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AIM: We aimed to characterize associations between diet and the gut microbiome and short chain fatty acid (SCFA) products in youth with islet autoimmunity or type 1 diabetes (IA/T1D) in comparison with controls. RESEARCH DESIGN AND METHODS: Eighty participants (25 diagnosed with T1D, 17 with confirmed IA, 38 sibling or unrelated controls) from the Australian T1D Gut Study cohort were studied (median [IQR] age 11.7 [8.9, 14.0] years, 43% female). A Food Frequency Questionnaire characterized daily macronutrient intake over the preceding 6 months. Plasma and fecal SCFA were measured by gas chromatography; gut microbiome composition and diversity by 16S rRNA gene sequencing. RESULTS: A 10 g increase in daily carbohydrate intake associated with higher plasma acetate in IA/T1D (adjusted estimate +5.2 (95% CI 1.1, 9.2) µmol/L p = 0.01) and controls (adjusted estimate +4.1 [95% CI 1.7, 8.5] µmol/L p = 0.04). A 5 g increase in total fat intake associated with lower plasma acetate in IA/T1D and controls. A 5% increase in noncore (junk) food intake associated with reduced richness (adjusted estimate -4.09 [95%CI -7.83, -0.35] p = .03) and evenness (-1.25 [95% CI -2.00, -0.49] p < 0.01) of the gut microbiome in IA/T1D. Fiber intake associated with community structure of the microbiome in IA/T1D. CONCLUSIONS: Modest increments in carbohydrate and fat intake associated with plasma acetate in all youth. Increased junk food intake associated with reduced diversity of the gut microbiome in IA/T1D alone. These associations with the gut microbiome in IA/T1D support future efforts to promote SCFA by using dietary interventions.
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Autoinmunidad/fisiología , Diabetes Mellitus Tipo 1/metabolismo , Dieta , Ácidos Grasos Volátiles/metabolismo , Microbioma Gastrointestinal , Islotes Pancreáticos/inmunología , Adolescente , Estudios de Casos y Controles , Niño , Estudios Transversales , Diabetes Mellitus Tipo 1/complicaciones , Femenino , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
AIMS/HYPOTHESIS: To investigate the longitudinal relationship between the gut microbiome, circulating short chain fatty acids (SCFAs) and intestinal permeability in children with islet autoimmunity or type 1 diabetes and controls. METHODS: We analyzed the gut bacterial microbiome, plasma SCFAs, small intestinal permeability and dietary intake in 47 children with islet autoimmunity or recent-onset type 1 diabetes and in 41 unrelated or sibling controls over a median (range) of 13 (2-34) months follow-up. RESULTS: Children with multiple islet autoantibodies (≥2 IA) or type 1 diabetes had gut microbiome dysbiosis. Anti-inflammatory Prevotella and Butyricimonas genera were less abundant and these changes were not explained by differences in diet. Small intestinal permeability measured by blood lactulose:rhamnose ratio was higher in type 1 diabetes. Children with ≥2 IA who progressed to type 1 diabetes (progressors), compared to those who did not progress, had higher intestinal permeability (mean [SE] difference +5.14 [2.0], 95% confidence interval [CI] 1.21, 9.07, P = .006), lower within-sample (alpha) microbial diversity (31.3 [11.2], 95% CI 9.3, 53.3, P = .005), and lower abundance of SCFA-producing bacteria. Alpha diversity (observed richness) correlated with plasma acetate levels in all groups combined (regression coefficient [SE] 0.57 [0.21], 95% CI 0.15, 0.99 P = .008). CONCLUSIONS/INTERPRETATION: Children with ≥2 IA who progress to diabetes, like those with recent-onset diabetes, have gut microbiome dysbiosis associated with increased intestinal permeability. Interventions that expand gut microbial diversity, in particular SCFA-producing bacteria, may have a role to decrease progression to diabetes in children at-risk.
