Risultati per: GUT

Functional gastrointestinal disorders—recently renamed into disorders of gut–brain interaction—such as irritable bowel syndrome and functional dyspepsia are highly prevalent conditions with bothersome abdominal symptoms in the absence of structural abnormalities. While traditionally considered as motility disorders or even psychosomatic conditions, our understanding of the pathophysiology has evolved significantly over the last two decades. Initial observations of subtle mucosal infiltration with immune cells, especially mast cells and eosinophils, are since recently being backed up by mechanistic evidence demonstrating increased release of nociceptive mediators by immune cells and the intestinal epithelium. These mediators can activate sensitised neurons leading to visceral hypersensitivity with bothersome symptoms. The interaction between immune activation and an impaired barrier function of the gut is most likely a bidirectional one with alterations in the microbiota, psychological stress and food components as upstream players in the pathophysiology. Only few immune-targeting treatments are currently available, but an improved understanding through a multidisciplinary scientific approach will hopefully identify novel, more precise treatment targets with ultimately better outcomes.

Objective
The obesity epidemic and its metabolic complications continue to be a major global public health threat with limited effective treatments, especially drugs that can be taken orally. Peptides are a promising class of molecules that have gained increased interest for their applications in medicine and biotechnology. In this study, we focused on looking for peptides that can be administrated orally to treat obesity and exploring its mechanisms.

Design
Here, a 9-amino-acid peptide named D3 was designed and administered orally to germ-free (GF) mice and wild-type (WT) mice, rats and macaques. The effects of D3 on body weight and other basal metabolic parameters were evaluated. The effects of D3 on gut microbiota were evaluated using 16S rRNA amplicon sequencing. To identify and confirm the mechanisms of D3, transcriptome analysis of ileum and molecular approaches on three animal models were performed.

Results
A significant body weight reduction was observed both in WT (12%) and GF (9%) mice treated with D3. D3 ameliorated leptin resistance and upregulated the expression of uroguanylin (UGN), which suppresses appetite via the UGN-GUCY2C endocrine axis. Similar effects were also found in diet-induced obese rat and macaque models. Furthermore, the abundance of intestinal Akkermansia muciniphila increased about 100 times through the IFN-Irgm1 axis after D3 treatment, which may further inhibit fat absorption by downregulating Cd36.

Conclusion
Our results indicated that D3 is a novel drug candidate for counteracting diet-induced obesity as a non-toxic and bioactive peptide. Targeting the UGN-GUCY2C endocrine axis may represent a therapeutic strategy for the treatment of obesity.

Objective
First decompensation development is a critical milestone that needs to be predicted. Transkingdom gut microbial interactions, including archaeal methanogens, may be important targets and predictors but a longitudinal approach is needed.

Design
Cirrhosis outpatients who provided stool twice were included. Group 1: compensated, group 2: 1 decompensation (decomp), group 3: >1 decompensationwere followed and divided into those who remained stable or decompensated. Bacteria, viral and archaeal presence, α/β diversity and taxa changes over time adjusted for clinical variables were analysed. Correlation networks between kingdoms were analysed.

Results
157 outpatients (72 group 1, 33 group 2 and 52 group 3) were followed and 28%–47% developed outcomes. Baseline between those who remained stable/developed outcome: While no α/β diversity differences were seen, commensals were lower and pathobionts were higher in those who decompensated. After decompensation: those experiencing their first decompensation showed greater decrease in α/β-diversity, bacterial change (Lactobacillus spp, Streptococcus parasanguinis and beneficial Lachnospiraceae and Eubacterium hallii) and viral change (Siphoviridae, Myoviridae) versus those with further decompensation. Archaea: 19% had Methanobacter brevii, which was similar between/within groups. Correlation networks: Baseline archaeal-viral-bacterial networks were denser and more homogeneous in those who decompensated versus the rest. Archaea-bacterial correlations collapsed post first decompensation. Lactobacillus phage Lc Nu and C2-like viruses were negatively linked with beneficial bacteria.

Conclusion
In this longitudinal study of cirrhosis outpatients, the greatest transkingdom gut microbial changes were seen in those reaching the first decompensation, compared with subsequent decompensating events. A transkingdom approach may refine prediction and provide therapeutic targets to prevent cirrhosis progression.

The Rome criteria are widely accepted for diagnosing disorders of gut-brain interaction (DGBI), but their global applicability has been debated. This study aimed to evaluate the validity of the Rome IV criteria by factor analysis globally, across geographical regions, by sex, and by age groups.

