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Objective: To investigate-by molecular, classical and functional methods-the microbiota in biopsies and faeces from patients with active Crohn's disease (CD) and controls., Design: The microbiota in biopsies was investigated utilizing a novel molecular method and classical cultivation technology. Faecal samples were investigated by classical technology and four functional methods, reflecting alterations in short chain fatty acids pattern, conversion of cholesterol and bilirubin and inactivation of trypsin., Results: By molecular methods we found more than 92% similarity in the microbiota on the biopsies from the two groups. However, 4.6% of microbes found in controls were lacking in CD patients. Furthermore, NotI representation libraries demonstrate two different clusters representing CD patients and controls, respectively. Utilizing conventional technology, Bacteroides (alt. Parabacteroides) was less frequently detected in the biopsies from CD patients than from controls. A similar reduction in the number of Bacteroides was found in faecal samples. Bacteroides is the only group of bacteria known to be able to inactivate pancreatic trypsin. Faecal tryptic activity was high in CD patients, and inversely correlated to the levels of Bacteroides., Conclusions: CD patients have compositional and functional alterations in their intestinal microbiota, in line with the global description hypothesis rather than the candidate microorganism theory. The most striking functional difference was high amount of faecal tryptic activity in CD patients, inversely correlated to the levels of Bacteroides in faeces.

Clostridium difficile-associated disease (CDAD) with frequent watery stools, sometimes with painful bowel movements, fever and sickness, is probably the major known cause of antibiotic-associated diarrhea and colitis, most probably depending on a disruption of the normal intestinal balance in the microbiome. In this study, we have inoculated a mixture of fecal microbes--as an enema--originating from a healthy Scandinavian middle-aged donor, regularly re-cultivated under strict anaerobic conditions for more than 10 years, to 32 patients. Twenty-two patients (69%) were durably cured. In those patients receiving the transplant by colonoscopy, four out of five were cured. To the best of our knowledge, this is the first time a fecal culture of microbes has retained the possibility for years to cure a substantial number of patients with CDAD.

Aim: To investigate whether functional changes of the gut flora over time were related to sensitization and allergic symptoms at four years of age., Methods: The levels of short chain fatty acids (SCFAs) in faecal samples at one (n = 139) and four (n = 53) years of age were related to the development of positive skin prick tests (SPT) and allergic symptoms during the first four years of life., Results: Faecal acetic (p < 0.01) and propionic (p < 0.01) acids decreased from one to four years of age, while valeric acid (p < 0.001) increased. Low levels of i-butyric (p = 0.01), i-valeric (p = 0.03) and valeric acids (p = 0.02) at one year were associated with questionnaire-reported symptoms of food allergy at four years. Positive SPTs and allergic symptoms at four years were associated with low faecal levels of i-butyric, i-valeric and valeric acids. At one year of age, infants with, as compared to without older siblings had higher median levels of valeric acid., Conclusion: A slow functional maturation of the gut microflora, as measured by faecal levels of SCFAs is associated with allergy both at one and four years. The findings lend further support to an association between allergy and the development of microbial diversity.

Fecal water (FW) has been shown to exert, in cultured cells, cytotoxic and genotoxic effects that have implications for colorectal cancer (CRC) risk. We have investigated a further biological activity of FW, namely, the ability to affect gap junctions in CACO2 cell monolayers as an index of mucosal barrier function, which is known to be disrupted in cancer. FW samples from healthy, free-living, European subjects that were divided into two broad age groups, adult (40+/-9.7 yr; n=53) and elderly (76+/-7.5 yr; n=55) were tested for effects on gap junction using the transepithelial resistance (TER) assay. Overall, treatment of CACO2 cells with FW samples from adults increased TER (+4%), whereas FW from elderly subjects decreased TER (-5%); the difference between the two groups was significant (P<0.05). We also measured several components of FW potentially associated with modulation of TER, namely, short-chain fatty acid (SCFA) and ammonia. SCFAs (propionic, acetic, and n-butyric) were significantly lower in the elderly population (-30%, -35%, and -21%, respectively, all P A pound 0.01). We consider that FW modulation of in vitro epithelial barrier function is a potentially useful noninvasive biomarker, but it requires further validation to establish its relationship to CRC risk.

A cross-sectional study on intestinal microbiota composition was performed on 230 healthy subjects at four European locations in France, Germany, Italy, and Sweden. The study participants were assigned to two age groups: 20 to 50 years (mean age, 35 years; n = 85) and >60 years (mean age, 75 years; n = 145). A set of 14 group- and species-specific 16S rRNA-targeted oligonucleotide probes was applied to the analysis of fecal samples by fluorescence in situ hybridization coupled with flow cytometry. Marked country-age interactions were observed for the German and Italian study groups. These interactions were inverse for the predominant bacterial groups Eubacterium rectale-Clostridium coccoides and Bacteroides-Prevotella. Differences between European populations were observed for the Bifidobacterium group only. Proportions of bifidobacteria were two- to threefold higher in the Italian study population than in any other study group, and this effect was independent of age. Higher proportions of enterobacteria were found in all elderly volunteers independent of the location. Gender effects were observed for the Bacteroides-Prevotella group, with higher levels in males than in females. In summary, age-related differences in the microbiota makeup were detected but differed between the study populations from the four countries, each showing a characteristic colonization pattern.

Intestinal cholesterol can be absorbed by the host or converted by the intestinal microbiota. The main metabolite of cholesterol conversion is coprostanol, which is unabsorbable. The aim of the present study was to examine the intestinal microbial conversion of cholesterol to coprostanol in healthy subjects. Cholesterol and coprostanol were determined in faecal samples from individuals living in Norway, Scotland and Sweden and examined for possible relationship to age ( 50 years old) and gender. The results were expressed as the percentage of coprostanol in the total amount of cholesterol plus coprostanol (coprostanol%). For purposes of classification, subjects were divided in non-converters ( p p [ABSTRACT FROM AUTHOR]

The prevalence of immunologically mediated diseases including allergies in Western countries has increased significantly during the past 3050 years, in contrast to what has happened in the former socialist countries. An altered intestinal microbial stimulation may be one reason for a changed immune response. One possible explanation is that there could be quantitative and/or qualitative differences between the establishment of a functionally active intestinal microflora in infants in Western countries leading to different maturation of the enterocytes. The aim of this study was to investigate the function of the metabolically active intestinal microflora in cohorts of 43 healthy infants from Estonia and 25 healthy infants from Sweden during their first year of life by studying the short-chain fatty acid (SCFA) profile in faecal samples. The SCFA profiles differ significantly during the first month of life. At 1 month of age, the Swedish infants have significantly higher amounts of SCFAs in their faeces, and all acids except iso-butyric acid were present in more Swedish than Estonian infants. Moreover, there was a quicker 'shift to the right' with regard to the presence of the higher acids (C4-C6) in the Swedish infants. Our results show significant differences in a major microbial intestinal function between Estonian and Swedish infants during their first month of life. Possible causes for these findings and the impact on the host of the diverse SCFA profiles is discussed. These findings have created a background for ongoing studies on allergy and atopy in infants. [ABSTRACT FROM AUTHOR]