a common malignant tumor in the digestive system， ranking third in incidence and second in the cause of death worldwide. In recent years， the incidence of colorectal cancer is on the rise， and the age of patients with colorectal cancer tends to be younger， with a heavy cancer burden. It is of great significance to prevent the occurrence， development， recurrence， and metastasis of colorectal cancer to reduce the incidence and mortality of colorectal cancer. Patriniae Herba has the effects of clearing heat， removing toxins， eliminating carbuncle， and discharging pus and shows good therapeutic efficacy on inflammatory bowel disease， digestive tract tumors， pelvic inflammation， gynecological tumor， and so on. Patriniae Herba is often used in the clinical treatment of colorectal cancer， but its mechanism of action is not clear. Modern studies have found that Patriniae Herba contains triterpenoids， saponins， iridoids， flavonoids， and other chemical components， with antioxidant， anti-tumor， anti-bacterial， and other pharmacological effects. The main anti-tumor components of Patriniae Herba are flavonoids. The analysis of network pharmacology and the spectrum-effect relationship has suggested that quercetin， luteolin， apigenin， isoorientin， and isovitexin play a major role in inhibiting the occurrence and development of colorectal cancer. In vivo and in vitro studies have shown that flavonoids in Patriniae Herba can play an anti-tumor role in various ways， such as preventing precancerous lesions of colorectal cancer， inhibiting the growth and proliferation of cancer cells， blocking cancer cell cycle， promoting cancer cell apoptosis， and reversing drug resistance of colorectal cancer. The oral availability of flavonoids is low. The gut is the main metabolic site of flavonoids in the body， its metabolic pathway is closely related to gut microbiota. This paper reviewed the anti-tumor mechanism of flavonoids and their influence on gut microbiota to provide a reference for further research on the mechanism of Patriniae Herba against colorectal cancer and its clinical application.
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Berberine (BBR) is the main pharmacological active ingredient of Coptidis, which has hypoglycemic effect, but its clinical application is limited due to its poor oral bioavailability. Polyphenols, derived from cinnamon, are beneficial for type 2 diabetes mellitus (T2DM). The combination of both may have an additive effect. The aim of this study was to investigate the hypoglycemic effect and mechanism of combined medication in diabetic rats. The modeling rats were randomly divided into 5 groups (berberine group, cinnamon group, combined group, metformin group, diabetic control group) and normal control group. The animal experiments were approved by the Animal Ethics Committee (approval number: HMUIRB2022003). The subjects were given orally, and the control group was given equal volume solvent and body weight was measured weekly. Thirty days after administration, oral glucose tolerance test and insulin sensitivity test were performed, and fasting blood glucose (FBG), glycated serum protein (GSP), and serum insulin (INS) levels were detected; high-throughput sequencing technology was used to detect intestinal microbiota structure; real-time quantitative PCR (RT-qPCR) and Western blot were used to detect G protein-coupled receptor 5 (TGR5) and glucagon-like peptide-1 (GLP-1) expression levels. The results showed that, compared with the diabetic control group, the levels of FBG (P < 0.01) and GSP (P < 0.01) in the combined group were lower, and the insulin resistance was improved, which was better than that in the berberine group. Combined treatment increased the relative abundance of Bacteroides, Prevotella and Lactobacillus, reversed the decrease in Lactobacillus in the berberine alone induction group, and the combination of the two could promote the expression of TGR5 and GLP-1. In summary, the combined application of cinnamon and berberine can regulate glucose metabolism better than the application of berberine alone. Berberine combined with cinnamon can improve the function of pancreatic islet β cells in diabetes mellitus type 2 rats by changing the intestinal microbiota, increasing the expression of TGR5 and GLP-1 proteins, and thereby better regulating glucose metabolism.
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Particulate matter (PM) is the main air pollutant in China. Due to its wide distribution and difficulties in control, PM has been widely concerned. PM mainly enters human body through respiratory exposure and can cause a variety of health problems. Recent studies have shown that PM exposure is also associated with the occurrence and development of digestive system diseases, as it can enter human body indirectly through the respiratory tract or directly through the digestive tract. Gut microbiota (GM) is a group of microorganisms located in the intestinal epithelium mucosa and intestinal lumen. GM is large in number and rich in functions, and its homeostasis plays an important role in the intestinal health of individuals and even the health of the body. Because GM may mediate the health effects induced by environmental factors, more and more studies have focused on the effects of ambient PM on GM. In this review, we summarized the effects of a variety of ambient PM on GM homeostasis, focusing on five major phyla including Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria, and Verrucomicrobia, and discussed their main functions and the effects of PM on their homeostasis and abundance.