Introduction
Despite clear linkages between provision of clean water and improvements in child health, limited information exists about the health impacts of large water infrastructure improvements in low-income settings. Billions of dollars are spent annually to improve urban water supply, and rigorous evaluation of these improvements, especially targeting informal settlements, is critical to guide policy and investment strategies. Objective measures of infection and exposure to pathogens, and measures of gut function, are needed to understand the effectiveness and impact of water supply improvements.

Methods and analysis
In the PAASIM study, we examine the impact of water system improvements on acute and chronic health outcomes in children in a low-income urban area of Beira, Mozambique, comprising 62 sub-neighbourhoods and ~26 300 households. This prospective matched cohort study follows 548 mother–child dyads from late pregnancy through 12 months of age. Primary outcomes include measures of enteric pathogen infections, gut microbiome composition and source drinking water microbiological quality, measured at the child’s 12-month visit. Additional outcomes include diarrhoea prevalence, child growth, previous enteric pathogen exposure, child mortality and various measures of water access and quality. Our analyses will compare (1) subjects living in sub-neighbourhoods with the improved water to those living in sub-neighbourhoods without these improvements; and (2) subjects with household water connections on their premises to those without such a connection. This study will provide critical information to understand how to optimise investments for improving child health, filling the information gap about the impact of piped water provision to low-income urban households, using novel gastrointestinal disease outcomes.

Ethics and dissemination
This study was approved by the Emory University Institutional Review Board and the National Bio-Ethics Committee for Health in Mozambique. The pre-analysis plan is published on the Open Science Framework platform (https://osf.io/4rkn6/). Results will be shared with relevant stakeholders locally, and through publications.

The human gut microbiome has been linked to numerous digestive disorders, but its metabolic products have been much less well characterized, in part due to the expense of untargeted metabolomics and in part to the lack of ability to process the data. In this Review, we focus on the rapidly expanding information about the bile acid repertoire produced by the gut microbiome, including the impacts of bile acids on a wide range of host physiological processes and diseases, while also discussing the role of short-chain fatty acids and other important gut microbiome-derived metabolites.

Objective
Bariatric surgery is an effective treatment for type 2 diabetes (T2D) that changes gut microbial composition. We determined whether the gut microbiota in humans after restrictive or malabsorptive bariatric surgery was sufficient to lower blood glucose.

Design
Women with obesity and T2D had biliopancreatic diversion with duodenal switch (BPD-DS) or laparoscopic sleeve gastrectomy (LSG). Faecal samples from the same patient before and after each surgery were used to colonise rodents, and determinants of blood glucose control were assessed.

Results
Glucose tolerance was improved in germ-free mice orally colonised for 7 weeks with human microbiota after either BPD-DS or LSG, whereas food intake, fat mass, insulin resistance, secretion and clearance were unchanged. Mice colonised with microbiota post-BPD-DS had lower villus height/width and crypt depth in the distal jejunum and lower intestinal glucose absorption. Inhibition of sodium-glucose cotransporter (Sglt)1 abrogated microbiota-transmissible improvements in blood glucose control in mice. In specific pathogen-free (SPF) rats, intrajejunal colonisation for 4 weeks with microbiota post-BPD-DS was sufficient to improve blood glucose control, which was negated after intrajejunal Sglt-1 inhibition. Higher Parabacteroides and lower Blautia coincided with improvements in blood glucose control after colonisation with human bacteria post-BPD-DS and LSG.

Conclusion
Exposure of rodents to human gut microbiota after restrictive or malabsorptive bariatric surgery improves glycaemic control. The gut microbiota after bariatric surgery is a standalone factor that alters upper gut intestinal morphology and lowers Sglt1-mediated intestinal glucose absorption, which improves blood glucose control independently from changes in obesity, insulin or insulin resistance.

Stroke, Volume 54, Issue Suppl_1, Page ATP238-ATP238, February 1, 2023. We currently evaluated the effect of focal cerebral ischemia on gut virome and bacteriome in adult mice. Adult male C57BL/6 mice were subjected to transient middle cerebral artery occlusion or sham surgery. Virome and bacteriome were analyzed using shotgun metagenomics in the fecal samples collected from each mouse before and at 24h of reperfusion. Bioinformatics tools including VIBRANT (v1.2.1), DIAMOND Blastp (v0.9.14.115), VConTACT2 (v0.9.5), Cytoscape (v3.7.2), mash (v2.0), MUMmer (v3.1), Samtools (v1.11), DESeq2 (v1.28.1), MetaWRAP, and CRISPR Recognition Tool (v1.2) were used to assess viral networks, viral auxiliary metabolic genes, and viral protein network changes. Bacteriome was analyzed by kneaddata v0.7.2, MetaPhlAn version 2.7.7, and humann2 v2.8.1. Focal ischemia induced significant differences in fecal viral and bacterial taxa at the strain levels compared with sham. Furthermore, viral protein networks altered significantly after stroke. In particular, the clusters of Clostridia-like phages and Erysipelatoclostridiaceae phages showed a differential association between stroke and sham. In addition, we identified a significant reduction in the phages and bacteria of Lactobacillus after stroke. These studies indicate a possible viral-bacterial correlative change in the gut after stroke.

