1887
Volume 2020, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: There has been a growing global interest in the role of gut microbiota in the pathogenesis of diseases and the potentials of targeting the microbiome in clinical interventions. Very few clinical studies in Qatar focused on gut microbiome. This study aimed to assess the awareness of healthcare professionals, scientists, and the general public on the role of gut microbiota in health and diseases and, more specifically, in disorders of the gut–brain axis such as neurodevelopmental disorders (NDDs) or gastrointestinal (GI) disorders. It also aimed to evaluate the readiness of the population to engage in clinical trials involving dietary interventions or fecal transplants.

Methods: A total of 156 participants were recruited to answer questionnaires—from healthcare professionals and scientists (HSs; n = 44) and the general public (n = 112). Participants from the general public self-reported their diagnosis of NDDs—autism or attention deficit hyperactivity disorder (n = 36)—or GI diseases or disorders (n = 18) or as having none of them (n = 58). Two questionnaires for HSs and for the general public were distributed, and basic descriptive and statistical analyses were conducted using the Fisher's exact test.

Results: Among the participating HSs, 95% admitted that they had minimum to no knowledge on the role of gut microbes in health and diseases, and only 15.9% felt that their peers were knowledgeable about it. Nevertheless, 97.7% of HSs thought that gut microbiota should be considered when devising treatment plans as 79.1% believed that gut dysbiosis is involved in the pathogenesis of diseases. For the general public, 54% stated that they have read about studies on the potential benefits of microbes in the prevention, treatment, and management of diseases, with a higher proportion of them belonging to the GI group ( = 0.0523). The GI group was also more aware of the existence of the use of fecal transplants for treating their condition (p = 0.01935). Awareness was also reflected in participants’ attempts to engage in dietary changes, as 40% tried a dietary intervention, which has noticeably changed their or their child's symptoms. This study reported a highly significant association between being exposed to multiple antibiotic courses before three years of age and being part of the NDD group (p = 0.0003). Public readiness to engage in interventions that target the gut microbiome, such as intensive dietary interventions or even fecal transplants, was perceived by HSs to be lower than what was stated by the public, with 87.96% of public being ready to engage in intensive dietary interventions and 66.98% in fecal transplants.

Conclusion: The study revealed that the role of gut microbes in health and diseases, and especially through the gut–brain axis, is still unclear in both the scientific community and general public. While acknowledging the importance of gut microbes, the lack of information regarding the link between lifestyle and gut microbes is considered to hold the public in the precontemplation/contemplation stages of the transtheoretical model of behavioral change. An interdisciplinary approach to new knowledge produced by microbiome studies is needed to run awareness campaigns and continue professional development activities on the benefits of lifestyle-based modulation of gut microbiome, thus engaging the general public in lifestyle changes and facilitating clinical research in human microbiome investigations in Qatar.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2020.47
2021-02-03
2021-08-04
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2020/3/qmj.2020.47.html?itemId=/content/journals/10.5339/qmj.2020.47&mimeType=html&fmt=ahah

References

  1. Althani AA, Marei HE, Hamdi WS, Nasrallah GK, El Zowalaty ME, Al Khodor S, et al. Human microbiome and its association with health and diseases. J Cell Physiol [Internet]. 2016 Aug [cited 2017 Mar 13]; 231:(8):168894. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26660761.
    [Google Scholar]
  2. Team NHMPA. A review of 10 years of human microbiome research activities at the US National Institutes of Health, Fiscal Years 2007-2016. Microbiome [Internet]. 2019 Dec [cited 2020 May 28]; 7(1):31. Available from: https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-019-0620-y .
    [Google Scholar]
  3. Wilkins LJ, Monga M, Miller AW. Defining dysbiosis for a cluster of chronic diseases. Sci Rep[Internet]. 2019 Dec 9 [cited 2019 Nov 26]; 9:(1):12918. Available from: http://www.nature.com/articles/s41598-019-49452-y.
    [Google Scholar]
  4. Buffington SA, Di Prisco GV, Auchtung TA, Ajami NJ, Petrosino JF, Costa-Mattioli M. Microbial reconstitution reverses maternal diet-induced social and synaptic deficits in offspring. Cell[Internet]. 2016 Jun 16 [cited 2017 Mar 13]; 165:(7):1762–75. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0092867416307309.
    [Google Scholar]
  5. Jahansouz C, Staley C, Bernlohr DA, Sadowsky MJ, Khoruts A, Ikramuddin S. Sleeve gastrectomy drives persistent shifts in the gut microbiome. Surg Obes Relat Dis[Internet].2017 Jan 4 [cited 2017 Mar 13]; 13:(6):91624. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28279578.
