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  • 1.
    Algilani, Samal
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Östlund-Lagerström, Lina
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kihlgren, Annica
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Blomberg, Karin
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Brummer, Robert Jan
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Schoultz, Ida
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Exploring the concept of optimal functionality in old age2014In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 7, p. 69-79Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Aging is characterized by loss of function and represents a perspective that puts the focus on the negative aspects of aging. Thus, it is fundamental to shift the focus from loss of function to maintaining good health and personal satisfaction through life; in other words, to promote optimal functionality at a level appropriate for older adults. However, it is not yet known what constitutes optimal functionality from the older adult's own perspective.

    OBJECTIVE: To explore the concept of optimal functionality in old age from the older adult's perspective (ie, people over 65 years of age) in industrialized Western countries.

    METHODS: We undertook a scoping review and searched two electronic databases (PubMed and the Cumulative Index to Nursing and Allied Health Literature [CINAHL]) from January 2002 to July 2013 for scientific studies, using the key search term personal satisfaction. In total, 25 scientific studies were analyzed.

    RESULTS: Only six of the included articles applied a qualitative methodology. By analyzing the results of these articles, three major themes were identified as cornerstones in the concept of optimal functionality at old age: 1) self-related factors (eg, mental well-being); 2) body-related factors (eg, physical well-being); and 3) external factors equal to demographic and environmental factors.

    CONCLUSION: There is a lack of qualitative studies in the current literature, and hence of what constitutes optimal functionality from the older adult's perspective. The results outlined in this review identify three cornerstones (self-related factors, body-related factors, and external factors) of what constitutes optimal functionality at old age. However, it is vital that these findings are taken further and are evaluated through qualitative studies to reflect older adults' opinions.

  • 2.
    Algilani, Samal
    et al.
    Örebro University, School of Health Sciences.
    Östlund-Lagerström, Lina
    Örebro University, School of Medical Sciences.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Brummer, Robert J.
    Örebro University, School of Medical Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    Increasing the qualitative understanding of optimal functionality in older adults: a focus group based study2016In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, no 1, article id 70Article in journal (Refereed)
    Abstract [en]

    Background: Decreased independence and loss of functional ability are issues regarded as inevitably connected to old age. This ageism may have negative influences on older adults' beliefs about aging, making it difficult for them to focus on their current ability to maintain a good health. It is therefore important to change focus towards promoting Optimal Functionality (OF). OF is a concept putting the older adult's perspective on health and function in focus, however, the concept is still under development. Hence, the aim was to extend the concept of optimal functionality in various groups of older adults.

    Methods: A qualitative study was conducted based on focus group discussions (FGD). In total 6 FGDs were performed, including 37 older adults from three different groups: group 1) senior athletes, group 2) free living older adults, group 3) older adults living in senior living homes. All data was transcribed verbatim and analyzed following the process of deductive content analysis.

    Results: The principal outcome of the analysis was "to function as optimally as you possibly can", which was perceived as the core of the concept. Further, the concept of OF was described as multifactorial and several new factors could be added to the original model of OF. Additionally the findings of the study support that all three cornerstones comprising OF have to occur simultaneously in order for the older adult to function as optimal as possible.

    Conclusions: OF is a multifaceted and subjective concept, which should be individually defined by the older adult. This study further makes evident that older adults as a group are heterogeneous in terms of their preferences and views on health and should thus be approached as such in the health care setting. Therefore it is important to promote an individualized approach as a base when caring for older adults.

  • 3.
    Bachmann, Radu
    et al.
    Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), UCLouvain, Université Catholique de Louvain, Brussels, Belgium; Colorectal Surgery Unit, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
    Van Hul, Matthias
    Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), UCLouvain, Université Catholique de Louvain, Brussels, Belgium.
    Baldin, Pamela
    Pathology Department, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.
    Léonard, Daniel
    Colorectal Surgery Unit, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
    Delzenne, Nathalie M.
    Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), UCLouvain, Université Catholique de Louvain, Brussels, Belgium.
    Belzer, Clara
    Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands.
    Ouwerkerk, Janneke P.
    Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Rangel, Ignacio
    Örebro University, School of Medical Sciences.
    Kartheuser, Alex
    Colorectal Surgery Unit, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    De Vos, Willem M.
    Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands; Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    Cani, Patrice D.
    Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), UCLouvain, Université Catholique de Louvain, Brussels, Belgium.
    Akkermansia muciniphila Reduces Peritonitis and Improves Intestinal Tissue Wound Healing after a Colonic Transmural Defect by a MyD88-Dependent Mechanism2022In: Cells, E-ISSN 2073-4409, Vol. 11, no 17, article id 2666Article in journal (Refereed)
    Abstract [en]

    Anastomotic leakage is a major complication following colorectal surgery leading to peritonitis, complications, and mortality. Akkermansia muciniphila has shown beneficial effects on the gut barrier function. Whether A. muciniphila reduces peritonitis and mortality during colonic leakage is unknown. Whether A. muciniphila can directly modulate the expression of genes in the colonic mucosa in humans has never been studied. We investigated the effects of a pretreatment (14 days) with live A. muciniphila prior to surgical colonic perforation on peritonitis, mortality, and wound healing. We used mice with an inducible intestinal-epithelial-cell-specific deletion of MyD88 (IEC-MyD88 KO) to investigate the role of the innate immune system in this context. In a proof-of-concept pilot study, healthy humans were exposed to A. muciniphila for 2 h and colonic biopsies taken before and after colonic instillation for transcriptomic analysis. Seven days after colonic perforation, A.-muciniphila-treated mice had significantly lower mortality and severity of peritonitis. This effect was associated with significant improvements of wound histological healing scores, higher production of IL22, but no changes in the mucus layer thickness or genes involved in cell renewal, proliferation, or differentiation. All these effects were abolished in IEC-MyD88 KO mice. Finally, human subjects exposed to A. muciniphila exhibited an increased level of the bacterium at the mucus level 2 h after instillation and significant changes in the expression of different genes involved in the regulation of cell cycling, gene transcription, immunity, and inflammation in their colonic mucosa. A. muciniphila improves wound healing during transmural colonic wall defect through mechanisms possibly involving IL22 signaling and requiring MyD88 in the intestinal cells. In healthy humans, colonic administration of A. muciniphila is well tolerated and changes the expression of genes involved in the immune pathways.

  • 4.
    Baunwall, Simon Mark Dahl
    et al.
    Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
    Terveer, Elisabeth M.
    Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands; Netherlands Donor Feces Bank, Leiden University Medical Center, Leiden, the Netherlands.
    Dahlerup, Jens Frederik
    Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
    Erikstrup, Christian
    Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
    Arkkila, Perttu
    Department of Gastroenterology, Helsinki University Hospital and Helsinki University, Helsinki, Finland.
    Vehreschild, Maria Jgt
    Department of Internal Medicine II, Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany; ESCMID Study Group for Host and Microbiota Interaction (ESGHAMI), Basel, Switzerland; Department I of Internal Medicine, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner site Bonn-Cologne, Germany.
    Ianiro, Gianluca
    Digestive Disease Center, CEMAD, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy.
    Gasbarrini, Antonio
    Digestive Disease Center, CEMAD, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy.
    Sokol, Harry
    Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Saint Antoine Hospital, Gastroenterology Department, Paris, France; INRA, UMR1319 Micalis, AgroParisTech, Jouy-en-Josas, France; French Group of Faecal Microbiota Transplantation (GFTF), Paris, France.
    Kump, Patrizia K.
    Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria.
    Satokari, Reetta
    Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    De Looze, Danny
    Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium.
    Vermeire, Séverine
    Department Gastroenterology and Hepatology, KU Leuven University Hospitals Leuven & KU Leuven, Belgium.
    Nakov, Radislav
    Clinic of Gastroenterology, Tsaritsa Yoanna University Hospital, Sofia, Bulgaria.
    Brezina, Jan
    Hepatogastroenterology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
    Helms, Morten
    Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Denmark.
    Kjeldsen, Jens
    Department of Medical Gastroenterology, Odense University Hospital Research Unit of Medical Gastroenterology, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
    Rode, Anne A.
    Department of Medicine, Zealand University Hospital, Køge, Denmark.
    Kousgaard, Sabrina Just
    Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark.
    Alric, Laurent
    Department of Internal Medicine and Digestive Diseases, IRD Toulouse 3 University, Toulouse, France.
    Trang-Poisson, Caroline
    Gastroenterology Department, Institut des maladies de l'Appareil Digestif (IMAD), Centre d'investigation Clinique IMAD, University Hospital, Hotel-Dieu, Nantes, France.
    Scanzi, Julien
    French Group of Faecal Microbiota Transplantation (GFTF), Paris, France; Gastroenterology Department, Centre Hospitalier de Thiers, Thiers, France.
    Link, Alexander
    Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany.
    Stallmach, Andreas
    Department of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Jena, Germany.
    Kupcinskas, Juozas
    Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Johnsen, Peter Holger
    University Hospital of North Norway Harstad, Harstad, Norway.
    Garborg, Kjetil
    Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway; Institute of Health and Society, University of Oslo, Oslo, Norway.
    Rodríguez, Eugenia Sánchez
    Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Madrid, Spain.
    Serrander, Lena
    Division of Clinical Microbiology, Linköping University Hospital, Linköping, Sweden.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Galpérine, Katerina Tatiana
    French Group of Faecal Microbiota Transplantation (GFTF), Paris, France; Infectious Diseases Service, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
    Goldenberg, Simon D.
    Centre for Clinical Infection and Diagnostics Research (CIDR), King's College London and Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
    Mullish, Benjamin H.
    Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom.
    Williams, Horace Rt.
    Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom.
    Iqbal, Tariq H.
    Department of Gastroenterology, Institute of Immunology and Immunotherapy, University of Birmingham, University Hospital, Birmingham, United Kingdom.
    Ponsioen, Cyriel
    Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
    Kuijper, Ed J.
    Netherlands Donor Feces Bank, Leiden University Medical Center, Leiden, the Netherlands; ESCMID Study Group for Host and Microbiota Interaction (ESGHAMI), Basel, Switzerland; Centre for Microbiota Analysis and Therapeutics, Leiden University Medical Centre, Leiden, the Netherlands; National Reference Laboratory for Clostridium difficile, Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
    Cammarota, Giovanni
    Digestive Disease Center, CEMAD, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy.
    Keller, Josbert J.
    Netherlands Donor Feces Bank, Leiden University Medical Center, Leiden, the Netherlands; Department of Gastroenterology, Haaglanden Medical Center, The Hague, the Netherlands; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands.
    Hvas, Christian Lodberg
    Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
    The use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey2021In: The Lancet Regional Health: Europe, E-ISSN 2666-7762, Vol. 9, article id 100181Article in journal (Refereed)
    Abstract [en]

    Background: Faecal microbiota transplantation (FMT) is an emerging treatment modality, but its current clinical use and organisation are unknown. We aimed to describe the clinical use, conduct, and potential for FMT in Europe.

