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Click [Medical Formula] Pay attention to the trillions of microorganisms in our human body, and they have a profound influence on regulating the function of the host.
Disorders of microorganisms in the intestine are related to many diseases, including neurological diseases, cardiovascular diseases, gastrointestinal diseases and even cancer.
Therefore, people focus on promoting human health and eliminating diseases by adjusting the microbiota, and considerable progress has been made.
Strategies to regulate intestinal microbes include fecal bacteria transplantation (FMT), which is the transfer of feces from a healthy individual to another individual to achieve the desired effect.
Fecal bacteria transplantation and other intestinal microbial regulation methods have shown good results in the treatment of several diseases.
Centuries ago, the ancient Greek doctor Hippocrates put forward the idea that gastrointestinal disorders may lead to systemic diseases.
The earliest reported use of FMT can be traced back to China in the 4th century BC to treat gastrointestinal diseases through fecal preparations.
Some animals also adopt a similar strategy to increase the diversity of intestinal microbes through fecal eating, and enhance digestion and other physiological functions.
In 1958, the first successful clinical application of FMT was to treat patients with pseudomembranous enteritis (Clostridioides difficile infection, CDI).
In addition, fecal bacteria transplantation has a certain effect on ulcerative colitis.
Now more clinical trials are trying to extend FMT and other intestinal microbiota regulation strategies to other diseases, such as the treatment of intestinal diseases (such as CDI and IBD) and Other systemic diseases, including metabolic syndrome, autism, multiple sclerosis, Parkinson's disease and even cancer-related clinical trials have been conducted.
The latest research has achieved good results in the treatment of patients with metastatic melanoma through fecal bacteria capsule transplantation combined with anti-PD-1 (anti-PD-1 treatment alone is not effective).
The regulation strategy of intestinal microbes mainly has two directions: one is the transfer of the entire microbial community (through FMT), and the second is the transfer of a single microbial group.
However, with the understanding of intestinal microbial functions, more methods are being developed.
However, there is still a lot of work to be done to achieve precise regulation of the intestinal microbiota.
When considering the strategy of mobilizing the gut microbiota, it is also necessary to consider the indications in the target population.
In the past few decades, due to the widespread use of antibiotics, infectious diseases have decreased, but allergies and autoimmune diseases have increased, partly due to the disorder of the intestinal microbiota.
By adjusting the intestinal flora, some diseases with serious imbalance of the flora (such as CDI) can be treated, and other diseases also have different degrees of destruction of the intestinal flora.
Therefore, choosing a suitable flora adjustment strategy also needs to consider the degree of flora imbalance.
And features.
When considering the regulation of the intestinal microbiota, many factors should also be considered, including the method of regulating the intestinal microbiota and the preparation plan, the method of measuring the intestinal microbiota and curative effect, and the intake of diet.
Generally speaking, the purpose of regulating the intestinal microbiota is to restore the patient's healthy intestinal microbiota, but the current definition of healthy intestinal microbiota is not clear.
There are data showing that highly functional and redundant microbial communities are associated with better health and treatment outcomes.
FMT has demonstrated its safety and effectiveness in the treatment of refractory CDI.
Correct treatment guidelines and screening of donor stool are the key to safety, including screening for infectious diseases related to intestinal flora disorders, and the use of drugs, such as antibiotics and proton pump inhibitors (PPIs).
Currently, it is recommended that donors be screened for multi-drug resistant microorganisms and the new coronavirus (COVID-19).
It was previously reported that several CDI patients developed systemic infections after FMT, developed drug-resistant bacterial infections and may be infected with the new coronavirus.
The method of fecal bacteria transplantation is also critical.
Big data studies have confirmed that enterobacteria capsules and colonoscopic enterobacteria transplantation have the most significant effects on disease intervention. The composition and function of the flora in the FMT donor may affect the efficacy, but this donor effect is not so significant for patients with severe microecological disorders, such as CDI or even IBD.
The optimal dosage and route of administration of FMT are not completely clear, and further research is still needed.
The characteristic of FMT is that the diversity of the flora provided (not only bacteria, but also viruses, fungi and archaea) helps to restore the functional redundancy of the flora, but it also has limitations in terms of repeatability and safety.
, Donor/recipient factors, dosage and transplantation route are the factors that should be considered in FMT.
At present, a number of studies are developing a multi-strain community that can be reliably, continuously produced and managed to well regulate the intestinal microbiota and provide better scalability than FMT.
