TRANSLOCATION OF INTESTINAL MICROFLORA IN CIRRHOSIS

Background. Understanding of intestinal bacteria-host interaction physiology as well as bacterial translocation characteristics at the initial stages and in advanced cirrhosis emphasizes the importance of approaches minimizing the migration of microorganisms and their components from the intestinal lumen. Objective – to provide a brief review of publications highlighting the problem of bacterial intestinal translocation as the main mechanism for the development of bacterial infections and pro-inﬂammatory status in patients with liver cirrhosis. Material and methods. We performed the study and analysis of English- and Russian-language articles over the past 30 years contained in the following databases: PubMed, Cochrane Collaboration, UpToDate. The key words were: «intestinal microﬂora translocation», «bacterial translocation», «translocation markers». Results. Contemporary views on changes of the intestinal barrier and those of innate and adaptive immunity systems in liver diseases are considered. Data on possibility and signifcance of detecting bacterial translocation are presented.Current methods used for gut microbiome analysis as well as some areas for future research are discussed. Conclusion. A validated marker/markers is required to study bacterial translocation in cirrhosis.

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Change of Intestinal Microbiome in Patients with Coronavirus Infection

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs06.05.022 ◽

2021 ◽

Vol 6 (5) ◽

pp. 22-27

Author(s):

M. M. Mishina ◽

◽

O. V. Kotsar ◽

Pochernina M. H. ◽

O. V. Kochnieva ◽

...

Keyword(s):

Bacterial Translocation ◽

Intestinal Barrier ◽

Multiple Organ ◽

Infection Process ◽

The Body ◽

Intestinal Microbiome ◽

Intestinal Lumen ◽

Treatment Regimens ◽

Analysis And Synthesis ◽

Coronavirus Infection

The purpose of the study was to analyze modern literature on the problems of dysbiosis in patients with COVID-19, to study the main mechanisms of systemic interaction between the intestine and lungs, as well as changes in the microbiota that occur under the influence of coronavirus infection. Materials and methods. A comprehensive selection of research methods was used for the work: systematization of the material, the method of generalization, methods of analysis and synthesis. Scientific works in the field of microbiology, epidemiology and infectious diseases were studied. Literature data for the last 2 years (2019-2021) were considered. The results of bacteriological studies from patients with COVID infection were described. The data obtained were processed using information-analytical and statistical-analytical methods. Results and discussion. As a result of this work, a complex of connections between intestine and lungs, which is called the "intestinal-lung axis", was considered. It is known that the interaction between these two biotopes occurs with the participation of microflora and its metabolites. Dysfunction of the intestinal barrier is accompanied by bacterial translocation. Bacteria from the intestinal lumen enter the liver through the portal vein system. The lymphatic pathway of bacterial translocation from the intestine to the lungs is also possible, which causes multiple organ failure syndrome in coronavirus infection. The COVID-19 virus is able to reduce the number of ACE2 receptors in the gastrointestinal tract, which leads to an imbalance in the intestines. At the same time, the infection process in the lungs promotes the growth of bacteria of the Enterobacteriacae family in the intestine, which also leads to dysbiotic disorders. The use of probiotics is an effective tool in the complex treatment of this infection, which facilitates the general condition of patients. In the course of treatment, it is important not only to eliminate the virus from the body, but also to restore normal intestinal microbiota after an infection. Conclusion. Thus, the use of probiotic drugs for the treatment of patients with coronavirus infection can significantly reduce the risk of developing dysbiosis and improve the condition of patients. A perspective direction is the development of new treatment regimens for dysbiotic conditions using probiotics, eubiotics, synbiotics and postbiotics to prevent the development of severe complications in COVID infection

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Effects of Synbiotics to Prevent Postoperative Infectious Complications in Highly Invasive Abdominal Surgery

Annals of Nutrition and Metabolism ◽

10.1159/000479920 ◽

2017 ◽

Vol 71 (Suppl. 1) ◽

pp. 23-30 ◽

Cited By ~ 2

Author(s):

Yukihiro Yokoyama ◽

Takashi Asahara ◽

Koji Nomoto ◽

Masato Nagino

Keyword(s):

