Intestinal Research

Reviews

IBD

Helminths in alternative therapeutics of inflammatory bowel disease: Himani Pandey, Daryl W. T. Tang, Sunny H. Wong, Devi Lal; Intest Res 2025;23(1):8-22. Published online January 12, 2024; DOI: https://doi.org/10.5217/ir.2023.00059

Abstract PDF PubReader ePub: Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is a nonspecific chronic inflammation of the gastrointestinal tract. Despite recent advances in therapeutics and newer management strategies, IBD largely remains untreatable. Helminth therapy is a promising alternative therapeutic for IBD that has gained some attention in the last two decades. Helminths have immunomodulatory effects and can alter the gut microbiota. The immunomodulatory effects include a strong Th2 immune response, T-regulatory cell response, and the production of regulatory cytokines. Although concrete evidence regarding the efficacy of helminth therapy in IBD is lacking, clinical studies and studies done in animal models have shown some promise. Most clinical studies have shown that helminth therapy is safe and easily tolerable. Extensive work has been done on the whipworm Trichuris, but other helminths, including Schistosoma, Trichinella, Heligmosomoides, and Ancylostoma, have also been explored for pre-clinical and animal studies. This review article summarizes the potential of helminth therapy as an alternative therapeutic or an adjuvant to the existing therapeutic procedures for IBD treatment.

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IBD

The practice of fecal microbiota transplantation in inflammatory bowel disease: Umang Arora, Saurabh Kedia, Vineet Ahuja; Intest Res 2024;22(1):44-64. Published online November 21, 2023; DOI: https://doi.org/10.5217/ir.2023.00085

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Current evidence posits a central role for gut microbiota and the metabolome in the pathogenesis and progression of inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) has been established as a means to manipulate this microbiome safely and sustainably. Several aspects of the technical improvement including pretreatment with antibiotics, use of frozen stool samples as well as short donor-to-recipient time are proposed to improve its response rates. Its efficacy in ulcerative colitis has been proven in clinical trials while data is emerging for Crohn’s disease. This review describes briefly the biology behind FMT, the available evidence for its use in IBD, and the host, recipient and procedural factors which determine the clinical outcomes.

Citations

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Advances in Fecal Microbiota Transplantation for Gut Dysbiosis‐Related Diseases
Shuna Hou, Jiachen Yu, Yongshuang Li, Duoyi Zhao, Zhiyu Zhang
Advanced Science.2025;[Epub] CrossRef
Gut Microbial Targets in Inflammatory Bowel Disease: Current Position and Future Developments
Naveen Sivakumar, Ashwin Krishnamoorthy, Harshita Ryali, Ramesh P. Arasaradnam
Biomedicines.2025; 13(3): 716. CrossRef
Medical management of acute severe ulcerative colitis in the hospitalized patient
Loren G Rabinowitz, Ajay Gade, Joseph D. Feuerstein
Expert Review of Gastroenterology & Hepatology.2025; : 1. CrossRef
Perception of fecal microbiota transplantation in patients with ulcerative colitis in Korea: a KASID multicenter study
Jebyung Park, Sung Noh Hong, Hong Sub Lee, Jongbeom Shin, Eun Hye Oh, Kwangwoo Nam, Gyeol Seong, Hyun Gun Kim, Jin-Oh Kim, Seong Ran Jeon
The Korean Journal of Internal Medicine.2024; 39(5): 783. CrossRef
Microbiome-based therapeutics for Parkinson's disease
Adam M. Hamilton, Ian N. Krout, Alexandria C. White, Timothy R. Sampson
Neurotherapeutics.2024; 21(6): e00462. CrossRef

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IBD

Gut microbiota in pathophysiology, diagnosis, and therapeutics of inflammatory bowel disease: Himani Pandey, Dheeraj Jain, Daryl W. T. Tang, Sunny H. Wong, Devi Lal; Intest Res 2024;22(1):15-43. Published online November 8, 2023; DOI: https://doi.org/10.5217/ir.2023.00080

Abstract PDF PubReader ePub

Inflammatory bowel disease (IBD) is a multifactorial disease, which is thought to be an interplay between genetic, environment, microbiota, and immune-mediated factors. Dysbiosis in the gut microbial composition, caused by antibiotics and diet, is closely related to the initiation and progression of IBD. Differences in gut microbiota composition between IBD patients and healthy individuals have been found, with reduced biodiversity of commensal microbes and colonization of opportunistic microbes in IBD patients. Gut microbiota can, therefore, potentially be used for diagnosing and prognosticating IBD, and predicting its treatment response. Currently, there are no curative therapies for IBD. Microbiota-based interventions, including probiotics, prebiotics, synbiotics, and fecal microbiota transplantation, have been recognized as promising therapeutic strategies. Clinical studies and studies done in animal models have provided sufficient evidence that microbiota-based interventions may improve inflammation, the remission rate, and microscopic aspects of IBD. Further studies are required to better understand the mechanisms of action of such interventions. This will help in enhancing their effectiveness and developing personalized therapies. The present review summarizes the relationship between gut microbiota and IBD immunopathogenesis. It also discusses the use of gut microbiota as a noninvasive biomarker and potential therapeutic option.

