[Endometriosis and microbiom]

Az endometriosis multifaktoriális betegség, melynek szűrése és kezelése komoly kihívások elé állítja a nőgyógyászokat. Jelenleg a hormonális kezelés – például GnRH-agonista injekciók, gesztagénimplantátumok – és az érintett szövet műtéti eltávolítása, illetve méretének csökkentése az endometriosis leggyakoribb kezelési módszerei. Jelenleg megbízható noninvazív módszerek hiányában az endometriosis igazolásának legbiztosabb módszere a műtéti feltárás. Kutatócsoportunk – részben saját eredményekre támaszkodva, részben széles körű irodalmi adatok alapján – arra a következtetésre jutott, hogy az alsó, illetve felső női genitalis traktus és a bél mikrobiomja kiemelkedő szerepet játszik az endometriosis kialakulásában. Az említett területek baktériumközösségének jelenleginél részletesebb feltérképezése fontos lépés lehet az endometriosis patomechanizmusának megértésében, és új diagnosztikai módszereket is biztosíthat a klinikum számára. A mikrobiom-vizsgálatok összehasonlíthatósága azonban megköveteli, hogy a jövőbeli, prospektív vizsgálatok során szigorú és standardizált módszertant alkalmazzanak annak érdekében, hogy tisztázni lehessen a mikrobiom pontos szerepét a betegség patogenezisében, a klinikai kép formálásában és a terápia monitorozásában. Orv Hetil. 2024; 165(1): 3–13.

The effects of per- and polyfluoroalkyl substances on environmental and human microorganisms and their potential for bioremediation

Utilised in a variety of consumer products, per- and polyfluoroalkyl substances (PFAS) are major environmental contaminants that accumulate in living organisms due to their highly hydrophobic, lipophobic, heat-resistant, and non-biodegradable properties. This review summarizes their effects on microbial populations in soils, aquatic and biogeochemical systems, and the human microbiome. Specific microbes are insensitive to and even thrive with PFAS contamination, such as Escherichia coli and the Proteobacteria in soil and aquatic environments, while some bacterial species, such as Actinobacteria and Chloroflexi, are sensitive and drop in population. Some bacterial species, in turn, have shown success in PFAS bioremediation, such as Acidimicrobium sp. and Pseudomonas parafulva.

Folgen nach SARS-CoV-2-Infektion einschließlich Post-COVID-Syndrom

Eine Infektion mit dem „severe acute respiratory syndrome coronavirus type 2“ (SARS-CoV-2) kann vielfältige gastroenterologische Symptome hervorrufen. Ein relevanter Anteil an Patient:innen klagt über Symptome einer Gastroenteritis; die Zahl der Betroffenen hat mit der Verbreitung der Omikron-Varianten zugenommen. Ebenso finden sich bei Infizierten Zeichen einer Leberbeteiligung, die sich durch erhöhte Leberfermente bis hin zu einer akuten Dekompensation ausdrückt. Bei Patient:innen mit vorbestehenden Lebererkrankungen kann sich diese in der akuten Phase der Infektion verschlechtern und z. B. in ein akut-auf-chronisches Leberversagen übergehen. Hiervon abzugrenzen sind langfristige Folgen der SARS-CoV-2-Infektion. Diese können sich entweder als direkte infektions- oder therapieassoziierte Folgen, wie der Entwicklung einer sekundär-sklerosierenden Cholangitis nach Intensivtherapie, äußern oder als Symptome im Rahmen eines Post-coronavirus-disease(COVID)-Syndroms. Dessen Pathophysiologie ist weiterhin ungeklärt; hier wird ein Einfluss des intestinalen Mikrobioms diskutiert. In dieser Übersichtsarbeit werden die akuten Symptome und chronischen Folgen einer SARS-CoV-2-Infektion, mit denen man im Alltag zunehmend konfrontiert wird, dargestellt.

[Fat tissue as the primary target organ of insulin resistance in diabetes mellitus.]