Lactic Acid ◽

Abdominal Surgery ◽

Bacterial Translocation ◽

Barrier Function ◽

Intestinal Microflora ◽

Surgical Stress ◽

Controlled Trial ◽

Intestinal Barrier ◽

Short Chain Fatty Acids ◽

Intestinal Barrier Function

Postoperative infectious complication (POIC) is one of the most common complications following highly invasive abdominal surgeries, such as hepatectomy, esophagectomy, and pancreatoduodenectomy. The surgical stress temporarily deteriorates the intestinal microenvironment, and the fecal concentrations of beneficial bacteria such as Bifidobacterium and Lactobacillus decrease following highly invasive abdominal surgery. In parallel with these changes, the concentrations of fecal short-chain fatty acids (SCFAs) such as acetic acid, propionic acid, and butyric acid also decrease after surgery. In contrast, the fecal concentration of lactic acid increases under this condition because of the deterioration of the metabolism from lactic acid to SCFAs by normal intestinal microflora. Decreased fecal concentration of SCFAs may lead to an impaired intestinal barrier function under stressful condition. Translocation of bacteria from the gut to lymphatic and bloodstream leads to bacteremia and subsequent POICs. The incidence of POICs in patients with unhealthy intestinal microflora before surgery may be more because their intestine is more susceptible to bacterial translocation induced by surgical stress. Therefore, improving the intestinal microenvironment and intestinal barrier function before surgery is crucial to prevent POICs following highly invasive abdominal surgeries. In this regard, the use preoperative synbiotics therapy may be one of the effective ways because it has been shown to improve intestinal microflora, increase fecal SCFAs, prevent bacterial translocation, and reduce the incidence of POICs in several randomized controlled trial in patients undergoing highly invasive abdominal surgeries.

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Intestinal mucus and gut-vascular barrier: FxR-modulated entry sites for pathological bacterial translocation in liver cirrhosis

10.1101/690057 ◽

2019 ◽

Author(s):

M. Sorribas ◽

M. O. Jakob ◽

B. Yilmaz ◽

H. Li ◽

D. Stutz ◽

...

Keyword(s):

Liver Cirrhosis ◽

Portal Hypertension ◽

Bacterial Translocation ◽

Bacterial Infections ◽

Bacterial Overgrowth ◽

Intestinal Bacteria ◽

Mucus Layer ◽

Thoracic Duct Ligation ◽

Duct Ligation ◽

Epithelial Barriers

AbstractBackground and aimsPathological bacterial translocation (PBT) in liver cirrhosis (LC) is the hallmark for spontaneous bacterial infections increasing mortality several-fold. Factors known to contribute to PBT in LC are among others an increased intestinal permeability of which however, the mucus layer has not been addressed so far in detail. A clear route of translocation for luminal intestinal bacteria is yet to be defined but we hypothesize that the recently described gut vascular barrier (GVB) is impaired in experimental portal hypertension leading to increased accessibility of the vascular compartment for translocating bacteria.ResultsHealthy and pre-hepatic portal-hypertensive (PPVL) mice lack translocation of FITC-dextran and GFP-Escherichia colifrom the small intestine to the liver whereas bile-duct-ligated (BDL) and CCl4-induced cirrhotic mice demonstrate pathological translocation which is not altered by prior thoracic-duct ligation. Mucus layer is reduced in thickness with loss of goblet-cells and Muc2-staining and expression in cirrhotic but not PPVL-mice associated with bacterial overgrowth in inner mucus layer and pathological translocation of GFP-E.colithrough the ileal epithelium. GVB is profoundly altered in BDL and CCl4-mice with Ileal extravasation of large-sized 150 kDa-FITC-dextran but only minor in PPVL-mice. This pathological endothelial permeability and accessibility in cirrhotic mice associates with an augmented expression of PV1 in intestinal vessels. OCA but not fexaramine stabilizes the GVB whereas both FXR-agonists ameliorate gut-liver-translocation of GFP-E.coli.ConclusionsLiver cirrhosis but not portal hypertension per se grossly impairs the endothelial and muco-epithelial barriers promoting PBT to the portal-venous circulation. Both barriers appear FXR-modulated with –agonists reducing PBT via the portal-venous route.