Citations

Citations to this article as recorded by

Chitosan and its derivatives: A novel approach to gut microbiota modulation and immune system enhancement
Great Iruoghene Edo, Alice Njolke Mafe, Ali B.M. Ali, Patrick Othuke Akpoghelie, Emad Yousif, Jesse Innocent Apameio, Endurance Fegor Isoje, Ufuoma Augustina Igbuku, Yasal Garba, Arthur Efeoghene Athan Essaghah, Dina S. Ahmed, Huzaifa Umar, Dilber Uzun Oz
International Journal of Biological Macromolecules.2025; 289: 138633. CrossRef
Advances in bio-polymer coatings for probiotic microencapsulation: chitosan and beyond for enhanced stability and controlled release
Great Iruoghene Edo, Alice Njolke Mafe, Nawar. F. Razooqi, Ebuka Chukwuma Umelo, Tayser Sumer Gaaz, Endurance Fegor Isoje, Ufuoma Augustina Igbuku, Patrick Othuke Akpoghelie, Rapheal Ajiri Opiti, Arthur Efeoghene Athan Essaghah, Dina S. Ahmed, Huzaifa Uma
Designed Monomers and Polymers.2025; 28(1): 1. CrossRef
Helminths in alternative therapeutics of inflammatory bowel disease
Himani Pandey, Daryl W. T. Tang, Sunny H. Wong, Devi Lal
Intestinal Research.2025; 23(1): 8. CrossRef
Protective effect of low-dose lactulose in dextran sulfate sodium induced ulcerative colitis model of rats
Min Cui, Wei-Ming Yang, Ping Yao
Scientific Reports.2025;[Epub] CrossRef
Unraveling the Role of Fusobacterium nucleatum in Colorectal Cancer: Molecular Mechanisms and Pathogenic Insights
Linda Galasso, Fabrizio Termite, Irene Mignini, Giorgio Esposto, Raffaele Borriello, Federica Vitale, Alberto Nicoletti, Mattia Paratore, Maria Elena Ainora, Antonio Gasbarrini, Maria Assunta Zocco
Cancers.2025; 17(3): 368. CrossRef
Lactobacillus vaginalis alleviates DSS induced colitis by regulating the gut microbiota and increasing the production of 3-indoleacrylic acid
Zhuoya Wang, Tian Liu, Li Liu, Jian Xie, Furui Tang, Yimin Pi, Yuchun Zhong, Zhidong He, Wenming Zhang, Cihua Zheng
Pharmacological Research.2025; 213: 107663. CrossRef
Therapeutic systems based on natural gut microbiota modulators: the latest advances in the treatment of inflammatory bowel disease
Zelin Guan, Peilin Niu, Qichao Tan, Yidong Wang, Shujing Deng, Danyang Wang, Kai Dong, Jianfeng Xing, Cuiyu You
Materials Advances.2025; 6(5): 1578. CrossRef
Metabolic musculoskeletal disorders in patients with inflammatory bowel disease
Young Joo Yang, Seong Ran Jeon
The Korean Journal of Internal Medicine.2025; 40(2): 181. CrossRef
Photobiomodulation and the oral-gut microbiome axis: therapeutic potential and challenges
Neda Hakimiha, Somayeh Jahani Sherafat, E-Liisa Laakso, Reza Fekrazad
Frontiers in Medicine.2025;[Epub] CrossRef
Editorial: Environments-pathogens-the gut microbiota and host diseases
Jinbo Xiong, Zunji Shi
Frontiers in Microbiology.2024;[Epub] CrossRef
Endoplasmic reticulum stress: A possible connection between intestinal inflammation and neurodegenerative disorders
Giorgio Vivacqua, Romina Mancinelli, Stefano Leone, Rosa Vaccaro, Ludovica Garro, Simone Carotti, Ludovica Ceci, Paolo Onori, Luigi Pannarale, Antonio Franchitto, Eugenio Gaudio, Arianna Casini
Neurogastroenterology & Motility.2024;[Epub] CrossRef
Advances in Precision Medicine Approaches for Colorectal Cancer: From Molecular Profiling to Targeted Therapies
Neelakanta Sarvashiva Kiran, Chandrashekar Yashaswini, Rahul Maheshwari, Sankha Bhattacharya, Bhupendra G. Prajapati
ACS Pharmacology & Translational Science.2024; 7(4): 967. CrossRef
Healing from Within: How Gut Microbiota Predicts IBD Treatment Success—A Systematic Review
Luana Alexandrescu, Alina Doina Nicoara, Doina Ecaterina Tofolean, Alexandra Herlo, Andreea Nelson Twakor, Cristina Tocia, Anamaria Trandafir, Andrei Dumitru, Eugen Dumitru, Cristian Florentin Aftenie, Ionela Preotesoiu, Elena Dina, Ioan Tiberiu Tofolean
International Journal of Molecular Sciences.2024; 25(15): 8451. CrossRef
Effect of Mutant and Engineered High-Acetate-Producing Saccharomyces cerevisiae var. boulardii Strains in Dextran Sodium Sulphate-Induced Colitis
Sara Deleu, Inge Jacobs, Jorge F. Vazquez Castellanos, Sare Verstockt, Bruna Trindade de Carvalho, Ana Subotić, Bram Verstockt, Kaline Arnauts, Lowie Deprez, Eva Vissers, Matthias Lenfant, Greet Vandermeulen, Gert De Hertogh, Kristin Verbeke, Gianluca Mat
Nutrients.2024; 16(16): 2668. CrossRef
The emerging role of the gut microbiota and its application in inflammatory bowel disease
Xiu Wang, Jianhua Peng, Peipei Cai, Yuxuan Xia, Chengxue Yi, Anquan Shang, Francis Atim Akanyibah, Fei Mao
Biomedicine & Pharmacotherapy.2024; 179: 117302. CrossRef
Bifidogenic Effect of Human Milk Oligosaccharides on Pediatric IBD Fecal Microbiota
Nize Otaru, Danica Bajic, Pieter Van den Abbeele, Saskia Vande Velde, Stephanie Van Biervliet, Robert E. Steinert, Ateequr Rehman
Microorganisms.2024; 12(10): 1977. CrossRef
Analysis of the Preventive Effect of Lonicera caerulea Pomace and Its Isolated Components on Colitis in Mice Based on Gut Microbiota and Serum Metabolomics
Zinuo Zhou, Xinwen Huang, Baixi Zhang
Antioxidants.2024; 13(12): 1478. CrossRef
Gut microbiota mediated T cells regulation and autoimmune diseases
Nabeel Khalid Bhutta, Xiujin Xu, Cuiqin Jian, Yifan Wang, Yi Liu, Jinlyu Sun, Bingnan Han, Shandong Wu, Ansar Javeed
Frontiers in Microbiology.2024;[Epub] CrossRef
Reduced gut microbiota diversity in ulcerative colitis patients with latent tuberculosis infection during vedolizumab therapy: insights on prophylactic anti-tuberculosis effects
Yibing Hu, Zhenping Wu, Xiaoyun Yang, Jin Ding, Qunying Wang, Hao Fang, Lujian Zhu, Minli Hu
BMC Microbiology.2024;[Epub] CrossRef

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Original Articles

Microbiota

Compositional changes in fecal microbiota associated with clinical phenotypes and prognosis in Korean patients with inflammatory bowel disease: Seung Yong Shin, Young Kim, Won-Seok Kim, Jung Min Moon, Kang-Moon Lee, Sung-Ae Jung, Hyesook Park, Eun Young Huh, Byung Chang Kim, Soo Chan Lee, Chang Hwan Choi, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):148-160. Published online June 14, 2022; DOI: https://doi.org/10.5217/ir.2021.00168

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The fecal microbiota of Korean patients with inflammatory bowel disease (IBD) was investigated with respect to disease phenotypes and taxonomic biomarkers for diagnosis and prognosis of IBD.
Methods
Fecal samples from 70 ulcerative colitis (UC) patients, 39 Crohn’s disease (CD) patients, and 100 healthy control individuals (HC) were collected. The fecal samples were amplified via polymerase chain reaction and sequenced using Illumina MiSeq. The relationships between fecal bacteria and clinical phenotypes were analyzed using the EzBioCloud database and 16S microbiome pipeline.
Results
The alpha-diversity of fecal bacteria was significantly lower in UC and CD (P<0.05) compared to that in HC. Bacterial community compositions in UC and CD were significantly different from that of HC according to Bray-Curtis dissimilarities, and there was also a difference between community composition in UC and CD (P=0.01). In UC, alpha-diversity was further decreased when the disease was more severe and the extent of disease was greater, and community composition significantly differed depending on the extent of the disease. We identified 9 biomarkers of severity and 6 biomarkers of the extent of UC. We also identified 5 biomarkers of active disease and 3 biomarkers of ileocolonic involvement in CD. Lachnospiraceae and Ruminococcus gnavus were biomarkers for better prognosis in CD.
Conclusions
The fecal microbiota profiles of IBD patients were different from those of HC, and several bacterial taxa may be used as biomarkers to determine disease phenotypes and prognosis. These data may also help discover new therapeutic targets for IBD.

