Intestinal Microbiota, Lipids, and the Pathogenesis of Intestinal Failure–Associated Liver Disease

Lee, Way Seah; Sokol, Ronald J.

doi:10.1016/j.jpeds.2015.05.048

Cited by 54 publications

(36 citation statements)

References 52 publications

(93 reference statements)

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“…Many factors have been implicated in the development of IFALD . Recent studies suggest that decrease in microbial diversity and overgrowth of certain bacterial groups are associated with IFALD.…”

Section: Resultsmentioning

confidence: 99%

“…Many factors have been implicated in the development of IFALD. [72][73][74] Recent studies suggest that decrease in microbial diversity and overgrowth of certain bacterial groups are associated with IFALD. Korpela et al 33 showed that increased abundance of Proteobacteria was strongly associated with liver steatosis, portal and intestinal inflammation, and liver fibrosis.…”

Section: Gut Microbiome In If and Clinical Outcomesmentioning

confidence: 99%

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The Gut Microbiome in Patients with Intestinal Failure: Current Evidence and Implications for Clinical Practice

Neelis

Koning

Rings

et al. 2018

J Parenter Enteral Nutr

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Intestinal failure (IF) is the reduction of gut function or mass below a minimum needed to absorb nutrients and fluids, such that patients are dependent on parenteral nutrition (PN). Patients with IF have an altered gut microbiome. Our aim was to review and evaluate the current evidence on gut microbiome and its metabolic activity, as well as its association with disease characteristics in adults and children with IF. We performed a PubMed literature search for articles published after 2000 using the following terms: intestinal, microbiome, microbiota, short-chain fatty acids, short bowel syndrome, and PN. Literature search was restricted to human studies only. The gut microbiome diversity is remarkably reduced, and community structure is altered with a noticeable overabundance of Proteobacteria, especially the Enterobacteriaceae family. A substantial increase in Lactobacillus level is often reported in patients with IF. Gut microbiome characteristics have been associated with poor growth, liver disease, D-lactic acidosis, and duration of intestinal adaptation. Differences in microbiome characteristics have been found between patients receiving PN and those whose guts have adapted and have been weaned off PN. Future research with prospective sample collection should explore the value of the gut microbiome as a biomarker to guide clinical practice and as a modifiable therapeutic target to optimize outcomes of patients with IF.

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Section: Resultsmentioning

confidence: 99%

Section: Gut Microbiome In If and Clinical Outcomesmentioning

confidence: 99%

The Gut Microbiome in Patients with Intestinal Failure: Current Evidence and Implications for Clinical Practice

Neelis

Koning

Rings

et al. 2018

J Parenter Enteral Nutr

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“…There is no unifying theory for IFALD [55]. Non-nutrient factors include hepatotoxic medications, endotoxemia related to sepsis and bacterial overgrowth, and intrinsic liver disease [3].…”

Section: Home Parenteral Nutritionmentioning

confidence: 99%

Parenteral Nutrition and Intestinal Failure

Bielawska

Allard

2017

Nutrients

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Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN. New hormonal therapies targeting intestinal adaptation hold promise. Surgical options for SBS including intestinal transplant are available, but have significant limitations. Home PN (HPN) is therefore the mainstay of treatment for severe SBS. HPN involves chronic administration of macronutrients, micronutrients, fluid, and electrolytes via central venous access in the patient’s home. HPN requires careful clinical and biochemical monitoring. Main complications of HPN are related to venous access (infection, thrombosis) and metabolic complications including intestinal failure associated liver disease (IFALD). Although HPN significantly impacts quality of life, outcomes are generally good and survival is mostly determined by the underlying disease. As chronic intestinal failure is a rare disease, registries are a promising strategy for studying HPN patients to improve outcomes.

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“…However, this form of therapy has several limitations, including overload and/or deficiency of certain food groups and nutrients ( Crenn and Maillot, 2007 ; Boyer et al , 2015 ). Theoretically, diets restricted or excessively rich in certain nutrients may prompt a state of intestinal dysbiosis with systemic effects, leading to malnutrition, obesity ( Henao-Mejia et al , 2012 ), type 1 ( Wen et al , 2008 ) or type 2 diabetes ( Larsen et al , 2010 ), inflammatory bowel disease ( Ashton et al , 2017 ; Geirnaert et al , 2017 ) and liver disease ( Lee and Sokol, 2015 ), as well as a variety of disorders featuring an inflammatory component, symptoms of autism spectrum disorders ( De Angelis et al , 2015 ), and even cancer ( Jacqueline et al , 2017 ; Xu and Jiang, 2017 ). Studies seeking to identify the effects of dietary treatment and nutrient supplementation on the microbiome of patients with IEMs are still scarce.…”

Section: Inborn Errors Of Metabolism (Iem)mentioning

confidence: 99%

The microbiome and inborn errors of metabolism: Why we should look carefully at their interplay?

2018

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Research into the influence of the microbiome on the human body has been shedding new light on diseases long known to be multifactorial, such as obesity, mood disorders, autism, and inflammatory bowel disease. Although inborn errors of metabolism (IEMs) are monogenic diseases, genotype alone is not enough to explain the wide phenotypic variability observed in patients with these conditions. Genetics and diet exert a strong influence on the microbiome, and diet is used (alone or as an adjuvant) in the treatment of many IEMs. This review will describe how the effects of the microbiome on the host can interfere with IEM phenotypes through interactions with organs such as the liver and brain, two of the structures most commonly affected by IEMs. The relationships between treatment strategies for some IEMs and the microbiome will also be addressed. Studies on the microbiome and its influence in individuals with IEMs are still incipient, but are of the utmost importance to elucidating the phenotypic variety observed in these conditions.

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Intestinal Microbiota, Lipids, and the Pathogenesis of Intestinal Failure–Associated Liver Disease

Cited by 54 publications

References 52 publications

The Gut Microbiome in Patients with Intestinal Failure: Current Evidence and Implications for Clinical Practice

The Gut Microbiome in Patients with Intestinal Failure: Current Evidence and Implications for Clinical Practice

Parenteral Nutrition and Intestinal Failure

The microbiome and inborn errors of metabolism: Why we should look carefully at their interplay?

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