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Intestinal Barrier Dysfunction, Bacterial Translocation and Inflammation: Deathly Triad in Sepsis

10.5772/intechopen.99554 ◽

2021 ◽

Author(s):

Bercis Imge Ucar ◽

Gulberk Ucar

Keyword(s):

Bacterial Translocation ◽

Current Knowledge ◽

Intestinal Barrier ◽

Intestinal Bacteria ◽

Mucosal Barrier ◽

High Morbidity ◽

Barrier Dysfunction ◽

Intestinal Barrier Dysfunction ◽

Gut Mucosa ◽

Sepsis Detection

Sepsis, as a complex entity, comprises multiple pathophysiological mechanisms which bring about high morbidity and mortality. The previous studies showed that the gastrointestinal tract is damaged during sepsis, and its main symptoms include increased permeability, bacterial translocation (BT), and malabsorption. BT is the invasion of indigenous intestinal bacteria via the gut mucosa to other tissues. It occurs in pathological conditions such as disruption of the intestine’s ecological balance and mucosal barrier permeability, immunosuppression, and oxidative stress through transcellular/paracellular pathways and initiate an excessive systemic inflammatory response. Thereby, recent clinical and preclinical studies focus on the association between sepsis and intestinal barrier dysfunction. This chapter overviews the current knowledge about the molecular basis of BT of the intestine, its role in the progress of sepsis, detection of BT, and actual therapeutic approaches.

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BACTERIAL TRANSLOCATION: MICROBIOTA-INTESTINE-LUNG AXIS AND PRO-INFLAMMATORY STATUS IN THE SEVERITY OF COVID-19

Journal of Experimental Biology and Agricultural Sciences ◽

10.18006/2021.9(3).239.253 ◽

2021 ◽

Vol 9 (3) ◽

pp. 239-253

Author(s):

Nereida Valero-Cedeño ◽

◽

Danna Álava ◽

Ronny Rodríguez ◽

Maricarmen Chacín ◽

...

Keyword(s):

Bacterial Translocation ◽

Clinical Symptoms ◽

Intestinal Barrier ◽

High Viral Load ◽

Intestinal Infection ◽

Gi Tract ◽

Oral Transmission ◽

Inflammatory Status ◽

Multisystem Involvement ◽

Translocation Of Bacteria

Although severe acute respiratory syndrome coronavirus – 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) pandemic, is primarily associated with a respiratory infection, it has also been linked to multisystem involvement that includes the digestive tract. Gastrointestinal (GI) manifestations are common in patients with COVID-19 due to the high viral load lodged in the small intestine's mucosa. As a result, it causes an increase in the permeability of the intestinal barrier that favours the passage and translocation of bacteria, from the lumen of the intestine, towards the internal environment, with the appearance of sepsis, with evidence that SARS-CoV-2 has been found in faeces. This article highlights epidemiology, clinical symptoms, and mechanisms related to manifestations of disease in the GI tract and its pathogenesis in patients with COVID-19. It highlights bacterial translocation and COVID-19, mechanisms that control bacterial translocation, intestinal infection and feco-oral transmission, defense

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The Multi-Component Causes of Late Neonatal Sepsis—Can We Regulate Them?

Nutrients ◽

10.3390/nu14020243 ◽

2022 ◽

Vol 14 (2) ◽

pp. 243

Author(s):

Magdalena Pilarczyk-Zurek ◽

Grzegorz Majka ◽

Beata Skowron ◽

Agnieszka Baranowska ◽

Monika Piwowar ◽

...

Keyword(s):

Bacterial Translocation ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Late Onset ◽

Intraperitoneal Administration ◽

Intestinal Barrier ◽

Oral Intake ◽

Intestinal Bacteria ◽

Stress Factors ◽

Rat Pups

Elucidating the mechanisms of bacterial translocation is crucial for the prevention and treatment of neonatal sepsis. In the present study, we aimed to evaluate the potential of lactoferrin to inhibit the development of late-onset blood infection in neonates. Our investigation evaluates the role of key stress factors leading to the translocation of intestinal bacteria into the bloodstream and, consequently, the development of life-threatening sepsis. Three stress factors, namely weaning, intraperitoneal administration of Gram-positive cocci and oral intake of Gram-negative rods, were found to act synergistically. We developed a novel model of rat pups sepsis induced by bacterial translocation and observed the inhibition of this process by supplementation of various forms of lactoferrin: iron-depleted (apolactoferrin), iron-saturated (hololactoferrin) and manganese-saturated lactoferrin. Additionally, lactoferrin saturated with manganese significantly increases the Lactobacillus bacterial population, which contributes to the fortification of the intestinal barrier and inhibits the translocation phenomenon. The acquired knowledge can be used to limit the development of sepsis in newborns in hospital neonatal intensive care units.