Stroke, Volume 54, Issue Suppl_1, Page A40-A40, February 1, 2023. Introduction:Cerebral amyloid angiopathy (CAA) is a debilitating disease that leads to intracerebral hemorrhage, white matter disease, and progressive cognitive decline in patients >50 years of age. Studies investigating the neuroimmune landscape in CAA are sparse. Here, we investigate the role of B cells in CAA.Methods:Pre-symptomatic (2 months) and symptomatic (10-13 months) male Tg-SwDI mice (CAA mice) harboring Swedish, Dutch, and Iowa mutations of human amyloid precursor protein (APP) were used as a mouse model of CAA. Single cells isolated from the brain were analyzed using flow cytometry to characterize neuroinflammation and cognitive impairment was assessed using fear conditioning. Fecal microbiota transplantation (FMT) of the microbiome from pre-symptomatic and symptomatic CAA mice into young wild-type (WT) recipient male mice (2 months) was performed to determine if CAA-induced gut dysbiosis contributes to brain B cell activation.Results:Cognitive assessment using fear conditioning indicated a significantly lower delta inactive state in symptomatic CAA mice (n=4/grp, *P

Stroke, Volume 54, Issue Suppl_1, Page AWP239-AWP239, February 1, 2023. While strokes are typically associated with the brain, it is widely known that stroke outcomes are influenced by communication between the brain and peripheral organs. The gastrointestinal (GI) tract comprises a critical organ system that is affected during and after stroke, and the interaction between the GI tract and the brain in stroke is attributed to the modulation of the gut-brain axis. Intestinal alkaline phosphatase (IAP; gene:Akp3) is a brush border enzyme localized in the intestinal epithelium that regulates intestinal homeostasis by modulating inflammation and intestinal integrity. We hypothesized that IAP regulates the early post-stroke changes within the gut-brain axis, and that loss of IAP disrupts the gut-brain axis to worsen post-stroke outcomes and disrupt immune responses. We utilized 4-6 month-old male and female mice with a genomic deletion ofAkp3and their wild type (WT) littermate controls. Following the induction of photothrombotic stroke (PTS), stroke-injured mice and their sham controls were for evaluated for bacterial load, intestinal permeability, intestinal motility, neurological deficits, cerebral blood flow, and immune responses over the next 24 hours. Statistical analysis of Clark’s neurological score, laser speckle flowmetry, and 2,3,5-Triphenyltetrazolium chloride (TTC) staining at day 1 post stroke showed a main effect of stroke but no differences between genotypes. While no differences in intestinal motility were observed due to stroke or genotype, gut permeability to 3kD-FITC dextran quantified at 3.5 hours post-stroke was higher inAkp3-/-mice compared to WT mice. Further analysis of bacterial burden showed that anaerobic bacteria in the ileum were diminished inAkp3-/-mice post-stroke compared to WT counterparts. Quantification of immune cell populations in cervical lymph nodes and spleen showed thatAkp3-/-mice displayed baseline decreases in monocyte and dendritic cell populations that were either maintained or further decreased at 24-hours post-stroke, suggesting that Akp3-/- mice are unable to mount an appropriate innate immune response in acute stroke. Taken together, the current results support the hypothesis that IAP shapes early outcomes and modulates the gut-brain axis in ischemic stroke.

