Max Roser and Hannah Ritchie (2020) - Burden of …...Max Roser and Hannah Ritchie (2020) - "Burden...
Transcript of Max Roser and Hannah Ritchie (2020) - Burden of …...Max Roser and Hannah Ritchie (2020) - "Burden...
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Max Roser and Hannah Ritchie (2020) - "Burden of Disease". Published online at OurWorldInData.org. 'https://ourworldindata.org/
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Max Roser and Hannah Ritchie (2020) - "Burden of Disease". Published online at OurWorldInData.org. 'https://ourworldindata.org/
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Hannah Ritchie and Max Roser (2020) - "Causes of Death". Published online at OurWorldInData.org. 'https://ourworldindata.org/causes-of-death'
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Hannah Ritchie and Max Roser (2020) - "Causes of Death". Published online at OurWorldInData.org. 'https://ourworldindata.org/causes-of-death'
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DEFECATIONRESIDUES IN DIET
MEALINGESTION
1000
mL
0POSTPRE
Colonic Biomass: Effect of Meals and Diet
MR imaging
•7
MR, magnetic resonance.
Bendezu R, et al. Neurogastroenterol Motil. 2016;28:849-854.
# of genes
Average gene set per individual 590,384
Common (>50% of individuals) 294,110
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http://www.hmdb.ca
Fluid TotalMicrobial
origin% Microbial origin
Blood 3158 104 3,3
Saliva 1233 59 4,8
Urine 1976 102 5,2
CSF 450 36 8,0
Breast milk 120 10 8,3
Bile 18 5 27,8
Number of Metabolites Detected in Human Fluids
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Rienks et al, Nutrients 2017
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McDonald et al, mSystems 2018
Diversity of plants in diet associated with microbiome composition American Gut Project: Microbial sequence and data from 15,096 samples from 11,336 human participants
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Gut microbes modulate response toimmunotherapy in melanoma patients
Gopalakrishnan et al, Science 2017
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Gut microbes modulate response toimmunotherapy in melanoma patients
Gopalakrishnan et al, Science 2017
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Exposure to antibiotics reduces survival in patients onimmunotherapy against epithelial tumors
Routy et al, Science 2017
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Palleja et al, Nat Microbiol 2018
Loss of Bacterial Diversity in the Human Gut Microbiome afterAntibiotic Exposure
Oral vancomycin, gentamicin and meropenem from D0 to D4
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Palleja et al, Nat Microbiol 2018
Different Recovery Capacities between Strains
Oral vancomycin, gentamicin and meropenem from D0 to D4
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Disorders associated with loss of richness/diversity of the gut microbiota:
• Nutrition-related disorders (obesity, type 2 diabetes and the metabolic syndrome)
• Inflammatory bowel diseases (UC and CD)
• Caeliac disease
• Recurrent diarrhoea by C. diff
• Functional bowel disorders
• Systemic complications of decompensated liver disease
• Colo-rectal cancer
• Certain allergies
• Certain mental and neuro-developmental conditions, such as autism spectrum disorders
Loss of microbial richness is a common feature of chronic non-communicable
diseases of modern society
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Dysbiosis in IBD
Pascal et al, Gut 2017
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Le Chatellier et al, Nature 2013
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Stewart et al, Nature 2018
Temporal development of the gut microbiome in early childhood
TEDDY study: The Environmental Determinants of Type 1 Diabetes in the YoungCohort: 8676 children with high-risk HLA-DR-DQ or first-degree relatives of persons with T1D enrolled at birth (from 2004 to 2010)Microbiome study: 12,005 gut microbiome samples from 903 children 3–46 months of age
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Gut microbiome in early-onset type 1diabetes from the TEDDY study
Vatanen et al , Nature 2018
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Zhao et al, Science 2018
Gut bacteria selectively promoted by dietary fibers alleviatetype 2 diabetes
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Zhao et al, Science 2018
Gut bacteria selectively promoted by dietary fibers alleviatetype 2 diabetes
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•30 patients complaining of flatulence •20 healthy subjects
Manichanh et al, Gut 2014
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Diet-induced Microbiota Changes
Manichanh et al, Gut 2014
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Bilophila wadsworthia was found positively correlated with volume of gas
evacuated in patients (r = 0.64; FDR = 0.12) but not in healthy subjects
Bilophila wadsworthia and gas volume
200 400 600
-2
0
2
4
6
8
Volume of gas evacuated
Rela
tive
ab
un
da
nce
Manichanh et al, Gut 2014
Flatulence PatientsBilophila wadsworthia and gas volume
200 400 600
-2
0
2
4
6
8
Rela
tive
ab
un
da
nce
Volume of gas evacuated
Healthy subjects
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A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome
Halmos et al, Gastroenterology 2014
• FODMAPs are poorly absorbed short-chain carbohydrates including fructose, lactose, polyols, fructans, and galacto-oligosaccharides.
• Vegetables, legumes, fruits, nuts, bread and cereals, dairy, honey, fruit juices, etc., may contain FODMAPS.
• Such dietary restrictions are difficult to maintain for long periods
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A Diet Low in FODMAPs Alters the Colonic Luminal Microenvironment
Halmos et al, Gut 2015
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Bimuno GOS versus low FODMAPs dietin patients with FGD complaining of excessive gas: experimental design
prebiotic GOS + balanced diet
placebo + low-FODMAPs diet
treatment period (4 wk)basal period follow-up (2 wk)
habitual diet habitual diet
Huaman et al, Gastroenterology 2018
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0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5flatulence pain distension borborygmi bloating
10
0
PREBIOTIC GROUP
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 50
10
flatulence pain distension borborygmi bloating
LOW FODMAPs GROUP
Digestive symptoms
pre-treatment
Huaman et al, Gastroenterology 2018
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0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5flatulence pain distension borborygmi bloating
***
10
0
PREBIOTIC GROUP
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5
*
*
*
**
0
10
flatulence pain distension borboriymi bloating
LOW FODMAPs GROUP
Digestive symptomspre-treatment treatment
Huaman et al, Gastroenterology 2018
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0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5flatulence pain distension borborygmi bloating
***
* * *
10
0
PREBIOTIC GROUP
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5
*
*
*
**
+
++*
**
0
10
flatulence pain distension borboriymi bloating
LOW FODMAPs GROUP
Digestive symptomspre-treatment treatment post-treatment
Huaman et al, Gastroenterology 2018
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Number of daytime anal gas evacuation
* p<0.05 vs pre-treatment
0
5
10
15
20
1 2 3
*
*
20
0pre treatment post
LOW FODMAPs GROUP
0
5
10
15
20
1 2 3pre treatment post
20
0
PREBIOTIC GROUPPREBIOTIC GROUP
Huaman et al, Gastroenterology 2018
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Changes in luminal bacteria during treatment
Huaman et al, Gastroenterology 2018
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Functional gut symptoms: treatment strategies
microbiota
RESTRICTED BENEFICIAL
INACTIVITY ADAPTATION
COMPETENCEDYSBIOSIS/ATROPHY
SUBSTRATES IN DIET
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• Maintaining gut microbiota diversity is a novel clinical target for health promotion and disease prevention.
• Improving gut species diversity and increasing abundance of fermentative taxa are to be considered as hard endpoints for human trials.
• Probiotics with high anti-oxidant and anti-inflammatory potential, and prebiotics promoting activity and abundance of butyrate producers, are to be developed and tested for their capacity of recovering vulnerable gut microbiotas in industrialized countries.