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Diabetes Mellitus Tipo 1/microbiología , Disbiosis/inmunología , Ácidos Grasos Volátiles/sangre , Microbioma Gastrointestinal , Mucosa Intestinal/metabolismo , Adolescente , Autoinmunidad , Niño , Preescolar , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/inmunología , Femenino , Humanos , Islotes Pancreáticos/inmunología , Masculino , Permeabilidad , Estudios ProspectivosRESUMEN
The capacity of our gut microbial communities to maintain a stable and balanced state, termed 'resilience', in spite of perturbations is vital to our achieving and maintaining optimal health. A loss of microbial resilience is observed in a number of diseases including obesity, diabetes and metabolic syndrome. There are large gaps in our understanding of why an individual's co-evolved microflora consortium fail to develop resilience thereby establishing a trajectory towards poor metabolic health. This review examines the connections between the developing gut microbiota and intestinal barrier function in the neonate, infant and during the first years of life. We propose that the effects of early life events on the gut microflora and permeability, whilst it is in a dynamic and vulnerable state, are fundamental in shaping the microbial consortia's resilience and that it is the maintenance of resilience that is pivotal for metabolic health throughout life. We review the literature supporting this concept suggesting new potential research directions aimed at developing a greater understanding of the longitudinal effects of the gut microflora on metabolic health and potential interventions to recalibrate the 'at risk' infant gut microflora in the direction of enhanced metabolic health.
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Microbioma Gastrointestinal/fisiología , Tracto Gastrointestinal/microbiología , Mucosa Intestinal/microbiología , Consorcios Microbianos/fisiología , Permeabilidad , Factores de Edad , Antiinfecciosos/farmacología , Femenino , Humanos , Lactante , Recién Nacido , Mucosa Intestinal/inmunología , Embarazo , Uniones Estrechas/fisiologíaRESUMEN
Background: This paper describes the development of low-cost, effective, non-invasive machine learning-based prediction models for Down Syndrome in the first two trimesters of pregnancy in Vietnam. These models are adaptable to different situations with limited screening capacities at community-based healthcare facilities. Method: Ultrasound and biochemical testing alone and in combination, from both trimesters were employed to build prediction models based on k-Nearest Neighbor, Support Vector Machine, Random Forest, and Extreme Gradient Boosting algorithms. Results: A total of 7,076 pregnant women from a single site in Northern Vietnam were included, and 1,035 had a fetus with Down Syndrome. Combined ultrasound and biochemical testing were required to achieve the highest accuracy in trimester 2, while models based only on biochemical testing performed as well as models based on combined testing during trimester 1. In trimester 1, Extreme Gradient Boosting produced the best model with 94% accuracy and 88% AUC, while Support Vector Machine produced the best model in trimester 2 with 89% accuracy and 84% AUC. Conclusions: This study explored a range of machine learning models under different testing scenarios. Findings point to the potential feasibility of national screening, especially in settings without enough equipment and specialists, after additional model validation and fine tuning is performed.
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Enteric protozoan pathogenic infections significantly contribute to the global burden of gastrointestinal illnesses. Their occurrence is considerable within remote and indigenous communities and regions due to reduced access to clean water and adequate sanitation. The robustness of these pathogens leads to a requirement of harsh treatment methods, such as medicinal drugs or antibiotics. However, in addition to protozoal infection itself, these treatments impact the gut microbiome and create dysbiosis. This often leads to opportunistic pathogen invasion, anti-microbial resistance, or functional gastrointestinal disorders, such as irritable bowel syndrome. Moreover, these impacts do not remain confined to the gut and are reflected across the gut-brain, gut-liver, and gut-lung axes, among others. Therefore, apart from medicinal treatment, nutritional supplementation is also a key aspect of providing recovery from this dysbiosis. Future proteins, prebiotics, probiotics, synbiotics, and food formulations offer a good solution to remedy this dysbiosis. Furthermore, nutritional supplementation also helps to build resilience against opportunistic pathogens and potential future infections and disorders that may arise due to the dysbiosis. Systems biology techniques have shown to be highly effective tools to understand the biochemistry of these processes. Systems biology techniques characterize the fundamental host-pathogen interaction biochemical pathways at various infection and recovery stages. This same mechanism also allows the impact of the abovementioned treatment methods of gut microbiome remediation to be tracked. This manuscript discusses system biology approaches, analytical techniques, and interaction and association networks, to understand (1) infection mechanisms and current global status; (2) cross-organ impacts of dysbiosis, particularly within the gut-liver and gut-lung axes; and (3) nutritional interventions. This study highlights the impact of anti-microbial resistance and multi-drug resistance from the perspective of protozoal infections. It also highlights the role of nutritional interventions to add resilience against the chronic problems caused by these phenomena.
