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| 1 | Effect of fiber supplementation on the microbiota in critically ill patients显示文摘AIM:To determine tolerance to fiber supplementation of semi-elemental tube feeds in critically ill patients and measure its effect on colonic microbiota and fermentation.METHODS:Thirteen intensive care unit patients receiving jejunal feeding with a semi-elemental diet for predominantly necrotizing pancreatitis were studied.The study was divided into 2 parts:first,short-term (3-9 d)clinical tolerance and colonic fermentation as assessed by fecal short chain fatty acid(SCFA)concentrations and breath hydrogen and methane was measured in response to progressive fiber supplementation increasing from 4 g tid up to normal requirement levels of 8 g tid;second,4 patients with diarrhea were studied for 2-5 wk with maximal supplementation to additionally assess its influence on fecal microbiota quantitated by quantitative polymerase chain reaction (qPCR)of microbial 16S rRNA genes and Human Intestinal Tract Chip(HITChip)microarray analysis.Nearly all patients were receiving antibiotics(10/13)and acid suppressants(11/13)at some stage during the studies.RESULTS:In group 1,tolerance to progressive fiber supplementation was good with breath hydrogen and methane evidence(P=0.008 and P<0.0001,respectively)of increased fermentation with no exacerbation of abdominal symptoms and resolution of diarrhea in 2 of 4 patients.In group 2 before supplementation,fecal microbiota mass and their metabolites,SCFA,were dramatically lower in patients compared to healthy volunteers.From qPCR and HITChip analyses we calculated that there was a 97%reduction in the predominant potential butyrate producers and starch degraders.Following 2-5 wk of fiber supplementation there was a significant increase in fecal SCFA(acetate 28.4±4.1μmol/g to 42.5±3.1μmol/g dry weight,P=0.01;propionate 1.6±0.5 vs 6.22±1.1,P=0.006 and butyrate 2.5±0.6 vs 5.9±1.1,P=0.04)and microbial counts of specific butyrate producers,with resolution of diarrhea in 3 of 4 patients.CONCLUSION:Conventional management of critically ill patients,which includes the use of elemental diets and broad-spectrum antibiotics,was associated with gross suppression of the colonic microbiota and their production of essential colonic fuels,i.e.,SCFA.Our investigations show that fiber supplementation of the feeds has the potential to improve microbiota mass and function,thereby reducing the risks of diarrhea due to dysbiosis. | Stephen JD O'Keefe Junhai Ou James P DeLany Scott Curry Erwin Zoetendal H Rex Gaskins Scott Gunn | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，6： | 3 |
| 2 | Antibody therapy of cancer 显示文摘 | Scott AM Wolchok JD Old LJ | 2012 | Nat Rev Cancer2012，12，： | 1 |
| 3 | The molecular cloning of a type II regulatory subunit of the camp-dependent protein kinase form rat skeletal muscle and mouse brain显示文摘 | Scott JD Glaccum MB Zolier MJ | 1987 | Proc Natl Acad Sci USA1987，84，15： | 1 |
| 4 | Masked confirmation of linkage between type 1 congenital vitreous anomaly and COL 2A1 in Stickler syndrome显示文摘 | Snead MP Yates JR Pope FM Temple IK Scott JD | 1996 | Graefe Arch Clin Exp Ophthalmol1996，234，： | 1 |
| 5 | Calcineurin anchoring and cell signaling显示文摘 | Dodge KL Scott JD | 2003 | Biochem Biophys Res Commun2003，311，： | 1 |
| 6 | External fixation as a bridge to intramedullary nailing for patients with multiple injuries and with femur fractures:damage control orthopedics显示文摘 | Scalea TM Boswell SA Scott JD | 2000 | J Trauma2000，48，： | 1 |
| 7 | Acid volatile sulfide predicts the acute toxicity of cadmium and nickel in sediments显示文摘 | Di Taro DM Mahony JD Hansen D J Scott KJ Carlson AR Ankley GT | 1992 | Environ- mental Science and Technology1992，26，： | 1 |
| 8 | Etiology of late developingincisional hernias : the possible role of mechanical stress 显示文摘 | Urschel JD Scott PG Williams H | 1988 | MedHypotheses1988，25，1： | 1 |
| 9 | External fixation asa bridge to intramedullary nailing for patients with multipleinjuries and with femur fractures : damage control orthope-dics显示文摘 | Scalea TM Boswell SA Scott JD | 2000 | J Trauma2000，48，4： | 1 |
| 10 | Signaling through scaffold, anchoring, and adaptor proteins 显示文摘 | Pawson T JD Scott | 1997 | Science1997，278，5346： | 1 |
| 11 | The mid-thigh loop arte- riovenousgraft: patient selection, technique, and results显示文摘 | Scott JD Cull SL Kalbaugh CA | 2006 | Am Surg2006，72，9： | 1 |
| 12 | Antibody therapy of cancer 显示文摘 | Scott AM Wolchok JD Old LI | 2012 | Nat Rev Cancer2012，12，4： | 1 |
| 13 | MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder显示文摘 | Bremner JD Randall P Scott TM | 1995 | Am J Psychiat1995，152，7： | 1 |
| 14 | Mediastinal lymph node staging of non-small-cell lung cancer:a prospective comparison of computed tomography and positron emission tomography显示文摘 | Scott WJ Gobar LS Terry JD Dewan NA | 1996 | J Thorac Cardiovasc Surg1996，111，3： | 1 |
| 15 | Signaling through scaffold, anchoring, and adaptorproteins显示文摘 | Pawson T Scott JD | 1997 | Science1997，278，5346： | 1 |
| 16 | Acute zonal occult outer reti- nopathy:a long term follow-up study显示文摘 | Gass JD Agarwal A Scott IU | 2002 | Am J Ophthalmol2002，134，3： | 1 |
| 17 | Recursive partitionging analysis of 1999 Readiation Therapy Oncology Group (RTOG) patients with locally-advanced non-small-cell lung cancer (LA_NSCLC) : identification of five groups with different survival显示文摘 | Werner-Wasik M Scott C Cox JD | 2000 | Int J Radiat Oncol Boil Phys2000，48，： | 1 |
| 18 | External fixation as a bridge to intramedullary nailing for patients with multiple injuries and with femur fractures :damage control orthopedics 显示文摘 | Scalea TM Boswell SA Scott JD | 2000 | J Trauma2000，48，4： | 1 |
| 19 | Antibody therapy of cancer显示文摘 | Scott AM Wolchok JD Old LJ | | 0，，： | 1 |
| 20 | Monoclonal antibodies in cancer therapy显示文摘 | Scott AM Allison JP Wolchok JD | | 0，，： | 1 |
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