Citations

Citations to this article as recorded by

Gut bacteriome in inflammatory bowel disease: An update on recent advances
Aditya Bajaj, Manasvini Markandey, Saurabh Kedia, Vineet Ahuja
Indian Journal of Gastroenterology.2024; 43(1): 103. CrossRef
An Update on the Role and Potential Molecules in Relation to Ruminococcus gnavus in Inflammatory Bowel Disease, Obesity and Diabetes Mellitus
Jinni Hong, Tingting Fu, Weizhen Liu, Yu Du, Junmin Bu, Guojian Wei, Miao Yu, Yanshan Lin, Cunyun Min, Datao Lin
Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 1235. CrossRef
Research advancements and perspectives of inflammatory bowel disease: A comprehensive review
Junyi Bai, Ying Wang, Fuhao Li, Yueyao Wu, Jun Chen, Meng Li, Xi Wang, Bin Lv
Science Progress.2024;[Epub] CrossRef
Integrated Analysis of Microbiome and Metabolome Reveals Disease-Specific Profiles in Inflammatory Bowel Diseases and Intestinal Behçet’s Disease
Yehyun Park, Jae Bum Ahn, Da Hye Kim, I Seul Park, Mijeong Son, Ji Hyung Kim, Hyun Woo Ma, Seung Won Kim, Jae Hee Cheon
International Journal of Molecular Sciences.2024; 25(12): 6697. CrossRef
Dynamic changes in the gut microbiota composition during adalimumab therapy in patients with ulcerative colitis: implications for treatment response prediction and therapeutic targets
Han Na Oh, Seung Yong Shin, Jong-Hwa Kim, Jihye Baek, Hyo Jong Kim, Kang-Moon Lee, Soo Jung Park, Seok-Young Kim, Hyung-Kyoon Choi, Wonyong Kim, Woo Jun Sul, Chang Hwan Choi
Gut Pathogens.2024;[Epub] CrossRef
Potential of Gut Microbe-Derived Extracellular Vesicles to Differentiate Inflammatory Bowel Disease Patients from Healthy Controls
Min Heo, Young Soo Park, Hyuk Yoon, Nam-Eun Kim, Kangjin Kim, Cheol Min Shin, Nayoung Kim, Dong Ho Lee
Gut and Liver.2023; 17(1): 108. CrossRef
Ruminococcus gnavus: friend or foe for human health
Emmanuelle H Crost, Erika Coletto, Andrew Bell, Nathalie Juge
FEMS Microbiology Reviews.2023;[Epub] CrossRef
The Relationship Between Rosacea and Inflammatory Bowel Disease: A Systematic Review and Meta-analysis
Yu Kyung Jun, Da-Ae Yu, Yoo Min Han, Soo Ran Lee, Seong-Joon Koh, Hyunsun Park
Dermatology and Therapy.2023; 13(7): 1465. CrossRef
Risk of all-cause and cause-specific mortality associated with immune-mediated inflammatory diseases in Korea
Oh Chan Kwon, See Young Lee, Jaeyoung Chun, Kyungdo Han, Yuna Kim, Ryul Kim, Min-Chan Park, Jie-Hyun Kim, Young Hoon Youn, Hyojin Park
Frontiers in Medicine.2023;[Epub] CrossRef
Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Kwang Woo Kim
Gut and Liver.2023; 17(6): 954. CrossRef
Evaluation of Bacterial and Fungal Biomarkers for Differentiation and Prognosis of Patients with Inflammatory Bowel Disease
Hyuk Yoon, Sunghyouk Park, Yu Kyung Jun, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee
Microorganisms.2023; 11(12): 2882. CrossRef
A Machine Learning-Based Diagnostic Model for Crohn’s Disease and Ulcerative Colitis Utilizing Fecal Microbiome Analysis
Hyeonwoo Kim, Ji Eun Na, Sangsoo Kim, Tae-Oh Kim, Soo-Kyung Park, Chil-Woo Lee, Kyeong Ok Kim, Geom-Seog Seo, Min Suk Kim, Jae Myung Cha, Ja Seol Koo, Dong-Il Park
Microorganisms.2023; 12(1): 36. CrossRef

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IBD

Fecal microbiota transplantation for induction of remission, maintenance and rescue in patients with corticosteroid-dependent ulcerative colitis: a long-term follow-up real-world cohort study: Avnish Kumar Seth, Priti Jain; Intest Res 2022;20(2):251-259. Published online February 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00069

Abstract PDF PubReader ePub

Background/Aims
To study role of fecal microbiota transplantation (FMT) in induction, maintenance, and rescue in patients with corticosteroid-dependent ulcerative colitis (CDUC).
Methods
Patients with active CDUC received 3 fortnightly sessions of colonoscopic induction FMT (iFMT) in addition to standard of care. In patients who achieved clinical remission (CR) or response, prednisolone was tapered from week 4 and azathioprine from week 12. Responders were advised maintenance FMT (mFMT) every 6 months. Those with relapse were offered rescue FMT (rFMT), and low dose prednisolone was added if there was no improvement in 2 weeks.
Results
All 27 patients enrolled completed iFMT and were followed up for 39 months (range, 9–71 months). The mean Mayo score decreased from 6.4±2.5 at baseline to 2.6±3.7 at week 4, 2.6±3.4 at week 12, and 2.8±3.8 at week 24 (P<0.05). Corticosteroid-free CR and clinical response at week 12 were seen in 13 patients (48%) and 1 patient (3.7%), respectively. Corticosteroid and azathioprine-free CR at week 24 was seen in 13 patients (48%) and in them histological response was seen in 2 patients (15.2%) at week 4, 5 patients (38.4%) at week 12, and 10 patients (76.9%) at week 24. First relapse was seen in 10 of 13 responders (76.9%) at a median of 14.8 months (range, 6–34 months) after iFMT and was less frequent in patients on mFMT. Relapse was treated successfully with rFMT alone in 4 patients (40%) and rFMT with low dose steroids in 5 patients (50%).
Conclusions
iFMT, mFMT, and rFMT may have a role in treatment of selected patients with CDUC.

