Presentazione a cura del Professor Davide Festi - M.A.S.T.E.R. ECM in Gastroenterologia Focus on: Microbiota e dintorni - Fondazione Santa Lucia - Roma
Presentation given at Eva Perry Library about the emerging information on the microbiome. Key highlights include definition of the microbiome, affect of microbiome on health, how to maintain a healthy/balanced microbiome.
The Leaky Gut Syndrome is a rapidly growing condition
Millions of people are struggling with and don’t even know it
We might think leaky gut syndrome only affects the digestive system, but in reality it can lead to many other health conditions
Food allergies, low energy, joint pain, thyroid disease, autoimmune conditions and slow metabolism could be leaky gut symptoms
Presentation given at Eva Perry Library about the emerging information on the microbiome. Key highlights include definition of the microbiome, affect of microbiome on health, how to maintain a healthy/balanced microbiome.
The Leaky Gut Syndrome is a rapidly growing condition
Millions of people are struggling with and don’t even know it
We might think leaky gut syndrome only affects the digestive system, but in reality it can lead to many other health conditions
Food allergies, low energy, joint pain, thyroid disease, autoimmune conditions and slow metabolism could be leaky gut symptoms
Carbohydrate Counting for insulin dose adjustmentltejas86
Carbohydrate counting is the method of estimating carbohydrates from your meal and adjusting insulin dose to keep blood sugar levels under control. It is easy and very effective specially for children with type 1 diabetes. It offers variety and flexibility in the diet at the same time improves blood sugar profile.
The presentation in detail covers the Glycemic index and glycemic load of various kinds of food. The standard calculation of Glycemic index and GLycemic load.
Moreover, it covers the food processing effects that can alter the glycemic load and glycemic index like gelatinization, retrogradation, cooking, annealing, etc.
A happy gut does not only helps in improving your immune system but also has a positive effect on your mood swings and brain. C.A.R.E. of your gut is important - Cleanse, Activate, Restore and Enhance. So what is your gut telling you? Cause, in the end, your gut feeling is always right. True. Here is everything you need to know about a healthy gut...
Many people who try an Ancestral Diet don’t get adequate relief for their digestive complaints. A key reason why may be the presence of SIBO. This presentation will discuss symptoms, causes, pathophysiology, diagnosis and treatment of SIBO. A simple breath test can diagnose SIBO and treatments include diet, antibiotics, herbal antibiotics, elemental diet, and probiotics. Central in all treatment of SIBO is a low- carbohydrate, grain-free diet (Specific Carbohydrate Diet, Gut and Psychology Diet, modified Low Fodmaps Diet). Discussion will include why an ancestral diet can benefit digestion and how the SIBO diets differ from standard Paleo/Primal diets.
Diet microbiota interactions: the mediterranean diet as a key to a healthy mi...Fabio Piccini
Lecture for: The Mediterranean Diet from an Italian Perspective
“Let food be thy medicine and medicine be thy food”
A knowledge and application-based continuing education activity for US pharmacists and dietitians
Florence, Italy - November 6-9, 2018
Dr. Tom Burkey - Host-Microbe Interactions: Effects on nutrition and physiologyJohn Blue
Host-Microbe Interactions: Effects on nutrition and physiology - Dr. Tom Burkey, University of Nebraska-Lincoln, from the 2014 Allen D. Leman Swine Conference, September 15-16, 2014, St. Paul, Minnesota, USA.
More presentations at http://www.swinecast.com/2014-leman-swine-conference-material
Carbohydrate Counting for insulin dose adjustmentltejas86
Carbohydrate counting is the method of estimating carbohydrates from your meal and adjusting insulin dose to keep blood sugar levels under control. It is easy and very effective specially for children with type 1 diabetes. It offers variety and flexibility in the diet at the same time improves blood sugar profile.
The presentation in detail covers the Glycemic index and glycemic load of various kinds of food. The standard calculation of Glycemic index and GLycemic load.
Moreover, it covers the food processing effects that can alter the glycemic load and glycemic index like gelatinization, retrogradation, cooking, annealing, etc.
