Intestinal Microbiota: Its role in digestive diseases

Journal of Clinical Gastroenterology

Volumn 48, Issue 8, 2014, Pages 657-666

  Fernandez, Luis M Bustos ^a   Lasa, Juan S ^a   Man, Fernando ^b  

^a Instituto Bustos Fernandez   (Argentina)

^b Gastro   (Argentina)

Author keywords

intestinal diseases; intestinal microbiota; metagenomics

Indexed keywords

COLIPASE; GLIADIN; LINOLEIC ACID; LIPOPROTEIN LIPASE; OXALIC ACID DERIVATIVE; POLYPEPTIDE ANTIBIOTIC AGENT; PREBIOTIC AGENT; PROBIOTIC AGENT; SHORT CHAIN FATTY ACID; SYMBIOTIC AGENT; UNCLASSIFIED DRUG; VSL3;

ACTINOBACTERIA; ACTINOMYCINAEAE; ADAPTIVE IMMUNITY; BACILLI; BACTERIAL OVERGROWTH; BACTEROIDES FRAGILIS; BACTEROIDETES; CD4+ T LYMPHOCYTE; CELIAC DISEASE; COMMENSAL; CONSTIPATION; CORYNEBACTERIACEAE; CROHN DISEASE; DENDRITIC CELL; DYSBIOSIS; ENERGY RESOURCE; ENZYME ACTIVITY; ESCHERICHIA COLI; FAECALIBACTERIUM PRAUSNITZII; GASTROINTESTINAL DISEASE; HELICOBACTER; HEPATIC ENCEPHALOPATHY; HUMAN; ILEITIS; IMMUNOLOGICAL TOLERANCE; INNATE IMMUNITY; INTESTINE FLORA; IRRITABLE COLON; LACHNOSPIRACEAE; LACTOBACILLUS; METAGENOMICS; METHANOBREVIBACTER SMITHII; NONHUMAN; NUTRIENT UPTAKE; OBESITY; OXALOBACTER FORMIGENES; PATHOGENESIS; POLYMERASE CHAIN REACTION; PRIORITY JOURNAL; REVIEW; SMALL INTESTINAL BACTERIAL OVERGROWTH; STREPTOCOCCACEAE; TH17 CELL; ULCERATIVE COLITIS; UPREGULATION; VEILLONELLA; ANIMAL; DIGESTIVE SYSTEM DISEASE; INTESTINE; MICROBIOLOGY; MICROFLORA; PATHOPHYSIOLOGY; PROCEDURES;

ANIMALS; DIGESTIVE SYSTEM DISEASES; HUMANS; INTESTINES; METAGENOMICS; MICROBIOTA;

EID: 84905995444     PISSN: 01920790     EISSN: 15392031     Source Type: Journal    
DOI: 10.1097/MCG.0000000000000153     Document Type: Review

References (116)

