Resolution of the Council of Experts “Dysbiosis. Immediate and long-term consequences of microbiome disorders and options for their correction with probiotics”

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The appearance of new high-tech microbiological research methods has significantly changed the understanding of the human microbiome. The purpose of the meeting of the Council of Experts “Dysbiosis. The immediate and long-term consequences of microbiome disorders and options for their correction with probiotics” was the definition of modern positions about possible methods of studying the intestinal microbiome, the possibilities of correcting dysbiosis, the use of Saccharomyces boulardii CNCM I-745 to correct microbiome disorders in various clinical situations. The criteria of the microbiological “norm” for the intestinal microbiome have not been definitively established. To study the microbiome, a set of methods is used that combine cultural and molecular genetic methods that complement each other. Currently, there are no clinical markers of dysbiosis, and laboratory markers of dysbiosis require modification.

Probiotics can provide restoration of the intestinal microbiota. The effectiveness and safety of the use of Saccharomyces boulardii CNCM I-745 for this purpose has been proven. In the case of acute intestinal infection, antibiotic-associated diarrhea, and the consequences of HP infection eradication, studies have a high level of evidence.

This article is a reprint. Primary Publication: Gorelov AV, Zakharova IN, Khavkin AI, Kafarskaya LI, Usenko DV, Belmer SV, Kornienko EA, Privorotsky VF, Krasnov VV, Kondyurina EG, Panfilova VN, Tkhakushinova NKh, Plaksina AN, Rychkova OA, Pechkurov DV, Nizhevich AA, Fayzullina RA, Yablokova EA. Resolution of the Council of Experts “Dysbiosis. Immediate and long-term consequences of microbiome disorders and options for their correction with probiotics”. Vopr. prakt. pediatr. (Clinical Practice in Pediatrics). 2022;17(1):213–221 (in Russian). DOI: 10.20953/1817-7646-2022-1-213-221. With the permission of the copyright holder. Published with reductions.

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About the authors

Aleksandr V. Gorelov

Sechenov First Moscow State Medical University (Sechenov University); Central Research Institute of Epidemiology

Author for correspondence.
Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof., Acad. RAS

Russian Federation, Moscow; Moscow

Irina N. Zakharova

Russian Medical Academy of Continuous Professional Education

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Anatolii I. Khavkin

Research Clinical Institute of Childhood

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Liudmila I. Kafarskaya

Pirogov Russian National Research Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Denis V. Usenko

Central Research Institute of Epidemiology

Email: agorelov_05@mail.ru

D. Sci. (Med.)

Russian Federation, Moscow

Sergei V. Belmer

Pirogov Russian National Research Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof., Acad. RANS

Russian Federation, Moscow

Elena A. Kornienko

Saint Petersburg State Pediatric Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof.

Russian Federation, Saint Petersburg

Valerii F. Privorotsky

Saint Petersburg State Pediatric Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof.

Russian Federation, Saint Petersburg

Viktor V. Krasnov

Privolzhsky Research Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof.

Russian Federation, Nizhny Novgorod

Elena G. Kondyurina

Novosibirsk State Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof.

Russian Federation, Novosibirsk

Viktoriia N. Panfilova

Voyno-Yasenetsky Krasnoyarsk State Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.)

Russian Federation, Krasnoyarsk

Nafiset Kh. Tkhakushinova

Kuban State Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.), Assoc. Prof.

Russian Federation, Krasnodar

Anna N. Plaksina

Ural State Medical University

Email: agorelov_05@mail.ru

Cand. Sci. (Med.)

Russian Federation, Yekaterinburg

Olga A. Rychkova

Tyumen State Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.)

Russian Federation, Tyumen

Dmitrii V. Pechkurov

Samara State Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof.

Russian Federation, Samara

Aleksandr A. Nizhevich

Bashkir State Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof.

Russian Federation, Ufa

Rezeda A. Fayzullina

Kazan State Medical University

Email: agorelov_05@mail.ru

D. Sci. (Med.), Prof.

Russian Federation, Kazan

Ekaterina A. Yablokova

Sechenov First Moscow State Medical University (Sechenov University); Research Clinical Institute of Childhood

Email: agorelov_05@mail.ru

Cand. Sci. (Med.)