A happy gut does not only helps in improving your immune system but also has a positive effect on your mood swings and brain. C.A.R.E. of your gut is important - Cleanse, Activate, Restore and Enhance. So what is your gut telling you? Cause, in the end, your gut feeling is always right. True. Here is everything you need to know about a healthy gut...
Many people who try an Ancestral Diet don’t get adequate relief for their digestive complaints. A key reason why may be the presence of SIBO. This presentation will discuss symptoms, causes, pathophysiology, diagnosis and treatment of SIBO. A simple breath test can diagnose SIBO and treatments include diet, antibiotics, herbal antibiotics, elemental diet, and probiotics. Central in all treatment of SIBO is a low- carbohydrate, grain-free diet (Specific Carbohydrate Diet, Gut and Psychology Diet, modified Low Fodmaps Diet). Discussion will include why an ancestral diet can benefit digestion and how the SIBO diets differ from standard Paleo/Primal diets.
Diet microbiota interactions: the mediterranean diet as a key to a healthy mi...Fabio Piccini
Lecture for: The Mediterranean Diet from an Italian Perspective
“Let food be thy medicine and medicine be thy food”
A knowledge and application-based continuing education activity for US pharmacists and dietitians
Florence, Italy - November 6-9, 2018
Dr. Tom Burkey - Host-Microbe Interactions: Effects on nutrition and physiologyJohn Blue
Host-Microbe Interactions: Effects on nutrition and physiology - Dr. Tom Burkey, University of Nebraska-Lincoln, from the 2014 Allen D. Leman Swine Conference, September 15-16, 2014, St. Paul, Minnesota, USA.
More presentations at http://www.swinecast.com/2014-leman-swine-conference-material
During the 5th Yogurt Summit, held in Buenos Aires during ICN2017, Professor Sharon Donovan (University of California, Davis, USA) explained why gut microbiota are recognised today as the intersection between diet and health.
Gasbarrini A. Microbiota, Antibiotici e Probiotici in Gastroenterologia. ASMa...Gianfranco Tammaro
PROF. ANTONIO GASBARRINI - 3° Giornata Master ECM in Gastroenterologia 2016 (25/11/2016) - Fondazione Santa Lucia - Sala Congressi - Roma
Sito: www.asmad.net
Canale Youtube: https://youtu.be/ouYcXg_ZtJM
The gut microbiota plays a pivotal role in maintaining our health, with its balance and diversity being key to overall well-being. Dysbiosis, or disruptions in this delicate ecosystem, can lead to a range of harmful effects on the body, including digestive problems, immune dysfunction, inflammation, and increased risks of various diseases. Recognizing the significance of gut health and adopting practices that promote a balanced microbiota, such as a healthy diet and lifestyle choices, is crucial for optimizing our physical and even mental health.The gut microbiota is a vast and complex collection of microorganisms that profoundly affects human health.The gut microbiota assists in a range of bodily functions, including:
harvesting energy from digested food
protecting against pathogens
regulating immune function
strengthening biochemical barriers of the gut and intestine
Impact of gut microbes on gastrointestinal diseaseSandra Unorji
Gut microbes have been identified play a role in both health and disease. Surprisingly, we are outnumbered by them which raises questions that has led to several research with interesting results.
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Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
Dieta e Microbiota intestinale: quale rapporto
1. Dieta e microbiota intestinale: quale
rapporto
Davide Festi, Ramona Schiumerini
Dipartimento di Scienze Mediche e Chirurgiche
Università di Bologna
davide.festi@unibo.it
M.A.S.T.E.R. ECM in Gastroenterologia 2018
Focus on: Microbiota e dintorni
Roma, 9 Febbraio 2018
2. Gut microbiota
Definition
• Human gut microbiota: complex and dynamic
ecosystem, residing in human gastrointestinal
tract, composed by different microorganisms,
living in a symbiotic relationship with the host.
• Composed by hundreds to thousands of
bacterial species, viruses, archaea, yeasts
and protozoa.
• The collective genome of host’s indigenous
microbes constitutes the “microbiome”.
• Gut microbiota: a sort of “metaorganism”,
exerting a great influence on host’s organism
functions.