Citations

Citations to this article as recorded by

The practice of fecal microbiota transplantation in inflammatory bowel disease
Umang Arora, Saurabh Kedia, Vineet Ahuja
Intestinal Research.2024; 22(1): 44. CrossRef
The Impact of Microbiome Interventions on the Progression and Severity of Inflammatory Bowel Disease: A Systematic Review
Malik Kasapoglu, Rajesh Yadavalli, Sarosh Nawaz, Abdulaziz Althwanay, Esraa M AlEdani, Harleen Kaur, Samia Butt
Cureus.2024;[Epub] CrossRef
Fecal Microbiota Transplantation
Suranjana Banik, Balamurugan Ramadass
Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(2): 44. CrossRef
Single-Donor and Pooling Strategies for Fecal Microbiota Transfer Product Preparation in Ulcerative Colitis: A Systematic Review and Meta-analysis
Benoît Levast, Mathieu Fontaine, Stéphane Nancey, Pierre Dechelotte, Joël Doré, Philippe Lehert
Clinical and Translational Gastroenterology.2023; 14(5): e00568. CrossRef
The Relationship Between Rosacea and Inflammatory Bowel Disease: A Systematic Review and Meta-analysis
Yu Kyung Jun, Da-Ae Yu, Yoo Min Han, Soo Ran Lee, Seong-Joon Koh, Hyunsun Park
Dermatology and Therapy.2023; 13(7): 1465. CrossRef
Faecal microbiota transplantation with anti-inflammatory diet (FMT-AID) followed by anti-inflammatory diet alone is effective in inducing and maintaining remission over 1 year in mild to moderate ulcerative colitis: a randomised controlled trial
Saurabh Kedia, Shubi Virmani, Sudheer K Vuyyuru, Peeyush Kumar, Bhaskar Kante, Pabitra Sahu, Kanav Kaushal, Mariyam Farooqui, Mukesh Singh, Mahak Verma, Aditya Bajaj, Manasvini Markandey, Karan Sachdeva, Prasenjit Das, Govind K Makharia, Vineet Ahuja
Gut.2022; 71(12): 2401. CrossRef

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Microbiota

Relationship between the gut microbiota and bile acid composition in the ileal mucosa of Crohn’s disease: Shigeki Bamba, Osamu Inatomi, Atsushi Nishida, Masashi Ohno, Takayuki Imai, Kenichiro Takahashi, Yuji Naito, Junichi Iwamoto, Akira Honda, Naohiro Inohara, Akira Andoh; Intest Res 2022;20(3):370-380. Published online May 14, 2021; DOI: https://doi.org/10.5217/ir.2021.00054

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Crosstalk between the gut microbiota and bile acid plays an important role in the pathogenesis of gastrointestinal disorders. We investigated the relationship between microbial structure and bile acid metabolism in the ileal mucosa of Crohn’s disease (CD).
Methods
Twelve non-CD controls and 38 CD patients in clinical remission were enrolled. Samples were collected from the distal ileum under balloon-assisted enteroscopy. Bile acid composition was analyzed by liquid chromatography-mass spectrometry. The gut microbiota was analyzed by 16S rRNA gene sequencing.
Results
The Shannon evenness index was significantly lower in endoscopically active lesions than in non-CD controls. β-Diversity, evaluated by the UniFrac metric, revealed a significant difference between the active lesions and non-CD controls (P=0.039). The relative abundance of Escherichia was significantly higher and that of Faecalibacterium and Roseburia was significantly lower in CD samples than in non-CD controls. The increased abundance of Escherichia was more prominent in active lesions than in inactive lesions. The proportion of conjugated bile acids was significantly higher in CD patients than in non-CD controls, but there was no difference in the proportion of primary or secondary bile acids. The genera Escherichia and Lactobacillus were positively correlated with the proportion of conjugated bile acids. On the other hand, Roseburia, Intestinibacter, and Faecalibacterium were negatively correlated with the proportion of conjugated bile acids.
Conclusions
Mucosa-associated dysbiosis and the alteration of bile acid composition were identified in the ileum of CD patients. These may play a role in the pathophysiology of ileal lesions in CD patients.

Citations

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hUCMSCs Regulate Bile Acid Metabolism to Prevent Heart Failure–Induced Intestinal Injury by Inhibiting the Activation of the STAT3/NF‐κB/MAPK Signaling Pathway via TGR5
Zetian Wang, Wei Luo, Qing Wang, Chunzheng Liu, Yanshan Gong, Baitian Li, Xuejiao Zeng, Jiaqi Lin, Zehua Su, Xin Li, Yongze Yu, Zhongmin Liu, Ling Gao, Lijun Liao
Food Frontiers.2025; 6(1): 575. CrossRef
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Min-Jae Kim, Young Ju Lee, Zahid Hussain, Hyojin Park
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A critical review on inflammatory bowel diseases risk factors, dietary nutrients regulation and protective pathways based on gut microbiota during recent 5 years
Pengkui Xia, Tao Hou, Hong Jin, Yaqi Meng, Jing Li, Fuchao Zhan, Fang Geng, Bin Li
Critical Reviews in Food Science and Nutrition.2024; 64(24): 8805. CrossRef
Gut microbiota disparities between active Crohn's disease and healthy controls: A global systematic review
Rupa Tharu, Geetika Malik Ahlawat, Savitesh Kushwaha, Poonam Khanna
Clinical Epidemiology and Global Health.2024; 25: 101497. CrossRef
Gut microbes improve prognosis of Klebsiella pneumoniae pulmonary infection through the lung-gut axis
Yuxiu Tang, Liquan Chen, Jin Yang, Suqing Zhang, Jun Jin, Yao Wei
Frontiers in Cellular and Infection Microbiology.2024;[Epub] CrossRef
Integrated Analysis of Microbiome and Metabolome Reveals Disease-Specific Profiles in Inflammatory Bowel Diseases and Intestinal Behçet’s Disease
Yehyun Park, Jae Bum Ahn, Da Hye Kim, I Seul Park, Mijeong Son, Ji Hyung Kim, Hyun Woo Ma, Seung Won Kim, Jae Hee Cheon
International Journal of Molecular Sciences.2024; 25(12): 6697. CrossRef
Gut Bacterial Composition and Nutritional Implications in Mexican and Spanish Individuals with Inflammatory Bowel Disease Compared to Healthy Controls
Ricardo García-Gamboa, Osiris Díaz-Torres, Misael Sebastián Gradilla-Hernández, Vicente Pérez-Brocal, Andrés Moya, Marisela González-Avila
International Journal of Molecular Sciences.2024; 25(22): 11887. CrossRef
Bile acid–induced metabolic changes in the colon promote Enterobacteriaceae expansion and associate with dysbiosis in Crohn’s disease
Ravi Holani, Haggai Bar-Yoseph, Zakhar Krekhno, Antonio Serapio-Palacios, Kyung-Mee Moon, Richard G. Stacey, Katherine A. Donald, Wanyin Deng, Brian Bressler, Armando A. Magaña, Leonard J. Foster, Michael G. Atser, James D. Johnson, Barton Finlay
Science Signaling.2024;[Epub] CrossRef
Compositional changes in fecal microbiota associated with clinical phenotypes and prognosis in Korean patients with inflammatory bowel disease
Seung Yong Shin, Young Kim, Won-Seok Kim, Jung Min Moon, Kang-Moon Lee, Sung-Ae Jung, Hyesook Park, Eun Young Huh, Byung Chang Kim, Soo Chan Lee, Chang Hwan Choi
Intestinal Research.2023; 21(1): 148. CrossRef
Meta-Analysis Reveals Compositional and Functional Microbial Changes Associated with Osteoporosis
Oluwamayowa S. Akinsuyi, Luiz F. W. Roesch, Olubukola Oluranti Babalola
Microbiology Spectrum.2023;[Epub] CrossRef
Crohn’s disease: Why the ileum?
Nicolas Richard, Guillaume Savoye, Mathilde Leboutte, Asma Amamou, Subrata Ghosh, Rachel Marion-Letellier
World Journal of Gastroenterology.2023; 29(21): 3222. CrossRef
The Emerging Role of Raman Spectroscopy as an Omics Approach for Metabolic Profiling and Biomarker Detection toward Precision Medicine
Gabriel Cutshaw, Saji Uthaman, Nora Hassan, Siddhant Kothadiya, Xiaona Wen, Rizia Bardhan
Chemical Reviews.2023; 123(13): 8297. CrossRef
Current insights on the roles of gut microbiota in inflammatory bowel disease-associated extra-intestinal manifestations: pathophysiology and therapeutic targets
Yizhe Tie, Yongle Huang, Rirong Chen, Li Li, Minhu Chen, Shenghong Zhang
Gut Microbes.2023;[Epub] CrossRef
Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Kwang Woo Kim
Gut and Liver.2023; 17(6): 954. CrossRef
Evaluation of gut dysbiosis using serum and fecal bile acid profiles
Tadakuni Monma, Junichi Iwamoto, Hajime Ueda, Makoto Tamamushi, Fumio Kakizaki, Naoki Konishi, Shoichiro Yara, Teruo Miyazaki, Takeshi Hirayama, Tadashi Ikegami, Akira Honda
World Journal of Clinical Cases.2022; 10(34): 12484. CrossRef
Microbial Modulation in Inflammatory Bowel Diseases
Jongwook Yu, Jae Hee Cheon
Immune Network.2022;[Epub] CrossRef

