scholarly journals Faecal Microbiota in Patients with Neurogenic Bowel Dysfunction and Spinal Cord Injury or Multiple Sclerosis—A Systematic Review

2021 ◽  
Vol 10 (8) ◽  
pp. 1598
Author(s):  
Willemijn Faber ◽  
Janneke Stolwijk-Swuste ◽  
Florian van Ginkel ◽  
Janneke Nachtegaal ◽  
Erwin Zoetendal ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Methodological Quality ◽  
Alpha Diversity ◽  
Bowel Function ◽  
Antibiotic Use ◽  
Bowel Dysfunction ◽  
Healthy Controls ◽  
Cord Injury ◽  
Neurogenic Bowel

Background: Neurogenic bowel dysfunction (NBD) frequently occurs in patients with spinal cord injury (SCI) and multiple sclerosis (MS) with comparable symptoms and is often difficult to treat. It has been suggested the gut microbiota might influence the course of NBD. We systematically reviewed the literature on the composition of the gut microbiota in SCI and MS, and the possible role of neurogenic bowel function, diet and antibiotic use. Methods: A systematic search was conducted in PubMed and Embase, which retrieved studies on the gut microbiota in SCI and MS. The Newcastle–Ottawa Quality Assessment Scale (NOS) was used to assess methodological quality. Results: We retrieved fourteen papers (four on SCI, ten on MS), describing the results of a total of 479 patients. The number of patients per study varied from 13 to 89 with an average of 34. Thirteen papers were observational studies and one study was an intervention study. The studies were case control studies in which the gut microbiota composition was determined by 16S rRNA gene sequencing. The methodological quality of the studies was mostly rated to be moderate. Results of two studies suggested that alpha diversity in chronic SCI patients is lower compared to healthy controls (HC), whereas results from five studies suggest that the alpha diversity of MS patients is similar compared to healthy subjects. The taxonomic changes in MS and SCI studies are diverse. Most studies did not account for possible confounding by diet, antibiotic use and bowel function. Conclusion: Based on these 14 papers, we cannot draw strong conclusions on the composition of the gut microbiota in SCI and MS patients. Putatively, alpha diversity in chronic SCI patients may be lower compared to healthy controls, while in MS patients, alpha diversity may be similar or lower compared to healthy controls. Future studies should provide a more detailed description of clinical characteristics of participants and of diet, antibiotic use and bowel function in order to make valid inferences on changes in gut microbiota and the possible role of diet, antibiotic use and bowel function in those changes.

scholarly journals Dynamic age-associated changes and their driver microbes in healthy gut microbiota of captive crab-eating macaques

2020 ◽  
Author(s):  
Zhi-Yuan Wei ◽  
Jun-Hua Rao ◽  
Ming-Tian Tang ◽  
Guo-An Zhao ◽  
Qi-Chun Li ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Alpha Diversity ◽  
Active Role ◽  
Antibiotic Use ◽  
Microbial Interactions ◽  
Topology Analysis ◽  
Show Evidence ◽  
Gut Mucosa ◽  
Metabolite Synthesis

Abstract Background: Previous population studies have indicated age-associated changes in the gut microbiota. However, the actual age effects on microbiota are inevitably confounded by varying environmental factors such as diets and antibiotic use in the populations. Captive crab-eating macaques reared in a well-controlled environment can provide a useful model to recapitulate dynamic age-associated changes in the healthy primate gut microbiota.Results: We show evidence supporting lifelong age-associated changes in the healthy gut microbiota of captive macaques. The Firmicutes to Bacteroidetes ratio and beta diversity but not alpha diversity changed significantly with age. The most significantly age-associated genera were mainly composed of commensals, such as Faecalibacterium . Unexpectedly, a subset of the age-associated microbes were suspicious pathogens such as Helicobacter and Campylobacter , which were enriched in infant macaques, and possibly associated with gut mucosa development. These age-associated microbes were main contributors to the gut microbiota networks. Importantly, topology analysis showed that connectivity of these networks changed with age, and its rapid decrease in elderly macaques might indicate altered microbial interactions associated with host aging. Prevotella 9 , one of the most abundant age-associated genera, was the driver responsible for the gut microbiota maturation from infants to young adults. In adults, Rikenellaceae RC9 gut group and Megasphaera were two key drivers that continuously played an active role in driving microbial community changes of across different stages of adulthood. We also showed evidence of age-associated changes in gut microbial phenotypes and functions, in particular pathways of immunomodulatory metabolite synthesis, and metabolism of lipids and carbohydrates. The driver microbes were key players involved in these functions.Conclusions: Our current study in captive macaques demonstrate evident age-associated changes during the lifelong process of healthy gut microbiota development. The enrichment of suspicious pathogens in healthy infant macaques might indicate the importance of appropriate exposure to these microbes for the developing immune system. The current study provides new insights into the pivotal role of driver microbes and microbial interactions in gut microbiota, and further underlines the importance of network analysis in microbiome studies. Our findings also provide a baseline for better understanding of disease-related changes in the primate gut microbiota.