    Methods: We invited all hospital-based FMT centres within the European Council member states to answer a web-based questionnaire covering their clinical activities, organisation, and regulation of FMT in 2019. Responders were identified from trials registered at clinicaltrials.gov and from the United European Gastroenterology (UEG) working group for stool banking and FMT.

    Findings: In 2019, 31 FMT centres from 17 countries reported a total of 1,874 (median 25, quartile 10-64) FMT procedures; 1,077 (57%) with Clostridioides difficile infection (CDI) as indication, 791 (42%) with experimental indications, and 6 (0•3%) unaccounted for. Adjusted to population size, 0•257 per 100,000 population received FMT for CDI and 0•189 per 100,000 population for experimental indications. With estimated 12,400 (6,100-28,500) annual cases of multiple, recurrent CDI and indication for FMT in Europe, the current European FMT activity covers approximately 10% of the patients with indication. The participating centres demonstrated high safety standards and adherence to international consensus guidelines. Formal or informal regulation from health authorities was present at 21 (68%) centres.

    Interpretation: FMT is a widespread routine treatment for multiple, recurrent CDI and an experimental treatment. Embedded within hospital settings, FMT centres operate with high standards across Europe to provide safe FMT. A significant gap in FMT coverage suggests the need to raise clinical awareness and increase the FMT activity in Europe by at least 10-fold to meet the true, indicated need.

    Funding: NordForsk under the Nordic Council and Innovation Fund Denmark (j.no. 8056-00006B).

  • 5.
    Boersma, Katja
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Ljótsson, Brjánn
    Deptartment of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    Edebol-Carlman, Hanna
    Schrooten, Martien
    Örebro University, School of Law, Psychology and Social Work.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences. Department of gastroenterology, Örebro university hospital, Örebro, Sweden.
    Exposure-based cognitive behavioral therapy for irritable bowel syndrome: A single-case experimental design across 13 subjects2016In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 45, no 6, p. 415-430Article in journal (Refereed)
    Abstract [en]

    Irritable bowel syndrome (IBS) is a highly prevalent disorder with a significant impact on quality of life. The presence of psychological symptoms in IBS patients such as catastrophic worry and behavioral avoidance suggests the possible efficacy of cognitive behavioral interventions. Exposure-based cognitive behavioral therapy (CBT) has proven to be a promising approach but has only been investigated in a few studies and mainly via the Internet. Therefore, the aims of this study were to extend and replicate previous findings and to evaluate whether an individual, face-to-face, exposure-based CBT leads to improvement in gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life in IBS patients. Thirteen patients with IBS according to Rome III criteria participated in a single-case experimental study using a five-week baseline and a subsequent twelve-session intervention phase focusing on psycho-education, mindfulness and in vivo exposure. Standardized measurement of gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life was conducted weekly during baseline as well as intervention phase and at six-month follow-up. Results showed that over 70% of patients improved significantly on gastrointestinal symptoms, pain catastrophizing, and quality of life. Effects on avoidance behavior were modest. These results strengthen and extend earlier findings and provide further support for the efficacy of exposure-based strategies for IBS.

  • 6. Dullemeijer, C.
    et al.
    Verhoef, P.
    Brouwer, I. A.
    Kok, F. J.
    Brummer, Robert
    Örebro University, School of Health and Medical Sciences.
    Durga, J.
    Plasma very long-chain n-3 polyunsaturated fatty acids and age-related hearing loss in older adults2010In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 14, no 5, p. 347-351Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Age-related hearing loss is a common social and health problem in the older adult population. Up until now, very little scientific attention has been given to the potential role of fatty acids in age-related hearing loss. In this study we investigated whether plasma very long-chain n-3 polyunsaturated fatty acids (PUFAs) are associated with age-related hearing loss over three years.

    DESIGN: Cross-sectional and 3-year longitudinal analyses.

    SETTING: Wageningen, the Netherlands.

    PARTICIPANTS: 720 men and postmenopausal women (50-70 years of age) without middle ear dysfunction or unilateral hearing loss.

    MEASUREMENTS: Fatty acid proportions were measured in plasma cholesteryl esters. Hearing thresholds (in decibels, dB) at baseline and after three years were measured with pure-tone audiometry. Hearing loss was calculated as the increase in mean hearing thresholds in the low (0.5-kHz, 1-kHz, and 2-kHz) and high (4-kHz, 6-kHz, and 8-kHz) frequencies over three years.

    RESULTS: Subjects in the highest quartile of plasma very long-chain n-3 PUFA had less hearing loss in the low frequencies over three years than subjects in the lowest quartile (p < 0.01, ANCOVA, difference in mean adjusted hearing thresholds= -1.2 dB). There were no significant differences between the quartiles of plasma very long-chain n-3 PUFA in hearing loss in the high frequencies (p=0.49, ANCOVA). These associations are adjusted for baseline mean hearing thresholds, age, sex, level of education and alcohol consumption.

    CONCLUSION: This study is the first to show an inverse association between plasma very long-chain n-3 PUFAs and age-related hearing loss. These results are encouraging, but require confirmation from future studies.

  • 7. Dullemeijer, Carla
    et al.
    Zock, Peter L.
    Coronel, Ruben
    Den Ruijter, Hester M.
    Katan, Martijn B.
    Brummer, Robert
    Örebro University, School of Health and Medical Sciences.
    Kok, Frans J.
    Beekman, Jet
    Brouwer, Ingeborg A.
    Differences in fatty acid composition between cerebral brain lobes in juvenile pigs after fish oil feeding2008In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 100, no 4, p. 794-800Article in journal (Refereed)
    Abstract [en]

    Very long-chain n-3 PUFA from fish are suggested to play a role in the development of the brain. Fish oil feeding results in higher proportions of n-3 PUFA in the brains of newborn piglets. However, the effect of fish oil on the fatty acid composition of specific cerebral brain lobes in juvenile pigs is largely uninvestigated. This study examined the effect of a fish oil diet on the fatty acid composition of the frontal, parietal, temporal and occipital brain lobes in juvenile pigs (7 weeks old). Pigs were randomly allocated to a semipurified pig diet containing either 4% (w/w) fish oil (n 19) or 4% (w/w) high-oleic acid sunflower oil (HOSF diet, n 18) for a period of 8 weeks. The fish oil diet resulted in significantly higher proportions (%) of DHA in the frontal (10.6 (SD1.2)), parietal (10.2 (SD1.5)) and occipital brain lobes (9.9 (SD 1.3)), but not in the temporal lobe (7.7 (SD1.6)), compared with pigs fed the HOSF diet (frontal lobe, 7.5 (SD1.0); parietal lobe, 8.1 (SD 1.3); occipital lobe, 7.3 (SD1.2), temporal lobe, 6.6 (SD1.2). Moreover, the proportion of DHA was significantly lower in the temporal lobe compared with the frontal, parietal and occipital brain lobes in pigs fed a fish oil diet. In conclusion, the brains of juvenile pigs appear to be responsive to dietary fish oil, although the temporal brain lobe is less responsive compared with the other three brain lobes. The functional consequences of these differences are a challenging focus for future investigation.

  • 8.
    Edebol Carlman, Hanna M. T.
    et al.
    Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Rode, Julia
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Hutchinson, Ashley
    Örebro University, School of Medical Sciences.
    Thunberg, Per
    Örebro University, School of Medical Sciences. Department of Radiology and Medical Physics.
    Persson, Jonas
    Örebro University, School of Law, Psychology and Social Work.
    Kiselev, Andrey
    Örebro University, School of Science and Technology. Center for Applied Autonomous Sensor Systems.
    Pruessner, Jens C.
    Douglas Institute, McGill University, Montréal, QC H4H1R3, Canada; Department of Psychology, University of Konstanz, Konstanz, Germany.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Probiotic Mixture Containing Lactobacillus helveticus, Bifidobacterium longum and Lactiplantibacillus plantarum Affects Brain Responses to an Arithmetic Stress Task in Healthy Subjects: A Randomised Clinical Trial and Proof-of-Concept Study2022In: Nutrients, E-ISSN 2072-6643, Vol. 14, no 7, article id 1329Article in journal (Refereed)
    Abstract [en]

    Probiotics are suggested to impact physiological and psychological stress responses by acting on the gut-brain axis. We investigated if a probiotic product containing Bifidobacterium longum R0175, Lactobacillus helveticus R0052 and Lactiplantibacillus plantarum R1012 affected stress processing in a double-blinded, randomised, placebo-controlled, crossover proof-of-concept study (NCT03615651). Twenty-two healthy subjects (24.2 ± 3.4 years, 6 men/16 women) underwent a probiotic and placebo intervention for 4 weeks each, separated by a 4-week washout period. Subjects were examined by functional magnetic resonance imaging while performing the Montreal Imaging Stress Task (MIST) as well as an autonomic nervous system function assessment during the Stroop task. Reduced activation in regions of the lateral orbital and ventral cingulate gyri was observed after probiotic intervention compared to placebo. Significantly increased functional connectivity was found between the upper limbic region and medioventral area. Interestingly, probiotic intervention seemed to predominantly affect the initial stress response. Salivary cortisol secretion during the task was not altered. Probiotic intervention did not affect cognitive performance and autonomic nervous system function during Stroop. The probiotic intervention was able to subtly alter brain activity and functional connectivity in regions known to regulate emotion and stress responses. These findings support the potential of probiotics as a non-pharmaceutical treatment modality for stress-related disorders.