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Endoscopy

Effect of gut microbiome on minor complications after a colonoscopy: Jae Hyun Kim, Youn Jung Choi, Hye Jung Kwon, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park; Intest Res 2021;19(3):341-348. Published online November 10, 2020; DOI: https://doi.org/10.5217/ir.2020.00057

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Minor complications that might occur after colonoscopy, including abdominal discomfort, bloating, diarrhea, and constipation, could a barrier for patients to undergo a screening colonoscopy. In this study, we aimed to identify the effect of gut microbial diversity and composition on minor complications after colonoscopy.
Methods
A total of 24 healthy subjects provided their stools before bowel preparation and on the 7th and 28th day after colonoscopy. On the 7th day after colonoscopy, the presence of minor complications was investigated using a questionnaire. We divided patients into 2 groups, the no complication group and complications group. The fecal microbial diversity, distribution, and composition were then compared between the groups.
Results
Five of the 24 subjects reported that they had undergone minor complications after colonoscopy. Most of the symptoms were mild and self-limited, but 1 patient needed medication. Interestingly, the Firmicutes/Bacteroidetes ratio of the initial stool samples before bowel preparation in the complication group was significantly higher than that in no complication group. After bowel preparation, the Firmicutes/Bacteroidetes ratio of the complication group decreased, but not in the no complication group. The microbial diversity of the no complication group decreased after bowel preparation, but not in the complication group.
Conclusions
The gut microbial composition and diversity before and after bowel preparation could be considered as one of the causes of minor complications after colonoscopy. Further studies are needed to delineate the role of gut microbiota in the occurrence of minor complications after colonoscopy.

Citations

Citations to this article as recorded by

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Case Report

Inflammatory bowel diseases

Incidental benefits after fecal microbiota transplant for ulcerative colitis: Ramit Mahajan, Vandana Midha, Arshdeep Singh, Varun Mehta, Yogesh Gupta, Kirandeep Kaur, Ritu Sudhakar, Anmol Singh Pannu, Dharmatma Singh, Ajit Sood; Intest Res 2020;18(3):337-340. Published online April 22, 2020; DOI: https://doi.org/10.5217/ir.2019.00108

Abstract PDF PubReader ePub

Gut dysbiosis can result in several diseases, including infections (Clostridium difficile infection and infectious gastroenteritis), autoimmune diseases (inflammatory bowel disease, diabetes, and allergic disorders), behavioral disorders and other conditions like metabolic syndrome and functional gastrointestinal disorders. Amongst various therapies targeting gut microbiome, fecal microbiota transplantation (FMT) is becoming a focus in the public media and peer reviewed literature. We have been using FMT for induction of remission in patients with moderate to severe active ulcerative colitis (UC) and also for subsequent maintenance of remission. Four cases reported incidental benefits while being treated with FMT for UC. These included weight loss (n=1), improvement in hair loss (n=1), amelioration of axial arthritis (n=1) and improvement in allergic rhinitis (n=1), thereby suggesting potential clinical applications of FMT in treating extraintestinal diseases associated with gut dysbiosis.

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Fecal microbiota transplantation in allergic diseases
Ece Tüsüz Önata, Öner Özdemir
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α‐Lipoic acid alleviates dextran sulfate sodium salt‐induced ulcerative colitis via modulating the Keap1–Nrf2 signaling pathway and inhibiting ferroptosis
Peng Jiang, Zongzhen Zhai, Linxian Zhao, Kai Zhang, Liwei Duan
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Reviews

IBD

Epithelial-microbial diplomacy: escalating border tensions drive inflammation in inflammatory bowel disease: Stephanie J King, Declan F McCole; Intest Res 2019;17(2):177-191. Published online March 7, 2019; DOI: https://doi.org/10.5217/ir.2018.00170

Abstract PDF PubReader ePub

Inflammatory bowel diseases (IBD) are chronic conditions of the gastrointestinal tract-the main site of host-microbial interaction in the body. Development of IBD is not due to a single event but rather is a multifactorial process where a patient’s genetic background, behavioral habits, and environmental exposures contribute to disease pathogenesis. IBD patients exhibit alterations to gut bacterial populations “dysbiosis” due to the inflammatory microenvironment, however whether this alteration of the gut microbiota precedes inflammation has not been confirmed. Emerging evidence has highlighted the important role of gut microbes in developing measured immune responses and modulating other host responses such as metabolism. Much of the work on the gut microbiota has been correlative and there is an increasing need to understand the intimate relationship between host and microbe. In this review, we highlight how commensal and pathogenic bacteria interact with host intestinal epithelial cells and explore how altered microenvironments impact these connections.

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IBD

Current new challenges in the management of ulcerative colitis: Tomohiro Fukuda, Makoto Naganuma, Takanori Kanai; Intest Res 2019;17(1):36-44. Published online January 25, 2019; DOI: https://doi.org/10.5217/ir.2018.00126

Abstract PDF PubReader ePub

Ulcerative colitis (UC) is a chronic inflammatory condition of the gastrointestinal tract. Although the cause of UC is postulated to be multifactorial in nature, including genetic predisposition, epithelial barrier defects, dysregulation of immune responses, and environmental factors, the specific pathogenesis of UC is still incompletely understood. In the treatment of UC so far, a method of suppressing immunity and treating it has been mainstream. Immunosuppressant drugs, including thiopurines (azathioprine or 6-mercaptopurine), anti-tumor necrosis factor-α (anti-TNF-α) antibody (infliximab and adalimumab), and calcineurin inhibitor, can be used in treat patients with corticosteroid-dependent and/or corticosteroid-refractory moderateto- severe UC. Recently, in addition to such a conventional therapeutic agent, golimumab, which is the first transgenic human monoclonal anti-TNF-α antibody to be fabricated, anti α-4/β-7 integrin antibody, and Janus kinase inhibitor have been reported to novel immunosuppressant therapy. Furthermore, other treatments with unique mechanisms different from immunosuppression, have also been suggested, including fecal microbiota transplantation and Indigo naturalis, which is a Chinese herbal medicine. We compared the features and efficacy of these new treatments. In this issue, the features and treatment options for these new treatments is reviewed.