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Soybean is the most economically important legume globally, providing a major source of plant protein for millions of people; it offers a high-quality, cost-competitive and versatile base-protein ingredient for plant-based meat alternatives. The health benefits of soybean and its constituents have largely been attributed to the actions of phytoestrogens, which are present at high levels. Additionally, consumption of soy-based foods may also modulate gastrointestinal (GI) health, in particular colorectal cancer risk, via effects on the composition and metabolic activity of the GI microbiome. The aim of this narrative review was to critically evaluate the emerging evidence from clinical trials, observational studies and animal trials relating to the effects of consuming soybeans, soy-based products and the key constituents of soybeans (isoflavones, soy proteins and oligosaccharides) on measures of GI health. Our review suggests that there are consistent favourable changes in measures of GI health for some soy foods, such as fermented rather than unfermented soy milk, and for those individuals with a microbiome that can metabolise equol. However, as consumption of foods containing soy protein isolates and textured soy proteins increases, further clinical evidence is needed to understand whether these foods elicit similar or additional functional effects on GI health.
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Isoflavonas , Proteínas de Soja , Animales , Proteínas de Soja/farmacología , Isoflavonas/farmacología , Equol/metabolismo , Fitoestrógenos/farmacología , Glycine max/metabolismoRESUMEN
Gastrointestinal diseases characterized by inflammation, including the inflammatory bowel diseases, chemotherapy-induced mucositis and non-steroidal anti-inflammatory drug-induced enteropathy, currently have variably effective treatment options, highlighting the need for novel therapeutic approaches. Recently, naturally-sourced agents including prebiotics, probiotics, plant-extracts and marine-derived oils known to possess anti-inflammatory and anti-oxidant properties have been investigated in vitro and in vivo. However, animal-derived oils are yet to be extensively tested. Emu Oil is extracted from the subcutaneous and retroperitoneal fat of the Emu, a flightless bird native to Australia, and predominantly comprises fatty acids. Despite the limited rigorous scientific studies conducted to date, with largely anecdotal claims, Emu Oil, when administered topically and orally, has been shown to possess significant anti-inflammatory properties in vivo. These include a CD-1 mouse model of croton oil-induced auricular inflammation, experimentally-induced polyarthritis and dextran sulfate sodium-induced colitis. Recently, Emu Oil has been demonstrated to endow partial protection against chemotherapy-induced mucositis, with early indications of improved intestinal repair. Emu Oil could therefore form the basis of an adjunct to conventional treatment approaches for inflammatory disorders affecting the gastrointestinal system.
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Antiinflamatorios/uso terapéutico , Enfermedades Intestinales/tratamiento farmacológico , Aceites/uso terapéutico , Paleognatos , Animales , Antiinflamatorios/química , Ácidos Grasos , Humanos , Aceites/químicaRESUMEN
The dual-sugar intestinal permeability test is a commonly used test to assess changes in gut barrier function. However, it does not identify functional changes and the exact mechanism of damage caused by the increased intestinal permeability. This study aims to explore the application of untargeted metabolomics and lipidomics to identify markers of increased intestinal permeability. Fifty fasting male participants (18-50 years) attended a single visit to conduct the following procedures: assessment of anthropometric measures, assessment of gastrointestinal symptoms, intestinal permeability test, and assessment of blood samples 90 min post-administration of the intestinal permeability test. Rhamnose and lactulose were analysed using gas chromatography-mass spectrometry (GC-MS). Untargeted polar metabolites and lipidomics were assessed by liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QToF MS). There was an elevated lactulose/rhamnose ratio in 27 subjects, indicating increased permeability compared to the remaining 23 control subjects. There were no significant differences between groups in characteristics such as age, body mass index (BMI), weight, height, and waist conference. Fourteen metabolites from the targeted metabolomics data were identified as statistically significant in the plasma samples from intestinal permeability subjects. The untargeted metabolomics and lipidomics analyses yielded fifteen and fifty-one statistically significant features, respectively. Individuals with slightly elevated intestinal permeability had altered energy, nucleotide, and amino acid metabolism, in addition to increased glutamine levels. Whether these biomarkers may be used to predict the early onset of leaky gut warrants further investigation.