  • 9.
    Edebol-Carlman, Hanna
    et al.
    Örebro University, School of Medical Sciences.
    Rode, Julia
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Hutchinson, Ashley
    Örebro University, School of Medical Sciences.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Kiselev, Andrey
    Örebro University, School of Science and Technology.
    Thunberg, Per
    Örebro University, School of Medical Sciences.
    Lathrop Stern, Lori
    Labus, Jennifer
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Evaluating the effects of probiotic intake on brain activity during an emotional attention task and blood markers related to stress in healthy subjects2019Conference paper (Refereed)
  • 10.
    Edebol-Carlman, Hanna
    et al.
    Örebro University, School of Medical Sciences.
    Rode, Julia
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Hutchinson, Ashley N.
    Örebro University, School of Medical Sciences.
    Thunberg, Per
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Medical Physics.
    Persson, Jonas
    Örebro University, School of Law, Psychology and Social Work.
    Kiselev, Andrey
    Örebro University, School of Science and Technology.
    Pruessner, Jens C.
    McGill Centre for Studies in Ageing, Department of Psychology, Psychiatry, Neurology and Neurosurgery, Douglas Institute, McGill University, Montréal, Canada.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Probiotic mixture containing Lactobacillus helveticus, Bifidobacterium longum and Lactiplantibacillus plantarum affects brain responses to an arithmetic stress task in healthy subjects: A randomized clinical trialManuscript (preprint) (Other academic)
  • 11.
    Edebol-Carlman, Hanna
    et al.
    Örebro University, School of Medical Sciences. Nutrition-Gut-Brain Interactions Research Centre.
    Schrooten, Martien G. S.
    Örebro University, School of Law, Psychology and Social Work.
    Ljóttson, Brjánn
    Department of Clinical Neuroscience, Division of Psychology and Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences. Nutrition-Gut-Brain Interactions Research Centre.
    Cognitive behavioral therapy for irritable bowel syndrome: the effects on state and trait anxiety and the autonomic nervous system during induced rectal distensions - An uncontrolled trial2018In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 18, p. 81-91Article in journal (Refereed)
    Abstract [en]

    Background and aims: Irritable bowel syndrome (IBS), is a common multifactorial gastrointestinal disorder linked to disturbances in the microbe gut-brain axis. Cognitive behavioral therapy (CBT), in face-to-face format has showed promising results on IBS and its associated psychological symptoms. The present study explored for the first time if CBT for IBS affects the autonomic nervous system (ANS) during experimentally induced visceral pain and cognitive stress, respectively. The levels of state and trait anxiety, current and perceived stress were also evaluated.

    Methods: In this uncontrolled trial, individual CBT was performed in face-to-face format for 12 weeks in 18 subjects with IBS. Heart rate variability and skin conductance were measured during experimentally induced visceral pain and during a cognitive task (Stroop color-word test), before and after intervention. The levels of state and trait anxiety as well as self-rated current and perceived stress were also measured before and after the intervention.

    Results: CBT did not affect ANS activity during experimentally induced visceral pain and cognitive stress. The sympathetic activity was high, typical for IBS and triggered during both visceral pain and cognitive stress. The levels of state and trait anxiety significantly decreased after the intervention. No significant changes in self-rated current or perceived stress were found.

    Conclusions: Results suggest that face-to-face CBT for IBS improved anxiety- a key psychological mechanism for the IBS pathophysiology, rather than the autonomic stress response to experimentally induced visceral pain and cognitive stress, respectively.

  • 12.
    Engel, S.
    et al.
    Chr. Hansen A/S, Human Health, Scientific Affairs, Hoersholm, Denmark.
    Mortensen, B.
    Chr. Hansen A/S, Human Health, Scientific Affairs, Hoersholm, Denmark.
    Wellejus, A.
    Chr. Hansen A/S, Human Health, Scientific Affairs, Hoersholm, Denmark.
    Vera-Jimenez, N.
    Chr. Hansen A/S, Human Health, Scientific Affairs, Hoersholm, Denmark.
    Struve, C.
    Chr. Hansen A/S, Human Health, Scientific Affairs, Hoersholm, Denmark.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Damholt, A.
    Chr. Hansen A/S, Human Health, Scientific Affairs, Hoersholm, Denmark.
    Woods, T.
    Mardyke Arena, Cork, Ireland.
    Shanahan, F.
    Department of Medicine, University College Cork, Clinical Sciences Building, Cork University Hospital, Wilton, Cork, Ireland; APC Microbiome, Biosciences Building, University College Cork, Ireland.
    Safety of Bifidobacterium breve, Bif195, employing a human exercise-induced intestinal permeability model: a randomised, double-blinded, placebo-controlled, parallel group trial2022In: Beneficial Microbes, ISSN 1876-2883, E-ISSN 1876-2891, Vol. 13, no 3, p. 243-252Article in journal (Refereed)
    Abstract [en]

    We have previously shown that the probiotic Bifidobacterium breve strain Bif195 alleviates mucosal injury including ulcer formation in the upper intestine induced by non-steroid anti-inflammatory drugs (NSAIDs). Here, we report additional safety use of Bif195 in 126 healthy humans undergoing an exercise-induced intestinal permeability challenge in a double-blinded, placebo-controlled randomised 6-week intervention trial. Intestinal permeability was assessed by urinary lactulose/rhamnose (L/R) ratio. L/R ratio, plasma intestinal fatty acid binding protein (I-FABP) and gastrointestinal symptom rating scale (GSRS) questionnaire were measured resting and after a 1 h treadmill challenge, prior to and at the end of the intervention. To be able to compare the equivalence of resting state at baseline, of this cohort of well-trained subjects, to non-trained subjects, a cohort of 63 healthy and non-trained subjects (<2 h/week of endurance sports) was included. Study subjects (well-trained) were 35.7% women with a mean age and body mass index (in kg/m2) of 35.0 years and 24.8, respectively. There were no differences between the Bif195 and placebo groups in effects on L/R ratio, I-FABP and GSRS questionnaire score. In addition, there were no differences between Bif195 and placebo in number of adverse events and change in cytokines, liver or kidney biomarkers. The exercise model successfully induced intestinal permeability by statistically significantly increasing L/R ratio by ~100% (P<0.0001) and cytokines after the exercise challenge. No significant difference was found between well-trained and non-trained subjects in baseline resting L/R ratio. In conclusion, the reported cytoprotective effects of Bif195 are unlikely to be primarily related to small bowel permeability, and the safety of Bif195 in individuals with increased permeability is supported by the present data. ClinicalTrials.gov: NCT03027583.

  • 13.
    Engelheart, Stina
    et al.
    Örebro University, School of Medical Sciences.
    Andrén, Daniela
    Örebro University, Örebro University School of Business.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Bertéus Forslund, Heléne
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Nutritional status in older people: an explorative analysisManuscript (preprint) (Other academic)
  • 14.
    Engelheart, Stina
    et al.
    Örebro University, School of Medical Sciences.
    Andrén, Daniela
    Örebro University, Örebro University School of Business.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Bertéus Forslund, Heléne
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Nutritional status in older people: An explorative analysis2021In: Clinical Nutrition ESPEN, E-ISSN 2405-4577, Vol. 46, p. 424-433Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: The nutritional status is seldom defined in general, but is considered to be important throughout life span, especially in times of diseases and disabilities. We previously proposed a theoretical model of the nutritional status from a functional perspective [1], however without proposing a definition of the nutritional status. The model comprises four domains that might affect the nutritional and functional status in a bidirectional way. These four domains are: Food and nutrition; Health and somatic disorders; Physical function and capacity; and Cognitive, affective, and sensory function. This study contributes to the existing literature and knowledge by empirically analysing patterns and relationships of possible nutritional status indicators within and between the four domains.

    METHODS: This study is based on a sample of 69 men and women; older than 65 years, receiving home health care. They were followed up for three years. A broad set of nutritional status indicators in the participants were assessed in their home yearly. Given the small sample size and large number of variables, we used both correlation and factor analysis to explore patterns of nutritional status indicators within the four domains and relationships between the four domains suggested by the theoretical model of nutritional status which we proposed earlier.

    RESULTS: At baseline, between 4 and 18 components were extracted from the four domains, separately, using factor analysis. The first three components of each domain (called main components) were correlated (p < 0.05) with at least one of the main components of each of the other three domains (r = -0.34-0.79 at baseline, 0.38-0.74 at year 1, 0.40-0.77 at year 2 and 0.47-0.71 at year 3). At baseline, these main components explained, respectively, 31%, 52%, 57% and 63% of the sample variation in the four domains. This remained stable throughout all three years of follow up. In all four domains, there were statistically significant differences in prevalence of malnutrition, frailty, sarcopenia, and dehydration (all different inadequate nutritional status) between individuals' individual component scores.

    CONCLUSIONS: This study provides empirical evidence for the relationship between nutritional status indicators within and between the four domains suggested by our theoretical model of nutritional status. Components in all four domains were associated with inadequate nutritional status, highlighting that a wide perspective of the nutritional status assessment is necessary to be applied in clinical practice.

  • 15.
    Engelheart, Stina
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Bertéus Forslund, Heléne
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Ljungqvist, Olle
    Örebro University, School of Medical Sciences. Department of Surgery.
    Dehydration and loss of appetite: Key nutrition features in older people receiving home health care2021In: Nutrition (Burbank, Los Angeles County, Calif.), ISSN 0899-9007, E-ISSN 1873-1244, Vol. 91-92, article id 111385Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim was to describe a population of older people in home health care based on what is probably a novel theoretical model, previously published, and to analyze longitudinal changes in different dimensions of nutritional status.

    METHODS: This explorative and longitudinal study examines nutritional status based on four domains in the novel theoretical model: health and somatic disorders; cognitive, affective, and sensory function; physical function and capacity; and food and nutrition. Inclusion criteria were age ≥65 y and need of home health care for more than three months. A total of 69 men and women were enrolled in the study. Participants' nutritional status was studied at baseline and regularly during the following three years.

    RESULTS: At baseline, 44% (n = 27) reported one or more severe symptoms and 83% had polypharmacy (≥5 prescribed medications). The prevalence of malnutrition, sarcopenia, frailty, and dehydration at baseline were, respectively, 83% (n = 35), 44% (n = 24), 34% (n = 18), and 45% (n = 25). Participants that died during the 3-y follow-up (n = 14) differed from survivors in the following aspects: more reduced appetite, lower quality of life, worse cognitive function, lower physical activity, and less intake of dietary fiber and water. Dehydration at baseline was associated with lower function in several domains and with general decline over time.

    CONCLUSIONS: Most participants had poor nutritional status. Dehydration and reduced appetite were important indicators of worsening nutritional and overall status and mortality.

  • 16.
    Engelheart, Stina
    et al.
    Örebro University, School of Medical Sciences.
    Bertéus Forslund, Heléne
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Ljungqvist, Olle
    Örebro University, School of Medical Sciences.
    Dehydration and loss of appetite: key nutrition features in olderpeople receiving home health careManuscript (preprint) (Other academic)
  • 17.
    Engelheart, Stina
    et al.
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Assessment of nutritional status in the elderly: a proposed function-driven model2018In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 62, article id 1366Article in journal (Refereed)
    Abstract [en]

    Background: There is no accepted or standardized definition of 'malnutrition'. Hence, there is also no definition of what constitutes an adequate nutritional status. In elderly people, assessment of nutritional status is complex and is complicated by multi-morbidity and disabilities combined with nutrition-related problems, such as dysphagia, decreased appetite, fatigue, and muscle weakness.