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Original Articles

IBD

Efficacy of fecal microbiota therapy in steroid dependent ulcerative colitis: a real world intention-to-treat analysis: Ajit Sood, Ramit Mahajan, Garima Juyal, Vandana Midha, Charanpreet Singh Grewal, Varun Mehta, Arshdeep Singh, Mohan C Joshi, Vikram Narang, Kirandeep Kaur, Hasrat Sidhu; Intest Res 2019;17(1):78-86. Published online November 20, 2018; DOI: https://doi.org/10.5217/ir.2018.00089

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Four high-quality randomized controlled trials have proven the efficacy of fecal microbiota transplantation (FMT) in active ulcerative colitis (UC). We assessed the efficacy of FMT in a real-world setting involving steroid-dependent patients with UC.
Methods
This was a single-center prospective analysis of data from steroid-dependent patients with UC treated with FMT from September 2015 to September 2017 at the Dayanand Medical College, a tertiary care center in India. Fecal samples from random unrelated donors were administered through colonoscopy at weeks 0, 2, 6, 10, 14, 18, and 22. The primary outcome was achievement of steroid-free clinical remission, and the secondary outcomes were clinical response and endoscopic remission at 24 weeks. Modified intention-to-treat analysis was performed, which included subjects who underwent at least 1 FMT.
Results
Of 345 patients with UC treated during the study period, 49 (14.2%) had steroid-dependent UC. Of these 49 patients, 41 underwent FMT: 33 completed 7 sessions over 22 weeks according to the protocol, and 8 discontinued treatment (non-response, 5; lost to follow-up, 2; and fear of adverse effects, 1). At week 24, steroid-free clinical remission was achieved in 19 out of 41 (46.3%) patients, whereas clinical response and endoscopic remission were achieved in 31 out of 41 (75.6%) and 26 out of 41 (63.4%) patients, respectively. All patients with clinical response were able to withdraw steroids. There were no serious adverse events necessitating discontinuation.
Conclusions
A multisession FMT via the colonoscopic route is a promising therapeutic option for patients with steroid-dependent UC, as it can induce clinical remission and aid in steroid withdrawal.

Citations

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Ajit Sood, Ramit Mahajan, Arshdeep Singh, Vandana Midha, Varun Mehta, Vikram Narang, Tarundeep Singh, Anmol Singh Pannu
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Microbiota

Development and diversity of lactic acid producing bacteria and bifidobacteria in healthy full term Indian infants from Himachal Pradesh: Sampan Attri, Rishi Mahajan, Gunjan Goel; Intest Res 2018;16(4):529-536. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00050

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The initial microbial colonization is a crucial step for the healthy development of an infant. Previous studies from India reported the dominance of target microbial species among Indian infants without any analysis on the diversity of target groups. This is the first study from India with an objective to investigate the establishment and diversity of lactic acid producing bacteria (LAB) and bifidobacteria in vaginally delivered, full term, breastfed infants for the first 4 months after birth.
Methods
Present study used polymerase chain reaction-denaturating gradient gel electrophoresis (PCR-DGGE) based sequence analysis of LAB and bifidobacteria in healthy infants. The results were used to compare the development and early colonization by LAB and bifidobacteria using diversity indices during the initial months of development of gut microbiota in infants.
Results
During the first 4 months, the Shannon diversity index (H) of LAB increased from 1.16 to 1.318 and for bifidobacteria the H increased from 0.975 to 1.293 (P<0.05). Higher Sorenson’s pair wise similarity coefficient was observed for LAB and bifidobacteria during 2nd and the 3rd month. The species of the genera Enterococcus, Streptococcus, and Lactobacillus were dominant among the LAB group whereas Bifidobacterium breve was dominant species among Bifidobacterium group.
Conclusions
Our results indicate that in breast fed infants, the microbial diversity of LAB and bifidobacteria increased during the period of study.

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Development and Functions of the Infant Gut Microflora: Westernvs. Indian Infants
Lalit Bharadia, Neha Agrawal, Nandan Joshi
International Journal of Pediatrics.2020; 2020: 1. CrossRef

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Focused Review: Colorectal Cancers

Colorectal neoplasia

Impact of microbiota in colorectal carcinogenesis: lessons from experimental models: Linda Chia-Hui Yu, Shu-Chen Wei, Yen-Hsuan Ni; Intest Res 2018;16(3):346-357. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.346

Abstract PDF PubReader ePub

A role of gut microbiota in colorectal cancer (CRC) growth was first suggested in germ-free rats almost 50 years ago, and the existence of disease-associated bacteria (termed pathobionts) had becoming increasingly evident from experimental data of fecal transplantation, and microbial gavage or monoassociation. Altered bacterial compositions in fecal and mucosal specimens were observed in CRC patients compared to healthy subjects. Microbial fluctuations were found at various cancer stages; an increase of bacterial diversity was noted in the adenoma specimens, while a reduction of bacterial richness was documented in CRC samples. The bacterial species enriched in the human cancerous tissues included Escherichia coli, Fusobacterium nucleatum, and enterotoxigenic Bacteroides fragilis. The causal relationship of gut bacteria in tumorigenesis was established by introducing particular bacterial strains in in situ mouse CRC models. Detailed experimental protocols of bacterial gavage and the advantages and caveats of different experimental models are summarized in this review. The microbial genotoxins, enterotoxins, and virulence factors implicated in the mechanisms of bacteria-driven tumorigenesis are described. In conclusion, intestinal microbiota is involved in colon tumorigenesis. Bacteria-targeting intervention would be the next challenge for CRC.

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Colorectal neoplasia

Intestinal microbiota, chronic inflammation, and colorectal cancer: Chan Hyuk Park, Chang Soo Eun, Dong Soo Han; Intest Res 2018;16(3):338-345. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.338

Abstract PDF PubReader ePub

In addition to genetic and epigenetic factors, various environmental factors, including diet, play important roles in the development of colorectal cancer (CRC). Recently, there is increasing interest in the intestinal microbiota as an environmental risk factor for CRC, because diet also influences the composition of the intestinal microbiota. The human intestinal microbiota comprises about 100 trillion microbes. This microbiome thrives on undigested dietary residues in the intestinal lumen and produces various metabolites. It is well known that the dietary risk factors for CRC are mediated by dysbiosis of the intestinal microbiota and their metabolites. In this review, we describe the bacterial taxa associated with CRC, including Fusobacterium nucleatum, enterotoxigenic Bacteroides fragilis, Escherichia coli, and butyrate-producing bacteria. We also discuss the host-diet interaction in colorectal carcinogenesis.

