Gut microbiota in health and disease Flashcards

1
Q

list some factors that might affect the gut microbiota

A
environment 
probiotics
antibiotics
prebiotics
faecal transplant
disease
diet
lifestage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what must you alway question if there is dysbiosis

A

whether it is the cause or consequence of a disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

give examples of diseases that can occur from microbes that normally live asymptomatically in the host

A
MRSA - staph aureus
strep throat
gingivitis
acne
meningitis
pneumonia
diarrhoea - c. diff
thrush
UTI
gastric cancer - helicobactor pylori
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

give example of disease that occurs when a bacterium colonises in a different site from where it is meant to be

A

sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

where does the inflammation in IBD most likely come from

A

dysregulated host immune response to gut microbiota

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

give some examples of evidence of the role of microbes in IBD development

A
  1. Increased mucosal bacterial load is observed in IBD patients
  2. Broad spectrum antibiotics can have some efficacy in reducing symptoms
  3. Faecal stream diversion induces remission in Crohn’s disease
  4. IBD does not occur in germ-free animals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

whats is the bacterial diversity like in patients with IBD

A

reduced diversity

often a reduction in firmicutes (gram+ve)

increase in facultative anaerobes (e.g. e.coli)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how does IBD manifest

A

non-uniformly - patients have regions of healthy tissue adjacent to inflamed regions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what features of IBD itself could affect the microbiota

A
antibiotic use
inflammation
diarrhoea
host diet
host genotype
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the impact of antibiotics on gut microbiota

A

reduced bacterial diversity and increases in enterobacteriaceae can occur as a result of broad spectrum antibiotic use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the impact of inflammation on the gut

A

Reduced bacterial diversity and increases in enterobacteriaceae will occur as a result of inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how does inflammation reduce bacterial diversity

A

vicious cycle:

inflammation

  • decrease in mucus barrier
  • increase in O2 exposure
  • alters microbial composition
  • increases inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how can diarrhoea affect microbial composition

A

decreases transit time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how can the host diet affect microbial composition

A

desire to eat less fibre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

define probiotics

A

live microorganisms which, when administered in adequate amounts
confer a health benefit on the host

i.e. ADDED LIVE BACTERIA to eg yogurt, supplements, etc

**beneficial in the treatment and prevention of GI diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

define prebiotics

A

a substrate that is selectively utilized by host microorganisms
conferring a health benefit

i.e. FOOD for resident bacteria, found naturally in some plant foods, also can be added to biscuits, bread, drinks, yogurts, supplements, etc

17
Q

what are the three main mechanism of action groups for probiotics

A
  1. widespread - genus or species relatively unimportant
  2. rare - ie strain specific effects
  3. frequent - genus or species important, strain relatively unimportant
18
Q

what actions are present in widespread mechanisms

A

competition
competitive exclusion
barrier function
reduced inflammation

19
Q

what actions are present in rare mechanisms

A

production of vitamins

20
Q

what actions are present in frequent mechanisms

A

bioconversions (diet)
direct antagonism (pathogens)
immune stimulation

21
Q

what are selected prebitoics that can affect microbiota

A

Fructo-oligosaccharides (FOS) and inulin

Galacto-oligosaccharides (GOS)

Lactulose

22
Q

give some health benefits of prebiotics

A

Improved gut function - stool bulking and faster gut transit

Management of Inflammatory bowel disease - reduction in inflammatory markers

Reduce the risk of colon cancer - reduced DNA damage and cell proliferation, faster gut transit

Prebiotic (GOS/FOS) supplementation of infant formula - increases bifidobacteria numbers

Prebiotics (FOS/Inulin) increase calcium absorption and bone health - pH effect

Consumption of prebiotics instead of sugars can lower glycaemic index - induce a lower blood glucose rise after meals compared to those containing sugars

23
Q

what are the different types of exposure to antibiotics

A

direct - e.g. taken orally, IV

indirect - e.g. cattle given antibiotics - still present when meat eaten

24
Q

what do broad spectrum antibiotics cause

A

remove of target pathogen BUT also commensal bacteria

can also cause spread go antibiotic resistance

25
what are the consequences of antibiotic treatment
``` During and immediately post-antibiotic treatment - Decreased microbial diversity - Opportunity for pathogen colonisation - Results in pathogen dominated community ```
26
how can antibiotic use result in recurrent c.diff infections
Clostridium difficile expands to occupy empty niches following antibiotic therapy Overgrowth of C. difficile results in toxin production, abdominal pain, fever (CDAD) Clostridium difficile spores are resistant to antibiotics Some C. difficile strains are antibiotic resistant Results in recurring C. difficile infections
27
what is the initial treatment for c diff associated diarrhoea (CDAD)
antibiotic therapy - cures 75%
28
what is the best treatment for recurrent CDAD when antibiotics DONT work
FMT (faecal microbial transplantation) effective in >90% patients with recurring c diff infections
29
how does FMT work
Faecal sample from screened healthy volunteer donor transplanted into recipient (enema, colonoscopy, naso-enteric tube, capsules) Donor microbiota repopulates large intestine, displaces C. difficile, prevents reinfection currently only approved for RECURRING CDAD
30
for what diseases is FMT NOT effective in producing disease remission
pouchitis (inflammation of the ileal pouch) ulcerative colitis
31
what is an essential process for the donor in FMT to undergo
proper screening for all known pathogens
32
list some of the diseases gut microbes (or the products they create) are linked to
``` IBS IBD CV disease allergies obesity bone health brain health rheumatoid arthritis diabetes colorectal cancer ```
33
what diseases can prebiotics help with
colorectal cancer diabetes osteoporosis