Publications by authors named "Anne Salonen"

79 Publications

Early-life gut microbiota and its connection to metabolic health in children: Perspective on ecological drivers and need for quantitative approach.

EBioMedicine 2021 Jul 10;69:103475. Epub 2021 Jul 10.

Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland. Electronic address:

The colonisation and development of the gut microbiota has been implicated in paediatric metabolic disorders via its powerful effect on host metabolic and immune homeostasis. Here we summarise the evidence from human studies on the early gut microbiota and paediatric overweight and obesity. Manipulation of the early gut microbiota may represent a promising target for countering the burgeoning metabolic disorders in the paediatric population, provided the assembly patterns of microbiota and their health consequences can be decoded. Therefore, in this review, we pay particular attention to the important ecological drivers affecting the community dynamics of the early gut microbiota. We then discuss the knowledge gaps in commonly studied exposures linking the gut microbiota to metabolic disorders, especially regarding maternal factors and antibiotic use. This review also attempts to give directions for future studies aiming to identify predictive and corrective measures for paediatric metabolic disorders based on the gut microbiota. Gut microbiota; Metabolism; Paediatric overweight and obesity; Ecological driver; Dynamics; Infants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ebiom.2021.103475DOI Listing
July 2021

Cast immobilisation in situ versus open reduction and internal fixation of displaced medial epicondyle fractures in children between 7 and 16 years old. A study protocol for a randomised controlled trial.

BMJ Open 2021 05 3;11(5):e044627. Epub 2021 May 3.

Department of Pediatric Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Uusimaa, Finland.

Introduction: Medial epicondyle fracture of the humerus is a common injury in childhood. There is uniform agreement that minimally displaced fractures (dislocation ≤2 mm) can be treated nonoperatively with immobilisation. Open fractures, fractures with joint incarceration or ulnar nerve dysfunction require surgery. There is no common consensus in treatment of closed medial epicondyle fractures with >2 mm dislocation without joint incarceration or ulnar nerve dysfunction. We hypothesise that there is no difference in treatment outcomes between nonoperative and operative treatment.

Methods And Analysis: This is a multicentre, controlled, prospective, randomised noninferiority study comparing operative treatment to non-operative treatment of >2 mm dislocated paediatric medial epicondyle fractures without joint incarceration or ulnar nerve dysfunction. A total of 120 patients will be randomised in 1:1 ratio to either operative or nonoperative treatment. The study will have a parallel nonrandomised patient preference arm. Operative treatment will be open reduction and internal fixation. Nonoperative treatment will be upper limb immobilisation in long arm cast for 4 weeks. Data will be collected at baseline and at each follow-up up to 2 years. Quick-DASH is used as primary outcome measure. Secondary outcomes are patient-reported pain, differences in range of motion, Pediatric Quality of Life Inventory, cosmetic visual analogue scale and Mayo Elbow Performance Score.

Ethics And Dissemination: Ethical approval has been obtained from Helsinki University Hospital (HUS) ethical board HUS/1443/2019. Each study centre has obtained their own permission for the study. A written authorisation from legal guardian will be acquired and the child will be informed about the trial. Results of the trial will be disseminated as published articles in peer-reviewed journals.

Trial Registration: The trial has been registered at clinicaltrials.gov with registration number NCT04531085.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2020-044627DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098981PMC
May 2021

Commentary: How to Count Our Microbes? The Effect of Different Quantitative Microbiome Profiling Approaches.

Front Cell Infect Microbiol 2021 5;11:627910. Epub 2021 Mar 5.

Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fcimb.2021.627910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982878PMC
July 2021

Protocol for oral transplantation of maternal fecal microbiota to newborn infants born by cesarean section.

STAR Protoc 2021 Mar 15;2(1):100271. Epub 2021 Jan 15.

Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland.