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Review

IBD

Why is it so difficult to evaluate faecal microbiota transplantation as a treatment for ulcerative colitis?: Natalie Grace Fairhurst, Simon P. L. Travis; Intest Res 2018;16(2):209-215. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.209

Abstract PDF PubReader ePub

Faecal microbiota transplantation (FMT) has recently re-emerged as a viable therapeutic option for colonic disorders. Its efficacy has been proved in the treatment of Clostridium difficile infection which has encouraged research into the use of FMT for other disorders involving gut dysbiosis, such as ulcerative colitis (UC), a chronic inflammatory disease characterized by relapsing and remitting colonic inflammation. Although the FMT protocol for C. difficile treatment is well established, there are numerous additional factors to consider when applying FMT to treat inflammatory diseases. Various studies have attempted to address these factors but technical inconsistency between reports has resulted in a failure to achieve clinically significant findings. Case reports of FMT in UC have shown favorable outcomes yet demonstrating these effects on a larger scale has proved difficult. The following review aims to explore these issues and to analyze why they may be hindering the progression of FMT therapy in UC.

Citations

Citations to this article as recorded by

The Role of Fecal Microbiota Transplantation in the Induction of Remission in Ulcerative Colitis
Adam Saleh, Shyon Parsa, Manuel Garza, Eamonn M.M. Quigley, Bincy P. Abraham
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M.C. Flux, Christopher A. Lowry
Neurobiology of Disease.2020; 135: 104578. CrossRef
In Situ Profiling of the Three Dominant Phyla Within the Human Gut Using TaqMan PCR for Pre-Hospital Diagnosis of Gut Dysbiosis
Young Jae Jo, Setu Bazie Tagele, Huy Quang Pham, YeonGyun Jung, Jerald Conrad Ibal, SeungDae Choi, Gi-Ung Kang, Sowon Park, Yunkoo Kang, Seung Kim, Hong Koh, Jae-Ho Shin
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Gut microbiota in ulcerative colitis: insights on pathogenesis and treatment
Xiao Yan Guo, Xin Juan Liu, Jian Yu Hao
Journal of Digestive Diseases.2020; 21(3): 147. CrossRef
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Stephanie A. Flowers, Shubha Bhat, James C. Lee
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Efficacy of fecal microbiota therapy in steroid dependent ulcerative colitis: a real world intention-to-treat analysis
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Multi-session fecal microbiota transplantation using colonoscopy has favorable outcomes for the treatment of steroid-dependent ulcerative colitis
Young-Seok Cho
Intestinal Research.2019; 17(1): 6. CrossRef
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Xiao Ding, Qianqian Li, Pan Li, Ting Zhang, Bota Cui, Guozhong Ji, Xiang Lu, Faming Zhang
Drug Safety.2019; 42(7): 869. CrossRef

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Case Reports

IBD

Fecal microbiota transplantation for recurrent Clostridium difficile infection in a patient with ulcerative colitis: Kosaku Nanki, Shinta Mizuno, Katsuyoshi Matsuoka, Keiko Ono, Shinya Sugimoto, Hiroki Kiyohara, Mari Arai, Moeko Nakashima, Kozue Takeshita, Keiichiro Saigusa, Mitsutoshi Senoh, Tadashi Fukuda, Makoto Naganuma, Haru Kato, Wataru Suda, Masahira Hattori, Takanori Kanai; Intest Res 2018;16(1):142-146. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.142

Abstract PDF PubReader ePub

Fecal microbiota transplantation (FMT) has been reported as a safe and effective therapy in patients with refractory and recurrent Clostridium difficile infection (CDI). FMT has also been reported as a promising therapy in patients with ulcerative colitis (UC). Both, CDI and UC, are believed to be caused by dysbiosis, such as altered compositions or decreased diversity of the intestinal microbiota. This report describes a patient with UC in remission with a second recurrent episode of CDI, who was treated with FMT. A single FMT performed via colonoscopy completely resolved the patient's diarrhea and eradicated C. difficile bacteriologically without any severe complications. Molecular biological analysis of the patient's fecal microbiota showed that FMT could dramatically change the altered composition of intestinal microbiota and restore its diversity. Despite the restoration of the intestinal microbiota, FMT could not prevent a relapse of UC in this patient. However, it improved the intestinal symptoms of CDI and could prevent further recurrences of CDI.

Citations

Citations to this article as recorded by

Impact of Clostridioides difficile Infection on Clinical Outcomes in Hospitalized IBD Patients and the Role of Fecal Microbiota Transplantation: A Retrospective Cohort Study
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The Kaohsiung Journal of Medical Sciences.2025;[Epub] CrossRef
Comparative Efficacy of Fecal Microbiota Transplantation in Treating Refractory or Recurrent Clostridioides difficile Infection among Patients with and without Inflammatory Bowel Disease: A Retrospective Cohort Study
Jing-Han Chen, Cheng-Hsun Chiu, Chien-Chang Chen, Yi-Ching Chen, Pai-Jui Yeh, Chia-Jung Kuo, Cheng-Tang Chiu, Hao-Tsai Cheng, Yu-Bin Pan, Puo-Hsien Le
Biomedicines.2024; 12(7): 1396. CrossRef
Case report: Fecal microbiota transplant for Clostridium difficile infection in a pregnant patient with acute severe ulcerative colitis
Hanyu Wang, Feihong Deng, Min Luo, Xuehong Wang
Frontiers in Immunology.2024;[Epub] CrossRef
The first international Rome consensus conference on gut microbiota and faecal microbiota transplantation in inflammatory bowel disease
Loris Riccardo Lopetuso, Sara Deleu, Lihi Godny, Valentina Petito, Pierluigi Puca, Federica Facciotti, Harry Sokol, Gianluca Ianiro, Luca Masucci, Maria Abreu, Iris Dotan, Samuel Paul Costello, Ailsa Hart, Tariq H Iqbal, Sudarshan Paramsothy, Maurizio San
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Fecal microbiota transplantation for refractory Crohn's disease: Seon Ho Bak, Hyun Ho Choi, Jinhee Lee, Mi Hee Kim, Youn Hee Lee, Jin Su Kim, Young-Seok Cho; Intest Res 2017;15(2):244-248. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.244

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Approximately one-third of patients with Crohn's disease do not respond to conventional treatments, and some experience significant adverse effects, such as serious infections and lymphoma, and many patients require surgery due to complications. Increasing evidence suggests that specific changes in the composition of gut microbiota, termed as dysbiosis, are a common feature in patients with inflammatory bowel disease (IBD). Dysbiosis can lead to activation of the mucosal immune system, resulting in chronic inflammation and the development of mucosal lesions. Recently, fecal microbiota transplantation, aimed at modifying the composition of gut microbiota to overcome dysbiosis, has become a potential alternative therapeutic option for IBD. Herein, we present a patient with Crohn's colitis in whom biologic therapy failed previously, but clinical remission and endoscopic improvement was achieved after a single fecal microbiota transplantation infusion.