Russian Federation, Moscow; Moscow

References

  1. https://hmpdacc.org/hmp/micro_analysis/microbiome_analyses.php. Accessed: 01.03.2022.
  2. Edgar RC, Erlich RL, Farmer CN, et al. A framework for human microbiome research. Nature. 2012;486(7402):215-21. doi: 10.1038/nature11209
  3. Huttenhower C, Gevers D, Knight R, et al. Structure, function and diversity of the healthy human microbiome. Human Microbiome Project Consortium. Nature. 2012;486:207-14.
  4. Eckburg PB, Bik EM, Bernstein CN, et al. Diversity of the Human Intestinal Microbial Flora. Science. 2005;308(5728):1635-8.
  5. Costello EK, Lauber CL, Hamady M, et al. Bacterial community variation in human body habitats across space and time. Science. 2009;326(5960):1694-7. doi: 10.1126/science.1177486
  6. Koren O, Knights D, Gonzalez A, et al. A Guide to Enterotypes across the Human Body: Meta-Analysis of Microbial Community Structures in Human Microbiome Datasets. PLoS Comput Biol. 2013;9(1):e1002863. doi: 10.1371/journal.pcbi.1002863
  7. Qin J, Li R, Raes J, et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature. 2010;464:59-65.
  8. Rodriguez JM, Murphy K, Stanton C, et al. The composition of the gut microbiota throughout life, with an emphasis on early life. Microb Ecol Health Dis. 2015;26:26050. doi: 10.3402/mehd.v26.26050
  9. Ventura M, Milani C, Lugli GA, van Sinderen D. Health benefits conferred by the human gut microbiota during infancy. Microb Biotechnol. 2019;12(2):243-8. doi: 10.1111/1751-7915.13334
  10. Arrieta MC, Stiemsma LT, Amenyogbe N, et al. The intestinal microbiome in earlylife: health and disease. Front Immunol. 2014;5:427.
  11. Arboleya S, Binetti A, Salazar N, et al. Establishment and development of intestinal microbiota in preterm neo-nates. FEMS Microbiol Ecol. 2012;79:763-72.
  12. Nylund L, Satokari R, Salminen S, de Vos WM. Intestinal microbiota during early life –impact on health and disease. Proc Nutr Soc. 2014;73:457-69.
  13. Nuriel-Ohayon M, Neuman H, Koren O. Microbial changes during pregnancy, birth, and infancy. Front Microbiol. 2016;7:1031.
  14. Selma-Royo M, Tarrazó M, García-Mantrana I, et al. Shaping Microbiota During the First 1000 Days of Life. Adv Exp Med Biol. 2019;1125:3-24. doi: 10.1007/5584_2018_312
  15. Zeissig S, Blumberg RS. Life at the Beginning: Perturbation of the Microbiota by Antibiotics in Early Life and Its Role in Health and Disease. Nat Immunol. 2014;15(4):307-10.
  16. Усенко Д.В., Горелов А.В., Одинцова В.Е., и др. Нарушение микробиоты кишечника в остром периоде инфекционной диареи у детей и сравнительная оценка влияния последующей терапии нифуроксазидом и препаратами группы цефалоспоринов. Инфекционные болезни. 2020;18(3):88-96 [Usenko DV, Gorelov AV, Odintsova VE, et al. Impairments of the intestinal microbiota in the acute period of infectious diarrhea in children and comparative analysis of the effects of nifuroxazide and cephalosporins. Infectious Diseases. 2020;18(3):88-96 (in Russian)]. doi: 10.20953/1729-9225-2020-3-88-96
  17. Guarino A, Ashkenazi Sh, Gendrel D, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014;59(1):132-52. doi: 10.1097/MPG.0000000000000375
  18. Mekonnen SA, Merenstein D, Fraser CM, Marco ML. Molecular mechanisms of probiotic prevention of antibiotic-associated diarrhea. Curr Opin Biotechnol. 2020;61:226-34. doi: 10.1016/j.copbio.2020.01.005
  19. McFarland LV. Therapies on the horizon for Clostridium difficile infections. Expert Opin Investig Drugs. 2016;25(5):541-55. doi: 10.1517/13543784.2016.1161025
  20. Hempel S, Newberry SJ, Maher AR, et al. Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis. JAMA. 2012;307(18):1959-69. doi: 10.1001/jama.2012.3507
  21. Zenga W, Qia K, Yec M, et al. Gastrointestinal symptoms are associated with severity of coronavirus disease 2019: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2022;34:168-76.
  22. Czepiel J, Dróżdż M, Pituch H. Clostridium difficile infection: review. Eur J Clin Microbiol Infect Dis. 2019;38:1211-21.
  23. Sokol H, Pigneur B, Watterlot L, et al. Faecalibacterium prausnitzii is an anti-inflammatory commensal bacterium identified by gut microbiota analysis of Crohn disease patients. Proc Natl Acad Sci U S A. 2008;105:16731-6.