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@#Abstract: To explore the mechanism of the intestinal microecology regulation by polysaccharide prebiotics, ELISA, histopathologic analysis, immunohistochemical analysis, 16S rRNA high-throughput sequencing, and gas chromatography-mass spectrometry were applied to investigate the effects of fermented polysaccharides on changes in the intestinal microbiota and short-chain fatty acids (SCFAs) in mice with dextran sulfate sodium (DSS)-induced colitis model and their relationship with the level of intestinal inflammation and barrier protein expression. It was found that fermented Lycium barbarum polysaccharides (FLBP) significantly reduced intestinal inflammation level, improved colonic tissue structure, up-regulated the expression of tight junction proteins Claudin-1 and ZO-1, and significantly increased the content of intestinal SCFAs in mice. Gut bacteria analyses showed that FLBP enriched intestinal Dubosiella and Akkermansia in mice and decreased the abundance of Turicibacter, Faecalibaculum, and Escherichia-Shigella. Results showed that remodeled Dubosiella activated by FLBP played a dominant role in ameliorating colitis by significantly increasing SCFAs content, improving intestinal barrier and reducing intestinal inflammation. The study aimed to provide a safer and better option for the amelioration of colitis and to provide a theoretical basis for the development of functional foods with FLBP.
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@#Abstract: Ulcerative colitis (UC) is a chronic intestinal disease caused by a variety of factors. Severe intestinal inflammation can also cause liver injury. Based on the previous research, microbial dysbiosis in the inflammatory state leads to the conversion of excess choline into trimethylamine (TMA) by the intestinal flora, which competes with the host for the use of the nutrient choline, and induces liver injury. 3, 3-dimethyl-1-butanol (DMB), a structural analogue of choline, can reduce TMA levels from choline conversion. The aim of this study was to investigate the protective effect and possible mechanism of DMB on UC and secondary liver injury. Dextran sulfate sodium-induced acute colitis model in mice was established. The weight of mice, and collected serum, liver and intestinal contents after mice sacrifice were measured. The morphological changes of colon and liver were observed; liver function was detected with the kit of biochemical indexes; UHPLC-MS/MS was applied to detect changes in choline metabolism in vivo. The experimental results showed that DMB could attenuate body weight loss index, improve colonic inflammation, and reduce liver injury in UC mice. The detection of choline-related metabolites in serum, intestinal contents and liver showed that DMB could effectively inhibit the production of trimethylamine in the intestine, improve the availability of host choline, effectively alleviate colitis deterioration, and reduce liver damage caused by severe intestinal lesions.
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Objective To explore the causal association between gut microbes and non-alcoholic fatty liver disease(NAFLD)by Mendelian randomisation analysis.Methods Genetic instrumental variables for gut microbiota were identified from a gene-wide association study of 18 340 participants,and summary statistics for NAFLD were ob-tained from the FinnGen database,which provided data on 894 NAFLD cases and 217 898 controls using the IVW method as the primary analysis.In order to test the robustness of the results,MR-Egger method,WM method,Simple Mode method,Weighted Mode method were used for Mendelian randomisation analysis,and heterogeneity test,sensitivity analysis,and multiplicity analysis were performed.Results class Gammaproteobacteria IVW re-sults showed(OR=0.621,95％CI=0.412～0.934,P=0.022);family Enterobacteriaceae IVW results showed(OR=1.481,95％CI=1.069～2.053,P=0.018);genus Lachnospiraceae IVW results showed(OR=1.405,95％CI=1.036～1.904,P=0.029);genus Prevotella7 IVW results showed(OR=0.834,95％CI=0.714～0.974,P=0.021);genus Prevotella9 IVW results showed(OR=1.251,95％CI=1.025～1.527,P=0.027);order Desulfovibrionales IVW results showed(OR=0.714,95％CI=0.519～0.982,P=0.038);or-der Enterobacteriales IVW results showed(OR=1.481,95％CI=1.069～2.053,P=0.018).And there was no heterogeneity in the heterogeneity test,and the sensitivity analyses all showed robustness and no pleiotropy was found.Conclusion This study implicates class Gammaproteobacteria,family Enterobacteriaceae,genus Lachno-spiraceae,genus Prevotella7,genus Prevotella9,order Desulfovibrionales,order Enterobacteriales seven species of gut microorganisms have a causal relationship with NAFLD.