    [Google Scholar]
  6. Peters BA, Shapiro JA, Church TR, Miller G, Trinh-Shevrin C, Yuen E, et al. A taxonomic signature of obesity in a large study of American adults OPEN. [cited 2019 Sep 17]; 8:(1):13. Available from: http://www.nature.com/scientificreports/.
    [Google Scholar]
  7. Dinan TG, Cryan JF. Gut instincts: microbiota as a key regulator of brain development, ageing and neurodegeneration. J Physiol [Internet]. 2017 Jan 15 [cited 2017 Mar 13]; 595:(2):489503. Available from: http://doi.wiley.com/10.1113/JP273106.
    [Google Scholar]
  8. Shivani Ghaisas, Joshua Maherand AK. Gut microbiome in health and disease: linking the microbiome-gut-brain axis and environmental factors in. Crime Justice Am [Internet]. 2012[cited 2020 May 14];41721. Available from: http://www.sciencedirect.com/science/article/pii/B9781437735123000160.
    [Google Scholar]
  9. Fung TC, Olson CA, Hsiao EY. Interactions between the microbiota, immune and nervous systems in health and disease. Nat Neurosci [Internet]. 2017 Feb 16 [cited 2017 Mar 13]; 20:(2):14555. Available from: http://www.nature.com/doifinder/10.1038/nn.4476 .
    [Google Scholar]
  10. Li Q, Han Y, Dy ABC, Hagerman RJ. The gut microbiota and autism spectrum disorders. Front Cell Neurosci. 2017 Apr; 11::120.
    [Google Scholar]
  11. Mayer EA, Knight R, Mazmanian SK, Cryan JF, Tillisch K. Gut microbes and the brain: paradigm shift in neuroscience. J Neurosci [Internet]. 2014 Nov 12[cited 2017 Mar 13]; 34:(46):154906. Available from: http://www.jneurosci.org/cgi/doi/10.1523/JNEUROSCI.3299-14.2014.
    [Google Scholar]
  12. Kho ZY, Lal SK. The human gut microbiome–a potential controller of wellness and disease. Front Microbiol [Internet]. 2018 Aug 14 [cited 2019 Nov 27];9:1835. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30154767 .
    [Google Scholar]
  13. Bere K, Krishnamoorthy G. Commensal gut flora and brain autoimmunity: a love or hate affair? Acta Neuropathol. 2012; 123:(5):63951.
    [Google Scholar]
  14. Kushner RF, Sorensen KW. Lifestyle medicine: the future of chronic disease management. Curr Opin Endocrinol, Diabetes Obes. 2013; 20:(5)38995.
    [Google Scholar]
  15. Attaye I, Pinto-Sietsma SJ, Herrema H, Nieuwdorp M. A crucial role for diet in the relationship between gut microbiota and cardiometabolic disease. Annu Rev Med [Internet]. 2019 Sep 3 [cited 2019 Sep 17];71;149–61. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31479620.
    [Google Scholar]
  16. Guthrie L, Gupta S, Daily J, Kelly L. Human microbiome signatures of differential colorectal cancer drug metabolism. npj Biofilms Microbiomes [Internet]. 2017 Dec 1 [cited 2019 Feb 14]; 3:(1):27. Available from: http://www.nature.com/articles/s41522-017-0034-1.
    [Google Scholar]
  17. Karhu E, Zukerman R, Eshraghi RS, Mittal J, Deth RC, Castejon AM, et al. Nutritional interventions for autism spectrum disorder. Nutr Rev. 2019; 0:(0):117.
    [Google Scholar]
  18. Zhou L, Foster JA. Psychobiotics and the gut-brain axis: in the pursuit of happiness. Neuropsychiatr Dis Treat [Internet]. 2015 Mar [cited 2017 Mar 13];11:715–23. Available from: http://www.dovepress.com/psychobiotics-and-the-gutndashbrain-axis-in-the-pursuit-of-happiness-peer-reviewed-article-NDT .
    [Google Scholar]
  19. Kok CR, Hutkins R. Yogurt and other fermented foods as sources of health-promoting bacteria. Nutr Rev [Internet]. 2018 Dec 1 [cited 2019 Feb 13];76(Supplement_1):4–15. Available from: https://academic.oup.com/nutritionreviews/article/76/Supplement_1/4/5185609 .