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Predicting Hyperoxia-Induced Lung Injury from Associated Intestinal and Lung Dysbiosis in Neonatal Mice

Neonatology ◽

10.1159/000513553 ◽

2021 ◽

pp. 106-116

Author(s):

Chung-Ming Chen ◽

Hsiu-Chu Chou ◽

Yu-Chen S.H. Yang ◽

Emily Chia-Yu Su ◽

Yun-Ru Liu

Keyword(s):

Lung Injury ◽

Intestinal Microbiota ◽

Bacterial Translocation ◽

Left Lung ◽

Intestinal Barrier ◽

Intestinal Bacteria ◽

Machine Learning Algorithms ◽

Neonatal Mice ◽

The Right ◽

Neonatal Hyperoxia

Background: Preclinical studies have demonstrated that hyperoxia disrupts the intestinal barrier, changes the intestinal bacterial composition, and injures the lungs of newborn animals. Objectives: The aim of the study was to investigate the effects of hyperoxia on the lung and intestinal microbiota and the communication between intestinal and lung microbiota and to develop a predictive model for the identification of hyperoxia-induced lung injury from intestinal and lung microbiota based on machine learning algorithms in neonatal mice. Methods: Neonatal C57BL/6N mice were reared in either room air or hyperoxia (85% O2) from postnatal days 1–7. On postnatal day 7, lung and intestinal microbiota were sampled from the left lung and lower gastrointestinal tract for 16S ribosomal RNA gene sequencing. Tissue from the right lung and terminal ileum were harvested for Western blot and histology analysis. Results: Hyperoxia induced intestinal injury, decreased intestinal tight junction expression, and impaired lung alveolarization and angiogenesis in neonatal mice. Hyperoxia also altered intestinal and lung microbiota and promoted bacterial translocation from the intestine to the lung as evidenced by the presence of intestinal bacteria in the lungs of hyperoxia-exposed neonatal mice. The relative abundance of these bacterial taxa was significantly positively correlated with the increased lung cytokines. Conclusions: Neonatal hyperoxia induced intestinal and lung dysbiosis and promoted bacterial translocation from the intestine to the lung. Further studies are needed to clarify the pathophysiology of bacterial translocation to the lung.

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Liver Cirrhosis and Intestinal Bacterial Translocation

Infection International ◽

10.1515/ii-2017-0088 ◽

2014 ◽

Vol 3 (3) ◽

pp. 133-138

Author(s):

Tao Lan ◽

Bao-chun Chen ◽

Li-ping Fu ◽

Zhi-juan Li ◽

Xiang-jun Wu ◽

...

Keyword(s):

Liver Cirrhosis ◽

Intestinal Flora ◽

Bacterial Overgrowth ◽

Intestinal Barrier ◽

Intestinal Bacteria ◽

The Body ◽

Intestinal Lumen ◽

Barrier Dysfunction ◽

Local Immunity ◽

Bacterial Products

Abstract Intestinal barrier dysfunction, facilitating translocation of bacteria and bacterial products, plays an important role in the pathophysiology of liver cirrhosis and its complications. Intestinal defense system including microbial barrier, immunologic barrier, mechanical barrier, chemical barrier, plays an important role in the maintenance of intestinal function. Under normal circumstances, the intestinal barrier can prevent intestinal bacteria through the intestinal wall from spreading to the body. Severe infection, trauma, shock, cirrhosis, malnutrition, immune suppression conditions, intestinal bacteria and endotoxin translocation, can lead to multiple organ dysfunction. The intestinal microflora is not only involved in the digestion of nutrients, but also in local immunity, forming a barrier against pathogenic microorganisms. The derangement of the gut microflora may lead to microbial translocation, defined as the passage of viable microorganisms or bacterial products from the intestinal lumen to the mesenteric lymph nodes and other extraintestinal sites. In patients with cirrhosis, primary and intestinal flora imbalance, intestinal bacterial overgrowth, intestinal mucosal barrier dysfunction, endotoxemia is associated with weakened immunity.