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The gastrointestinal motility disorder of the patients with Parkinson's disease(PD)occurs in the early stages of this disease,even before the onset of motor symptoms.The gastrointestinal motility disorder is one type of gastrointestinal dysfunction,not only affect the absorption of medication,exacerbating the progression of PD,but also severely impact the quality of life of the patients.Therefore,it is essential to find new therapeutic targets to alleviate PD-induced gastrointestinal dysmotility in order to improve the progression of the disease and the quality of life of the patients.The gastrointestinal motility function is highly dependent on the health of the gut and central nervous regulating the gastrointestinal movements.A healthy gut is closely related to the integrity of the intestinal barrier,gut microbiota,neuroinflammation,and the normal function of enteric neurons responsible for the contraction and relaxation of the gastrointestinal tract.The gut function of the PD patients is compromised to some extent.This review summarizes the effects of the enteric nervous system,central nervous system,and gut microbiota on the development of gastrointestinal motility disorder of the PD patients;it also outlines the current therapeutic methods available and their limitations,with the aim of providing the new insights into the treatment of gastrointestinal motility disorder of the PD patients.
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Polycystic ovary syndrome(PCOS)is a heterogeneous disorder closely associated with reproductive endocrine dysfunction in the women.The etiology and pathogenesis of PCOS remain unclear.PCOS is the result of the combination of endocrine metabolic disorders,genetics,and environmental factors.Hyperandrogenemia(HA)and insulin resistance(IR)are the fundamental pathophysiological changes in the development of PCOS,and their interactions exacerbate the clinical manifestations of the PCOS patients.The family aggregation and twin study results confirm the genetic predisposition of PCOS;the genome-wide association study(GWAS)results confirm some risk loci and candidate genes of PCOS.The unhealthy lifestyle habits and environmental endocrine disruptors also play an important role in the progression of PCOS,and the gut microbita is involved in the pathogenesis of PCOS.This article provides a comprehensively retrospective analysis on the recent studies about PCOS,and reviews both internal factors and external factors related to the etiology and pathogenesis of PCOS.
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Psoriasis is a chronic,recurrent,systemic inflammatory skin disease that is immune-media-ted.The balance and communication between the intestinal microbiota and its metabolites and the host play an important role in maintaining the body's normal functions,such as immune homeostasis and vitamin synthe-sis.Recent studies have found that compared with the healthy individuals,the psoriasis patients have experi-enced significant changes in the abundance and diversity of intestinal microbiota,including an imbalance in in-testinal microbiota,reduced production of short-chain fatty acids(SCFAs),and abnormal Firmicutes/Bacte-roidetes(F/B)ratio.The gut microbiota also changed after systematic medication treatment,biologic agents treatment and small molecule chemotherapy,indicating that the gut microbiota could be a potential biomarker for assessing treatment efficacy.The relationship between psoriasis and gut microbiota is not fully under-stood,and further research is needed.
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In recent years，the prevalence of childhood obesity has increased rapidly，and obesity can seriously affect physical and mental health of children and adolescents，and is likely to extend into adulthood. The onset and development of childhood obesity is related to multiple factors such as genetic predisposition and environment. So far，more and more studies have found that the gut microbiota，as an important part of the internal environment，is closely related to childhood obesity. Perturbed gut microbiota and its derived metabolites such as short-chain fatty acids，bile acids，indole and their derivatives are widely involved in the onset and development of childhood obesity. At present，regulating the compositions and function of gut microbiota through probiotics and prebiotics，fecal microbiota transplantation，dietary intervention，and bariatric surgery is a new direction for the prevention and treatment of obesity. This paper reviews the research progress on the association between gut microbiota and childhood obesity，in order to provide novel insights for prevention and intervention of childhood obesity based on gut microbiota.