1. Kunz C, Kuntz S, Rudloff S. Intestinal flora. Adv Exp Med Biol. 2009;639:67-79.
2. Whitman WB, Coleman DC, Wiebe WJ. Prokaryotes: the unseen majority. Proc Natl Acad Sci USA. 1998;95:6578-6583. (Pubitemid 28278022)
3. Simren M, Barbara G, Flint HJ, et al. Intestinal microbiota in functional bowel disorders: a Rome Foundation Report. Gut. 2013;62:159-176.
4. Frank DN, Pace NR. Gastrointestinal microbiology enters the metagenomics era. Curr Opin Gastroenterol. 2008;24:4-10. (Pubitemid 350190890)
5. Arumugam M, Raes J, Pelletier E, et al. Enterotypes of the human gut microbiome. Nature. 2011;473:174-180.
6. Swidsinski A, Loening-Baucke V, Lochs H, et al. Spatial organization of bacterial flora in normal and inflamed intestine: a fluorescence in situ hybridization study in mice. World J Gastroenterol. 2005;11:1131-1140. (Pubitemid 40352998)
7. Huurre A, Kalliomaki M, Rautava S, et al. Mode of delivery: effects on gut microbiota and humoral immunity. Neo-natology. 2008;93:236-240. (Pubitemid 351799101)
8. Mandar R, Mikelsaar M. Transmission of mother's microflora to the newborn at birth. Biol Neonate. 1996;69:30-35. (Pubitemid 26073073)
9. Ley RE, Backhed F, Turnbaugh P, et al. Obesity alters gut microbial ecology. Proc Natl Acad Sci USA. 2005;102: 11070-11075. (Pubitemid 41105994)
10. Turnbaugh PJ, Backhed F, Fulton L, et al. Diet-induced obesity is linked to marked but reversible alterations in the mouse distal gut microbiome. Cell Host Microbe. 2008;3:213-223. (Pubitemid 351494716)
11. Gill SR, Pop M, Deboy RT, et al. Metagenomic analysis of the human distal gut microbiome. Science. 2006;312:1355-1359. (Pubitemid 43839542)
12. Bouskra D, Brezillon C, Berard M, et al. Lymphoid tissue genesis induced by commensals through NOD1 regulates intestinal homeostasis. Nature. 2008;456:507-510. (Pubitemid 352759006)
13. Macpherson AJ, Harris NL. Interactions between commensal intestinal bacteria and the immune system. Nat Rev Immunol. 2004;4:478-485. (Pubitemid 38745559)
14. Mazmanian SK, Liu CH, Tzianabos AO, et al. An immuno-modulatory molecule of symbiotic bacteria directs maturation of the host immune system. Cell. 2005;122:107-118. (Pubitemid 40977944)
15. Lee J, Mo JH, Katakura K, et al. Maintenance of colonic homeostasis by distinctive apical TLR9 signalling in intestinal epithelial cells. Nat Cell Biol. 2006;8:1327-1336. (Pubitemid 44835107)
16. Zeuthen LH, Fink LN, Frokiaer H. Epithelial cells prime the immune response to an array of gut-derived commensals towards a tolerogenic phenotype through distinct actions of thymic stromal lymphopoietin and transforming growth factor-beta. Immunology. 2008;123:197-208.
17. Hooper LV. Do symbiotic bacteria subvert host immunity? Nat Rev Microbiol. 2009;7:367-374.
18. Salzman NH, Underwood MA, Bevins CL. Paneth cells, defensins, and the commensal microbiota: a hypothesis on intimate interplay at the intestinal mucosa. Semin Immunol. 2007;19:70-83. (Pubitemid 46824070)
19. Kida Y, Shimizu T, Kuwano K. Sodium butyrate up-regulates cathelicidin gene expression via activator protein-1 and histone acetylation at the promoter region in a human lung epithelial cell line, EBC-1. Mol Immunol. 2006;43:1972-1981.
20. Termen S, Tollin M, Rodriguez E, et al. PU1 and bacterial metabolites regulate the human gene CAMP encoding antimicrobial peptide LL-37 in colon epithelial cells. Mol Immunol. 2008;45:3947-3955.
21. Schauber J, Svanholm C, Termen S, et al. Expression of the cathelicidin LL-37 is modulated by short chain fatty acids in colonocytes: relevance of signaling pathways. Gut. 2003;52: 735-741. (Pubitemid 36528878)
22. Duncan SH, Louis P, Flint HJ. Lactate-utilizing bacteria, isolated from human feces, that produce butyrate as a major fermentation product. Appl Environ Microbiol. 2004;70: 5810-5817. (Pubitemid 39471821)
23. Macfarlane S, Macfarlane GT. Regulation of short-chain fatty acid production. Proc Nutr Soc. 2003;62:67-72.
24. Sartor RB. Microbial influences in inflammatory bowel diseases. Gastroenterology. 2008;134:577-594. (Pubitemid 351173057)