    [Google Scholar]
  20. Hartman RE, Patel D. Dietary approaches to the management of autism spectrum disorders. In: Adv Neurobiol. Springer; 2020; 24:: 54771.
    [Google Scholar]
  21. Kang D-W, Adams JB, Coleman DM, Pollard EL, Maldonado J, McDonough-Means S, et al. Long-term benefit of microbiota transfer therapy on autism symptoms and gut microbiota. Sci Rep [Internet]. 2019Dec9[cited 2019 Nov 14]; 9:(1):5821. Available from: http://www.nature.com/articles/s41598-019-42183-0 .
    [Google Scholar]
  22. Suskind DL, Brittnacher MJ, Wahbeh G, Shaffer ML, Hayden HS, Qin X, et al. Fecal microbial transplant effect on clinical outcomes and fecal microbiome in active Crohn's disease. Inflam Bowel Dis [Internet]. 2015 Mar [cited 2018 Nov 8]; 21:(3):55663. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25647155.
    [Google Scholar]
  23. Ding X, Li Q, Li P, Zhang T, Cui B, Ji G, et al. Long-term safety and efficacy of fecal microbiota transplant in active ulcerative colitis. Drug Saf. 2019 Jul 1; 42:(7):86980.
    [Google Scholar]
  24. Rossen NG, Fuentes S, Van Der Spek MJ, Tijssen JG, Hartman JHA, Duflou A, et al. Findings from a randomized controlled trial of fecal transplantation for patients with ulcerative colitis. Gastroenterology. 2015 Jul 1; 149:(1):110-118.e4.
    [Google Scholar]
  25. Cueva C, Gil-Sánchez I, Ayuda-Durán B, González-Manzano S, González-Paramás AM, Santos-Buelga C, et al. An integrated view of the effects of wine polyphenols and their relevant metabolites on gut and host health. Molecules [Internet]. 2017 Jan 6 [cited 2019 Nov 26]; 22:(1):99. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28067835.
    [Google Scholar]
  26. De Filippo C, Cavalieri D, Di Paola M, Ramazzotti M, Poullet JB, Massart S, et al. Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. Proc Natl Acad Sci [Internet]. 2010 Aug 17 [cited 2019 Nov 26]; 107:(33):146916. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20679230 .
    [Google Scholar]
  27. García-Díez J, Alheiro J, Pinto AL, Soares L, Falco V, Fraqueza MJ, et al. Influence of food characteristics and food additives on the antimicrobial effect of garlic and oregano essential oils. Foods (Basel, Switzerland) [Internet]. 2017 Jun 10 [cited 2017 Aug 20]; 6:(6):44. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28604598 .
    [Google Scholar]
  28. Williams B, Grant L, Gidley M, Mikkelsen D. Gut Fermentation of Dietary Fibres: Physico-chemistry of plant cell walls and implications for health. Int J Mol Sci [Internet]. 2017 Oct 20 [cited 2019 Feb 14]; 18:(10):2203. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29053599 .
    [Google Scholar]
  29. Wang H, Lu Y, Yan Y, Tian S, Zheng D, Leng D, et al. Promising treatment for type 2 diabetes: fecal microbiota transplantation reverses insulin resistance and impaired islets. Front Cell Infect Microbiol. 2020Jan17; 9::455.
    [Google Scholar]
  30. Search of: autism | diet - Results on Map - ClinicalTrials.gov [Internet]. [cited 2020 Apr 28]. Available from: https://clinicaltrials.gov/ct2/results/map?term = autism&cond = diet&map =  .
  31. Search of: fecal transplant - List Results - ClinicalTrials.gov [Internet]. [cited 2018 Nov 8]. Available from: https://clinicaltrials.gov/ct2/results?cond = &term = fecal+transplant&cntry = &state = &city = &dist = &Search = Search .
  32. Gardener H, Spiegelman D, Buka SL. Perinatal and neonatal risk factors for autism: a comprehensive meta-analysis. Pediatrics. 2011; 128:(2)34455.
    [Google Scholar]
  33. Penders J, Thijs C, Vink C, Stelma FF, Snijders B, Kummeling I, et al. Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics. 2006; 118:(2):51121.
    [Google Scholar]
  34. Tribe RM, Taylor PD, Kelly NM, Rees D, Sandall J, Kennedy HP. Parturition and the perinatal period: can mode of delivery impact on the future health of the neonate? J Physiol [Internet]. 2018 Dec 1 [cited 2020 Jul 19]; 596:(23):570922. Available from: /pmc/articles/PMC6265543/?report = abstract.