scholarly journals Neurostimulation for Neurogenic Bowel Dysfunction

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
J. Worsøe ◽  
M. Rasmussen ◽  
P. Christensen ◽  
K. Krogh
Keyword(s):  
Nerve Stimulation ◽  
Magnetic Stimulation ◽  
Bowel Function ◽  
Bowel Dysfunction ◽  
Cochrane Library ◽  
Congenital Defects ◽  
Clinical Use ◽  
Pilot Studies ◽  
Cord Injury ◽  
Neurogenic Bowel

Background. Loss of normal bowel function caused by nerve injury, neurological disease or congenital defects of the nervous system is termed neurogenic bowel dysfunction (NBD). It usually includes combinations of fecal incontinence, constipation, abdominal pain and bloating. When standard treatment of NBD fails surgical procedures are often needed. Neurostimulation has also been investigated, but no consensus exists about efficacy or clinical use.Methods. A systematic literature search of NBD treated by sacral anterior root stimulation (SARS), sacral nerve stimulation (SNS), peripheral nerve stimulation, magnetic stimulation, and nerve re-routing was made in Pubmed, Embase, Scopus, and the Cochrane Library.Results. SARS improves bowel function in some patients with complete spinal cord injury (SCI). Nerve re-routing is claimed to facilitate defecation through mechanical stimulation of dermatomes in patients with complete or incomplete SCI or myelomeningocele. SNS can reduce NBD in selected patients with a variety of incomplete neurological lesions. Peripheral stimulation using electrical stimulation or magnetic stimulation may represent non-invasive alternatives.Conclusion. Numerous methods of neurostimulation to treat NBD have been investigated in pilot studies or retrospective studies. Therefore, larger controlled trials with well-defined inclusion criteria and endpoints are recommended before widespread clinical use of neurostimulation against NBD.

scholarly journals Neurogenic bowel dysfunction

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1800 ◽  
Author(s):  
Anton Emmanuel
Keyword(s):  
Quality Of Life ◽  
Neurological Diseases ◽  
Bowel Function ◽  
Bowel Dysfunction ◽  
Laxative Use ◽  
Cord Injury ◽  
Surgical Options ◽  
Neurogenic Bowel ◽  
Monitoring Response

The symptoms of neurogenic bowel dysfunction (NBD) comprise constipation and fecal incontinence. These have a major impact on quality of life and dignity. Bowel symptoms occur in the majority of patients with chronic neurological diseases like multiple sclerosis, spinal cord injury, and Parkinson’s disease. Management relies on obtaining a careful bowel history, including assessment of bowel function prior to the onset of neurological symptoms. Objective measures of NBD are available and important in terms of monitoring response for what are often intensely personal and difficult-to-elicit symptoms. Conservative management begins by establishing an effective and regular bowel regime by optimizing diet and laxative use. If this is insufficient, as seen in about half of patients, transanal irrigation has been shown to reduce NBD symptoms and improve quality of life. Failing that, there are more invasive surgical options available. This review aims to provide practical guidance for the clinician who encounters these patients, focusing on a stepwise approach to assessment, interventions, and monitoring.

scholarly journals Gut Microbiota in male patients with chronic traumatic complete spinal cord injury