25. Backhed F, Ding H, Wang T, et al. The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad Sci USA. 2004;101:15718-15723. (Pubitemid 39473554)
26. Hooper LV, Wong MH, Thelin A, et al. Molecular analysis of commensal host-microbial relationships in the intestine. Science. 2001;291:881-884. (Pubitemid 32120760)
27. Scanlan PD, Shanahan F, Marchesi JR. Human methanogen diversity and incidence in healthy and diseased colonic groups using mcrA gene analysis. BMC Microbiol. 2008;8:79.
28. Oh DK, Hong GH, Lee Y, et al. Production of conjugated linoleic acid by isolate Bifidobacterium strains. World J Microbiol Biotechnol. 2003;19:907-912. (Pubitemid 38092637)
29. Sidhu H, Allison MJ, Chow JM, et al. Rapid reversal of hyperoxaluria in a rat model after probiotic administration of Oxalobacter formigenes. J Urol. 2001;166:1487-1491. (Pubitemid 32862225)
30. Sartor RB. Genetics and environmental interactions shape the intestinal microbiome to promote inflammatory bowel disease versus mucosal homeostasis. Gastroenterology. 2010;139: 1816-1833.
31. Swidsinski A, Ladhoff A, Pernthaler A, et al. Mucosal flora in inflammatory bowel disease. Gastroenterology. 2002;122: 44-54. (Pubitemid 34049193)
32. Abubakar I, Myhill D, Aliyu SH, et al. Detection of Mycobacterium avium subspecies paratuberculosis from patients with Crohn's disease using nucleic acid-based techniques: a systematic review and meta-analysis. Inflamm Bowel Dis. 2008;14:401-410. (Pubitemid 351441331)
33. Darfeuille-Michaud A, Boudeau J, Bulois P, et al. High prevalence of adherent-invasive Escherichia coli associated with ileal mucosa in Crohn's disease. Gastroenterology. 2004;127:412-421. (Pubitemid 39091889)
34. Clayton EM, Rea MC, Shanahan F, et al. The vexed relationship between Clostridium difficile and inflammatory bowel disease: an assessment of carriage in an outpatient setting among patients in remission. Am J Gastroenterol. 2009;104:1162-1169.
35. Peterson DA, Frank DN, Pace NR, et al. Metagenomic approaches for defining the pathogenesis of inflammatory bowel diseases. Cell Host Microbe. 2008;3:417-427. (Pubitemid 351773097)
36. Sokol H, Pigneur B, Watterlot L, et al. Faecalibacterium prausnitzii is an anti-inflammatory commensal bacterium identified by gut microbiota analysis of Crohn's disease patients. Proc Natl Acad Sci USA. 2008;105:16731-16736.
37. Schwiertz A, Jacobi M, Frick J-S, et al. Microbiota in pediatric inflammatory bowel disease. J Pediatr. 2010; 157:240-244.
38. Frank DN, St Amand AL, Feldman RA, et al. Molecular-phylogenetic characterization of microbial community imbalances in human inflammatory bowel diseases. Proc Natl Acad Sci USA. 2007;104:13780-13785. (Pubitemid 350003397)
39. Qin J, Li R, Raes J, et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature. 2010;464:59-65.
40. Pruteanu M, Hyland NP, Clarke DJ, et al. Degradation of the extracellular matrix components by bacterial-derived metal-loproteases: implications for inflammatory bowel diseases. Inflamm Bowel Dis. 2011;17:1189-1200.
41. Knight P, Campbell BJ, Rhodes JM. Host-bacteria interaction in inflammatory bowel disease. Br Med Bull. 2008; 88:95-113.
42. Sewell GW, Marks DJB, Segal AW. The immunopatho-genesis of Crohn's disease: a three-stage model. Curr Opin Immunol. 2009;21:506-513.
43. Round JL, Lee SM, Li J, et al. The Toll-like receptor 2 pathway establishes colonization by a commensal of the human microbiota. Science. 2011;332:974-977.
44. Mazmanian SK, Round JL, Kasper DL. A microbial symbiosis factor prevents intestinal inflammatory disease. Nature. 2008;453:620-625. (Pubitemid 351769307)
45. Atarashi K, Nishimura J, Shima T, et al. ATP drives lamina propria TH17 cell differentiation. Nature. 2008;455:808-812.
46. MacDonald TT, Monteleone I, Fantini MC, et al. Regulation of homeostasis and inflammation in the intestine. Gastro-enterology. 2011;140:1768-1775.
47. Maslowski KM, Vieira AT, Ng A, et al. Regulation of immunomodulatory responses by gut microbiota and chemo-attractant receptor GPR43. Nature. 2009;461:1282-1286.