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Pediatric intussusception has been reported to be associated with coronavirus disease 2019 (COVID-19) infection in the literature since the start of the pandemic in the past two years. Although this occurrence is exceptionally rare, rapid diagnosis based on recognition of gastrointestinal manifestations, clinical examination, and ultrasound confirmation can expedite appropriate care and prevent delayed complications. Intussusception is the most common cause of intestinal obstruction and acute abdomen in pediatric patients. Without prompt identification, the disease process can lead to necrosis, bowel perforation, shock, and, subsequently, multiorgan failure. Intussusception has previously been associated with viral upper respiratory infections, which can cause mesenteric lymphadenopathy as a lead point to allow the bowel to telescope upon itself. The mechanism of how COVID-19 can contribute to intussusception without respiratory symptoms remains unknown. Here, we present a case of pediatric intussusception associated with COVID-19.
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INTRODUCTION: Several studies have reported women's worry that sexual intercourse may harm the course of pregnancy. This worry might lead to avoidance of sexual intercourse during pregnancy. AIM: To assess if fears about harming the pregnancy are associated with avoidance of sexual intercourse during pregnancy. METHODS: A cross-sectional study was conducted on 250 Vietnamese pregnant women in the first or second trimester who visited our hospital for antenatal care. We explored 5 types of fears including miscarriage/preterm labor, premature rupture of membranes, bleeding, infection, and injury to the fetus. Fears were measured by modified questions from the Reasons For Not Engaging in Sexual Activity During Pregnancy questionnaire. Using the total fear score, pregnant women were categorized into having low, moderate, and high fear. MAIN OUTCOME MEASURE: Not having sexual intercourse during the past 4 weeks. RESULTS: 72 (28.8%) pregnant women had no sexual intercourse for the past 4 weeks. All types of fear were considered important among pregnant women; the more important fears were infection and injury to the fetus. In multivariable regression analysis, the prevalence of not having sexual intercourse was higher in both women who had moderate (adjusted prevalence ratio = 2.84, 95% CI 1.42-5.67) and high fear (adjusted prevalence ratio = 4.39, 95% CI 2.28-8.44). CONCLUSION: Avoidance of sexual intercourse was common among Vietnamese pregnant women and was associated with the fears about harming the pregnancy. This can be a target in the health education programs for pregnancy couples. Thanh C. Phan, Long B. Hoang, Thanh K. Tran, et al. Fear-Related Reasons for Avoiding Sexual Intercourse in Early Pregnancy: A Cross-Sectional Study. Sex Med 2021;9:100430.
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Regular almond consumption has been shown to improve body weight management, lipid profile and blood glucose control. We hypothesized that almond consumption would alter fecal microbiota composition, including increased abundance and activity of potentially beneficial bacterial taxa in adults who are overweight and obese with elevated fasting blood glucose. A total of 69 adults who were overweight or obese with an elevated plasma glucose (age: 60.8 ± 7.4, BMI ≥27 kg/m2, fasting plasma glucose ≥5.6 to <7.0 mmol/L) were randomized to daily consumption of either 2 servings of almonds (AS:56 g/day) or an isocaloric, high carbohydrate biscuit snack for 8 weeks. AS but not biscuit snack experienced significant changes in microbiota composition (P= .011) and increases in bacterial richness, evenness, and diversity (P< .01). Increases in both the relative and absolute abundance of operational taxonomic units in the Ruminococcaceae family, including Ruminiclostridium (false discovery rate P = .002), Ruminococcaceae NK4A214 (P = .002) and Ruminococcaceae UCG-003 (P = .002) were the principal drivers of microbiota-level changes. No changes in fecal short chain fatty acid levels, or in the carriage of the gene encoding butyryl-CoA:acetate CoA-transferase (an enzyme involved in butyrate synthesis) occurred. Almond consumption was not associated with reduced gut permeability, but fecal pH (P= .0006) and moisture content (P = .027) decreased significantly in AS when compared to BS. Regular almond consumption increased the abundance of potentially beneficial ruminococci in the fecal microbiota in individuals with elevated blood glucose. However, fecal short-chain fatty acid levels remained unaltered and the capacity for such microbiological effects to precipitate host benefit is not known.
