10 WORLD GASTROENTEROLOGY NEWS JULY 2014 Editorial | Expert Point of View | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events biology of re-introductions, as well as developing microbial breeding programs20. Different interventional approaches have emerged, including the use of antibiotics, probiotics, prebiotics, com-binations of probiotics and prebiotics, or techniques for microbial reconsti-tution by fecal transplantation. The referred approaches aim at improving host-microbes symbiosis in the gut by combating overgrowth of opportunistic community members or providing live microorganism or metabolic substrates in order to promote growth and activ-ity of beneficial species. Probiotics were defined as “live micro-organisms which, when admin-istered in adequate amounts as part of food, confer a health benefit on the host” as proposed by the Joint FAO/ WHO Expert Consultation in 2001. Our guideline for the use of probiotics and prebiotics in gastroenterology is available online21, and will be updated later this year. The term prebiotic refers to “a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microbiota that confers benefits upon host well being and health”. Concurrently, a prebiotic should not be hydrolyzed by human intestinal enzymes, it should be selec-tively fermented by beneficial bacteria, and this selective fermentation should result in beneficial effects on health or well-being of the host22. Finally, fecal transplant has emerged as an alternative approach to treat relapsing diarrhea by Clostridium difficile infection. This procedure has shown success in a subset of patients who failed standard treatment, with reported response rates up to 87%23. A total of 239 patients who had undergone fecal transplantation were reported. Seventeen of 22 studies of fecal transplantation were performed in patients with fulminant or refracto-ry Clostridium difficile infection. The major concern about this approach is the potential risk of transmitting infectious diseases23. Conclusions The development of novel gene sequencing technologies as well as the availability of powerful bio-informatic analysis tools have allowed a dramatic proliferation of research work on the human gut microbiota. Large-scale studies are providing a deeper insight on the microbial communities that usually inhabit the human gut, and allow the identification of changes that are associated with disease states. A better knowledge of the contribu-tions of microbial symbionts to host health will certainly help in the design of new potential interventions to im-prove symbiosis and combat disease. Moreover, such sequencing techniques provide novel insights into the field of infectious diseases by enabling the dis-covery of microbial pathogens, more accurate diagnostic tests, and disclo-sure of drug-resistance profiles24. References 1. Wostmann BS. The germfree ani-mal in nutritional studies. Annual review of nutrition. 1981;1:257- 79. Epub 1981/01/01. 2. Handelsman J, Rondon MR, Brady SF, Clardy J, Goodman RM. Molecular biological access to the chemistry of unknown soil microbes: a new frontier for natural products. Chemistry & biology. 1998;5(10):R245-9. Epub 1998/11/18. 3. Frank DN, Pace NR. Gastro-intestinal microbiology enters the metagenomics era. Cur-rent opinion in gastroenterol-ogy. 2008;24(1):4-10. Epub 2007/11/29. 4. Turnbaugh PJ, Ley RE, Hamady M, Fraser-Liggett CM, Knight R, Gordon JI. The human microbiome project. Nature. 2007;449(7164):804-10. Epub 2007/10/19. 5. Eckburg PB, Bik EM, Bernstein CN, Purdom E, Dethlefsen L, Sargent M, et al. Diversity of the human intestinal microbial flora. Science. 2005;308(5728):1635-8. Epub 2005/04/16. 6. Qin J, Li R, Raes J, Arumugam M, Burgdorf KS, Manichanh C, et al. A human gut micro-bial gene catalogue established by metagenomic sequencing. Nature. 2010;464(7285):59-65. Epub 2010/03/06. 7. Arumugam M, Raes J, Pelletier E, Le Paslier D, Yamada T, Mende DR, et al. Enterotypes of the human gut microbiome. Nature. 2011;473(7346):174-80. Epub 2011/04/22. 8. Wu GD, Chen J, Hoffmann C, Bittinger K, Chen YY, Keil-baugh SA, et al. Linking long-term dietary patterns with gut microbial enterotypes. Science. 2011;334(6052):105-8. Epub 2011/09/03. 9. Caporaso JG, Lauber CL, Costello EK, Berg-Lyons D, Gonzalez A, Stombaugh J, et al. Moving pic-tures of the human microbiome. Genome biology. 2011;12(5):R50. Epub 2011/06/01. 10. Costello EK, Lauber CL, Hamady M, Fierer N, Gordon JI, Knight R. Bacterial community varia-tion in human body habitats across space and time. Science. 2009;326(5960):1694-7. Epub 2009/11/07. 11. Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecol-ogy: human gut microbes as-sociated with obesity. Nature. 2006;444(7122):1022-3. Epub 2006/12/22. 12. Le Chatelier E, Nielsen T, Qin J, Prifti E, Hildebrand F, Fa-lony G, et al. Richness of hu-man gut microbiome correlates with metabolic markers. Nature. 2013;500(7464):541-6. Epub 2013/08/30.
ewgn-vol19-issue2-FINAL
To see the actual publication please follow the link above