These methods include the use of commercially commonly used probiotics, but the results of a number of clinical trials of microbial agents to treat diseases have been mixed.
So far, there are no microbial preparations approved for use by major regulatory agencies such as the US Food and Drug Administration.
The next generation of live microbial therapeutic drugs are under development and clinical trials.
For example, on August 10, 2020, Seres announced the results of phase III clinical trials of its gut microbiome drug SER-109, showing that it can effectively reduce difficulties Clostridium infection recurrence risk, and 4D Pharma announced that its live microbial drug MRx0518 is combined with Merck’s immune checkpoint inhibitor K drug (Keytruda), and positive progress has been made in phase I/II clinical trials.
On a global scale, it has become a trend to use live bacteria drugs that are probiotics in a broad sense to help fight cancer, and there will soon be more research breakthroughs.
Although these microbial preparations are generally well tolerated, their safety still needs to be considered.
It has been reported that when probiotics are used for critically ill patients to regulate the intestinal microbiota, these microorganisms enter the blood from the intestine.
Other important factors that regulate gut microbes are diet and prebiotics, which can affect existing symbiotic gut microbes and microbes used for treatment.
Probiotics are a class of active microorganisms that are beneficial to the host.
They are a general term for active beneficial microorganisms that colonize the human intestines and reproductive system and can produce definite health effects to improve the host's microecological balance and exert beneficial effects.
Bacteria or fungi that are beneficial to the human body mainly include: Clostridium butyricum, Lactobacillus, Bifidobacterium, Actinomycetes, Yeasts, etc.
At the commercial level, Lactobacillus and Bifidobacterium shall prevail.
Studies have shown that dramatic changes in diet will have a significant impact on gut microbes and related physiological responses in the short term.
If the dietary changes are not sustained, the gut microbiota can be restored to its pre-intervention state.
At present, many studies on dietary intervention are underway, ranging from simple dietary intervention (such as adding a small amount of beans every day, NCT02843425) to long-term dietary intervention (NCT03950635).
FMT or biopharmaceutical treatment is performed at the same time of dietary intervention to observe the effect of diet on maintaining and promoting the transfer of intestinal microbes, but the best method of these dietary interventions has not yet been defined.
Some substrates that can be used as beneficial symbiotic microorganisms, such as prebiotic supplements (such as resistant starch, polyphenols and polyunsaturated fatty acids) are also under investigation.
Single/multi-strain live bacteria drugs, diet/prebiotic interventions and their combined use with FMT or live bacteria drugs are also hot spots in clinical research.
Intestinal microbial regulation will be increasingly used to promote human health and treat diseases, although the best strategy for precise regulation of intestinal microbial regulation remains to be studied.
Methods of regulating the intestinal flora include fecal bacteria transplantation (FMT), multi-strain communities, diet intervention, probiotics/metabolites and epibiotics, etc.
They have certain effects in the treatment of some intestinal and systemic diseases, but they are not universally applicable.
, There are big differences in patient selection, treatment plans, efficacy evaluation standards, follow-up systems, etc.
, and clinical efficacy and safety are also inconsistent.
Intestinal microbiota regulation strategies need further research and efforts to better understand the disorders of the intestinal microbiota associated with disease states and the best intestinal microbiota to promote overall health, which has a wide range of impacts on public health.
References: [1] Modulating gut microbes.
DOI:10.
1126/science.
abc3965END Call for Papers "Medical Fang" is now officially open to fans! The content must be originally published and related to scientific research.
Once adopted, a generous reward (300-2000 yuan) will be given.
Please stamp for details.
"Medical side" has always been committed to serving "medical people", pushing the most cutting-edge and most valuable original clinical and scientific research articles to clinicians and scientific researchers.
The medical department has launched "Laboratory Basics", "SCI Writing Skills", "Document Intensive Reading and Analysis", "Medical English Easy", "National Natural Science Foundation of China", "Clinical Data Mining", "Gene Data Mining", "R Language Tutorial", "Medical Statistics", "Minimally Invasive Animal Experiment Training" and many other special courses, if you need to know the detailed tweets of the courses, you can follow the "Medical Party" public account and click on the "excellent topics" to enter the Tencent classroom: https://medfun .
ke.
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com NetEase Cloud Classroom: http://study.