Insulin resistance is a pathological condition in which the effect of endogenous or externally administered (exogenous) insulin to promote tissue glucose uptake and utilization falls short of that observed in metabolically healthy individuals. It affects the entire organism, but the pathogenetic and underlying molecular biological processes of its selected target tissues - the liver, muscle and adipose tissue - are partially different. Recently, knowledge about the role of adipose tissue has expanded significantly, and it increasingly seems that dysfunctional adipose tissue is the central player in these pathological events. The manuscript reviews the structure of adipose tissue, the regulation of adipogenesis and lipolysis, data on the relationship between the microbiome and adipose tissue, the typical differences of the acute and chronic insulin resistance as well as the therapeutic tools currently available to reduce adipose tissue insulin resistance. It may well be that a molecule with a selective adipose tissue attack point and enabling safe long-term use in humans is not yet within the hoped-for proximity, the first animal experimental observations related to the first "adipeuticum" being under development outline the promise of a new treatment option. Orv Hetil. 2023; 164(1): 3-10.

[The role of the microbiome in otorhinolaryngology]

Our health is highly determined by the diverse microbial community living within our body and upon our skin. Balance among the members of the commensal microbiota is essential for the preservation of health. New generation sequencing is a rapid, sensitive method for determining the whole microbiome without prior hypothesis and also gives information on the resistance and virulence status. Application of this method can help to identify the pathogens contributing to different diseases, and also the protective bacteria inhibiting their growth. Detecting the changes of the microbiome helps to identify new therapeutic targets and establish targeted antibiotic therapy. Broad-spectrum antibiotics also act against the beneficial members of the microbial flora, which may lead to the development of recurrent or chronic disease. Ear, nose and throat infections are the most common infective diseases in humans and the leading cause for antibiotic prescription worldwide. In recent years, many studies using molecular biology methods were performed examining the microbiome of healthy humans and in otorhinolaryngologic diseases. In the present work, the authors review the changes of the microbiological communities in the healthy state and in various pathologic states in the anatomic regions of the ear, nose and throat. Orv Hetil. 2019; 160(39): 1533-1541.

[The role of gut microbiota in chronic liver diseases, and treatment possibilities]

The community of microorganisms in the intestine, namely gut microbiome lives in symbiosis with the host, contributing to its homeostasis and influencing it simultaneously. It can be suspected that gut microbiome plays a central role in the pathophysiology of intestinal and extraintestinal diseases: determining their development, progress and complications. Recently, intestinal microbiome has become a highlighted field of interest and important topic in research, especially in hepatology. It is in the focus of relevant research as the liver is the organ which meets nutrients, bacterial components, toxins and metabolites at first, as a filter. The evolvement of different liver diseases - just like alcoholic and non-alcoholic fatty liver disease, steatohepatitis, cirrhosis or hepatocellular carcinoma - correlates with the changed composition and activity of gut microbiome. Thus, it can be hypothesized that pre-, pro- and antibiotics could have an impact on the treatment of these diseases. In our review article, the relationship between intestinal flora and liver diseases with different etiologies as well as therapeutic possibilities are discussed. Orv Hetil. 2018; 159(36): 1465-1474.

[Review of the relation between gut microbiome, metabolic disease and hypertension]

Gut flora has personal characteristics for each individual, similar to the fingerprints, consisting of a special mixture of bacterial species living in the intestines, now referred to as the gut microbiome. There is a strong correlation between the loss of microbial diversity and the functional bowel disorders, obesity, type 2 diabetes and cardiovascular disease as well as many autoimmune disorders. With genetic testing of stool diversity of the gut microbiome and exact analysis of the species and phylogenetic classification of the gut flora, the changes of diversity can be identified and the overgrowth of some bacteria can be revealed. In cases with pre- and manifest hypertension, an overgrowth of species from the phylum Firmicutes has been reported along with the relative decline of the phylum Bacteroidetes as opposed with cases of normotension. At the same time, the physiological balance among bacterial families was lost. According to the first studies, there is a correlation between hypertension and the lost balance of the gut microflora, both in animal experiments and in the human clinical setting. This evidence also suggests that targeted dietary alteration of the gut microbiome can be a new innovative approach in the treatment of hypertension. Orv Hetil. 2018; 159(9): 346-351.