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Glucemia/análisis , Heces/química , Firmicutes/clasificación , Microbioma Gastrointestinal , Nueces , Obesidad , Sobrepeso , Prunus dulcis , Bacterias/clasificación , Bacterias/crecimiento & desarrollo , Ingestión de Alimentos , Ácidos Grasos Volátiles/análisis , Heces/microbiología , Femenino , Firmicutes/crecimiento & desarrollo , Humanos , Concentración de Iones de Hidrógeno , Masculino , Persona de Mediana Edad , Obesidad/sangre , Obesidad/microbiología , Sobrepeso/sangre , Sobrepeso/microbiologíaRESUMEN
OBJECTIVE: To investigate the combination therapy, consisting of hyperimmune bovine colostrum, N-acetyl cysteine, zinc and amoxicillin on the eradication of Helicobacter pylori in a mouse model. MATERIAL AND METHODS: C57BL/6 female mice (6 weeks of age) were inoculated with 0.1 ml of 1×10(9) H. pylori via a single oro-gastric gavage and were left infected for 4 weeks. Mice (n=9/group) were randomly allocated to receive by oral gavage (0.1 ml) HNZ (hyperimmune bovine colostrum+N-acetyl cysteine+zinc), HNZA (HNZ+amoxicillin; A), HNZA2 (2× amoxicillin; A2), HNZA5 (5× amoxicillin; A5), triple therapy (TT) or saline twice daily for 10 days. Bacterial load was assessed by culture. Gastric emptying was assessed by 13C-octanoic acid breath test. RESULTS: Mice receiving HNZ, HNZA, and HNZA2 have a 22%, 44% and 67% eradication rate, respectively. Eradication rate was 100% with HNZA5, TT and those animals receiving A5 alone. In H. pylori infected mice there was an increased gastric emptying time by 7.9, 3.7, 10.1 and 7.7 min for the TT, HNZ, HNZA2, and HNZA5, respectively, compared to saline. CONCLUSIONS: HNZ with the addition of a high dose of amoxicillin is effective at eradicating H. pylori in vivo as HNZA1 and HNZA2 did not give raise to eradication. The potency of the novel anti-H. pylori combination therapy may be due to the delayed gastric emptying.
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Antibacterianos/uso terapéutico , Calostro , Infecciones por Helicobacter/tratamiento farmacológico , Acetilcisteína/uso terapéutico , Amoxicilina/uso terapéutico , Animales , Bovinos , Modelos Animales de Enfermedad , Quimioterapia Combinada , Femenino , Ratones , Ratones Endogámicos C57BL , Resultado del Tratamiento , Zinc/uso terapéuticoRESUMEN
OBJECTIVE: The effectiveness of probiotic therapy for acute rotavirus infectious diarrhoea in an indigenous setting with bacterial/parasitic diarrhoea is unclear. In the present study, we assessed the efficacy of probiotics in Australian Aboriginal children in the Northern Territory admitted to hospital with diarrhoeal disease. PATIENTS AND METHODS: A randomised double-blind placebo-controlled study was conducted in Aboriginal children (ages 4 months-2 years), admitted to hospital with acute diarrhoeal disease (>3 loose stools per day). Children received either oral Lactobacillus GG (5 x 10(9) colony-forming units 3 times per day for 3 days; n = 33) or placebo (n = 31). Small intestinal functional capacity was assessed by the noninvasive 13C-sucrose breath test on days 1 and 4. RESULTS: Both groups showed mean improvement in the sucrose breath test after 4 days; however, there was no difference (mean, 95% confidence interval) between probiotic (2.9 [cumulative percentage of dose recovered at 90 minutes]; 1.7-4.2) and placebo (3.7; 2.3-5.2) groups. Probiotics did not change the duration of diarrhoea, total diarrhoea stools, or diarrhoea score compared with placebo. There was a significant (P < 0.05) difference in diarrhoea frequency on day 2 between probiotics (3.3 [loose stools]; 2.5-4.3) and placebo (4.7; 3.8-5.7) groups. CONCLUSIONS: Lactobacillus GG did not appear to enhance short-term recovery following acute diarrhoeal illness in this setting.