    [Google Scholar]
  35. Axelsson PB, Clausen TD, Petersen AH, Hageman I, Pinborg A, Kessing LV, et al. Relation between infant microbiota and autism: results from a National Cohort Sibling Design Study. Epidemiology. 2019 Jan 1; 30:(1):5260.
    [Google Scholar]
  36. Stinson LF, Payne MS, Keelan JA. A critical review of the bacterial baptism hypothesis and the impact of cesarean delivery on the infant microbiome. Front Med. 2018.
    [Google Scholar]
  37. Curran EA, O'Neill SM, Cryan JF, Kenny LC, Dinan TG, Khashan AS, Kearney PM. Research review: Birth by caesarean section and development of autism spectrum disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. J Child Psychol Psychiatry. 2015May; 56:(5):500-8. doi: 10.1111/jcpp.12351. Epub 2014 Oct 27. PMID: 25348074.
    [Google Scholar]
  38. Curran EA, Khashan AS, Dalman C, Kenny LC, Cryan JF, Dinan TG, Kearney PM. Obstetric mode of delivery and attention-deficit/hyperactivity disorder: a sibling-matched study. Int J Epidemiol. 2016 Apr; 45:(2):532-42. doi: 10.1093/ije/dyw001. Epub 2016 Apr 10. PMID: 27063604.
    [Google Scholar]
  39. Seelig MS. Mechanisms by which antibiotics increase the incidence and severity of candidiasis and alter the immunological defenses. Bacteriol Rev .1966; 30:(2):442-459.
    [Google Scholar]
  40. Hsiao EY, McBride SW, Hsien S, Sharon G, Hyde ER, McCue T, et al. Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders.Cell [Internet]. 2013 Dec 19 [cited 2017 Mar 13]; 155:(7):145163. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0092867413014736 .
    [Google Scholar]
  41. Yano JM, Yu K, Donaldson GP, Shastri GG, Ann P, Ma L, et al. Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. Cell [Internet]. 2015 Apr 9 [cited 2019 May 26]; 161:(2):26476. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25860609 .
    [Google Scholar]
  42. Javurek AB, Spollen WG, Johnson SA, Bivens NJ, Bromert KH, Givan SA, et al. Effects of exposure to bisphenol A and ethinyl estradiol on the gut microbiota of parents and their offspring in a rodent model. Gut Microbes [Internet]. 2016 Nov [cited 2017 Mar 13]; 7:(6):47185. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27624382 .
    [Google Scholar]
  43. Krajmalnik-Brown R, Lozupone C, Kang D-W, Adams JB. Gut bacteria in children with autism spectrum disorders: challenges and promise of studying how a complex community influences a complex disease. Microb Ecol Health Dis [Internet]. 2015 [cited 2017 Mar 13];26:26914. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25769266 .
    [Google Scholar]
  44. Colman RJ, Rubin DT. Fecal microbiota transplantation as therapy for inflammatory bowel disease: A systematic review and meta-analysis. Vol. 8, Journal of Crohn's and Colitis. 2014. p. 156981.
    [Google Scholar]
  45. Lam WC, Zhao C, Ma WJ, Yao L. The clinical and steroid-free remission of fecal microbiota transplantation to patients with ulcerative colitis: a meta-analysis. 2019 [cited 2020 Jun 24]; Available from: https://doi.org/10.1155/2019/1287493 .
  46. Kang DW, Adams JB, Gregory AC, Borody T, Chittick L, Fasano A, et al. Microbiota transfer therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: an open-label study. Microbiome. 2017; 5:(1).
    [Google Scholar]
  47. Greenhough B, Read CJ, Lorimer J, Lezaun J, McLeod C, Benezra A, et al. Setting the agenda for social science research on the human microbiome. Palgrave Commun [Internet]. 2020 Dec 1 [cited 2020 Jun 25]; 6:(1):111. Available from: https://www.nature.com/articles/s41599-020-0388-5 .
    [Google Scholar]
  48. Gu G, Ottesen A, Bolten S, Luo Y, Rideout S, Nou X. Microbiome convergence following sanitizer treatment and identification of sanitizer resistant species from spinach and lettuce rinse water. Int J Food Microbiol [Internet]. 2020 Apr 2 [cited 2020 Jun 25];318. Available from: https://pubmed.ncbi.nlm.nih.gov/31816526/.