    Objective: We propose a nutritional status model that presents nutritional status from a comprehensive functional perspective. This model visualizes the complexity of the nutritional status in elderly people.

    Design and results: The presented model could be interpreted as the nutritional status is conditional to a person's optimal function or situation. Another way of looking at it might be that a person's nutritional status affects his or her optimal situation. The proposed model includes four domains: (1) physical function and capacity; (2) health and somatic disorders; (3) food and nutrition; and (4) cognitive, affective, and sensory function. Each domain has a major impact on nutritional status, which in turn has a major impact on the outcome of each domain.

    Conclusions: Nutritional status is a multifaceted concept and there exist several knowledge gaps in the diagnosis, prevention, and optimization of treatment of inadequate nutritional status in elderly people. The nutritional status model may be useful in nutritional assessment research, as well as in the clinical setting.

  • 18.
    Engelheart, Stina
    et al.
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Forslund, Helene Berteus
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Meal patterns in relation to energy and protein intake in older adults in home health care2020In: Clinical Nutrition ESPEN, E-ISSN 2405-4577, Vol. 35, p. 180-187Article in journal (Refereed)
    Abstract [en]

    Background & aims: Inadequate dietary intake is common in frail elderly people, however knowledge of meal patters and their relation to dietary intake is scarce, but is important for planning meals and nutritional prevention and interventions. The aim of this study was to describe meal patterns and the relation to energy and protein intake in elderly people in home health care.

    Methods: In this cross-sectional study, 69 men and women >= 65 years old with a lasting need for home health care were included. A 24-hour recall was used to analyse meal patterns as well as intake of energy and protein. Meal patterns were analysed in terms of number of eating occasions, time of the first, and the last meal each day, length of the overnight fast, timing of the energy and protein intake, energy content and time for the largest meal of the day, and classification as an early or late eater.

    Results: In this population, 77% had four or five eating occasions per day. The median length of the overnight fast was 13 h and 87% of participants had an overnight fast of >11 h. Regarding the timing of the energy and protein intake, there were three peaks: in the morning, mid-day and in the evening. The mid-day meal was the most important eating occasion regarding total energy intake; mid-day was also the time of the day when most participants had a protein intake >20 g. The majority (60%) of participants were categorized as early eaters. Neither the number of eating occasions nor the length of the overnight fast was correlated with energy or protein intake; however, a large energy intake from the largest meal of the day was significantly correlated with an increased total energy and protein intake, indicating that daily energy intake is stimulated by at least one large meal per day.

    Conclusions: This study showed that one large meal a day had more impact on daily energy and protein intake than did several eating occasions or a short overnight fast in elderly people in home health care. Further research is needed to elucidate how to stimulate large energy intake at main meals to stimulate daily energy and protein intake. (c) 2019 European Society for Clinical Nutrition and Metabolism.

  • 19.
    Fart, Frida
    et al.
    Örebro University, School of Medical Sciences.
    Rajan, Sukithar K
    Örebro University, School of Medical Sciences.
    Wall, Rebecca
    Örebro University, School of Medical Sciences.
    Rangel, Ignacio
    Örebro University, School of Medical Sciences.
    Ganda Mall, John Peter
    Örebro University, School of Medical Sciences. Laboratory of Translational Mucosal Immunology, Digestive Diseases Research Unit, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
    Tingö, Lina
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Lindqvist, Carl Mårten
    Örebro University, School of Medical Sciences.
    Differences in Gut Microbiome Composition between Senior Orienteering Athletes and Community-Dwelling Older Adults2020In: Nutrients, E-ISSN 2072-6643, Vol. 12, no 9, article id E2610Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Gastrointestinal (GI) health is an important aspect of general health. Gastrointestinal symptoms are of specific importance for the elderly, an increasing group globally. Hence, promoting the elderly's health and especially gastrointestinal health is important. Gut microbiota can influence gastrointestinal health by modulation of the immune system and the gut-brain axis. Diverse gut microbiota have been shown to be beneficial; however, for the elderly, the gut microbiota is often less diverse. Nutrition and physical activity, in particular, are two components that have been suggested to influence composition or diversity.

    MATERIALS AND METHODS: In this study, we compared gut microbiota between two groups of elderly individuals: community-dwelling older adults and physically active senior orienteering athletes, where the latter group has less gastrointestinal symptoms and a reported better well-being. With this approach, we explored if certain gut microbiota were related to healthy ageing. The participant data and faecal samples were collected from these two groups and the microbiota was whole-genome sequenced and taxonomically classified with MetaPhlAn.

    RESULTS: unclassified, which have been associated with impaired GI health. We could not observe any difference between the groups in terms of Shannon diversity index. Interestingly, a subgroup of community-dwelling older adults showed an atypical microbiota profile as well as the parameters for gastrointestinal symptoms and well-being closer to senior orienteers.

    CONCLUSIONS: Our results suggest specific composition characteristics of healthy microbiota in the elderly, and show that certain components of nutrition as well as psychological distress are not as tightly connected with composition or diversity variation in faecal microbiota samples.

  • 20.
    Fart, Frida
    et al.
    Örebro University, School of Medical Sciences.
    Tingö, Lina
    Örebro University, School of Medical Sciences.
    Engelheart, Stina
    Örebro University, School of Medical Sciences.
    Lindqvist, Carl M.
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Gut Health and its Associations to Well-being and Nutrient intake in Community-Dwelling Older AdultsManuscript (preprint) (Other academic)
  • 21.
    Fart, Frida
    et al.
    Örebro University, School of Medical Sciences.
    Tingö, Lina
    Örebro University, School of Medical Sciences. Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
    Engelheart, Stina
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Lindqvist, Carl Mårten
    Örebro University, School of Medical Sciences.
    Brummer, Robert J.
    Örebro University, School of Medical Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Gut Health and Its Association with Wellbeing and Nutrient Intake in Community-Dwelling Older Adults2022In: Gastroenterology Insights, ISSN 2036-7414, E-ISSN 2036-7422, Vol. 13, no 4, p. 349-364Article in journal (Refereed)
    Abstract [en]

    Many of the increasing number of community-dwelling older adults will need increased healthcare in the future. By characterising gut health and its association with wellbeing and nutrient intake in this population, we aim to recognise areas along the gut-brain axis through which the health of community-dwelling older adults might be promoted. In this cross-sectional observational study, validated questionnaires were used to assess gut health, nutrient intake, and wellbeing in 241 community-dwelling older adults (>= 65 years old). In total, 65% of the participants experienced at least one gastrointestinal symptom, of which females had more abdominal pain and constipation, while the oldest old (i.e., >= 80 years old) had more diarrhoea. Increased gastrointestinal symptoms correlated with more stress, anxiety, depression, and a decreased quality of life, in addition to dyspepsia which correlated with a lower E% of protein. Most of the participants did not reach the recommended intake for protein, fibre and polyunsaturated fats. Males had a lower intake of protein (E%) and fibre (g/MJ) than females, and the oldest old had a lower E% of protein than younger older adults. In conclusion, our results demonstrate that gastrointestinal symptoms are common, and most of the study participants had an imbalanced macronutrient intake, which could be a target for future possible dietary interventions to improve overall health.

  • 22.
    Forsgård, Richard A.
    et al.
    Örebro University, School of Medical Sciences. Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Rode, Julia
    Örebro University, School of Medical Sciences. Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Lobenius Palmér, Karin
    Örebro University, School of Health Sciences. Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Kamm, Annalena
    Örebro University, School of Medical Sciences. Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Patil, Snehal
    Örebro University, School of Medical Sciences. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Tacken, Mirriam G. J.
    Wageningen Bioveterinary Research, Wageningen University and Research, Lelystad, The Netherlands.
    Lentjes, Marleen A. H.
    Örebro University, School of Medical Sciences. Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Axelsson, Jakob
    BioGaia AB, Stockholm and Lund, Sweden.
    Grompone, Gianfranco
    BioGaia AB, Stockholm and Lund, Sweden.
    Montgomery, Scott
    Örebro University, School of Medical Sciences. Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences. Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Limosilactobacillus reuteri DSM 17938 supplementation and SARS-CoV-2 specific antibody response in healthy adults: a randomized, triple-blinded, placebo-controlled trial2023In: Gut microbes, ISSN 1949-0976, E-ISSN 1949-0984, Vol. 15, no 1, article id 2229938Article in journal (Refereed)
    Abstract [en]

    Studies have shown that probiotics can decrease the symptoms of respiratory tract infections as well as increase antibody responses following certain vaccinations. We examined the effect of probiotic supplementation on anti-SARS-CoV-2 specific antibody responses upon SARS-CoV-2 infection as well as after COVID-19 vaccination. In this randomized, triple-blinded, placebo-controlled intervention study with a parallel design, 159 healthy adults without prior SARS-CoV-2 infection or COVID-19 vaccination and any known risk factors for severe COVID-19 were randomly allocated into two study arms. The active treatment arm consumed a probiotic product containing a minimum of 1 × 108 colony-forming units of Limosilactobacillus reuteri DSM 17938 + 10 μg vitamin D3 twice daily for 6 months. The placebo arm consumed identical tablets containing only 10 μg vitamin D3. Anti-SARS-CoV-2 specific antibodies and virus neutralizing antibody titers were analyzed from blood samples collected at baseline, after 3 months, and after 6 months. Differences in serum antibody titers between the two study arms were tested with independent t-test using log-transformed values. In the intention-to-treat (ITT) analysis, SARS-CoV-2 infected individuals in the active treatment arm (n = 6) tended to have higher serum anti-spike IgG (609 [168-1480] BAU/ml vs 111 [36.1-1210] BAU/ml, p = 0.080) and anti-receptor binding domain (RBD) IgG (928 [212-3449] BAU/ml vs (83.7 [22.8-2094] BAU/ml, p = 0.066) levels than individuals in the placebo arm (n = 6). Considering individuals who were fully vaccinated with mRNA-based COVID-19 vaccines, the active treatment arm (n = 10) exhibited significantly higher serum levels of anti-RBD IgA (135 [32.9-976] BAU/ml vs 61.3 [26.7-97.1] BAU/ml, p = 0.036) than the placebo arm (n = 7) >28 days postvaccination. Supplementation with specific probiotics might improve the long-term efficacy of mRNA-based COVID-19 vaccines via enhanced IgA response.