Hooper (2001);Van Best (2015)
3. Barrier function and protection against pathogens
Maturation and modulation of immune system
Metabolic functions
Promotion of mucosal trophism
Influence on neurological health and performance
Gut microbiota
Beneficial functions in host organism
4. Gut microbiota
Microbiome and host:
a mutualistic relationship
• Microbiome ferments substrated that humans cannot and
produces biologically active metabolites
Hurst NR, 2014
• Microbiome has a bidirectional relationship with the
endocrine system
Neuman H, 2015
• Microbiome has genes not possessed by humans
Harvil R, 2016
5. Gut microbiota
Factors affecting composition
• Host genotype
Benson AK, 2010
• Age
Yatsumenko T, 2012
• Sex
Bolnick DI, 2014
• Environmental factors
Voreades N, 2014
7. Gupta VK, Front Microbiol 2017
Gut microbiota
Population-specific variations in human
microbiome composition and diversity
8. Changes in dietary habits bring human species evolution changes in gut
microbiota composition.
Studying populations with different dietary habits, from hunter-gatherers
to rural farming and industrial agriculture, it’s possible to understand the
progressive adaptation of gut microbiota to dietary changes.
Progressive↓ of bacterial diversity and fibrolytic micro-organisms such as
Proteobacteria and Spirochaetes, in parallel with ↑ Actinobacteria.
Diet and gut microbiota
Evolution of gut microbiota in parallel with dietary habits
Schnorr, 2014; He, 2013
9. Diet and gut microbiota
Gut microbiome of the Hadza hunter-gatherers
(Hazda = 27; Italians = 16)
Metabolite production
(Hazda: orange; Italians: blue)
Bacterial relative abundance: Hazda vs Italians
Schnorr SL, Nat Comm 2014
10. Diet and gut microbiota
Dietary habits, geographical origins and gut microbiota
Comparison between fecal microbiota of Burkina Faso (BF) children and European
(EU) children:
• High fiber diet of BF children promotes ↑Bacteroidetes (in particular genus of
Prevotella, Xylanibacter) that hydrolize complex starch
• Low fiber diet of EU children is associated to relative ↑Firmicutes and
Enterobacteriaceae (Shigella and Escherichia)
De Filippo C et al, Proc Natl Acad Sci 2010
11. Diet and gut microbiota
Dietary habits, geographical origins and gut microbiota
Native AfricansAfrican Americans
High CCR risk Low CCR risk
Ou J et al,Am J Clin Nutr 2013
↑ protein and fat consumption ↑ complex starch consumption
↑ bacteria capable of proteolytic fermentation
(Bacteroides)
↑ bacteria capable of polysaccharide fermentation
(Prevotella)
↑ microbial genes encoding for secondary bile acid
production (pro-inflammatory)
↑ production of SCFAs (i.e. anti-inflammatory
butyrate)
12. Diet and gut microbiota
Gut microbiota and host subsistence strategies
Gupta VK et al Front Microbiol 2017
13. Diet and gut microbiota
Human gut microbiota through life stages
14. Diet and gut microbiota
Gut microbiota during antenatal period
• Presence of bacteria in the amniotic fluid, placenta, cord blood, meconium
Jemenez E, 2005; Di Giulio DB, 2012; Moles L, 2013
• Mother’s diet before and during pregnancy influences child gut microbiota
development
Mother’s diet Influences in child gut microbiota
• maternal gluten-free diet Achermansia and Proteobacteria
• unhealthy mother’s diet Inadequate gut microbiota composition and
functionality
• oil fish consumption positive effects on intestinal microbiota
Boscia AL, 2014; Myles A, 2014; Hansen CH, 2014
15. Diet and gut microbiota
Mother-infant relationship
Nash MJ et al, Front Endocrinol 2017
17. At the end of the first 3 years of life gut microbiota an adult-like stable system.
• 60-70% of the microbiota composition remains stable throughout life.
• 30-40% can be altered by changes in the diet, physical activity, lifestyle, bacterial
infections, and antibiotic or surgical treatment.