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com/u/ykt1467466791112 Customer Service Tel: 15821255568 Customer Service WeChat: yixuefang1234
Disorders of microorganisms in the intestine are related to many diseases, including neurological diseases, cardiovascular diseases, gastrointestinal diseases and even cancer.
Therefore, people focus on promoting human health and eliminating diseases by adjusting the microbiota, and considerable progress has been made.
Strategies to regulate intestinal microbes include fecal bacteria transplantation (FMT), which is the transfer of feces from a healthy individual to another individual to achieve the desired effect.
Fecal bacteria transplantation and other intestinal microbial regulation methods have shown good results in the treatment of several diseases.
Centuries ago, the ancient Greek doctor Hippocrates put forward the idea that gastrointestinal disorders may lead to systemic diseases.
The earliest reported use of FMT can be traced back to China in the 4th century BC to treat gastrointestinal diseases through fecal preparations.
Some animals also adopt a similar strategy to increase the diversity of intestinal microbes through fecal eating, and enhance digestion and other physiological functions.
In 1958, the first successful clinical application of FMT was to treat patients with pseudomembranous enteritis (Clostridioides difficile infection, CDI).
In addition, fecal bacteria transplantation has a certain effect on ulcerative colitis.
Now more clinical trials are trying to extend FMT and other intestinal microbiota regulation strategies to other diseases, such as the treatment of intestinal diseases (such as CDI and IBD) and Other systemic diseases, including metabolic syndrome, autism, multiple sclerosis, Parkinson's disease and even cancer-related clinical trials have been conducted.
The latest research has achieved good results in the treatment of patients with metastatic melanoma through fecal bacteria capsule transplantation combined with anti-PD-1 (anti-PD-1 treatment alone is not effective).
The regulation strategy of intestinal microbes mainly has two directions: one is the transfer of the entire microbial community (through FMT), and the second is the transfer of a single microbial group.
However, with the understanding of intestinal microbial functions, more methods are being developed.
However, there is still a lot of work to be done to achieve precise regulation of the intestinal microbiota.
When considering the strategy of mobilizing the gut microbiota, it is also necessary to consider the indications in the target population.
In the past few decades, due to the widespread use of antibiotics, infectious diseases have decreased, but allergies and autoimmune diseases have increased, partly due to the disorder of the intestinal microbiota.
By adjusting the intestinal flora, some diseases with serious imbalance of the flora (such as CDI) can be treated, and other diseases also have different degrees of destruction of the intestinal flora.
Therefore, choosing a suitable flora adjustment strategy also needs to consider the degree of flora imbalance.
And features.
When considering the regulation of the intestinal microbiota, many factors should also be considered, including the method of regulating the intestinal microbiota and the preparation plan, the method of measuring the intestinal microbiota and curative effect, and the intake of diet.
Generally speaking, the purpose of regulating the intestinal microbiota is to restore the patient's healthy intestinal microbiota, but the current definition of healthy intestinal microbiota is not clear.
There are data showing that highly functional and redundant microbial communities are associated with better health and treatment outcomes.
FMT has demonstrated its safety and effectiveness in the treatment of refractory CDI.
Correct treatment guidelines and screening of donor stool are the key to safety, including screening for infectious diseases related to intestinal flora disorders, and the use of drugs, such as antibiotics and proton pump inhibitors (PPIs).
Currently, it is recommended that donors be screened for multi-drug resistant microorganisms and the new coronavirus (COVID-19).
It was previously reported that several CDI patients developed systemic infections after FMT, developed drug-resistant bacterial infections and may be infected with the new coronavirus.
The method of fecal bacteria transplantation is also critical.
Big data studies have confirmed that enterobacteria capsules and colonoscopic enterobacteria transplantation have the most significant effects on disease intervention. The composition and function of the flora in the FMT donor may affect the efficacy, but this donor effect is not so significant for patients with severe microecological disorders, such as CDI or even IBD.
The optimal dosage and route of administration of FMT are not completely clear, and further research is still needed.
The characteristic of FMT is that the diversity of the flora provided (not only bacteria, but also viruses, fungi and archaea) helps to restore the functional redundancy of the flora, but it also has limitations in terms of repeatability and safety.
, Donor/recipient factors, dosage and transplantation route are the factors that should be considered in FMT.
At present, a number of studies are developing a multi-strain community that can be reliably, continuously produced and managed to well regulate the intestinal microbiota and provide better scalability than FMT.