  • 23.
    Ganda Mall, John Peter
    et al.
    Örebro University, School of Medical Sciences. Orebro Univ, Fac Med & Hlth, Sch Med Sci, Sodra Grey Rosengatan 32, S-70362 Orebro, Sweden..
    Fart, Frida
    Örebro University, School of Medical Sciences.
    Sabet, Julia A.
    Örebro University, School of Medical Sciences.
    Lindqvist, Carl Mårten
    Örebro University, School of Medical Sciences.
    Nestestog, Ragnhild
    Genetic Analysis AS, Oslo, Norway.
    Hegge, Finn Terje
    Genetic Analysis AS, Oslo, Norway.
    Keita, Åsa, V
    Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Effects of Dietary Fibres on Acute Indomethacin-Induced Intestinal Hyperpermeability in the Elderly: A Randomised Placebo Controlled Parallel Clinical Trial2020In: Nutrients, E-ISSN 2072-6643, Vol. 12, no 7, article id 1954Article in journal (Refereed)
    Abstract [en]

    The effect of dietary fibres on intestinal barrier function has not been well studied, especially in the elderly. We aimed to investigate the potential of the dietary fibres oat beta-glucan and wheat arabinoxylan to strengthen the intestinal barrier function and counteract acute non-steroid anti-inflammatory drug (indomethacin)-induced hyperpermeability in the elderly. A general population of elderly subjects (>= 65 years,n= 49) was randomised to a daily supplementation (12g/day) of oat beta-glucan, arabinoxylan or placebo (maltodextrin) for six weeks. The primary outcome was change in acute indomethacin-induced intestinal permeability from baseline, assessed by an in vivo multi-sugar permeability test. Secondary outcomes were changes from baseline in: gut microbiota composition, systemic inflammatory status and self-reported health. Despite a majority of the study population (85%) showing a habitual fibre intake below the recommendation, no significant effects on acute indomethacin-induced intestinal hyperpermeability in vivo or gut microbiota composition were observed after six weeks intervention with either dietary fibre, compared to placebo.

  • 24.
    Ganda Mall, John Peter
    et al.
    Örebro University, School of Medical Sciences.
    Löfvendahl, Lisa
    Örebro University, School of Medical Sciences.
    Lindqvist, Carl Mårten
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Keita, Å. V.
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Differential effects of dietary fibres on colonic barrier function in elderly individuals with gastrointestinal symptoms2018In: Scientific Reports, E-ISSN 2045-2322, Vol. 8, no 1, article id 13404Article in journal (Refereed)
    Abstract [en]

    Gastrointestinal problems are common in elderly and often associated with psychological distress and increased levels of corticotrophin-releasing hormone, a hormone known to cause mast cell (MC) degranulation and perturbed intestinal barrier function. We investigated if dietary fibres (non-digestible polysaccharides [NPS]) could attenuate MC-induced colonic hyperpermeability in elderly with gastrointestinal (GI) symptoms. Colonic biopsies from elderly with diarrhoea and/or constipation (n = 18) and healthy controls (n = 19) were mounted in Ussing chambers and pre-stimulated with a yeast-derived beta (β)-glucan (0.5 mg/ml) or wheat-derived arabinoxylan (0.1 mg/ml) before the addition of the MC-degranulator Compound (C) 48/80 (10 ng/ml). Permeability markers were compared pre and post exposure to C48/80 in both groups and revealed higher baseline permeability in elderly with GI symptoms. β-glucan significantly attenuated C48/80-induced hyperpermeability in elderly with GI symptoms but not in healthy controls. Arabinoxylan reduced MC-induced paracellular and transcellular hyperpermeability across the colonic mucosa of healthy controls, but did only attenuate transcellular permeability in elderly with GI symptoms. Our novel findings indicate that NPS affect the intestinal barrier differently depending on the presence of GI symptoms and could be important in the treatment of moderate constipation and/or diarrhoea in elderly.

  • 25.
    Ganda Mall, John-Peter
    et al.
    Örebro University, School of Medical Sciences.
    Casado-Bedmar, Maite
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Winberg, Martin E.
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Keita, Åsa V.
    A β-Glucan-Based Dietary Fiber Reduces Mast Cell-Induced Hyperpermeability in Ileum From Patients With Crohn's Disease and Control Subjects2017In: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 24, no 1, p. 166-178Article in journal (Refereed)
    Abstract [en]

    Background: Administration of β-glucan has shown immune-enhancing effects. Our aim was to investigate whether β-glucan could attenuate mast cell (MC)-induced hyperpermeability in follicle-associated epithelium (FAE) and villus epithelium (VE) of patients with Crohn's disease (CD) and in noninflammatory bowel disease (IBD)-controls. Further, we studied mechanisms of β-glucan uptake and effects on MCs in vitro.

    Methods: Segments of FAE and VE from 8 CD patients and 9 controls were mounted in Ussing chambers. Effects of the MC-degranulator compound 48/80 (C48/80) and yeast-derived β-1,3/1,6 glucan on hyperpermeability were investigated. Translocation of β-glucan and colocalization with immune cells were studied by immunofluorescence. Caco-2-cl1- and FAE-cultures were used to investigate β-glucan-uptake using endocytosis inhibitors and HMC-1.1 to study effects on MCs.

    Results: β-glucan significantly attenuated MC-induced paracellular hyperpermeability in CD and controls. Transcellular hyperpermeability was only significantly attenuated in VE. Baseline paracellular permeability was higher in FAE than VE in both groups, P<0.05, and exhibited a more pronounced effect by C48/80 and β-glucan P<0.05. No difference was observed between CD and controls. In vitro studies showed increased passage, P<0.05, of β-glucan through FAE-culture compared to Caco-2-cl1. Passage was mildly attenuated by the inhibitor methyl-β-cyclodextrin. HMC-1.1 experiments showed a trend to decreasing MC-degranulation and levels of TNF-α but not IL-6 by β-glucan. Immunofluorescence revealed more β-glucan-uptake and higher percentage of macrophages and dendritic cells close to β-glucan in VE of CD compared to controls.

    Conclusions: We demonstrated beneficial effects of β-glucan on intestinal barrier function and increased β-glucan-passage through FAE model. Our results provide important and novel knowledge on possible applications of β-glucan in health disorders and diseases characterized by intestinal barrier dysfunction.

  • 26.
    Ganda Mall, John-Peter
    et al.
    Örebro University, School of Medical Sciences.
    Fart, Frida
    Örebro University, School of Medical Sciences.
    Sabet, Julia
    Örebro University, School of Medical Sciences.
    Lindqvist, Carl-Mårten
    Örebro University, School of Medical Sciences.
    Keita, Åsa V.
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Brummer, Robert J.
    Örebro University, School of Medical Sciences.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Effects of dietary fibres on indomethacin-induced intestinal permeability in elderly: A randomised placebo controlled parallel clinical trialManuscript (preprint) (Other academic)
  • 27.
    Ganda Mall, John-Peter
    et al.
    Örebro University, School of Medical Sciences.
    Löfvendahl, Lisa
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Keita, Åsa V.
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Differential effects of dietary fibres on colonic barrier function in elderly individuals with gastrointestinal symptomsManuscript (preprint) (Other academic)
  • 28.
    Ganda Mall, John-Peter
    et al.
    Örebro University, School of Medical Sciences.
    Östlund-Lagerström, Lina
    Department of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Nutrition and Physical Activity Research Centre, Department of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Lindqvist, Carl Mårten
    Örebro University, School of Medical Sciences.
    Algilani, Samal
    Örebro University, School of Health Sciences.
    Rasoal, Dara
    Örebro University, School of Health Sciences.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    V. Keita, Åsa
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Are self-reported gastrointestinal symptoms among older adults associated with increased intestinal permeability and psychological distress?2018In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, no 1, article id 75Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite the substantial number of older adults suffering from gastrointestinal (GI) symptoms little is known regarding the character of these complaints and whether they are associated with an altered intestinal barrier function and psychological distress. Our aim was to explore the relationship between self-reported gut health, intestinal permeability and psychological distress among older adults.

    METHODS: Three study populations were included: 1) older adults with GI symptoms (n = 24), 2) a group of older adults representing the general elderly population in Sweden (n = 22) and 3) senior orienteering athletes as a potential model of healthy ageing (n = 27). Questionnaire data on gut-health, psychological distress and level of physical activity were collected. Intestinal permeability was measured by quantifying zonulin in plasma. The level of systemic and local inflammation was monitored by measuring C-reactive protein (CRP), hydrogen peroxide in plasma and calprotectin in stool samples. The relationship between biomarkers and questionnaire data in the different study populations was illustrated using a Principal Component Analysis (PCA).

    RESULTS: Older adults with GI symptoms displayed significantly higher levels of both zonulin and psychological distress than both general older adults and senior orienteering athletes. The PCA analysis revealed a separation between senior orienteering athletes and older adults with GI symptoms and showed an association between GI symptoms, psychological distress and zonulin.

    CONCLUSIONS: Older adults with GI symptoms express increased plasma levels of zonulin, which might reflect an augmented intestinal permeability. In addition, this group suffer from higher psychological distress compared to general older adults and senior orienteering athletes. This relationship was further confirmed by a PCA plot, which illustrated an association between GI symptoms, psychological distress and intestinal permeability.

  • 29.
    Geraedts, Maartje C. P.
    et al.
    Med Ctr, Dept Human Biol, Maastricht Univ, Maastricht, Netherlands.
    Troost, Freddy J.
    Med Ctr, Dept Internal Med, Div Gastroenterol & Hepatol, Maastricht Univ, Maastricht, Netherlands.
    Tinnemans, Rik
    Med Ctr, Dept Anim Res & Testing Serv, Maastricht Univ, Maastricht, Netherlands.
    Soderholm, Johan D.
    Dept Clin & Expt Med, Linköping Univ, Linköping, Sweden.
    Brummer, Robert
    Örebro University, School of Health and Medical Sciences. Med Ctr, Dept Internal Med, Div Gastroenterol & Hepatol, Maastricht Univ, Maastricht, Netherlands.
    Saris, Wim H. M.
    Med Ctr, Dept Human Biol, Maastricht Univ, Maastricht, Netherlands.
    Release of Satiety Hormones in Response to Specific Dietary Proteins Is Different between Human and Murine Small Intestinal Mucosa2010In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 56, no 4, p. 308-313Article in journal (Refereed)
    Abstract [en]

    Background/Aim: High protein diets are the most effective to stimulate cholecystokinin (CCK) and glucagon-like peptide 1 (GLP-1) release; however, which proteins are the most potent is not known. Here, the effects of specific dietary proteins on intestinal CCK and GLP-1 release were examined. Methods: Duodenal biopsies of 10 healthy male subjects and 10 male rats were taken and placed in an Ussing chamber system. The biopsies were exposed on the luminal side to buffer, egg protein, codfish protein, ovomucoid, pea protein, and wheat protein. After an exposure time of 2 h, samples were taken from the serosal side. Results: Pea protein and wheat protein increased CCK and GLP-1 release in human duodenal tissue, while codfish protein only increased CCK release. No elevated levels of CCK and GLP-1 were found after exposure of rat tissue to different proteins. Conclusion: Pea and wheat protein are the most potent stimulators of CCK and GLP-1 release in human duodenal tissue, and may therefore be good dietary additives in weight management. Copyright (C) 2010 S. Karger AG, Basel