2018 ◽  
Author(s):  
Chao Zhang ◽  
Wenhao Zhang ◽  
Jie Zhang ◽  
Yingli Jing ◽  
Mingliang Yang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Gut Microbiota ◽  
Bowel Dysfunction ◽  
Serum Biomarkers ◽  
Bowel Management ◽  
Cord Injury ◽  
Complete Spinal Cord Injury ◽  
Neurogenic Bowel ◽  
Gut Microbiota Dysbiosis

AbstractThis study examined the diversity and structure of gut microbiota in healthy adults and chronic traumatic complete spinal cord injury (SCI) patients, documented neurogenic bowel management of SCI patients. The V3-V4 region of 16S rRNA gene from DNA of 91 fecal samples of 48 healthy and 43 diseased subjects was amplified and sequenced. There was difference in gut microbiota between healthy adult males and females. Neurogenic bowel dysfunction (NBD) was common in patients with chronic traumatic complete SCI, patients with quadriplegia have longer time to defecate than paraplegic patients, with higher NBD scores and heavier neurogenic bowel symptoms. Gut microbiota dysbiosis existed in SCI patients. The abundance of Veillonellaceae and Prevotellaceae increased while Bacteroidaceae and Bacteroides decreased in SCI group. The abundance of Bacteroidaceae, Bacteroides in quadriplegia group and Acidaminococcaceae, Blautia in paraplegia group were significant high than the health male group. Serum biomarkers GLU, HDL, CR and NBD symptoms defecation time, COURSE had significant correlation with microbial community structure. This study presents a comprehensive landscape of gut microbiota in adult male patients with chronic traumatic complete SCI and documents their neurogenic bowel management. The gut microbiota dysbiosis of SCI patients was correlation with serum biomarkers and NBD symptoms.IMPORTANCENeurogenic bowel dysfunction is a major physical and psychological problem in patients with spinal cord injury, which can seriously affect the quality life of them. Gut dysbiosis are highly likely to occur in spinal cord injury patients There are few studies on intestinal microecology after spinal cord injury, and the clinical studies are fewer. It is importance to document their neurogenic bowel management and present a landscape of gut microbiota in them. We found the gut microbiota dysbiosis of spinal cord injury patients was correlation with serum biomarkers and neurogenic bowel dysfunction symptoms. These results may have implications in the next study about metagenomics and precision treatment of neurogenic bowel dysfunction in spinal cord injury patients.

scholarly journals Improvement of Gut Diversity and Composition After Direct-Acting Antivirals in Hepatitis C Virus–Infected Patients With or Without Human Immunodeficiency Virus Coinfection

2021 ◽  
Author(s):  
Natthaya Chuaypen ◽  
Thananya Jinato ◽  
Anchalee Avihingsanon ◽  
Sakkarin Chirapongsathorn ◽  
Supapon Cheevadhanarak ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Gut Microbiota ◽  
Alpha Diversity ◽  
Healthy Controls ◽  
Direct Acting Antivirals ◽  
Microbial Dysbiosis ◽  
Immunodeficiency Virus ◽  
Direct Acting

Abstract Background The influence of direct-acting antivirals (DAAs) on the composition of gut microbiota in hepatitis C virus (HCV)–infected patients with or without human immunodeficiency virus (HIV) is unclear. Methods We enrolled 62 patients with HCV monoinfection and 24 patients with HCV/HIV coinfection receiving elbasvir-grazoprevir from a clinical trial. Fecal specimens collected before treatment and 12 weeks after treatment were analyzed using amplicon-based 16S ribosomal RNA sequencing. Results Sustained virological response rates in the monoinfection and coinfection groups were similar (98.4% vs 95.8%). Pretreatment bacterial communities in the patient groups were less diverse and distinct from those of healthy controls. Compared with HCV-monoinfected patients, HCV/HIV-coinfected individuals showed comparable microbial alpha diversity but decreased Firmicutes-Bacteroidetes ratios. The improvement of microbial dysbiosis was observed in responders achieving sustained virological response across fibrosis stages but was not found in nonresponders. Responders with a low degree of fibrosis exhibited a recovery in alpha diversity to levels comparable to those in healthy controls. Reciprocal alterations of increased beneficial bacteria and reduced pathogenic bacteria were also observed in responders. Conclusions This study indicates a short-term effect of direct-acting antivirals in restoration of microbial dysbiosis. The favorable changes in gut microbiota profiles after viral eradication might contribute toward the reduction of HCV-related complications among infected individuals.