48. Fukuda S, Toh H, Hase K, et al. Bifidobacteria can protect from enteropathogenic infection through production of acetate. Nature. 2011;469:543-547.
49. Suzuki K, Meek B, Doi Y, et al. Aberrant expansion of segmented filamentous bacteria in IgA-deficient gut. Proc Natl Acad Sci USA. 2004;101:1981-1986. (Pubitemid 38229001)
50. Wen L, Ley RE, Volchkov PV, et al. Innate immunity and intestinal microbiota in the development of type 1 diabetes. Nature. 2008;455:1109-1113.
51. Vijay-Kumar M, Aitken JD, Carvalho FA, et al. Metabolic syndrome and altered gut microbiota in mice lacking Toll-like receptor 5. Science. 2010;328:228-231.
52. Elinav E, Strowig T, Kau AL, et al. NLRP6 inflammasome regulates colonic microbial ecology and risk for colitis. Cell. 2011;145:1-13.
53. von Schillde MA, Hormannsperger G, Weiher M, et al. Lactocepin secreted by Lactobacillus exerts anti-inflammatory effects by selectively degrading proinflammatory chemokines. Cell Host Microbe. 2012;11:387-396.
54. Petersen AM, Schjørring S, Gerstrøm SC, et al. Treatment of inflammatory bowel disease associated E. coli with ciproflox-acin and E. coli Nissle in the streptomycin-treated mouse intestine. PLoS One. 2011;6:e22823.
55. Altenhoefer A, Oswald S, Sonnenborn U, et al. The probiotic Escherichia coli strain Nissle 1917 interferes with invasion of human intestinal epithelial cells by different enteroinvasive bacterial pathogens. FEMS Immunol Med Microbiol. 2004;40:223-229. (Pubitemid 38368186)
56. Scaldaferri F, Gerardi V, Lopetuso LR, et al. Gut microbial flora, prebiotics, and probiotics in IBD: their current usage and utility. Biomed Res Int. 2013;2013:435268.
57. Reiff C, Kelly D. Inflammatory bowel disease, gut bacteria and probiotic therapy. Int J Med Microbiol. 2010;300: 25-33.
58. Hormannsperger G, Haller D. Molecular crosstalk of pro-biotic bacteria with the intestinal immune system: clinical relevance in the context of inflammatory bowel disease. Int J Med Microbiol. 2010;300:63-73.
59. Elahi B, Nikfar S, Derakhshani S, et al. On the benefit of probiotics in the management of pouchitis in patients underwent ileal pouch anal anastomosis: a meta-analysis of controlled clinical trials. Dig Dis Sci. 2008;53:1278-1284. (Pubitemid 351514636)
60. Pardi DS, D'Haens G, Shen B, et al. Clinical guidelines for the management of pouchitis. Inflamm Bowel Dis. 2009;15: 1424-1431.
61. Kuisma J, Mentula S, Jarvinen H, et al. Effect of Lactobacillus rhamnosus GG on ileal pouch inflammation and microbial flora. Aliment Pharmacol Ther. 2003;17:509-515. (Pubitemid 36384810)
62. Laake KO, Bjorneklett A, Aamodt G, et al. Outcome of four weeks' intervention with probiotics on symptoms and endo-scopic appearance after surgical reconstruction with a J-configuration ileal-pouch-anal-anastomosis in ulcerative colitis. Scand J Gastroenterol. 2005;40:43-51.
63. Gionchetti P, Rizzello F, Morselli C, et al. High-dose probiotics for the treatment of active pouchitis. Dis Colon Rectum. 2007;50:2075-2078.
64. Mimura T, Rizzello F, Helwig U, et al. Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis. Gut. 2004;53:108-114. (Pubitemid 38083018)
65. Longstreth Gf, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology. 2006;130:1480-1491.
66. Camilieri M. Peripheral mechanisms in irritable bowel syndrome. N Engl J Med. 2012;367:1626-1635.
67. Pimentel M, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms in irritable bowel syndrome. Am J Gastroenterol. 2000;95:3503-3506.
68. Pyleris E, Giamarellos-Bourboulis EJ, Tzivras D, et al. The prevalence of overgrowth by aerobic bacteria in the small intestine by small bowel culture: relationship with irritable bowel syndrome. Dig Dis Sci. 2012;57:1321-1329.
69. Ford AC, Spiegel BM, Talley NJ, et al. Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2009;7: 1729-1786.
70. Khoshini R, Dai SC, Lezcano S, et al. A systematic review of diagnostic tests for small intestinal bacterial overgrowth. Dig Dis Sci. 2008;53:1443-1454.