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Based on the introduction of gut-brain-skin axis, this article discussed the relationship between psychological behavior, intestinal flora, and atopic dermatitis. By combing the literature on the treatment of atopic dermatitis with TCM, it is found that TCM therapy can regulate the relative abundance of intestinal flora, participate in immune metabolism and restore skin barrier function by intervening in the gut-brain-skin axis, so as to achieve the purpose of treating atopic dermatitis.
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Stroke is the main cause of disability in adults.With the progress of stroke diagnosis and treatment technology,the mortality rate of stroke patients has decreased significantly,but its incidence keeps increasing,and there is an increasing number of stroke survivors develop chronic neurological disorders.At present,there is no clear drug to promote functional repair after stroke.Several studies have shown that gut microbiota can improve stroke prognosis by regulating neuroactive molecules and immune cell functions,enhancing neural network plasticity,and reducing neuroinflammation.Based on a review of previous studies,this paper describes the mechanism of action of gut microbiota on neural network plasticity and neuroinflammation after stroke and its impact on functional recovery after stroke and explores its clinical value and feasibility in improving neurological dysfunction after stroke.
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Objective·To analyze the diversity and composition of the maternal gut microbiota and vaginal microbiota in late pregnancy,neonatal meconium microbiota and vernix caseosa microbiota,and analyze the similarities,differences and correlations.Methods·This is a prospective study.Maternal stool samples and vaginal swabs in late-pregnancy,and neonatal meconium samples were collected from 11 mother-infant pairs at Xinhua Hospital,Shanghai Jiao Tong University School of Medicine from August to November 2018;the vernix caseosa from three sites(forehead,axilla,and inguinal crease)and meconium samples were collected from 14 healthy newborns at International Peace Maternity and Child Health Hospital,Shanghai Jiao Tong University School of Medicine in December 2018.All births were vaginal deliveries.The 16S rRNA gene V3?V4 region sequencing was used.The diversity,composition and similarities/differences of the maternal gut microbiota,the vaginal microbiota,and the neonatal meconium microbiota from the 11 mother-infant pairs,as well as the neonatal vernix caseosa microbiota and the meconium microbiota from the 14 newborns were analyzed.Results·The number of operational taxonomic units(OTUs),ACE index,Chao1 index,and Shannon index of maternal gut microbiota were all higher than those of vaginal microbiota;the ACE indices and the Chao1 indices of the vernix caseosa microbiota at three sites were all higher than those of meconium microbiota(P<0.01).The β diversity varied among the maternal gut microbiota,vaginal microbiota,and neonatal meconium microbiota(P<0.01).The β diversity of neonatal vernix caseosa microbiota from three sites(forehead,axilla,and inguinal crease)was similar,but different from meconium microbiota(P<0.01).At the phylum level,the dominant bacteria were Firmicutes(52.76%)and Bacteroidetes(41.67%)in the maternal gut microbiota,Firmicutes(74.36%)and Actinobacteria(21.25%)in the maternal vaginal microbiota,and Firmicutes(84.22%)and Proteobacteria(8.80%)in the neonatal vernix caseosa microbiota.The dominant bacterium in the neonatal meconium was Proteobacteria in the two batches of samples(81.11%and 88.72%,respectively).At the genus level,the dominant bacteria were Bacteroides(35.42%)and Faecalibacterium(10.12%)in the maternal gut microbiota,Lactobacillus(69.10%)and Bifidobacterium(11.30%)in the vaginal microbiota,and Lactobacillus(79.81%)and Pseudomonas(3.23%)in the vernix caseosa microbiota.The dominant bacterium in the neonatal meconium was Escherichia in the two batches of samples(55.21%and 31.18%,respectively).Conclusion·The α diversity of maternal gut microbiota is higher than that of vaginal microbiota and neonatal meconium microbiota,and it is higher in neonatal vernix caseosa than that in meconium microbiota.The Firmicutes is the predominant phylum in the maternal late-pregnancy gut microbiota,vaginal microbiota,and neonatal vernix microbiota.Lactobacillus is the predominant genus in both maternal vaginal and neonatal vernix caseosa microbiota.Proteobacteria in phylum and Escherichia in genus are predominant in meconium microbiota.The microbiota composition is similar in vernix caseosa at different body sites,but there are differences between the vernix caseosa microbiota and meconium microbiota.