  • 30.
    Gorreja, Frida
    et al.
    Örebro University, School of Medical Sciences.
    Rangel, Ignacio
    Örebro University, School of Medical Sciences.
    Rush, Stephen
    Örebro University, School of Medical Sciences.
    Wall, Rebecca
    Örebro University, School of Medical Sciences.
    De Vos, Willem M.
    Wageningen University & Research Centre, Wageningen, Netherlands; Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Double-blind cross-over trial reveals human mucosal transcriptome responses to variants of LGG administration in vivo2018In: Targeting microbiota: 6th World congress on targeting microbiota towards clinical revolution / [ed] Peter Konturek, Porto, Portugal: ISM , 2018, Vol. 5, article id 978-2-35609-010-2Conference paper (Other academic)
  • 31.
    Gorreja, Frida
    et al.
    Örebro University, School of Medical Sciences.
    Rush, Stephen
    Örebro University, School of Medical Sciences.
    Kasper, Dennis
    Department of Microbiology and Molecular Genetics, Boston, USA; Harvard Medical School, Boston, USA.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Meng, Di
    Harvard Medical School, Boston, USA; Mucosal Immunology Laboratory, Massachusetts General Hospital for Children, Boston, USA.
    Walker, W. Allan
    Harvard Medical School, Boston, USA; Mucosal Immunology Laboratory, Massachusetts General Hospital for Children, Boston, USA.
    Beneficial bacteria that affect Toll-like receptors in the gut immune system: the case of PSA on Bacteroides fragilis and transcription profile of developmentally-regulated genes2018Conference paper (Other academic)
  • 32.
    Gorreja, Frida
    et al.
    Örebro University, School of Medical Sciences.
    Rush, Stephen
    Örebro University, School of Medical Sciences.
    Marques, Tatiana M.
    Örebro University, School of Medical Sciences.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Baker, Adam
    Örebro University, School of Medical Sciences. Head of Discovery, Microbiome and Human Health, Christian Hansen, Danimark.
    Wall, Rebecca
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    The impacts of probiotics and prebiotics on the gut mucosa and immune system through targeting inflammation and intestinal barrier function2018Conference paper (Other academic)
  • 33.
    Halkjær, Sofie Ingdam
    et al.
    Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
    Lo, Bobby
    Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
    Cold, Frederik
    Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
    Højer Christensen, Alice
    Holster, Savanne
    Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
    König, Julia
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Aroniadis, Olga C.
    Renaissance School of Medicine, Stony Brook University Hospital, New York, NY 11794-8434, United States.
    Lahtinen, Perttu
    Central Hospital, Lahti 15850, Finland; University of Helsinki, Helsinki 00014, Finland.
    Holvoet, Tom
    University Hospital Ghent, Ghent 9000, Belgium.
    Gluud, Lise Lotte
    University of Copenhagen, Copenhagen 2200, Denmark .
    Petersen, Andreas Munk
    Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; University of Copenhagen, Copenhagen 2200, Denmark .
    Fecal microbiota transplantation for the treatment of irritable bowel syndrome: A systematic review and meta-analysis2023In: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 29, no 20, p. 3185-3202Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND; Irritable bowel syndrome (IBS) is the most prevalent gastrointestinal disorder in developed countries and reduces patients’ quality of life, hinders their ability to work, and increases health care costs. A growing number of trials have demonstrated an aberrant gut microbiota composition in IBS, also known as ‘gut dysbiosis’. Fecal microbiota transplantation (FMT) has been suggested as a treatment for IBS.

    AIM: To assess the efficacy and safety of FMT for the treatment of IBS.

    METHODS: We searched Cochrane Central, MEDLINE, EMBASE and Web of Science up to 24 October 2022 for randomised controlled trials (RCTs) investigating the effectiveness of FMT compared to placebo (including autologous FMT) in treating IBS. The primary outcome was the number of patients with improvements of symptoms measured using a validated, global IBS symptoms score. Secondary outcomes were changes in quality-of-life scores, non-serious and serious adverse events. Risk ratios (RR) and corresponding 95%CI were calculated for dichotomous outcomes, as were the mean differences (MD) and 95%CI for continuous outcomes. The Cochrane risk of bias tool was used to assess the quality of the trials. GRADE criteria were used to assess the overall quality of the evidence.

    RESULTS: Eight RCTs (484 participants) were included in the review. FMT resulted in no significant benefit in IBS symptoms three months after treatment compared to placebo (RR 1.19, 95%CI: 0.68-2.10). Adverse events were reported in 97 participants in the FMT group and in 45 participants in the placebo group (RR 1.17, 95%CI: 0.63-2.15). One serious adverse event occurred in the FMT group and two in the placebo group (RR 0.42, 95%CI: 0.07-2.60). Endoscopic FMT delivery resulted in a significant improvement in symptoms, while capsules did not. FMT did not improve the quality of life of IBS patients but, instead, appeared to reduce it, albeit non significantly (MD -6.30, 95%CI: -13.39-0.79). The overall quality of the evidence was low due to moderate-high inconsistency, the small number of patients in the studies, and imprecision.

    CONCLUSION: We found insufficient evidence to support or refute the use of FMT for IBS. Larger trials are needed

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  • 34. Hamer, H. M.
    et al.
    Jonkers, D. M. A. E.
    Loof, A.
    Vanhoutvin, S. A. L. W.
    Troost, F. J.
    Venema, K.
    Kodde, A.
    Koek, G. H.
    Schipper, R. G.
    van Heerde, W. L.
    Brummer, Robert
    Örebro University, School of Health and Medical Sciences.
    Analyses of human colonic mucus obtained by an in vivo sampling technique2009In: Digestive and Liver Disease, ISSN 1590-8658, E-ISSN 1878-3562, Vol. 41, no 8, p. 559-564Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The mucus layer is an important dynamic component of the epithelial barrier. It contains mucin glycoproteins and other compounds secreted by the intestinal epithelium, such as secretory IgA. However, a standardized in vivo sampling technique of mucus in humans is not yet available.

    AIM: To assess the validity and feasibility of mucin and protein determinations in human colonic mucus collected under physiological conditions.

    SUBJECTS AND METHODS: Triplicate colonic mucus samples were collected in 11 healthy volunteers using cytology brushes during sigmoidoscopy. As an indication of the quantity of collected mucus, total protein and mucin concentrations were determined by measuring oligosaccharide equivalents and monosaccharides. Also secretory IgA and sialic acid concentrations were determined and proteomic analysis was performed using surface enhanced laser desorption/ionization-time of flight-mass spectrometry.

    RESULTS: Mean values of secretory IgA and sialic acid corrected for the amount of mucus ranged from 0.16 to 1.81g secretory IgA/mmol oligosaccharide equivalents and from 12.6 to 48.6g sialic acid/mmol oligosaccharide equivalents. Proteomic analysis of mucus is feasible and cluster analysis showed subject specific profiles. CONCLUSION: Using cytology brushes, human colonic mucus can be sampled and under physiological conditions. These samples could give information on the composition and quality of the mucus layer.

  • 35. Hamer, H. M.
    et al.
    Jonkers, D.
    Venema, K.
    Vanhoutvin, S.
    Troost, F. J.
    Brummer, Robert
    Örebro University, School of Health and Medical Sciences.
    Review article: the role of butyrate on colonic function2008In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 27, no 2, p. 104-119Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Butyrate, a short-chain fatty acid, is a main end-product of intestinal microbial fermentation of mainly dietary fibre. Butyrate is an important energy source for intestinal epithelial cells and plays a role in the maintenance of colonic homeostasis. AIM: To provide an overview on the present knowledge of the bioactivity of butyrate, emphasizing effects and possible mechanisms of action in relation to human colonic function. METHODS: A PubMed search was performed to select relevant publications using the search terms: 'butyrate, short-chain fatty acid, fibre, colon, inflammation, carcinogenesis, barrier, oxidative stress, permeability and satiety'. RESULTS: Butyrate exerts potent effects on a variety of colonic mucosal functions such as inhibition of inflammation and carcinogenesis, reinforcing various components of the colonic defence barrier and decreasing oxidative stress. In addition, butyrate may promote satiety. Two important mechanisms include the inhibition of nuclear factor kappa B activation and histone deacetylation. However, the observed effects of butyrate largely depend on concentrations and models used and human data are still limited. CONCLUSION: Although most studies point towards beneficial effects of butyrate, more human in vivo studies are needed to contribute to our current understanding of butyrate-mediated effects on colonic function in health and disease.

  • 36. Hamer, Henrike M.
    et al.
    Jonkers, Daisy M. A. E.
    Bast, Aalt
    Vanhoutvin, Steven A. L. W.
    Fischer, Marc A. J. G.
    Kodde, Andrea
    Troost, Freddy J.
    Venema, Koen
    Brummer, Robert
    Örebro University, School of Health and Medical Sciences.
    Butyrate modulates oxidative stress in the colonic mucosa of healthy humans2009In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 28, no 1, p. 88-93Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: Butyrate, a short-chain fatty acid produced by colonic microbial fermentation of undigested carbohydrates, has been implicated in the maintenance of colonic health. This study evaluates whether butyrate plays a role in oxidative stress in the healthy colonic mucosa. METHODS: A randomized, double blind, cross-over study with 16 healthy volunteers was performed. Treatments consisted of daily rectal administration of a 60 ml enema containing 100 mM sodium butyrate or saline for 2 weeks. After each treatment, a blood sample was taken and mucosal biopsies were obtained from the sigmoid colon. In biopsies, the trolox equivalent antioxidant capacity, activity of glutathione-S-transferase, concentration of uric acid, glutathione (GSH), glutathione disulfide and malondialdehyde, and expression of genes involved in GSH and uric acid metabolism was determined. Secondary outcome parameters were CRP, calprotectin and intestinal fatty acid binding protein in plasma and histological inflammatory scores. RESULTS: Butyrate treatment resulted in significantly higher GSH (p<0.05) and lower uric acid (p<0.01) concentrations compared to placebo. Changes in GSH and uric acid were accompanied by increased and decreased expression, respectively, of their rate limiting enzymes determined by RT-PCR. No significant differences were found in other parameters. CONCLUSIONS: This study demonstrated that butyrate is able to beneficially affect oxidative stress in the healthy human colon.