    [Google Scholar]
  49. Pidot SJ, Gao W, Buultjens AH, Monk IR, Guerillot R, Carter GP, et al. Increasing tolerance of hospital Enterococcus faecium to handwash alcohols. Sci Transl Med [Internet]. 2018 Aug 1 [cited 2020 Jun 25];10(452). Available from: https://stm.sciencemag.org/content/10/452/eaar6115 .
    [Google Scholar]
  50. Dietert RR. The microbiome in early life: self-completion and microbiota protection as health priorities. Birth Defects Res Part B - Dev Reprod Toxicol. 2014; 101:(4):33340.
    [Google Scholar]
  51. York A. Microbiota succession in early life. Nat Res 2020 [Internet]. 2019 Jun 17 [cited 2020 Jun 25]; Available from: https://www.nature.com/articles/d42859-019-00010-6 .
    [Google Scholar]
  52. Black E, Cartwright A, Bakharaiba S, Al-Mekaty E, Alsahan D. A qualitative study of pharmacists’ perceptions of, and recommendations for improvement of antibiotic use in Qatar. Int J Clin Pharm [Internet]. 2014 Aug [cited 2020 Jun 4]; 36:(4):78794. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24899213 .
    [Google Scholar]
  53. Aljayyousi GF, Abdel-Rahman ME, El-Heneidy A, Kurdi R, Faisal E. Public practices on antibiotic use: a cross-sectional study among Qatar University students and their family members. PLoS One. 2019; 14:(11).
    [Google Scholar]
  54. Moienzadeh A, Massoud T, Black E. Evaluation of the general public's knowledge, views and practices relating to appropriate antibiotic use in Qatar. Int J Pharm Pract. 2017Apr1; 25:(2):1339.
    [Google Scholar]
  55. Hamad AF, Alessi-Severini S, Mahmud SM, Brownell M, fan Kuo I. Prenatal antibiotics exposure and the risk of autism spectrum disorders: a population-based cohort study. PLoS One [Internet]. 2019 [cited 2020 Jun 25];14(8). Available from: /pmc/articles/PMC6715235/?report = abstract.
    [Google Scholar]
  56. Łukasik J, Patro-Gołąb B, Horvath A, Baron R, Szajewska H, Besseling van der Vaart I, et al. Early life exposure to antibiotics and autism spectrum disorders: a systematic review. J Autism Dev Disord [Internet]. 2019 Sep 15 [cited 2020 Jun 25]; 49:(9):386676. Available from: https://link.springer.com/article/10.1007/s10803-019-04093-y .
    [Google Scholar]
  57. Lee E, Cho J, Kim KY. The association between autism spectrum disorder and pre-and postnatal antibiotic exposure in childhood—a systematic review with meta-analysis [Internet]. Vol. 16, IntJ Environ Res Public Health. MDPI AG; 2019 [cited 2020 Jun 25]. Available from: https://pubmed.ncbi.nlm.nih.gov/31652518/.
    [Google Scholar]
  58. Keen D V., Reid FD, Arnone D. Autism, ethnicity and maternal immigration. Br J Psychiatry [Internet]. 2010 Apr [cited 2020 Jun 25]; 196:(4):27481. Available from: https://pubmed.ncbi.nlm.nih.gov/20357302/.
    [Google Scholar]
  59. Zhang Y-J, Li S, Gan R-Y, Zhou T, Xu D-P, Li H-B. Impacts of gut bacteria on human health and diseases. Int J Mol Sci [Internet]. 2015 Apr 2 [cited 2017 Mar 13]; 16:(4):7493519. Available from: http://www.mdpi.com/1422-0067/16/4/7493/.
    [Google Scholar]
  60. Trompette A, Gollwitzer ES, Yadava K, Sichelstiel AK, Sprenger N, Ngom-Bru C, et al. Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis. Nat Med. 2014; 20:(2):15966.
    [Google Scholar]
  61. Chen Z, Guo L, Zhang Y, Walzem RL, Pendergast JS, Printz RL, et al. Incorporation of therapeutically modified bacteria into Gut microbiota inhibits obesity. J Clin Invest. 2014; 124:(8):3391406.
    [Google Scholar]
  62. Tandon D, Haque MM, R.S, Shaikh S, P.S, Dubey AK, et al. A snapshot of gut microbiota of an adult urban population from Western region of India. Arora PK, editor. PLoS One. 2018Apr; 13:(4):e0195643.
    [Google Scholar]
  63. Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995Jun; 125:(6):140112.
