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Journal articleTurner BRH, Jenkinson PI, Huttman M, et al., 2024,
Inflammation, oxidative stress and the gut microbiome perturbation: A narrative review of mechanisms and treatment of the alcohol hangover
, Alcoholism: Clinical and Experimental Research, ISSN: 0145-6008Background: Alcohol is the most widely abused substance in the world and the leading source of mortality in 15-49-year-olds and a major risk factor for heart disease, liver disease, diabetes and cancer. In spite of this, alcohol is regularly and dangerously abused in wider society. Consumers of excess alcohol often note a constellation of negative symptoms, known as the alcohol hangover.However, the alcohol hangover is not considered to have long-term clinical significance by clinicians or consumers.Methods: A critical review of the literature was undertaken to demonstrate the pathophysiological mechanisms of the alcohol hangover.Results: Hereafter, the alcohol hangover is re-defined as a manifestation of sickness behaviour secondary to alcohol-induced inflammation, using the Bradford-Hill criteria to demonstrate causation above correlation. Alcohol causes inflammation through oxidative stress and endotoxaemia. Alcohol metabolism is oxidative and increased intake causes relative tissue hypoxia and increased free radical generation. Tissue damage ensues through lipid peroxidation and the formation of DNA/protein adducts. Alcohol metabolism by-products such as acetaldehyde,congeners, sleep deprivation and the activation of non-specific inducible CYP2E1 in alcoholexposed tissues exacerbate free radical generation. Tissue damage and cell death lead to inflammation, but in the intestine loss of epithelial cells leads to intestinal permeability, allowingtranslocation of pathogenic bacteria to the systemic circulation (endotoxaemia). This leads to a wellcharacterised cascade of systemic inflammation, additionally activating toll-like receptor 4 to inducesickness behaviour.Conclusions: Considering the evidence, it is suggested that hangover frequency and severity may be predictors of the development of later alcohol-related diseases, meriting formal confirmation in prospective studies. In light of the mechanisms of alcohol-mediated inflammation, research into gut permeabili
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Journal articleMullish BH, Thursz MR, 2024,
Alcohol-associated liver disease: emerging therapeutic strategies
, Hepatology, ISSN: 0270-9139 -
Journal articleEdwards L, Auch B, Portlock T, et al., 2024,
OS-070 Faecal microbiota transplantation in patients with cirrhosis, reduces antimicrobial resistance and enteric pathogen carriage, and enhances intestinal barrier function, associated with bacteriophage remodelling
, Journal of Hepatology, Vol: 80, Pages: S46-S47, ISSN: 0168-8278 -
Journal articleMullish BH, Merrick B, Quraishi MN, et al., 2024,
The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridioides difficile infection and other potential indications: second edition of joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines
, Gut, Vol: 73, Pages: 1052-1075, ISSN: 0017-5749The first British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS)-endorsed faecal microbiota transplant (FMT) guidelines were published in 2018. Over the past 5 years, there has been considerable growth in the evidence base (including publication of outcomes from large national FMT registries), necessitating an updated critical review of the literature and a second edition of the BSG/HIS FMT guidelines. These have been produced in accordance with National Institute for Health and Care Excellence-accredited methodology, thus have particular relevance for UK-based clinicians, but are intended to be of pertinence internationally. This second edition of the guidelines have been divided into recommendations, good practice points and recommendations against certain practices. With respect to FMT for Clostridioides difficile infection (CDI), key focus areas centred around timing of administration, increasing clinical experience of encapsulated FMT preparations and optimising donor screening. The latter topic is of particular relevance given the COVID-19 pandemic, and cases of patient morbidity and mortality resulting from FMT-related pathogen transmission. The guidelines also considered emergent literature on the use of FMT in non-CDI settings (including both gastrointestinal and non-gastrointestinal indications), reviewing relevant randomised controlled trials. Recommendations are provided regarding special areas (including compassionate FMT use), and considerations regarding the evolving landscape of FMT and microbiome therapeutics.
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Conference paperRadhakrishnan ST, Alexander JL, Mullish BH, et al., 2024,
P126 Gut microbiota composition and functionality in a thiopurine-naïve cohort of inflammatory bowel disease (IBD) can differentiate between clinical outcomes
, BSG LIVE’24, 17-20 June 2024, ICC Birmingham, Publisher: BMJ Publishing Group Ltd and British Society of Gastroenterology -
Journal articleMullish BH, Merrick B, Quraishi MN, et al., 2024,
The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridioides difficile infection and other potential indications: second edition of joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines
, Journal of Hospital Infection, Vol: 148, Pages: 189-219, ISSN: 0195-6701The first British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS)-endorsed faecal microbiota transplant (FMT) guidelines were published in 2018. Over the past five years, there has been considerable growth in the evidence base (including publication of outcomes from large national FMT registries), necessitating an updated critical review of the literature and a second edition of the BSG/HIS FMT guidelines. These have been produced in accordance with NICE-accredited methodology, thus have particular relevance for UK-based clinicians, but are intended to be of pertinence internationally. This second edition of the guidelines have been divided into recommendations, good practice points, and recommendations against certain practices. With respect to FMT for Clostridioides difficile infection (CDI), key focus areas centred around timing of administration, increasing clinical experience of encapsulated FMT preparations, and optimising donor screening. The latter topic is of particular relevance given the COVID-19 pandemic, and cases of patient morbidity and mortality resulting from FMT-related pathogen transmission. The guidelines also considered emergent literature on the use of FMT in non-CDI settings (including both gastrointestinal and non-gastrointestinal indications), reviewing relevant randomised controlled trials. Recommendations are provided regarding special areas (including compassionate FMT use), and considerations regarding the evolving landscape of FMT and microbiome therapeutics.
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Journal articleMullish BH, Michael DR, Dabcheva M, et al., 2024,
Authors' reply to letter: He who controls Clostridia and Bacteroidia controls the gut microbiome: The concept of targeted probiotics to restore the balance of keystone taxa in irritable bowel syndrome
, Neurogastroenterology & Motility, Vol: n/a, ISSN: 1350-1925 -
Journal articleAllegretti JR, Khanna S, Mullish BH, et al., 2024,
The progression of microbiome therapeutics for the management of gastrointestinal diseases and beyond
, Gastroenterology, ISSN: 0016-5085There has been an increased ability to investigate human microbiota through next-generation sequencing and functional assessment. This advancement has rapidly expanded our ability to study and manipulate the gastrointestinal microbiome to mitigate disease. Fecal microbiota transplantation, a therapy that broadly transfers the entire intestinal ecosystem, has been explored as a potential therapeutic in a variety of gastrointestinal, hepatic, and extraintestinal conditions. The field, however, continues to evolve, with a movement toward precision microbiome therapeutics individualizing care for various disorders. This review will describe the use of fecal microbiota transplantation, microbiota restoration, and precision microbiome therapeutics focusing on gastrointestinal and hepatic diseases.
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Journal articlePerry RW, Mullish BH, Alexander JL, et al., 2024,
Sa1889 3D Printed rectal swabs for assessing the gut microbiome, metabolome, and inflammation
, Gastroenterology, Vol: 166, Pages: S566-S567, ISSN: 0016-5085 -
Conference paperKing OG, Yip AY, Horrocks V, et al., 2024,
Sa1927 ANTIBIOTIC TREATMENT PROMOTES THE INTESTINAL COLONISATION OF VANCOMYCIN-RESISTANT ENTEROCOCCUS BY KILLING MEMBERS OF THE GUT MICROBIOTA AND DECREASING NUTRIENT COMPETITION
, Publisher: Elsevier BV, Pages: S-584, ISSN: 0016-5085
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