Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT

You'll have to read this for the view that taking them doesn't really do anything.

Probiotics – It’s Complicated

Whereas these posts are mostly on the positive side;

• probiotics (15)

You could ask your doctor but they will know nothing, just like they know nothing about stroke recovery.  

Another view. Hope you can put two and two together and see which way to go. I'm staying with probiotics, don't listen to me, I'm not medically trained.

Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT

• Jotham Suez ¹¹
• Niv Zmora ¹¹
• Gili Zilberman-Schapira ¹¹
• 
  
• Zamir Halpern ¹²
• Eran Segal ¹²
• Eran Elinav ^{12, 13}
• Show all authors
• Show footnotes

DOI:https://doi.org/10.1016/j.cell.2018.08.047

Accuri™ C6 Plus Flow Cytometer Resources

White papers, webinars, videos, technical documents, experiment sheets and much more. Click here.

Best Approaches for Antibiotic Discovery

See how you can tackle the increasingly difficult task of finding new, effective antibiotics.

Best Approaches for Antibiotic Discovery

Tackle the increasingly difficult task of finding new antibiotics for gram negative bacteria.

Immuno-Oncology Research Tools

Tumor-bearing, humanized NSG™ & NSG™-SGM3 mice are a new and valuable preclinical testing platform.

Ads Powered with

Highlights

• Murine gut mucosal probiotic colonization is only mildly enhanced by antibiotics
• Human gut mucosal probiotic colonization is significantly enhanced by antibiotics
• Post antibiotics, probiotics delay gut microbiome and transcriptome reconstitution
• In contrast, aFMT restores mucosal microbiome and gut transcriptome reconstitution

Summary

Probiotics are widely prescribed for prevention of antibiotics-associated dysbiosis and related adverse effects. However, probiotic impact on post-antibiotic reconstitution of the gut mucosal host-microbiome niche remains elusive. We invasively examined the effects of multi-strain probiotics or autologous fecal microbiome transplantation (aFMT) on post-antibiotic reconstitution of the murine and human mucosal microbiome niche. Contrary to homeostasis, antibiotic perturbation enhanced probiotics colonization in the human mucosa but only mildly improved colonization in mice. Compared to spontaneous post-antibiotic recovery, probiotics induced a markedly delayed and persistently incomplete indigenous stool/mucosal microbiome reconstitution and host transcriptome recovery toward homeostatic configuration, while aFMT induced a rapid and near-complete recovery within days of administration. In vitro, Lactobacillus-secreted soluble factors contributed to probiotics-induced microbiome inhibition. Collectively, potential post-antibiotic probiotic benefits may be offset by a compromised gut mucosal recovery, highlighting a need of developing aFMT or personalized probiotic approaches achieving mucosal protection without compromising microbiome recolonization in the antibiotics-perturbed host.

Graphical Abstract

• View Large Image
• Figure Viewer
• Download Hi-res image
• Download (PPT)

Keywords

• Probiotics
• antibiotics
• microbiome

Introduction

Antibiotics have transformed medicine and the fight against common life-threatening bacterial infections (Van Boeckel et al., 2014). However, widespread antibiotic exposure is associated with the emergence of resistant strains and with a variety of gastrointestinal (GI) effects, hypersensitivity, and drug-specific adverse effects, most notably antibiotic-associated diarrhea (AAD) in 5% to 35% of treated humans (Wiström et al., 2001,

McFarland, 1998). Non-selective antibiotics-induced disruption of commensal microbiome community structure (“dysbiosis”) accounts for up to 20% of all AAD cases (Bartlett, 2002). Such dysbiosis occurs rapidly within days, leading to altered bacterial metabolism and impaired host proteome in mice and humans (Ferrer et al., 2014, Lichtman et al., 2016). Human microbiome reconstitution from antibiotic treatment is often slow and incomplete (Dethlefsen et al., 2008, Dethlefsen and Relman, 2011, Jernberg et al., 2007) and, in some cases, may take years to revert to naive configuration (Lankelma et al., 2017). Of note, studies in rodent models and humans suggest an association between antibiotic exposure, especially during early stages of life, and a host propensity for a variety of long-term disorders (Vangay et al., 2015), including obesity (Shao et al., 2017), allergy (Risnes et al., 2011, Hoskin-Parr et al., 2013), increased risk of autoimmunity (Arvonen et al., 2015), and inflammatory bowel disease (Virta et al., 2012, Kronman et al., 2012).

Probiotics have been proposed to constitute an effective preventive treatment for antibiotics-induced dysbiosis and associated adverse effects in mice (Ekmekciu et al., 2017) and in some (Hempel et al., 2012) but not all human studies (Olek et al., 2017, Allen et al., 2013). Importantly, adverse effects associated with probiotics consumption may be under-reported in clinical trials (Bafeta et al., 2018), further complicating the efficacy debate. The extent and pattern of probiotic gut mucosal colonization and impact on the indigenous gut microbiome following antibiotic use also remain unclear. While few small-scale culture-based studies attempted to quantify supplemented probiotics in the antibiotics-perturbed GI mucosa (Klarin et al., 2005), the vast majority of studies extrapolate their conclusions from stool samples, resulting in inconclusive findings regarding probiotics capability to restore the pre-antibiotics microbiome configuration (McFarland, 2014). Importantly, no in vivo studies have directly examined the global extent of human mucosal probiotic colonization following antibiotic treatment and their impact on reconstitution of the indigenous mucosal microbiome or the host gut transcriptome.

Here, we explored the impact of probiotics consumption following antibiotic exposure on the gut luminal, mucosal, and fecal microbiome composition and function and the GI transcriptome in mice and humans. To this aim, mice and a cohort of human volunteers were treated with broad-spectrum antibiotics and then either were supplemented with probiotics, underwent autologous fecal microbiome transplantation (aFMT), or were allowed to spontaneously recover over time. We found significant differences between mice and humans with respect to post-antibiotic probiotics gut mucosal colonization. Mice featured only a mild improvement in colonization of the “human-compatible” probiotics regimen upon antibiotic treatment as compared to homeostatic conditions, while humans demonstrated a marked colonization improvement in this setting. Importantly, post-antibiotic probiotic supplementation significantly delayed the extent of reconstitution of the indigenous fecal and mucosal microbiome (in both mice and humans) and the reversion of the gut transcriptome toward homeostatic configuration (in humans) compared to either spontaneous reconstitution or aFMT. In contrast, post-antibiotic aFMT in both mice and humans achieved a rapid and near-complete gut mucosal microbiome recolonization associated with reversion of the human gut transcriptome toward its pre-antibiotic configuration.

 

More at link.