  24. Mentella MC, Scaldaferri F, Pizzoferrato M, et al. Nutrition, IBD and Gut Microbiota: A Review. Nutrients. 2020;12:944. doi: 10.3390/nu12040944
  25. Loddo I, Romano C. Inflammatory bowel disease: genetics, epigenetics, and pathogenesis. Front Immunol. 2015;6:551. doi: 10.3389/fimmu.2015.00551
  26. Chen SJ, Liu XW, Liu JP, et al. Ulcerative colitis as a polymicrobial infection characterized by sustained broken mucus barrier. World J Gastroenterol. 2014;20(28):9468-75.
  27. Pimentel M, Lembo A. Microbiome and Its Role in Irritable Bowel Syndrome. Dig Dis Sci. 2020;65(3):829-39.
  28. Kuenzig ME, Fung SG, Marderfeld L, et al. Twenty-first Century Trends in the Global Epidemiology of Pediatric-Onset Inflammatory Bowel Disease: Systematic Review. Gastroenterology. 2022:S0016-5085(22)00002-6. doi: 10.1053/j.gastro.2021.12.282
  29. Wang JW, Kuo Ch-H, Kuo F-Ch. Fecal microbiota transplantation: Review and update. J Formos Med Assoc. 2019;118(l):23-31.
  30. Guarner F, Sanders ME, Eliakim R, et al. Глобальные практические рекомендации Всемирной Гастроэнтерологической Организации. Пробиотики и пребиотики. Февраль 2017 г. [Guarner F, Sanders ME, Eliakim R, et al. Global practice guidelines of the World Gastroenterological Organization. Probiotics and prebiotics. 2017 (in Russian)].
  31. MacKenzie DA, Defernez M, Dunn WB, et al. Relatedness of medically important strains of Saccharomyces cerevisiae as revealed by phylogenetics and metabolomics. Yeast. 2008;25(7):501-12.
  32. Kelesidis T, Pothoulakis C. Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders. Ther Adv Gastroenterol. 2012;5(2):111-25.
  33. McFarland LV. Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. World J Gastroenterol. 2010;16(18):2202-22. doi: 10.3748/wjg.v16.i18.2202
  34. Szajewska H, Guarino A, Hojsak I, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Use of probiotics for management of acute gastroenteritis: a position paper by the ESPGHAN Working Group for Probiotics and Prebiotics. J Pediatr Gastroenterol Nutr . 2014;58(4):531-9. doi: 10.1097/MPG.0000000000000320
  35. Szajewska H, Kołodziej M, Zalewski BM. Systematic review with meta-analysis: Saccharomyces boulardii for treating acute gastroenteritis in children – a 2020 update. Aliment Pharmacol Ther. 2020;51(7):678-88. doi: 10.1111/apt.15659
  36. Li Z, Zhu G, Li C, Lai H. Which Probiotic Is the Most Effective for Treating Acute Diarrhea in Children? A Bayesian Network Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021;13(12):4319. doi: 10.3390/nu13124319
  37. Farthing M, Salam M, Lindberg G, et al. Острая диарея у взрослых и детей: глобальная перспектива. Глобальные практические рекомендации Всемирной Гастроэнтерологической Организации. 2012 г. [Farthing M, Salam M, Lindberg G, et al. Acute diarrhea in adults and children: a global perspective. Global practice guidelines of the World Gastroenterological Organization. 2012 (in Russian)].
  38. Cruchet S, Furnes R, Maruy A, et al. The use of probiotics in pediatric gastroenterology: a review of the literature and recommendations by Latin-American experts. Paediatr Drugs. 2015;17(3):199-216.
  39. Практические рекомендации Научного сообщества по содействию клиническому изучению микробиома человека (НСОИМ) и Российской гастроэнтерологической ассоциации (РГА) по применению пробиотиков, пребиотиков, синбиотиков и обогащенных ими функциональных пищевых продуктов для лечения и профилактики заболеваний гастроэнтерологического профиля у детей и взрослых. Режим доступа: https://mcrbm.com/files/getlinkedfile/682. Ссылка активна на 01.03.2022 [Prakticheskie rekomendatsii Nauchnogo soobshchestva po sodeistviyu klinicheskomu izucheniyu mikrobioma cheloveka (NSOIM) i Rossiiskoi gastroenterologicheskoi assotsiatsii (RGA) po primeneniyu probiotikov, prebiotikov, sinbiotikov i obogashchennykh imi funktsional'nykh pishchevykh produktov dlya lecheniya i profilaktiki zabolevanii gastroenterologicheskogo profilya u detei i vzroslykh). Available at: https://mcrbm.com/files/getlinkedfile/682. Accessed: 01.03.2022 (in Russian)].
  40. Szajewska H, Kołodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea. Aliment Pharmacol Ther. 2015;42(7):793-801. doi: 10.1111/apt.13344
