The Human Microbiome: Implications for Health and Disease
Date
2018-09-10
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Abstract
The human microbiome is the collective genome of native microbial flora that have evolved with us over millennia and which are typically consistent, despite geographic, ethnic and dietary differences around the globe. Studies have revealed that agitation to the normal development of the microbiome during the first year of life, such as with antimicrobial use, can lead to atrophy later on, resulting in the development of autoimmune diseases such as inflammatory bowel disease (IBD). Moreover, dysbioses, such as those seen with Clostridium difficile infection (CDI), have an accelerated deleterious effect on patients who have already developed inflammatory bowel disease, potentially resulting in life-threatening complications, including ileus, toxic megacolon, and death. We composed a review article which presents an outline of the loss of a normal microbiome as an etiology of immune dysregulation and IBD pathogenesis initiation. Moreover, we summarized the knowledge base with respect to the role of a healthy microbiome in terms of its diversity and important functional elements, and synopsized some of the therapeutic interventions and modalities that are being explored as potential applications of microbiome-host interactions. Additionally, we conducted a systematic review of the literature and a meta-analysis in order to clarify the risk of colectomy among the subset of IBD patients with ulcerative colitis (UC) subsequent to their development of CDI. We determined that UC patients with CDI are indeed at an increased risk of colectomy relative to their counterparts without CDI, but that future better quality prospective studies, ideally with a population-based approach and with long term follow-up of outcomes, would be helpful to better evaluate this potential relationship under different circumstances.
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Keywords
Microbiome, Clostridium difficile, inflammatory bowel disease, ulcerative colitis, colectomy, Antimicrobials
Citation
Missaghi, B. (2018). The Human Microbiome: Implications for Health and Disease (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/32926