71. Pimentel M. 2011 Spring Post Graduate Course Syllabus Digestive Disease Week. 2011.
72. Shah ED, Basseri RJ, Chong K, et al. Abnormal breath testing in IBS: a meta-analysis. Dig Dis Sci. 2010;55: 2441-2449.
73. Barbara G, Stanghellini V, Brandi G, et al. Interactions between commensal bacteria and gut sensorimotor function in health and disease. Am J Gastroenterol. 2005;100: 2560-2568.
74. Malinen E, Rinttila E, Kajander K, et al. Analysis of the fecal microbiota of irritable bowel syndrome patients and healthy control with real-time PCR. Am J Gastroenterol. 2005;100: 373-382. (Pubitemid 40314522)
75. Pimentel M, Lembo A, Chey WD, et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011;364:22-32.
76. Menees SB, Maneerattannaporn M, Kim HM, et al. The efficacy and safety of rifaximin for the irritable bowel syndrome: a systematic review and meta-analysis. Am J Gastroenterol. 2012;107:28-35.
77. Pimentel M, Morales W, Chua K, et al. Effects of rifaximin treatment and retreatment in nonconstipated IBS subjects. Dig Dis Sci. 2011;56:2067-2072.
78. Spiller RC. Postinfectious irritable bowel syndrome. Gastro-enterology. 2003;124:1662-1671. (Pubitemid 36617684)
79. Barbara G, Stanghellini V, De Giorgio R, et al. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome. Gastroenterol-ogy. 2004;126:693-702. (Pubitemid 38298317)
80. Schoepfer AM, Schaffer T, Seibold-schmid B, et al. Antibodies to flagellin indicate reactivity to bacterial antigens in IBS patients. Neurogastroenterol Motil. 2008;20:1110-1118.
81. Langhorst J, Junge A, Rueffer A, et al. Elevated human B-defensin-2 levels indicate an activation of the innate immune system in patients with irritable bowel syndrome. Am J Gastroenterol. 2009;104:404-410.
82. Brint EK, MacSharry J, Fanning A, et al. Differential expression of Toll-like receptors in patients with irritable bowel syndrome. Am J Gastroenterol. 2011;106:329-336.
83. Thabane M, Kottachchi DT, Marshall JK. Systematic review and meta-analysis: the incidence and prognosis of post-infectious irritable bowel syndrome. Aliment Pharmacol Ther. 2007;26:535-544. (Pubitemid 47174284)
84. Kunkel D, Brasseri RJ, Makhani MD, et al. Methane on breath testing is associated with constipation: a systematic review and meta-analysis. Dig Dis Sci. 2011;56:1612-1618.
85. Kim G, Weitsman S, Choy JY, et al. Methanobrevibacter smithii is prominent in stool of subjects with constipation predominant IBS and methane on lactulose breath test. Dig Dis Week. 2010. Abstract.
86. van Hycklama Vlieg JE, Veiga P, Zhang C, et al. Impact of microbial transformation of food on health-from fermented foods to fermentation in the gastrointestinal tract. Curr Opin Biotech. 2011;22:211-215.
87. Shepherd SJ, Parker FC, Muir JG, et al. Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence. Clin Gastro-enterol Hepatol. 2008;6:765-769.
88. Staudacher HM, Whelan K, Irving PM, et al. Comparison of symptom (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet. 2011;24:487-495.
89. Brenner DM, Moeller MJ, Chey WD, et al. The utility of probiotics in the treatment of irritable bowel syndrome: a systematic review. Am J Gastroenterol. 2009;104:1033-1049.
90. Monteleone I, Sarra M, Del Vecchio Blanco G, et al. Characterization of IL-17A-producing cells in celiac disease mucosa. J Immunol. 2010;184:2211-2218.
91. Drago S, El Asmar R, Di Pierro M, et al. Gliadin, zonulin and gut permeability: effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scand J Gastro-enterol. 2006;41:408-419. (Pubitemid 43675406)
92. Ivarsson A, Hernell O, Stenlund H, et al. Breast-feeding protects against coeliac disease. Am J Clin Nutr. 2002;75: 914-921. (Pubitemid 34441261)
93. Stene LC, Honeyman MC, Hoffenberg EJ, et al. Rotavirus infection frequency and risk of celiac disease autoimmunity in early childhood: a longitudinal study. Am J Gastroenterol. 2006;101:2333-2340. (Pubitemid 44477562)