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Antidiarreicos/uso terapéutico , Diarrea/etnología , Intestino Delgado/efectos de los fármacos , Lactobacillus , Nativos de Hawái y Otras Islas del Pacífico , Probióticos/uso terapéutico , Enfermedad Aguda , Pruebas Respiratorias , Defecación/efectos de los fármacos , Diarrea/tratamiento farmacológico , Diarrea/virología , Método Doble Ciego , Femenino , Humanos , Lactante , Intestino Delgado/virología , Masculino , Probióticos/farmacología , Estudios Prospectivos , RotavirusRESUMEN
Understanding the health implications of human exposure to mixtures of chemical contaminants is aided by analytical methods that can screen for a broad range of both expected and unexpected compounds. We performed a proof-of-concept analysis combining human breast milk, a biomonitoring matrix for determining contaminant exposure to mothers and infants, with a non-targeted method based on comprehensive two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC×GC/TOF-MS). A total of 172 presumably anthropogenic halogenated compounds and non-halogenated cyclic and aromatic compounds were tentatively identified in breast milk from San Diego, California through mass spectral database searches. Forty of the compounds were prioritized for confirmation based on halogenation or 100% frequency of detection, and the identities of 30 were verified using authentic standards. Thirty-four (85%) of the prioritized contaminants are not typically monitored in breast milk surveys, and 31 (77%) are regulated in at least one market worldwide, indicating breast milk may be a useful biomonitoring matrix for non-targeted analysis and the assessment of human exposure to future emerging or undiscovered contaminants.
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Monitoreo Biológico/estadística & datos numéricos , Leche Humana/química , Compuestos Orgánicos/análisis , California , Exposición a Riesgos Ambientales , Femenino , Cromatografía de Gases y Espectrometría de Masas/métodos , Halogenación , HumanosRESUMEN
BACKGROUND: : The prevalence of Helicobacter pylori infection among Aboriginal Australians children is unclear. The aims of the present study are to determine the prevalence of H. pylori infection among young Aboriginal children recovering from acute diarrheal disease in hospital and to evaluate the H. pylori stool antigen test as a noninvasive diagnostic test in this setting. METHODS: : This was a prospective comparative study using the C-Urea Breath Test as reference standard. Fifty-two children between 4 months and 2 years of age were consecutively enrolled. These children comprised a representative sample of Australian Aboriginal children admitted to hospital with acute diarrheal disease from remote and rural communities across Northern Territory of Australia. RESULTS: : The overall prevalence of H. pylori was 44.2%. The stool antigen test had a sensitivity of 0.55 (95% confidence interval [CI]: 0.35-0.73) with a positive predictive value of 0.65 (95% CI: 0.42-0.82). The specificity was 0.68 (95% CI: 0.46-0.84) with a negative predictive value of 0.58 (95% CI: 0.39-0.75). Analysis of receiver operator characteristic curve yielded an overall accuracy of the stool antigen test of 61% (48%-75%). CONCLUSIONS: : The prevalence of H. pylori infection among very young Aboriginal children from remote and rural communities was high and consistent with early acquisition. The diagnostic accuracy of the stool antigen test to diagnose H. pylori in this setting was poor.