Stroke, Volume 54, Issue Suppl_1, Page AWMP117-AWMP117, February 1, 2023. Background:Stroke is associated with profound immunodepression and aberrations of autonomic signaling which render the body more susceptible to infection from without and from within. Dramatic alterations of sensitive signaling networks within the gut after stroke along with systemic inflammation may promote pathways that evoke a leaky gut. The enzyme matrix metalloproteinase 7 (MMP-7) has been shown to play a prominent role in evoking gut permeability in models of systemic inflammation. We found that stoke elicits a profound increase in MMP-7 across the small intestine rapidly after injury.Hypothesis:We hypothesize that this increase in MMP-7 in the gut after stroke contributes to post-stroke gut permeability and that mice deficient in MMP-7 are protected from this effect.Methods:Young (2-5-month-old)Mmp7knockout (Mmp7-/-) and wild type (WT) control littermates were subjected to 45min-tMCAO. At 3h post-tMCAO, mice were injected intraocularly with 200mg/kg FITC-inulin at 3h post-tMCAO and euthanized 1h later. Aged (24-month-old)Mmp7-/-mice and WT control littermates were subjected to pMCAO, injected intraocularly with 200mg/kg FITC-inulin at 47h, and euthanized 1h later. Intestinal tissue was collected, homogenized, and used to detect FITC-inulin as well as for Western blotting and RT-qPCR.Results:We demonstrate that MMP-7 levels rapidly increase throughout the small intestine after stroke at 6h and 24h post-stroke. This increase in MMP-7 is accompanied by a concurrent decrease in tight junction proteins and increase in intestinal permeability at 3h post-transient middle cerebral artery occlusion (tMCAO) and 48h post-permanent (p)MCAO. Interestingly, MMP-7 deficient mice are protected from gut permeability after stroke.Conclusion:Our data identify a novel causative agent in the phenomenon of gut permeability observed after stroke and prompt further study of the role of MMP’s in promoting gut permeability after stroke.

Stroke, Volume 54, Issue Suppl_1, Page AWP218-AWP218, February 1, 2023. Background:Our previous studies have shown that reproductively senescent (RS) female rats, who have lower circulating levels of the peptide hormone Insulin-like Growth Factor (IGF-1), display worse outcomes after a stroke event than young adult female rats. ICV administration of IGF-1, decreases infarct volume, improves sensory motor performance, and reduces cytokine levels in the ischemic hemisphere of RS females as compared to vehicle-treated controls. Yet, icv IGF1 administration failed to attenuate peripheral inflammation and depressive behaviors in the chronic phase of stroke. In view of the evidence that stroke induces gut dysbiosis, and that gut dysfunction is implicated in depressive and cognitive behaviors, we hypothesize that, unlike icv administration of IGF-1, which is restricted to the brain, systemic i.p. administration of IGF1 would repair the gut, attenuate peripheral cytokine levels and improve long-term behavior outcomes.Methods:Acyclic middle-aged Sprague Dawley female rats (9-11 mos) were subjected to endothelin-1 induced middle cerebral artery occlusion (MCAo) or sham operation. Animals received IGF1 via i.p. injections 4h post MCAo and 24 h post MCAo, or icv infusions, while controls received vehicle. Sensory motor tests, blood and gut samples were acquired pre and post MCAo. Animals were terminated either in the acute phase (2d) or chronic phase (30d). The latter group was also subject to tests of cognition and depressive-like behavior.Results:In contrast to icv treatment, i.p.-IGF-1 did not reduce infarct volume or acute sensory motor impairment, but significantly attenuated circulating levels of several inflammation associated cytokines. In addition, ip-IGF-1 significantly attenuated post stroke gut dysmorphology, by preserving villus:crypt ratio and the mucin barrier. Furthermore, in the chronic phase, i.p.-IGF1 attenuated cognitive decline post stroke in the NORT and Barnes Maze tasks, while icv IGF-1 did not.Conclusion:Since long term disability after stroke is correlated with elevated levels of peripheral cytokines, our data suggest that systemic IGF1 may be a better therapeutic option for long term outcomes.Supported by NS074895 to FS. YEH is supported by a generous gift from the WoodNext Foundation.

Stroke, Volume 54, Issue Suppl_1, Page AWMP114-AWMP114, February 1, 2023. Introduction:Vascular cognitive impairment (VCI) is the second most common cause of clinical dementia after Alzheimer’s disease. VCI results from injury to the cerebral blood vessels. Cerebral perfusion is diminished in elderly individuals and additional reduction of cerebral blood flow increases the risk of developing VCI. These findings have been successfully modeled in mice with bilateral common carotid artery stenosis (BCAS). Age is associated with gut dysbiosis and transplantation of aged microbiome leads to cognitive decline in young animals. However, there are large gaps in our understanding of the molecular mechanisms induced by chronic hypoperfusion contributes to impaired cognitive function.Methods:C57Bl6 aged (~18m) male mice were subjected to a sham or a BCAS surgery using 0.18mm titanium coils placed on both common carotid arteries. Mice were followed for 90d after surgery to assess both gut microbial content and behavioral changes. 16S ribosomal RNA (rRNA) sequencing analysis was performed on fecal samples collected from aged baseline, sham and BCAS animals at 7 and 28 days. Cognition was assessed using Y-maze. Tissues were collected at the time of euthanasia for metabolomics and histological analysis.Results:BCAS resulted in significant reduction of cerebral blood flow, measured using laser speckle (p