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Original Article

Single fecal microbiota transplantation failed to change intestinal microbiota and had limited effectiveness against ulcerative colitis in Japanese patients: Shinta Mizuno, Kosaku Nanki, Katsuyoshi Matsuoka, Keiichiro Saigusa, Keiko Ono, Mari Arai, Shinya Sugimoto, Hiroki Kiyohara, Moeko Nakashima, Kozue Takeshita, Makoto Naganuma, Wataru Suda, Masahira Hattori, Takanori Kanai; Intest Res 2017;15(1):68-74. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.68

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

Recent developments in analytical techniques including next-generation sequencing have clarified the correlation between intestinal microbiota and inflammatory bowel disease. Fecal microbiota transplantation (FMT) for patients with ulcerative colitis (UC) is proposed as a potential approach to resolving their dysbiosis; however, its safety and efficacy have not been confirmed. This single-arm, open-label, non-randomized study aimed to evaluate the safety and efficacy of FMT for Japanese patients with UC as the first registered clinical trial in Japan.

Methods

We enrolled 10 patients with active UC despite medical therapy. The donors were the patients' relatives and were carefully screened for infectious diseases. Fecal material was administered via colonoscopy, and the primary endpoint was the presence or absence of serious adverse events related to FMT. The secondary endpoint was a change in partial Mayo score at 12 weeks post-FMT. Scores ≤2 were considered a clinical response. Fecal samples were collected to follow changes in gut microbiota, while extracted complementary DNA were analyzed by a next-generation sequencer. We obtained written informed consent from all patients and donors. This study was approved by our Institutional Review Board and is registered in the University hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN 000012814).

Results

Five patients with moderate disease and five with severe disease were enrolled. No severe adverse effects were observed. One patient achieved clinical response; however, none of the patients' microbiota diversity recovered to the donor levels.

Conclusions

The use of single FMT for UC was safe; however, we failed to show its clinical efficacy and potential to change the intestinal microbiota.

Citations

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Review

Pathogenic role of the gut microbiota in gastrointestinal diseases: Hiroko Nagao-Kitamoto, Sho Kitamoto, Peter Kuffa, Nobuhiko Kamada; Intest Res 2016;14(2):127-138. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.127

Abstract PDF PubReader ePub

The gastrointestinal (GI) tract is colonized by a dense community of commensal microorganisms referred to as the gut microbiota. The gut microbiota and the host have co-evolved, and they engage in a myriad of immunogenic and metabolic interactions. The gut microbiota contributes to the maintenance of host health. However, when healthy microbial structure is perturbed, a condition termed dysbiosis, the altered gut microbiota can trigger the development of various GI diseases including inflammatory bowel disease, colon cancer, celiac disease, and irritable bowel syndrome. There is a growing body of evidence suggesting that multiple intrinsic and extrinsic factors, such as genetic variations, diet, stress, and medication, can dramatically affect the balance of the gut microbiota. Therefore, these factors regulate the development and progression of GI diseases by inducing dysbiosis. Herein, we will review the recent advances in the field, focusing on the mechanisms through which intrinsic and extrinsic factors induce dysbiosis and the role a dysbiotic microbiota plays in the pathogenesis of GI diseases.

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Case Report

Refractory Clostridium difficile Infection Cured With Fecal Microbiota Transplantation in Vancomycin-Resistant Enterococcus Colonized Patient: Mi-Ok Jang, Jun Hwan An, Sook-In Jung, Kyung-Hwa Park; Intest Res 2015;13(1):80-84. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.80

Abstract PDF PubReader

The rates and severity of Clostridium difficile infections, including pseudomembranous colitis, have increased markedly. However, there are few effective treatments for refractory or recurrent C. difficile infections and the outcomes are poor. Fecal microbiota transplantation is becoming increasingly accepted as an effective and safe intervention in patients with recurrent disease, likely due to the restoration of a disrupted microbiome. Cure rates of >90% are being consistently reported from multiple centers. We cured a case of severe refractory C. difficile infection with fecal microbiota transplantation in a patient colonized by vancomycin-resistant enterococcus.

Citations

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The potential utility of fecal (or intestinal) microbiota transplantation in controlling infectious diseases
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Original Article

Comparative Analysis of Gastrointestinal Microbiota Between Normal and Caudal-Related Homeobox 2 (Cdx2) Transgenic Mice: Hirotsugu Sakamoto, Takashi Asahara, Osamu Chonan, Norikatsu Yuki, Hiroyuki Mutoh, Shunji Hayashi, Hironori Yamamoto, Kentaro Sugano; Intest Res 2015;13(1):39-49. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.39

Abstract PDF PubReader

Background/Aims

Caudal-related homeobox 2 (Cdx2) is expressed in the human intestinal metaplastic mucosa and induces intestinal metaplastic mucosa in the Cdx2 transgenic mouse stomach. Atrophic gastritis and intestinal metaplasia commonly lead to gastric achlorhydria, which predisposes the stomach to bacterial overgrowth. In the present study, we determined the differences in gut microbiota between normal and Cdx2 transgenic mice, using quantitative reverse transcription-polymerase chain reaction (qRT-PCR).

Methods

Twelve normal (control) and 12 Cdx2 transgenic mice were sacrificed, and the gastric, jejunal, ileac, cecal and colonic mucosa, and feces were collected. To quantitate bacterial microbiota, we used real-time qRTPCR with 16S rRNA gene-targeted, species-specific primers.

Results

The total numbers of bacteria in the gastric, jejunal, ileac, cecal, and colonic mucosa of the Cdx2 transgenic mice were significantly higher than those of the normal mice. The Bacteroides fragilis group and also Prevotella were not detected in the stomach of the normal mice, although they were detected in the Cdx2 transgenic mice. Moreover, the Clostridium coccoides group, Clostridium leptum subgroup, Bacteroides fragilis group, and Prevotella were not detected in the jejunum or ileum of the normal mice, although they were detected in the Cdx2 transgenic mice. The fecal microbiota of the normal mice was similar to that of the Cdx2 transgenic mice.

Conclusions

Our results showed the differences in composition of gut microbiota between normal and Cdx2 transgenic mice, which may be caused by the development of gastric achlorhydria and intestinal metaplasia in Cdx2 transgenic mice.

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Review

Current Status and Prospects of Intestinal Microbiome Studies: Dong Soo Han; Intest Res 2014;12(3):178-183. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.178

Abstract PDF PubReader ePub

The incidence and prevalence of inflammatory bowel disease (IBD) in Asia has witnessed a rapid increase within a few decades. The genetic susceptibility and epidemiologic backgrounds in the Asian population have been found to be different from that of Western populations. There is an extensive crosstalk between gut microbiota and human hosts, with evidence of reciprocal interactions. It is well known that gut microbiota can affect the host immune system and in turn, host genetic backgrounds can affect gut microbiota reciprocally. Evidences have implicated gut microbes in the development of IBD, but no causative microorganisms have been identified. Recent advances in sequencing technology and computational analysis have now made identification of complex gut microbiomes accessible. Further research targeting gut microbiota could help in identifying biomarkers to predict clinical response, and therapeutic modalities that might affect their resilience.

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