    [Google Scholar]
  64. Stilling RM, van de Wouw M, Clarke G, Stanton C, Dinan TG, Cryan JF. The neuropharmacology of butyrate: the bread and butter of the microbiota-gut-brain axis? Neurochem Int. 2016; 99::11032.
    [Google Scholar]
  65. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Heal Promot. 1997; 12:(1):3848.
    [Google Scholar]
  66. Nagpal R, Kumar A, Kumar M, Behare P V., Jain S, Yadav H. Probiotics, their health benefits and applications for developing healthier foods: a review. FEMS Microbiol Lett. 2012Sep; 334:(1):115.
    [Google Scholar]
  67. Moludi J, Maleki V, Jafari-Vayghyan H, Vaghef-Mehrabany E, Alizadeh M. Metabolic endotoxemia and cardiovascular disease: A systematic review about potential roles of prebiotics and probiotics. Clin Exp Pharmacol Physiol. 2020 Jan;1440-1681.13250.
    [Google Scholar]
  68. Akbari V, Hendijani F. Effects of probiotic supplementation in patients with type 2 diabetes: systematic review and meta-analysis. Nutr Rev.2016 Dec; 74:(12):77484.
    [Google Scholar]
  69. Kesika P, Sivamaruthi BS, Chaiyasut C. Do probiotics improve the health status of individuals with diabetes mellitus? A review on outcomes of clinical trials. Biomed Res Int. 2019Dec; 2019::111.
    [Google Scholar]
  70. Lau K, Benitez P, Ardissone A, Wilson TD, Collins EL, Lorca G, et al. Inhibition of type 1 diabetes correlated to a Lactobacillus johnsonii N6.2-mediated Th17 bias. J Immunol. 2011Mar; 186:(6):353846.
    [Google Scholar]
  71. Mangiola F, Ianiro G, Franceschi F, Fagiuoli S, Gasbarrini G, Gasbarrini A. Gut microbiota in autism and mood disorders. World J Gastroenterol. 2016; 22:(1):361.
    [Google Scholar]
  72. Zhang Y, Kutateladze TG. Diet and the epigenome. Nat Commun. 2018; 9:(1).
    [Google Scholar]
  73. Hashemzadeh M, Rahimi A, Zare-Farashbandi F, Alavi-Naeini A, Daei A. Transtheoretical model of health behavioral change: A systematic review [Internet]. Vol. 24, Iranian Journal of Nursing and Midwifery Research. Wolters Kluwer Medknow Publications; 2019 [cited 2020 Jun 25]. p. 83–90. Available from: /pmc/articles/PMC6390443/?report=abstract.
  74. Antonio J, Quaresma S, Poidinger M, Ohshima Y, Vitte J, Ghannoum MA, et al.The gut microbiome as a major regulator of the gut-skin axis. 2018 [cited 2019 Sep 16]; Available from: www.frontiersin.org .
  75. Tripathi A, Debelius J, Brenner DA, Karin M, Loomba R, Schnabl B, et al. The gut–liver axis and the intersection with the microbiome. Nat Rev Gastroenterol Hepatol [Internet]. 2018 [cited 2019 Sep 16]; Available from: https://doi.org/10.1038/.
    [Google Scholar]
  76. Miranda MCG, Oliveira RP, Torres L, Aguiar SLF, Pinheiro-Rosa N, Lemos L, et al. Frontline science: abnormalities in the gut mucosa of non-obese diabetic mice precede the onset of type 1 diabetes. J Leukoc Biol. 2019; 106:(3):51329.
    [Google Scholar]
  77. Salameh M, Burney Z, Mhaimeed N, Laswi I, Yousri NA, Bendriss G, et al.The role of gut microbiota in atopic asthma and allergy, implications in the understanding of disease pathogenesis. Vol. 91, Scand J Immunol. Blackwell Publishing Ltd; 2020.
  78. Parents Seek Help: Child with Severe Autism Eats Only Sweets | Autism Speaks [Internet]. [cited 2020 Jun 4]. Available from: https://www.autismspeaks.org/expert-opinion/parents-seek-help-child-severe-autism-eats-only-sweets .
  79. Fernandes AB, Alves da Silva J, Almeida J, Cui G, Gerfen CR, Costa RM, et al. Postingestive modulation of food seeking depends on vagus-mediated dopamine neuron activity. Neuron. 2020 Apr; 0:(0).
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2020.47
Loading
/content/journals/10.5339/qmj.2020.47
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): Autism , Awareness , dietary intervention , fecal transplants , gastrointestinal , health and Microbiota
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error