  • 37.
    Hamer, Henrike M.
    et al.
    Dept Internal Med, Div Gastroenterol Hepatol, Nutrim, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Jonkers, Daisy M. A. E.
    Dept Internal Med, Div Gastroenterol Hepatol, Nutrim, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Renes, Ingrid B.
    Dept Pediat, Div Neonatol, Erasmus MC, Rotterdam, Netherlands; Sophia Childrens Univ Hosp, Rotterdam, Netherlands.
    Vanhoutvin, Steven A. L. W.
    Dept Internal Med, Div Gastroenterol Hepatol, Nutrim, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Kodde, Andrea
    Dept Internal Med, Div Gastroenterol Hepatol, Nutrim, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Troost, Freddy J.
    Dept Internal Med, Div Gastroenterol Hepatol, Nutrim, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Venema, Koen
    TI Food & Nutr, Wageningen, Netherlands; Dept Biosci, TNO Qual Life, Zeist, Netherlands.
    Brummer, Robert
    Örebro University, School of Health and Medical Sciences. Dept Internal Med, Div Gastroenterol Hepatol, Nutrim, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Butyrate enemas do not affect human colonic MUC2 and TFF3 expression2010In: European Journal of Gastroenterology and Hepathology, ISSN 0954-691X, E-ISSN 1473-5687, Vol. 22, no 9, p. 1134-1140Article in journal (Refereed)
    Abstract [en]

    Introduction The colonic mucus layer plays an important role in the protection of the intestinal epithelium and mainly consists of mucin glycoproteins (primarily MUC2 in the colon) trefoil factor 3 (TFF3) and secretory IgA. Butyrate is a major end product of fermentation of dietary fibres and is associated with beneficial effects on colonic health. Earlier in-vitro and animal studies showed that butyrate modulates MUC2 and TFF3 expression and mucin secretion, although data from human studies are not yet available. Methods Sixteen healthy volunteers and 35 ulcerative colitis (UC) patients in clinical remission self-administered a 60 ml rectal enema containing 100 mmol/l butyrate or placebo once daily for 2 and 3 weeks, respectively. After each treatment, biopsies were taken from the distal sigmoid for quantitative RT-PCR and immunohistochemical analysis of MUC2 and TFF3. In addition, mucosal sections were stained with high iron diamine-alcian blue to distinguish between sialomucins and sulphomucins. To analyse total mucin secretion and secretory IgA concentrations, 24 h faeces were collected during the day before the endoscopic examination. Results The butyrate intervention did not significantly modulate the expression of MUC2 ( fold change: 1.04 and 1.05 in healthy volunteers and ulcerative colitis patients, respectively) or TFF3 (fold change: 0.91 and 0.94 in healthy volunteers and UC patients, respectively). Furthermore, the percentage of sialomucins, mucus secretion and secretory IgA concentrations were not affected by the butyrate intervention in both the groups. Conclusion Butyrate exposure in healthy volunteers and UC patients in remission did not affect the measured parameters of the colonic mucus layer. Eur J Gastroenterol Hepatol 22: 1134-1140 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

  • 38.
    Hamer, Henrike M.
    et al.
    Dept Internal Med, Div Gastroenterol Hepatol, Med Ctr, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Jonkers, Daisy M. A. E.
    Dept Internal Med, Div Gastroenterol Hepatol, Med Ctr, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Vanhoutvin, Steven A. L. W.
    Dept Internal Med, Div Gastroenterol Hepatol, Med Ctr, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Troost, Freddy J.
    Dept Internal Med, Div Gastroenterol Hepatol, Med Ctr, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Rijkers, Ger
    St Antonius Hosp, Nieuwegein, Netherlands.
    de Bruine, Adriaan
    Dept Pathol, Med Ctr, Maastricht Univ, Maastricht, Netherlands.
    Bast, Aalt
    Dept Pharmacol & Toxicol, Med Ctr, Maastricht Univ, Maastricht, Netherlands.
    Venema, Koen
    TI Food & Nutr, Wageningen, Netherlands; Dept Biosci, TNO Qual Life, Zeist, Netherlands.
    Brummer, Robert
    Örebro University, School of Health and Medical Sciences. Dept Internal Med, Div Gastroenterol Hepatol, Med Ctr, Maastricht Univ, Maastricht, Netherlands; TI Food & Nutr, Wageningen, Netherlands.
    Effect of butyrate enemas on inflammation and antioxidant status in the colonic mucosa of patients with ulcerative colitis in remission2010In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 29, no 6, p. 738-744Article in journal (Refereed)
    Abstract [en]

    Background & Aims: Butyrate, produced by colonic fermentation of dietary fibers is often hypothesized to beneficially affect colonic health. This study aims to assess the effects of butyrate on inflammation and oxidative stress in subjects with chronically mildly elevated parameters of inflammation and oxidative stress.

    Methods: Thirty-five patients with ulcerative colitis in clinical remission daily administered 60 ml rectal enemas containing WO mM sodium butyrate (n = 17) or saline (n = 18) during 20 days (NCT00696098). Before and after the intervention feces, blood and colonic mucosal biopsies were obtained. Parameters of antioxidant defense and oxidative damage, myeloperoxidase, several cytokines, fecal calprotectin and CRP were determined.

    Results: Butyrate enemas induced minor effects on colonic inflammation and oxidative stress. Only a significant increase of the colonic IL-10/IL-12 ratio was found within butyrate-treated patients (p = 0.02), and colonic concentrations of CCL5 were increased after butyrate compared to placebo treatment (p = 0.03). Although in general butyrate did not affect colonic glutathione levels, the effects of butyrate enemas on total colonic glutathione appeared to be dependent on the level of inflammation.

    Conclusion: Although UC patients in remission were characterized by low-grade oxidative stress and inflammation, rectal butyrate enemas showed only minor effects on inflammatory and oxidative stress parameters.

  • 39. He, T.
    et al.
    Venema, K.
    Priebe, M. G.
    Welling, G. W.
    Brummer, Robert
    Örebro University, School of Health and Medical Sciences.
    Vonk, R. J.
    The role of colonic metabolism in lactose intolerance2008In: European Journal of Clinical Investigation, ISSN 0014-2972, E-ISSN 1365-2362, Vol. 38, no 8, p. 541-547Article, review/survey (Refereed)
    Abstract [en]

    Lactose maldigestion and intolerance affect a large part of the world population. The underlying factors of lactose intolerance are not fully understood. In this review, the role of colonic metabolism is discussed, i.e. fermentation of lactose by the colonic microbiota, colonic processing of the fermentation metabolites and how these processes would play a role in the pathophysiology of lactose intolerance. We suggest that the balance between the removal and production rate of osmotic-active components (lactose, and intermediate metabolites, e.g. lactate, succinate, etc.) in the colon is a key factor in the development of symptoms. The involvement of the colon may provide the basis for designing new targeted strategies for dietary and clinical management of lactose intolerance.

  • 40.
    Hiyoshi, Ayako
    et al.
    Örebro University, School of Medical Sciences.
    Sabet, Julia A.
    Örebro University, School of Medical Sciences.
    Sjöqvist, Hugo
    Örebro University, Örebro University School of Business.
    Melinder, Carren
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Montgomery, Scott
    Örebro University, School of Medical Sciences. Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK .
    Precursors in adolescence of adult-onset bipolar disorder2017In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 218, p. 353-358Article in journal (Refereed)
    Abstract [en]

    Background: Although the estimated contribution of genetic factors is high in bipolar disorder, environmental factors may also play a role. This Swedish register-based cohort study of men examined if physical and psychological characteristics in late adolescence, including factors previously linked with bipolar disorder (body mass index, asthma and allergy), are associated with subsequent bipolar disorder in adulthood. Unipolar depression and anxiety are analysed as additional outcomes to identify bipolar disorder-specific associations.

    Methods: A total of 213,693 men born between 1952 and 1956, who participated in compulsory military conscription assessments in late adolescence were followed up to 2009, excluding men with any psychiatric diagnoses at baseline. Cox regression estimated risk of bipolar disorder, depression and anxiety in adulthood associated with body mass index, asthma, allergy, muscular strength stress resilience and cognitive function in adolescence.

    Results: BMI, asthma and allergy were not associated with bipolar disorder. Higher grip strength, cognitive function and stress resilience were associated with a reduced risk of bipolar disorder and the other disease outcomes.

    Limitations: The sample consisted only of men; even though the characteristics in adolescence pre-dated disease onset, they may have been the consequence of prodromal disease.

    Conclusions: Associations with body mass index and asthma found by previous studies may be consequences of bipolar disorder or its treatment rather than risk factors. Inverse associations with all the outcome diagnoses for stress resilience, muscular strength and cognitive function may reflect general risks for these psychiatric disorders or intermediary factors.

  • 41.
    Holster, S.
    et al.
    Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Geng, D.
    Faculty of Business, Science and Engineering, School of Science and Technology, Örebro University, Örebro, Sweden.
    Hyötyläinen, Tuulia
    Örebro University, School of Science and Technology.
    Salonen, A.
    Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    Lindqvist, Carl Mårten
    Örebro University, School of Medical Sciences.
    Rajan, Sukithar K
    Örebro University, School of Medical Sciences.
    De Vos, W. M.
    Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Laboratory of Microbiology, Wageningen University and Research Centre, Wageningen, The Netherlands.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Correlations between microbiota and metabolites after faecal microbiota transfer in irritable bowel syndromeManuscript (preprint) (Other academic)
  • 42.
    Holster, S.
    et al.
    Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Geng, D.
    Faculty of Business, Science and Engineering, School of Science and Technology, Örebro University, Örebro, Sweden.
    Hyötyläinen, Tuulia
    Örebro University, School of Science and Technology.
    Salonen, A.
    Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    Lindqvist, Carl Mårten
    Örebro University, School of Medical Sciences.
    Rajan, Sukithar K
    Örebro University, School of Medical Sciences.
    de Vos, W. M.
    Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Laboratory of Microbiology, Wageningen University and Research Centre, Wageningen, the Netherlands.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Correlations between microbiota and metabolites after faecal microbiota transfer in irritable bowel syndrome2021In: Beneficial Microbes, ISSN 1876-2883, E-ISSN 1876-2891, Vol. 12, no 1, p. 17-30Article in journal (Refereed)
    Abstract [en]

    Faecal microbiota transfer (FMT) consists of the infusion of donor faecal material into the intestine of a patient with the aim to restore a disturbed gut microbiota. In this study, it was investigated whether FMT has an effect on faecal microbial composition, its functional capacity, faecal metabolite profiles and their interactions in 16 irritable bowel syndrome (IBS) patients. Faecal samples from eight different time points before and until six months after allogenic FMT (faecal material from a healthy donor) as well as autologous FMT (own faecal material) were analysed by 16S RNA gene amplicon sequencing and gas chromatography coupled to mass spectrometry (GS-MS). The results showed that the allogenic FMT resulted in alterations in the microbial composition that were detectable up to six months, whereas after autologous FMT this was not the case. Similar results were found for the functional profiles, which were predicted from the phylogenetic sequencing data. While both allogenic FMT as well as autologous FMT did not have an effect on the faecal metabolites measured in this study, correlations between the microbial composition and the metabolites showed that the microbe-metabolite interactions seemed to be disrupted after allogenic FMT compared to autologous FMT. This shows that FMT can lead to altered interactions between the gut microbiota and its metabolites in IBS patients. Further research should investigate if and how this affects efficacy of FMT treatments.