94. Akobeng AK, Ramanan AV, Buchan I, et al. Effect of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies. Arch Dis Child. 2006; 91:39-43. (Pubitemid 43059171)
95. Sanz Y. Gut microbes in coeliac disease pathogenesis and therapy. In: Eduards MA, ed. Celiac Disease: Etiology, Diagnosis, and Treatment. New York: Nova Science; 2009.
96. Nadal I, Donat E, Ribes-Koninckx C, et al. Imbalance in the composition of the duodenal microbiota of children with coeliac disease. J Med Microbiol. 2007;56:1669-1674. (Pubitemid 350276518)
97. Collado MC, Donat E, Ribes-Koninckx C, et al. Imbalances in faecal and duodenal Bifidobacterium species composition inactive and non-active coeliac disease. BMC Microbiol. 2008;22:232.
98. Collado MC, Donat E, Ribes-Koninckx C, et al. Specific duodenal and faecal bacterial groups associated with paedi-atric coeliac disease. J Clin Pathol. 2009;62:264-269.
99. De Palma G, Nadal I, Medina M, et al. Intestinal dysbiosis and reduced immunoglobulin-coated bacteria associated with coeliac disease in children. BMC Microbiol. 2010;10:63.
100. Tjellstrom B, Stenhammar L, Hogberg L, et al. Gut microflora associated characteristics in children with CD. Am J Gastroenterol. 2005;100:2784-2788.
101. Tjellstrom B, Stenhammar L, Hogberg L, et al. Gut microflora associated characteristics in first-degree relatives of children with CD. Scand J Gastroenterol. 2007;42: 1204-1208. (Pubitemid 47542222)
102. Rubio-Tapia A, Barton SH, Rosenblatt JE, et al. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. J Clin Gastroenterol. 2009;43:157-161.
103. Cinova J, De Palma G, Stepankova R, et al. Role of intestinal bacteria in gliadin-induced changes in intestinal mucosa: study in germ-free rats. PLoS One. 2011;6:161-169.
104. Szebeni B, Veres G, Dezsofi A, et al. Increased mucosal expression of Toll-like receptor (TLR)2 and TLR4 in coeliac disease. J Pediatr Gastroenterol Nutr. 2007;45:187-193. (Pubitemid 47220526)
105. Westerholm-Ormio M, Vaarala O, Tiittanen M, et al. Infiltration of Foxp3-and Toll-like receptor-4-positive cells in the intestines of children with food allergy. J Pediatr Gastroenterol Nutr. 2010;50:367-376.
106. Tlaskalova-Hogenova H, Stepankova R, Kozakova H, et al. The role of gut microbiota (commensal bacteria) and the mucosal barrier in the pathogenesis of inflammatory and autoimmune diseases and cancer: contribution of germ-free and gnotobiotic animal models of human diseases. Cell Mol Immunol. 2011;8:110-120.
107. Medina M, De Palma G, Ribes-Koninckx C, et al. Bifido-bacterium strains suppress in vitro the pro-inflammatory milieu triggered by the large intestinal microbiota of coeliac patients. J Inflamm (Lond). 2008;5:19.
108. Lindfors K, Blomqvist T, Juuti-Uusitalo K, et al. Live probiotic Bifidobacterium lactis bacteria inhibit the toxic effects induced by wheat gliadin in epithelial cell culture. Clin Exp Immunol. 2008;152:552-558. (Pubitemid 351661494)
109. Lorenzo-Zuniga V, Rodriguez-Ortigosa CM, Bartoli R, et al. Insulin-like growth factor I improves intestinal barrier function in cirrhotic rats. Gut. 2006;55:1306-1312. (Pubitemid 44277363)
110. Zhao HY, Wang HJ, Lu Z, et al. Intestinal microflora in patients with liver cirrhosis. Chin J Dig Dis. 2004;5:64-67. (Pubitemid 38594316)
111. Liu Q, Duan ZP, Ha DK, et al. Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology. 2004;39: 1441-1449. (Pubitemid 38569067)
112. Morgan MY, Blei A, Grungreiff K. The treatment of hepatic encephalopathy. Metab Brain Dis. 2007;22:389-405. (Pubitemid 47624312)
113. Bass NM, Mullen KD, Sanyal A, et al. Rifaximin treatment in hepatic encephalopathy. N Engl J Med. 2010;362: 1071-1081.
114. Ley RE, Turnbaugh PJ, Klein S, et al. Microbial ecology: human gut microbes associated with obesity. Nature. 2006;444:1022-1023. (Pubitemid 46018512)
115. Turnbaugh PJ, Ley RE, Mahowald MA, et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006;444:1027-1031. (Pubitemid 46018515)
116. Ridaura VK, Faith JJ, Rey FE, et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science. 2013;341:1-22.