scholarly journals The Effect of Exoskeletal-Assisted Walking on Spinal Cord Injury Bowel Function: Results from a Randomized Trial and Comparison to Other Physical Interventions

2021 ◽  
Vol 10 (5) ◽  
pp. 964
Author(s):  
Peter H. Gorman ◽  
Gail F. Forrest ◽  
Pierre K. Asselin ◽  
William Scott ◽  
Stephen Kornfeld ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Bowel Function ◽  
Bowel Dysfunction ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Cord Injury ◽  
Patient Reported ◽  
Stool Form ◽  
Time Since Injury

Bowel function after spinal cord injury (SCI) is compromised because of a lack of voluntary control and reduction in bowel motility, often leading to incontinence and constipation not easily managed. Physical activity and upright posture may play a role in dealing with these issues. We performed a three-center, randomized, controlled, crossover clinical trial of exoskeletal-assisted walking (EAW) compared to usual activity (UA) in people with chronic SCI. As a secondary outcome measure, the effect of this intervention on bowel function was assessed using a 10-question bowel function survey, the Bristol Stool Form Scale (BSS) and the Spinal Cord Injury Quality of Life (SCI-QOL) Bowel Management Difficulties instrument. Fifty participants completed the study, with bowel data available for 49. The amount of time needed for the bowel program on average was reduced in 24% of the participants after EAW. A trend toward normalization of stool form was noted. There were no significant effects on patient-reported outcomes for bowel function for the SCI-QOL components, although the time since injury may have played a role. Subset analysis suggested that EAW produces a greater positive effect in men than women and may be more effective in motor-complete individuals with respect to stool consistency. EAW, along with other physical interventions previously investigated, may be able to play a previously underappreciated role in assisting with SCI-related bowel dysfunction.

scholarly journals Effects of Transanal Irrigation on Gut Microbiota in Pediatric Patients with Spina Bifida

2021 ◽  
Vol 10 (2) ◽  
pp. 224
Author(s):  
Akira Furuta ◽  
Yasuyuki Suzuki ◽  
Ryosuke Takahashi ◽  
Birte Petersen Jakobsen ◽  
Takahiro Kimura ◽  
...  
Keyword(s):  
Spina Bifida ◽  
16S Rrna ◽  
Gut Microbiota ◽  
Pediatric Patients ◽  
Host Immune System ◽  
Healthy Controls ◽  
Transanal Irrigation ◽  
Rrna Sequencing ◽  
Before And After ◽  
Neurogenic Bowel

Recent studies using 16S rRNA-based microbiota profiling have demonstrated dysbiosis of gut microbiota in constipated patients. The aim of this study was to investigate the changes in gut microbiota after transanal irrigation (TAI) in patients with spina bifida (SB). A questionnaire on neurogenic bowel disfunction (NBD), Bristol scale, and gut microbiota using 16S rRNA sequencing were completed in 16 SB patients and 10 healthy controls aged 6–17 years. Then, 11 of 16 SB patients with moderate to severe NBD scores received TAI for 3 months. Changes in urine cultures were also examined before and after the TAI treatments. In addition, correlation of gut microbiota and Bristol scale was analyzed. Significantly decreased abundance in Faecalibacterium, Blautia and Roseburia, and significantly increased abundance in Bacteroides and Roseburia were observed in the SB patients compared with controls and after TAI, respectively. The abundance of Roseburia was significantly correlated positively with Bristol scale. Urinary tract infection tended to decrease from 82% to 55% after TAI (p = 0.082) despite persistent fecal incontinence. Butyrate-producing bacteria such as Roseburia play a regulatory role in the intestinal motility and host immune system, suggesting the effects of TAI on gut microbiota.

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