  • 43.
    Holster, Savanne
    et al.
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Fecal Microbiota Transplantation in Irritable Bowel Syndrome and a Randomized Placebo-Controlled Trial2017In: 2017 DDW Abstracts, Saunders Elsevier, 2017, Vol. 152, no 5, p. S101-S102Conference paper (Other academic)
  • 44.
    Holster, Savanne
    et al.
    Örebro University, School of Medical Sciences.
    Hooiveld, Guido J.
    Nutrition, Metabolism and Genomics group, Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    de Vos, Willem
    Laboratory of Microbiology, Wageningen University and Research Centre and Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Allogenic Faecal Microbiota Transfer Induces Immune-Related Gene Sets in the Colon Mucosa of Patients with Irritable Bowel Syndrome2019In: Biomolecules, E-ISSN 2218-273X, Vol. 9, no 10, article id 586Article in journal (Refereed)
    Abstract [en]

    Faecal microbiota transfer (FMT) consists of the introduction of new microbial communities into the intestine of a patient, with the aim of restoring a disturbed gut microbiota. Even though it is used as a potential treatment for various diseases, it is unknown how the host mucosa responds to FMT. This study aims to investigate the colonic mucosa gene expression response to allogenic (from a donor) or autologous (own) FMT in patients with irritable bowel syndrome (IBS). In a recently conducted randomised, double-blinded, controlled clinical study, 17 IBS patients were treated with FMT by colonoscopy. RNA was isolated from colonic biopsies collected by sigmoidoscopy at baseline, as well as two weeks and eight weeks after FMT. In patients treated with allogenic FMT, predominantly immune response-related gene sets were induced, with the strongest response two weeks after the FMT. In patients treated with autologous FMT, predominantly metabolism-related gene sets were affected. Furthermore, several microbiota genera showed correlations with immune-related gene sets, with different correlations found after allogenic compared to autologous FMT. This study shows that the microbe–host response is influenced by FMT on the mucosal gene expression level, and that there are clear differences in response to allogenic compared to autologous FMT.

    Download full text (pdf)
    Allogenic Faecal Microbiota Transfer Induces Immune-Related Gene Sets in the Colon Mucosa of Patients with Irritable Bowel Syndrome
  • 45.
    Holster, Savanne
    et al.
    Örebro University, School of Medical Sciences.
    Lindqvist, Carl Mårten
    Örebro University, School of Medical Sciences.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Salonen, Anne
    Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    de Vos, Willem
    Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Laboratory of Microbiology, Wageningen University and Research Centre, Wageningen, the Netherlands.
    König, Julia
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    The Effect of Allogenic Versus Autologous Fecal Microbiota Transfer on Symptoms, Visceral Perception and Fecal and Mucosal Microbiota in Irritable Bowel Syndrome: A Randomized Controlled Study2019In: Clinical and Translational Gastroenterology, E-ISSN 2155-384X, Vol. 10, no 4, article id e00034Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Fecal microbiota transfer (FMT) is suggested as a potential treatment for patients with irritable bowel syndrome (IBS). We aimed to study the effect of allogenic and autologous FMT on IBS symptoms, visceral sensitivity, and compositional changes in fecal and mucosa-adherent microbiota.

    METHODS: Seventeen patients with IBS were randomized either to receive fecal material from a healthy donor (allogenic) or to receive their own fecal material (autologous). The fecal material was administered into the cecum by whole colonoscopy after bowel cleansing.

    RESULTS: No significant differences were found between the allogenic and the autologous FMT regarding symptom scores. However, symptom scores of patients receiving allogenic fecal material significantly decreased after FMT compared with baseline (P 5 0.02), which was not the case in the autologous group (P50.16). Visceral sensitivity was not affected except for a small beneficial effect on urge scores in the autologous group (P < 0.05). While both fecal and mucosa-adherent microbiota of some patients shifted to their respective donor’s fecal microbiota, some patients showed no relevant microbial changes after allogenic FMT. Large compositional shifts in fecal and mucosa-adherent microbiota also occurred in the autologous group.

    CONCLUSIONS: This study showed that a single FMT by colonoscopy may have beneficial effects in IBS; however, the allogenic fecal material was not superior to the autologous fecal material. This suggests that bowel cleansing prior to the colonoscopy and/or processing of the fecal material as part of the FMT routine contribute to symptoms and gut microbiota composition changes in IBS.

    Download full text (pdf)
    The Effect of Allogenic Versus Autologous Fecal Microbiota Transfer on Symptoms, Visceral Perception and Fecal and Mucosal Microbiota in Irritable Bowel Syndrome: A Randomized Controlled Study
  • 46.
    Holster, Savanne
    et al.
    Örebro University, School of Medical Sciences.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Faecal microbiota transfer in irritable bowel syndrome: clinical outcomes of a randomised placebo-controlled trial2017In: UEG Week 2017 Oral Presentations, Sage Publications, 2017, Vol. 5, p. A155-A156Conference paper (Refereed)
  • 47.
    Holster, Savanne
    et al.
    Örebro University, School of Medical Sciences.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Geng, Dawei
    Science and Engineering, School of Science and Technology, Örebro University, Sweden.
    Hyötyläinen, Tuulia
    Örebro University, School of Science and Technology.
    Lindqvist, Carl Mårten
    Örebro University, School of Medical Sciences.
    de Vos, W.
    Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Laboratory of Microbiology, Wageningen University and Research Centre, Wageningen, The Netherlands.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Faecal microbiota transfer in irritable bowel syndrome results inaltered correlations between the gut microbiota and its metabolitesManuscript (preprint) (Other academic)
  • 48.
    Holster, Savanne
    et al.
    Örebro University, School of Medical Sciences.
    Rode, Julia
    Örebro University, School of Medical Sciences.
    Bohr, Johan
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Gastroenterology.
    Kumawat, Ashok Kumar
    Örebro University, School of Medical Sciences.
    Hultgren Hörnquist, Elisabeth
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Faecal microbiota transfer in patients with microscopic colitis: A proof-of-concept study in collagenous colitisManuscript (preprint) (Other academic)
  • 49.
    Holster, Savanne
    et al.
    Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Rode, Julia
    Örebro University, School of Medical Sciences.
    Bohr, Johan
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Gastroenterology.
    Kumawat, Ashok Kumar
    Örebro University, School of Medical Sciences.
    Veress, Gábor
    Department of Laboratory Medicine, Faculty for Medicine and Health, Örebro University, Örebro, Sweden; Örebro University Hospital, Örebro, Swed.
    Hultgren Hörnquist, Elisabeth
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    König, Julia
    Örebro University, School of Medical Sciences.
    Faecal microbiota transfer in patients with microscopic colitis: a pilot study in collagenous colitis2020In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 55, no 12, p. 1454-1466Article in journal (Refereed)
    Abstract [en]

    Objectives: Faecal microbiota transfer (FMT) consists of the infusion of donor faecal material into the intestine of patients with the aim to restore a disturbed gut microbiota.

    Methods: In this pilot study (NCT03275467), the effect of three repeated FMTs (day 0, two weeks, four weeks) was studied and followed up for six months in nine collagenous colitis (CC) patients, using two stool donors.

    Results: Five patients had an active disease at the time of baseline sampling. The primary endpoint (remission at six weeks, defined as <3 stools whereof <1 watery stool per day) was achieved by two of these patients, and by one at eight weeks. Overall, in all nine patients, FMT did not result in a significant reduction of watery stools, assessed by daily diary. However, diarrhoea (assessed by gastrointestinal symptom rating scale) was significantly improved at four (p = .038) and eight weeks (p = .038), indigestion at eight (p = .045) and 12 weeks (p = .006), disease-related worries at four (p = .027) and eight weeks (p = .027), and quality of life at six months (p = .009). FMT resulted in an increased number of lamina propria lymphocytes, possibly indicating an initial mucosal immune activation. No serious adverse events, no systemic effects, and no changes in faecal calprotectin and psychological symptoms were observed.

    Conclusions: FMT is able to improve symptoms in a yet undefined subset of CC patients. Further studies could help to characterise this subset and to understand if these results can be generalised to all microscopic colitis patients.

    Download full text (pdf)
    Faecal microbiota transfer in patients with microscopic colitis – a pilot study in collagenous colitis
  • 50.
    Hutchinson, Ashley
    et al.
    Örebro University, School of Medical Sciences.
    Östlund-Lagerström, Lina
    Örebro University, School of Medical Sciences. Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    The Potential Effects of Probiotics and ω-3 Fatty Acids on Chronic Low-Grade Inflammation2020In: Nutrients, E-ISSN 2072-6643, Vol. 12, no 8, article id E2402Article in journal (Refereed)
    Abstract [en]

    Chronic low-grade inflammation negatively impacts health and is associated with aging and obesity, among other health outcomes. A large number of immune mediators are present in the digestive tract and interact with gut bacteria to impact immune function. The gut microbiota itself is also an important initiator of inflammation, for example by releasing compounds such as lipopolysaccharides (LPS) that may influence cytokine production and immune cell function. Certain nutrients (e.g., probiotics, ω-3 fatty acids [FA]) may increase gut microbiota diversity and reduce inflammation. Lactobacilli and Bifidobacteria, among others, prevent gut hyperpermeability and lower LPS-dependent chronic low-grade inflammation. Furthermore, ω-3 FA generate positive effects on inflammation-related conditions (e.g., hypertriglyceridemia, diabetes) by interacting with immune, metabolic, and inflammatory pathways. Ω-3 FA also increase LPS-suppressing bacteria (i.e., Bifidobacteria) and decrease LPS-producing bacteria (i.e., Enterobacteria). Additionally, ω-3 FA appear to promote short-chain FA production. Therefore, combining probiotics with ω-3 FA presents a promising strategy to promote beneficial immune regulation via the gut microbiota, with potential beneficial effects on conditions of inflammatory origin, as commonly experienced by aged and obese individuals, as well as improvements in gut-brain-axis communication.

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