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Conceptual Foundations of Environmental Marketing and Environmental Product

Economics and Management ◽

10.35854/1998-1627-2020-6-665-671 ◽

2020 ◽

Vol 26 (6) ◽

pp. 665-671

Author(s):

D. V. Bagnyuk ◽

A. V. Lebedev

Keyword(s):

Sustainable Development ◽

Methodological Approach ◽

Russian Language ◽

Future Research ◽

Environmental Friendliness ◽

Environmental Marketing ◽

Qualitative Empirical Research ◽

Green Approach ◽

Market Practices ◽

Conceptual Foundations

The presented study examines the concepts of “environmental marketing” and “environmental product”. The study attempts to conceptualize these terms in Russian language with allowance for the concept of sustainable development and the principles of the circular economy.Aim. The study aims to develop the conceptual foundations of environmental marketing and its derivative — environmental product, laying the groundwork for future research in specifying the concepts of “environmental marketing” and “environmental product”.Tasks. The authors examine the current state of environmental marketing and environmental product in Russia in terms of legislation and market practices; analyze the evolution of these concepts in foreign and Russian publications; systematize experience in this field; provide an original conceptualization of these terms; operationalize their key characteristics and features.Methods. This study is based on qualitative empirical research using such methods as content analysis, synthesis, formalization, and systematization. The theoretical and methodological approach of the study is based on the works of foreign and Russian scientists in the field of environmental marketing, the “green” approach to the promotion of goods, and sustainable enterprise development.Results. A research gap in the conceptualization of “environmental marketing” and “environmental product” in Russian language is identified. The authors provide an original interpretation of these concepts with allowance for the principles of sustainable development and “green” promotion.Conclusions. This study serves to elaborate on the scientific meaning of the concept of “environmental friendliness” applicable in marketing, changing the trend of the increasing number of products that fall under the definition of greenwashing. The published materials can be useful for environmental consultants, marketers, and representatives of legislative authorities in certifying products according to environmental standards.

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Neonatal Uterine Bleedings: An Ignored Sign but a Possible Cause of Early-Onset Endometriosis – A Systematic Review

Biomedicine Hub ◽

10.1159/000512663 ◽

2021 ◽

pp. 6-16

Author(s):

Judith Dekker ◽

Isabelle Hooijer ◽

Johannes C.F. Ket ◽

Aleksandra Vejnović ◽

Giuseppe Benagiano ◽

...

Keyword(s):

Systematic Review ◽

Full Text ◽

Early Onset ◽

Cochrane Collaboration ◽

Systematic Search ◽

Future Research ◽

Screening Techniques ◽

Screening Strategies ◽

The Cochrane Collaboration ◽

Possible Cause

Objective: Based on the hypothesis that neonatal uterine bleedings (NUB), occurring mostly in the first week after birth, could represent a pathogenetic mechanism for early-onset endometriosis, this systematic review (SR) was undertaken to evaluate the prevalence and screening strategies used to assess and quantify NUB. Design: Both a SR and a sample literature search in PubMed and Embase were conducted to gather information on NUB prevalence and screening techniques. This was performed by an information specialist. Only full-text articles regarding the assessment of NUB in neonates in the first 2 weeks after birth were included. No limit on language or publication data was used. Materials and Methods: The SR was registered in PROSPERO (CRD42019138121). Data was first assessed for eligibility on title and abstract by 2 blinded review authors. Any disagreements were discussed with a third reviewer if necessary. Subsequently, full-text articles were read and assessed for quality using the Cochrane Collaboration Handbook. Results: Out of 1,988 articles in the systematic search, 10 relevant articles were selected, of which 8 were identified through the systematic search and 2 were found through other sources. The sample search of 4,445 articles did not bring up relevant articles. Results were not comparable due to the heterogeneity of screening techniques, although data showed consensus. The prevalence of visible bleeding ranged from 3.3 to 53.8% and the prevalence of occult bleeding from 25.4 to 96.7%. The occurrence was the highest between the 3rd and 7th day postpartum (PP) and the bleeding lasted for 3–4 days on average. Various screening techniques for detecting NUB were found in the literature, including the use of hemoglobin detection devices (such as Hemastix) in the vaginal vestibulum, comparison of diapers with stains of known volume, colposcopy, and ultrasonography. Conclusion: The reported prevalence of NUB varies considerably, with a consistent occurrence between the 3rd and the 7th day PP. Literature to assess NUB is dated. The techniques are poorly described and heterogeneous. Future research should focus on prospective cohort studies in order to attempt to correlate NUB cases to (early-onset) endometriosis.

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