  41. Kabbani TA, Pallav K, Dowd SE, et al. Prospective randomized controlled study on the effects of Saccharomyces boulardii CNCM I-745 and amoxicillin-clavulanate or the combination on the gut microbiota of healthy volunteers. Gut Microbes. 2017;8(1):17-32. doi: 10.1080/19490976.2016.1267890
  42. Swidsinski A, Loening-Baucke V, Swidsinski S. Saccharomyces boulardii prevents the antibiotic induced changes in colonic microbiota. Gastroenterology. 2013;144(5 Suppl. 1):S-824.
  43. Kullar R, Johnson S, McFarland LV, Goldstein EJC. Potential Roles for Probiotics in the Treatment of COVID-19 Patients and Prevention of Complications Associated with Increased Antibiotic Use. Antibiotics (Basel). 2021;10(4):408. doi: 10.3390/antibiotics10040408
  44. Malfertheiner P, Megraud F, O'Morain C, et al. Management of Helicobacter pylori infection – the Maastricht V/Florence Consensus Report. Gut. 2017;66(1):6-30.
  45. Cifuentes SG, Prado MB, Fornasini M, et al. Saccharomyces boulardii CNCM I-745 supplementation modifies the fecal resistome during Helicobacter pylori eradication therapy. Helicobacter. 2022;e12870. doi: 10.1111/hel.12870
  46. Cindoruk M, Erkan G, Karakan T, et al. Efficacy and safety of Saccharomyces boulardii in the 14-day triple anti-Helicobacter pylori therapy: a prospective randomized placebo-controlled double-blind study. Helicobacter. 2007;12(4):309-16. doi: 10.1111/j.1523-5378.2007.00516.x
  47. Бельмер С.В., Корниенко Е.А., Волынец Г.В., и др. Диагностика и лечение хеликобактерной инфекции у детей. Рекомендации общества детских гастроэнтерологов, гепатологов, нутрициологов. Редакция от 31.10.2021 г. Приняты на XX Российском Конгрессе «Инновационные технологии в педиатрии и детской хирургии». Москва, 21 октября 2021 г. [Bel'mer SV, Kornienko EA, Volynets GV, et al. Diagnostika i lechenie khelikobakternoi infektsii u detei. Rekomendatsii obshchestva detskikh gastroenterologov, gepatologov, nutritsiologov. Redaktsiya ot 31.10.2021. Prinyaty na XX Rossiiskom Kongresse "Innovatsionnye tekhnologii v pediatrii i detskoi khirurgii". Moskva, 21 oktyabrya 2021 g. (in Russian)].
  48. Клинические рекомендации. Язвенная болезнь желудка и/или двенадцатиперстной кишки. 2021. Режим доступа: https://cr.minzdrav.gov.ru/recomend/388_2. Cсылка активна на 01.03.2022 [Clinical guidelines. Peptic ulcer of the stomach and/or duodenum. 2021. Available at: https://cr.minzdrav.gov.ru/recomend/388_2. Accessed: 01.03.2022 (in Russian)].
  49. Shen J, Zuo Z-X, Mao A-P. Effect of probiotics on inducing remission and maintaining therapy in ulcerative colitis, Crohn's disease, and pouchitis: meta-analysis of randomized controlled trials. Inflamm Bowel Dis. 2014;20(1):21-35. doi: 10.1097/01.MIB.0000437495.30052
  50. Bjarnason I, Sission G, Hayee BH. A randomised, double-blind, placebo-controlled trial of a multi-strain probiotic in patients with asymptomatic ulcerative colitis and Crohn’s disease. Infammopharmacology. 2019;27:465-73. doi: 10.1007/s10787-019-00595-4
  51. Miele E, Shamir R, Aloi M, et al. Nutrition in Paediatric Inflammatory Bowel Disease: A Position Paper on Behalf of The Porto IBD Group of ESPGHAN. J Pediatr Gastroenterol Nutr. 2018;66(4):687-708. doi: 10.1097/MPG.0000000000001896
  52. Ford AC, Quigley EMM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-61.
  53. Choi CH, Jo SY, Park HJ, et al. A randomized, double-blind, placebo-controlled multicenter trial of Saccharomyces boulardii in irritable bowel syndrome: effect on quality of life. J Clin Gastroenterol. 2011;45(8):679-83.
  54. Горелов А.В., Захарова И.Н., Хавкин А.И., и др. Резолюция Совета экспертов «Дисбиоз. Ближайшие и отдаленные последствия нарушения микробиома и варианты их коррекции с помощью пробиотиков». Вопросы практической педиатрии. 2022;17(1):213-221 [Gorelov AV, Zaharova IN, Havkin AI, et al. Rezoljucija Soveta jekspertov «Disbioz. Blizhajshie i otdalennye posledstvija narushenija mikrobioma i varianty ih korrekcii s pomoshh'ju probiotikov». Voprosy prakticheskoj pediatrii. 2022;17(1):213-221 (in Russian)]. doi: 10.20953/1817-7646-2022-1-213-221

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