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Antígenos Bacterianos/análisis , Heces/microbiología , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/etnología , Helicobacter pylori/aislamiento & purificación , Nativos de Hawái y Otras Islas del Pacífico , Australia , Pruebas Respiratorias , Isótopos de Carbono/análisis , Interpretación Estadística de Datos , Errores Diagnósticos , Diarrea/microbiología , Heces/química , Femenino , Helicobacter pylori/inmunología , Humanos , Lactante , Masculino , Curva ROCRESUMEN
Arabinoxylans (AXs) treated with enzymes, pentosanase (Pn) and glucose oxidase (GOX) not only offer a promising way to improve wheat product quality but also change their prebiotic potentials by modifying the structures of AXs. In the present study, the different crosslinking degrees of water-extracted arabinoxylans (WEAXs) treated with GOX alone or in combination with Pn + GOX were examined. The structural features and candidate prebiotic capabilities were investigated. It was demonstrated that WEAXs treated with 50 µg g-1 (w/w, enzyme/WEAX) GOX and 200 µg g-1 (w/w, enzyme/WEAX) Pn + 400 µg g-1 (w/w, enzyme/WEAX) GOX exhibited weak gel formation, while WEAXs treated with 400 µg g-1 (w/w, enzyme/WEAX) GOX and 25 µg g-1 (w/w, enzyme/WEAX) Pn + 400 µg g-1 (w/w, enzyme/WEAX) GOX formed strong gels. The ferulic acid content was significantly decreased due to the formation of ferulic acid crosslinking in the enzyme-treated WEAXs (p < 0.05). During in vitro fermentation, GOX and Pn + GOX treatments resulted in significantly (p < 0.05) increased amounts of bifidobacteria compared to WEAX alone. Pn + GOX-treated WEAXs had higher (p < 0.05) bifidobacteria populations than WEAXs treated with GOX alone. The bifidobacteria numbers and the SCFAs content of the weak gels were significantly higher than those in the strong gels under the same enzyme action (p < 0.05). These findings suggested that the increased bifidobacteria populations of GOX-treated WEAXs were due to the formation of ferulic acid crosslinking in contrast to a combination of ferulic acid crosslinking and degradation of the xylan backbone as seen in WEAXs treated with Pn + GOX. The reason the weak gels had better prebiotic potential than the corresponding strong gels was their high content of ferulic acid crosslinking.
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OBJECTIVES: Chronic liver disease (CLD) is associated with both alterations of the stool microbiota and increased small intestinal permeability. However, little is known about the role of the small intestinal mucosa-associated microbiota (MAM) in CLD. The aim of this study was to evaluate the relationship between the duodenal MAM and both small intestinal permeability and liver disease severity in CLD. METHODS: Subjects with CLD and a disease-free control group undergoing routine endoscopy underwent duodenal biopsy to assess duodenal MAM by 16S rRNA gene sequencing. Small intestinal permeability was assessed by a dual sugar (lactulose: rhamnose) assay. Other assessments included transient elastography, endotoxemia, serum markers of hepatic inflammation, dietary intake, and anthropometric measurements. RESULTS: Forty-six subjects (35 with CLD and 11 controls) were assessed. In subjects with CLD, the composition (P = 0.02) and diversity (P < 0.01) of the duodenal MAM differed to controls. Constrained multivariate analysis and linear discriminate effect size showed this was due to Streptococcus-affiliated lineages. Small intestinal permeability was significantly higher in CLD subjects compared to controls. In CLD, there were inverse correlations between microbial diversity and both increased small intestinal permeability (r = -0.41, P = 0.02) and serum alanine aminotransferase (r = -0.35, P = 0.04). Hepatic stiffness was not associated with the MAM. DISCUSSION: In CLD, there is dysbiosis of the duodenal MAM and an inverse correlation between microbial diversity and small intestinal permeability. TRANSLATIONAL IMPACT: Strategies to ameliorate duodenal MAM dysbiosis may ameliorate intestinal barrier dysfunction and liver injury in CLD.