These methods include the use of commercially commonly used probiotics, but the results of a number of clinical trials of microbial agents to treat diseases have been mixed.
So far, there are no microbial preparations approved for use by major regulatory agencies such as the US Food and Drug Administration.
The next generation of live microbial therapeutic drugs are under development and clinical trials.
For example, on August 10, 2020, Seres announced the results of phase III clinical trials of its gut microbiome drug SER-109, showing that it can effectively reduce difficulties Clostridium infection recurrence risk, and 4D Pharma announced that its live microbial drug MRx0518 is combined with Merck’s immune checkpoint inhibitor K drug (Keytruda), and positive progress has been made in phase I/II clinical trials.
On a global scale, it has become a trend to use live bacteria drugs that are probiotics in a broad sense to help fight cancer, and there will soon be more research breakthroughs.
Although these microbial preparations are generally well tolerated, their safety still needs to be considered.
It has been reported that when probiotics are used for critically ill patients to regulate the intestinal microbiota, these microorganisms enter the blood from the intestine.
Other important factors that regulate gut microbes are diet and prebiotics, which can affect existing symbiotic gut microbes and microbes used for treatment.
Probiotics are a class of active microorganisms that are beneficial to the host.
They are a general term for active beneficial microorganisms that colonize the human intestines and reproductive system and can produce definite health effects to improve the host's microecological balance and exert beneficial effects.
Bacteria or fungi that are beneficial to the human body mainly include: Clostridium butyricum, Lactobacillus, Bifidobacterium, Actinomycetes, Yeasts, etc.
At the commercial level, Lactobacillus and Bifidobacterium shall prevail.
Studies have shown that dramatic changes in diet will have a significant impact on gut microbes and related physiological responses in the short term.
If the dietary changes are not sustained, the gut microbiota can be restored to its pre-intervention state.
At present, many studies on dietary intervention are underway, ranging from simple dietary intervention (such as adding a small amount of beans every day, NCT02843425) to long-term dietary intervention (NCT03950635).
FMT or biopharmaceutical treatment is performed at the same time of dietary intervention to observe the effect of diet on maintaining and promoting the transfer of intestinal microbes, but the best method of these dietary interventions has not yet been defined.
Some substrates that can be used as beneficial symbiotic microorganisms, such as prebiotic supplements (such as resistant starch, polyphenols and polyunsaturated fatty acids) are also under investigation.
Single/multi-strain live bacteria drugs, diet/prebiotic interventions and their combined use with FMT or live bacteria drugs are also hot spots in clinical research.
Intestinal microbial regulation will be increasingly used to promote human health and treat diseases, although the best strategy for precise regulation of intestinal microbial regulation remains to be studied.
Methods of regulating the intestinal flora include fecal bacteria transplantation (FMT), multi-strain communities, diet intervention, probiotics/metabolites and epibiotics, etc.
They have certain effects in the treatment of some intestinal and systemic diseases, but they are not universally applicable.
, There are big differences in patient selection, treatment plans, efficacy evaluation standards, follow-up systems, etc.
, and clinical efficacy and safety are also inconsistent.
Intestinal microbiota regulation strategies need further research and efforts to better understand the disorders of the intestinal microbiota associated with disease states and the best intestinal microbiota to promote overall health, which has a wide range of impacts on public health.
References: [1] Modulating gut microbes.
DOI:10.
1126/science.
abc3965END Call for Papers "Medical Fang" is now officially open to fans! The content must be originally published and related to scientific research.
Once adopted, a generous reward (300-2000 yuan) will be given.
Please stamp for details.
"Medical side" has always been committed to serving "medical people", pushing the most cutting-edge and most valuable original clinical and scientific research articles to clinicians and scientific researchers.
The medical department has launched "Laboratory Basics", "SCI Writing Skills", "Document Intensive Reading and Analysis", "Medical English Easy", "National Natural Science Foundation of China", "Clinical Data Mining", "Gene Data Mining", "R Language Tutorial", "Medical Statistics", "Minimally Invasive Animal Experiment Training" and many other special courses, if you need to know the detailed tweets of the courses, you can follow the "Medical Party" public account and click on the "excellent topics" to enter the Tencent classroom: https://medfun .
ke.
qq.
com NetEase Cloud Classroom: http://study.
163.
com/u/ykt1467466791112 Customer Service Tel: 15821255568 Customer Service WeChat: yixuefang1234