Kashtanova, 2016
Diet and gut microbiota
18. • Gut microbiota rapid turnover (doulble within 1hr)
(Sonnenburg JL, 2016)
• Diurnal oscillations driven primarly by food intake rhythm
(Zarrinpar, 2014)
• Gut microbiota responds rapidly to large changes in diet (short
term and long-term responders)
(Wu GD, 2011, Arumugam M, 2011; David LA, 2014)
• Long-term dietary habits composition of an individual’s gut
microbiota
(Wu GD, 2011, 2016)
Diet and gut microbiota
19. Even if microbiome composition changes detectably within 24 hours of initiating a 10-day
controlled diet (high-fat/low-fiber or low-fat/high-fiber diet) the enterotype identity
remains stable Wu GD et al. 2011
Diet and gut microbiota
Short-term influence of diet variation
20. Diet and gut microbiota
The concept of enterotypes
“Enterotypes”: clusters of predominant microbial species reflecting a
host-microbial symbiotic state, influenced by diet.
• Enterotype 1: predominant genus: Bacteroides; association with animal
protein rich-diet and saturated fats (Western diet)
• Enterotype 2: predominant genus: Prevotella; association with complex
carbohydrates and simple sugars-rich diet (agrarian societies diet)
• Enterotype 3: predominant genus: Ruminococcus; degrades mucins; derives
energy from simple sugars.
Arumgam M et al. 2011; Wu GD et al. 2011
21. • Little, or no clear, segregation into enterotypes among stool samples of
200 subject
(Huse et al. 2012)
Diet and gut microbiota
The «shadows» of enterotypes concept
• Only two distinct clusters enterotypes (Prevotella and Bacteroides),
because the third enterotype dominated by Ruminococcus appeared to be
fused with Bacteroides (Wu et al. 2011)
• Not fixed entities, but a continuous gradient
(Wu GD, 2011; Jeffery IB, 2012; Koren O, 2013; Knights D, 2014)
22. Diet and gut microbiota
Effects of protein on gut microbiota
Singh RK etal, J Transl Med 2017
23. Diet and gut microbiota
Effects of fats on gut microbiota
Singh RK etal, J Transl Med 2017
24. Diet and gut microbiota
Effects of natural and artificial sugars and of non-
digestible carbohydrates on gut microbiota
Singh RK etal, J Transl Med 2017
NATURAL AND ARTIFICIAL SUGARS
NON-DIGESTIBLE CARBOHYDRATES
25. Diet and gut microbiota
Effects of diets on gut microbiota
Singh RK etal, J Transl Med 2017
26. Diet and gut microbiota
Limits of studies
1. Several studies on animals but few studies on human subjects.
2. Fecal samples are less representative of sites of active food fermentation
(cecum and proximal colon).
3. High variability of diet and lifestyle between studied subjects.
4. Scarce evidence about long term effects of diet.
5. Bias of interpretation of results due to physiologic inter-individual variability.
6. A common agreement on the definition of «healthy microbiota» doesn’t exist
Additional well designed studies, exploring variability and modification of
microbial functionality rather than its mere composition are needed.
Graf, 2015
27. Diet and gut microbiota
Role of microbiota biodiversity
• modern diet ↓ agrobiodiversity
(FAO, 2004)
• ↑ widespread of antibiotics and pesticides ↓microbiota richness
(Cho, 2012)
• Gut microbiota richness is well correlated with health
(Chatelier, 2013)
• More diverse is diet, more diverse is microbiome, more adaptable
to perturbations (Heiman, 2016)
• Microbial biodiversity strictly related to its functional richness
↑ adaptability to perturbations (Heiman, 2016)
28. Diet and gut microbiota
Decreased agrobiodiversity
• 75% of plant genetic diversity has been lost;
• Humans use 150-200 edible plant species of the 250-300.000 known;
• 75% world’s food is generated from 12 plants and 5 animal species.