Stroke, Volume 54, Issue Suppl_1, Page A20-A20, February 1, 2023. Introduction:Neonatal Hypoxic Ischemic Encephalopathy (nHIE) is a leading cause of infant mortality and morbidity worldwide. Males are at greater risk than females, and survivors of nHIE suffer from major disability with limited therapeutic options. Growing clinical and pre-clinical evidence shows neurological injury adversely alters the microbial populations in the gut (dysbiosis) and depletes anti-inflammatory metabolites exclusively made by the gut microbiota. Replacing key microbially-derived beneficial metabolites improves cognitive outcomes in pre-clinical models of adult stroke. However, changes in the gut microbiota and its metabolites after nHIE have not been explored and may lay the foundation for future therapies.Hypothesis:nHIE leads to gut dysbiosis and reduces microbial-derived metabolites, which worsens neurological outcomes in males and females.Methods:A modified Rice Vannucci Model on PND9 C57BL/6 mice was used to model nHIE. Fecal, plasma, gut, and brain samples were collected acutely (24hrs) and chronically (7wks) after injury.Results:We found a significant decrease in 3-indolepropionic acid (p=0.0190, n=4-6), inoxyl-3-sulfate (p=0.0098, n=4-6) and indoxyl acetate (p=0.0096, n=4-6) in the plasma of male mice 24hrs after HIE compared to sham controls, with no significant changes in female plasma. There was a significant increase in indole metabolites in the ischemic hemisphere in both males and females 24hrs after HIE. 7wks after nHIE, there was a significant increase in anxiety-like behavior in males (decrease in % of time immobile during tail suspension=0.018, n=6) and decreased functional ability (nest building score p=0.0147, n=6) in males with HIE compared to sham controls. No significant changes were observed in females. 16S rRNA sequencing data showed dysbiotic microbiota composition after nHIE, consistent with the microbial-metabolite changes found by mass spectroscopy analysis.Conclusion:nHIE induced brain injury results in gut dysbiosis, with sex-specific alterations in circulating indole metabolites and behavioral deficits. This supports our hypothesis that a sex-specific reduction in bioavailability of microbial-metabolites worsens CNS damage after nHIE.

Introduction
Chronic cytomegalovirus (CMV) infection is very frequent in people living with HIV (PLWH). High anti-CMV IgG titres, which may be linked to transient CMV replication, have been associated with earlier mortality, CD8 T-cell expansion, lower CD4/CD8 ratio and increased T-cell senescence. We previously showed that anti-CMV IgG titres correlated with gut permeability in PLWH on antiretroviral therapy (ART), which was associated with microbial translocation, systemic inflammation and non-infectious/non-AIDS comorbidities. Letermovir, a novel anti-CMV drug with a good safety profile, was recently approved for anti-CMV prophylaxis in allogeneic haematopoietic stem cell transplant recipients. A drastic and selective reduction of both low-grade replication and clinically significant CMV infections, combined with an improved immune reconstitution have been reported. In vitro, letermovir prevented CMV-induced epithelial disruption in intestinal tissues. Based on these findings, we aim to assess whether letermovir could inhibit CMV subclinical replication in CMV-seropositive PLWH receiving ART and, in turn, decrease CMV-associated gut damage and inflammation.

Method and analysis
We will conduct a multi-centre, open-label, randomised, controlled clinical trial, including a total of 60 CMV-seropositive ART-treated PLWH for at least 3 years, with a viral load 400 cells/µL. Forty participants will be randomised to receive letermovir for 14 weeks and 20 participants will receive standard of care (ART) alone. Plasma, pheripheral blood mononuclear cells (PBMCs), and stool samples will be collected. Colon biopsies will be collected in an optional substudy. We will assess the effect of letermovir on gut damage, microbial translocation, inflammation and HIV reservoir size.

Ethics and dissemination
The study was approved by Health Canada and the Research Ethics Boards of the McGill University Health Centre (MUHC-REB, protocol number: MP37-2022-8295). Results will be made available through publications in open access peer-reviewed journals and through the CIHR/CTN website.

Trial registration number
NCT05362916.

At least in mice, gut microbes affect the brain’s reward center during exercise.