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Duodeno/patología , Disbiosis/patología , Mucosa Intestinal/patología , Hepatopatías/diagnóstico , Hígado/patología , Adulto , Anciano , Enfermedad Crónica , ADN Bacteriano/aislamiento & purificación , Progresión de la Enfermedad , Duodeno/microbiología , Disbiosis/diagnóstico , Disbiosis/microbiología , Femenino , Microbioma Gastrointestinal/genética , Humanos , Mucosa Intestinal/microbiología , Hepatopatías/complicaciones , Hepatopatías/microbiología , Hepatopatías/patología , Masculino , Persona de Mediana Edad , Permeabilidad , ARN Ribosómico 16S/genéticaRESUMEN
Studies on the efficacy of zinc supplementation for treatment or prevention of diarrhea have shown an inconsistent effect in populations at risk for zinc deficiency. Unlike drugs, which have no preexisting presence in the body, endogenous zinc must be assessed pharmacokinetically by isotope tracer studies. Although such methods have produced much data, very few studies have estimated the dose and the timing of dosing of zinc supplementation. This review examines drug kinetics used to establish the best dose, the timing of such doses, and the mechanism of action through pharmacodynamic markers and applies them, where possible, to zinc supplements. The findings reveal that little is known, especially in children at highest risk of zinc deficiency. Key data missing to inform proper dosing, whether for treatment of disease or for preventive nutrient supplementation, are noted. Addressing these uncertainties could improve study design, leading to future studies of zinc supplements that might be of greater benefit.
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Diarrea/tratamiento farmacológico , Suplementos Dietéticos , Zinc/administración & dosificación , Zinc/deficiencia , Ensayos Clínicos como Asunto , Interacciones Farmacológicas , Interacciones Alimento-Droga , Humanos , Política Nutricional , Factores de Riesgo , Zinc/farmacocinéticaRESUMEN
The focus of this paper is on the application of measurements of zinc absorption in human research, especially studies designed to assess the efficacy of intervention strategies to prevent and manage zinc deficiency in populations. Emphasis is given to the measurement of quantities of zinc absorbed rather than restricting investigations to measurements of fractional absorption of zinc. This is especially important when determining absorption of zinc from the diet, whether it be the habitual diet or an intervention diet under evaluation. Moreover, measurements should encompass all meals for a minimum of one day with the exception of some pilot studies. Zinc absorption is primarily via an active saturable transport process into the enterocytes of the proximal small intestine. The relationship between quantity of zinc absorbed and the quantity ingested is best characterized by saturable binding models. When applied to human studies that have sufficient data to examine dose-response relationships, efficiency of absorption is high until approximately 50-60% maximal absorption is achieved, even with moderate phytate intakes. This also coincides approximately with the quantity of absorbed zinc necessary to meet physiologic requirements. Efficiency of absorption with intakes that exceed this level is low or very low. These observations have important practical implications for the design and interpretation of intervention studies to prevent zinc deficiency. They also suggest the potential utility of measurements of the quantity of zinc absorbed when evaluating the zinc status of populations.
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Absorción Intestinal/fisiología , Zinc/farmacocinética , Disponibilidad Biológica , Dieta , Humanos , Masculino , Política Nutricional , Proyectos de Investigación , Zinc/análisisRESUMEN
It is well recognised that zinc deficiency is a major global public health issue, particularly in young children in low-income countries with diarrhoea and environmental enteropathy. Zinc supplementation is regarded as a powerful tool to correct zinc deficiency as well as to treat a variety of physiologic and pathologic conditions. However, the dose and frequency of its use as well as the choice of zinc salt are not clearly defined regardless of whether it is used to treat a disease or correct a nutritional deficiency. We discuss the application of zinc stable isotope tracer techniques to assess zinc physiology, metabolism and homeostasis and how these can address knowledge gaps in zinc supplementation pharmacokinetics. This may help to resolve optimal dose, frequency, length of administration, timing of delivery to food intake and choice of zinc compound. It appears that long-term preventive supplementation can be administered much less frequently than daily but more research needs to be undertaken to better understand how best to intervene with zinc in children at risk of zinc deficiency. Stable isotope techniques, linked with saturation response and compartmental modelling, also have the potential to assist in the continued search for simple markers of zinc status in health, malnutrition and disease.