FAO, 2004
29. Diet and gut microbiota
Microbiota diversity and disease
Mosca A et al, 2016
30. Diet and gut microbiota
Gut microbiota in health and disease
Cerf-Bensussan, 2010
31. Diet and gut microbiota
Diet, dysbiosis and metabolic disorders
Ojeda P, 2016
33. Diet and gut microbiota
Microbiota, energy homeostasis and high fat diet
Mulders et al, Obes ev 2018
34. Insulin
resistance
and type 2
diabetes
LPS induced
systemic low
grade
inflammation
↑intestinal
permeability
Alteration of
bile acid
metabolism
↑activity of
endocannabinoid
system (eCB1)
HFD, artificial sweeteners,
emulsifiers
Genetic susceptibility
(TLR-4, TLR-5, CD-14)
Cani, 2007; Vrieze, 2013; Scheithauer, 2016
↓butyrate producing and anti-inflammatory bacteria
(Roseburia, F. prausnitzii, Akkermansia muciniphila)
↑ Gram negative bacteria,
Enterobacteriaceae,
Proteobacteria
Diet and gut microbiota
Gut microbiota, insulin resistance and
diabetes
35. Bajaj JS, Hepatology 2018, in press
• Microbial diversity was associated with an independently lower risk
of 90-day hospitalizations.
• Diet rich in fermented milk, vegetables, cereals, coffee and tea, is
associated with a higher microbial diversity
Diet and gut microbiota
Diet, gut microbiota and liver cirrhosis
296 subjects
157 USA:48 controls, 59 compensated, 50 decompensated;
139 Turkey:46 controls, 50 compensated, 43 decompensated)
36. Diet and gut microbiota
Complex interplay between gut, brain and adipose tissue
Influence of gut microbiota on
central nervous system function:
• production of substances
interacting with terminal
nerve (NO or GABA);
• ematoencefalic membrane
permeability;
• modulation of appetite and
satiety (GLP-1, peptide YY and
ghrelin).
Influence of central nervous
system on microbiota
composition:
• mucin production and gut
epithelial function;
• gut motility.
• local immune response
Ghaisas, 2016; Cani, 2016; Machado, 2016
Leptin and adipokine modulate both
appetite and gut microbial composition
(affecting production of antimicrobial
peptide by Paneth cells)
37. Diet and gut microbiota
Western diet, gut microbiota and
cognitive dysfunction
Noble E et Al, Front Behav Neurosci 2017
38. Gut Microbiota in Obesity and Metabolic Abnormalities
A Matter of Composition or Functionality?
Moran-Ramos S, Arch Med Res 2017
39. Diet and gut microbiota
How to manipulate gut microbiota
1. Probiotics: live micro-organisms which, when administered in adequate
amounts, confer a health benefit on the host.
Psychobiotics: live bacteria which, when ingested, confer mental
health benefits through interactions with commensal gut bacteria.
2. Prebiotics: selectively fermented ingredients that allow specific changes,
both in the composition and/or activity in the gastrointestinal microflora
that confer benefits upon host well-being and health.
3. Antibiotics
4. Fecal microbiota transplantation: transfer of fecal material containing
bacteria and natural antibacterials from a healthy individual into a
specific recipient.
41. Diet and gut microbiota
Take home message
• Gut microbiota is a complex “metaorganism” which exerts a great
influence on host’s homeostasis.
• Genetic and environmental factors affect its composition, during all
stages of life. Diet seems to represent the most influent
determinant.
• Even if gut microbiota composition rapidly responds to dietary
changes, long-term dietary habits seem to really delineate its
identity.
42. • gut microbiota biodiversity its adaptability to external
perturbations affects host’s homeostasis.
• gut microbial composition as predictor of response to dietary
therapeutical strategies personalized therapeutical plan
• gut microbiota manipulation techniques potential therapeutical
option
Diet and gut microbiota
Take home message
• diversified diet gut microbiota biodiversity and richness.
• dysbiosis, plus to host’s genetic and environmental factors (e.g.
diet) development of several diseases.
44. • Short term diet-induced changes of gut microbial composition are mostly influenced by a
strict animal-based diet vs plant-based diet
• A significant modification of gut microbial composition from baseline (↑ β-diversity) is
observed only during a shift to animal-based diet.
• Gut microbiota rapidly reverts to its original composition 2 days after diet interruption.
• ↓ Prevotella genus and ↑bile-tolerant microorganisms during fiber restriction.
• ↓ SCFAs production and ↑ protein fermentation during animal-based diet.
David, 2014
Diet and gut microbiota
Short-term influence of diet variation