The gut microbiome in patients with intestinal failure: Current evidence and implications for clinical practice

Neelis, E., de Koning, B., Rings, E., Wijnen, R., Nichols, B., Hulst, J. and Gerasimidis, K. (2019) The gut microbiome in patients with intestinal failure: Current evidence and implications for clinical practice. Journal of Parenteral and Enteral Nutrition, 43(2), pp. 194-205. (doi: 10.1002/jpen.1423) (PMID:30070709)

Abstract

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 failure, microbiome, microbiota, short-chain fatty acids, short bowel syndrome and parenteral nutrition. Literature search was restricted to human studies only. The gut microbiome diversity is remarkably reduced and community structure is altered with a noticeable over-abundance 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 on 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.

• Item Type: Articles
• Additional Information: KG has received research funding, speakers fees, from Nutricia, Nestle, Mead Johnson and DrFalk.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Nichols, Mr Ben and Gerasimidis, Professor Konstantinos
• Authors: Neelis, E., de Koning, B., Rings, E., Wijnen, R., Nichols, B., Hulst, J., and Gerasimidis, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Journal of Parenteral and Enteral Nutrition
• Publisher: Wiley
• ISSN: 0148-6071
• ISSN (Online): 1941-2444
• Published Online: 02 August 2018
• Copyright Holders: Copyright © 2018 American Society for Parenteral and Enteral Nutrition
• First Published: First published in Journal of Parenteral and Enteral Nutrition 43(2): 194-205
• Publisher Policy: Reproduced in accordance with the publisher copyright policy