Infants born by cesarean section have an intestinal microbiota that differs from that of infants delivered vaginally. Here, we report a protocol for performing oral transplantation of maternal fecal microbiota to newborn infants born by elective cesarean section. The crucial step of this protocol is the health screening process. This protocol can only be applied to healthy mothers and infants. For complete details on the use and execution of this protocol, please refer to Korpela et al. (2020).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.xpro.2020.100271DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817495PMC
March 2021

Bacterial and Fungal Profiles as Markers of Infliximab Drug Response in Inflammatory Bowel Disease.

J Crohns Colitis 2021 Jun;15(6):1019-1031

Translational Immunology Research Program, University of Helsinki, Helsinki, Finland.

Background And Aims: Inflammatory bowel diseases [IBDs], Crohn's disease [CD] and ulcerative colitis [UC], are globally increasing chronic gastro-intestinal inflammatory disorders associated with altered gut microbiota. Infliximab [IFX], a tumour necrosis factor [TNF]-alpha blocker, is used to treat IBD patients successfully, though one-third of the patients do not respond to therapy. No reliable biomarkers are available for prediction of IFX response. Our aims were to investigate the faecal bacterial and fungal communities during IFX therapy and find predictors for IFX treatment response in IBD patients.

Methods: A total of 72 IBD patients [25 CD and 47 UC] started IFX therapy and were followed for 1 year or until IFX treatment was discontinued. An amplicon sequencing approach, targeting the bacterial 16S rRNA gene and fungal ITS 1 region separately, was used to determine the microbiota profiles in faecal samples collected before IFX therapy and 2, 6, and 12 weeks and 1 year after initiation of therapy. The response to IFX was evaluated by colonoscopy and clinically at 12 weeks after initiation.

Results: Both faecal bacterial and fungal profiles differed significantly between response groups before start of IFX treatment. Non-responders had lower abundances of short chain fatty acid producers, particularly of the class Clostridia, and higher abundances of pro-inflammatory bacteria and fungi, such as the genus Candida, compared with responders. This was further indicated by bacterial taxa predicting the response in both CD and UC patients [area under the curve >0.8].

Conclusions: Faecal bacterial and fungal microbiota composition could provide a predictive tool to estimate IFX response in IBD patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ecco-jcc/jjaa252DOI Listing
June 2021

Influence of Depressive Symptoms on the Outcome of Lumbar Spine Fusion-A 5-year Follow-up Study.

Spine (Phila Pa 1976) 2021 Mar;46(6):408-412

Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland.

Study Design: Prospective follow-up study.

Objective: The aim of this study was to assess whether depressive symptoms change the outcome of lumbar spine fusion (LSF) surgery at a 5-year follow-up.

Summary Of Background Data: Previous reports of the influence of depressive symptoms on the results of spine surgery are controversial, but the patient characteristics and indications for surgery varied widely between the studies. The influence of depressive symptoms on the 5-year outcome of LSF has not been studied.

Methods: The study was based on data from a local LSF database from two hospitals comprising 392 consecutive patients (mean age 61 years, 277 women) who underwent an instrumented LSF and fulfilled the 5-year follow-up. At the 5-year follow-up, the patients were compared with a control group from the general population (n = 477, age-, sex-, and residential area-matched) extracted from Official Statistics of Finland. The prevalence of depressive symptoms was evaluated using the Depression Scale (DEPS; 0-30) and disability was evaluated by the Oswestry Disability Index (ODI; 0-100%). A DEPS score ≥12 was considered to indicate depressive symptoms.

Results: Before surgery, 35% of the patients had depressive symptoms. The proportion diminished to 13% at 3 months postoperatively and increased to 24% at 5 years. In the population, the prevalence was 11% at baseline and 10% at the 5-year follow-up. The preoperative ODI was 54 in the patients with depressive symptoms, and it was 41 in the patients with no depressive symptoms. The changes at 5-year follow-up were -20 and -18, correspondingly. The same congruence was preserved when analyzing short and long fusions separately. These changes were statistically and clinically significant. In the control population, the ODI remained around 24 in depressive people and 10 in nondepressive people.

Conclusion: Our data suggest that patients with and without depressive symptoms may benefit equally well from LSF.

Level Of Evidence: 3.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/BRS.0000000000003803DOI Listing
March 2021

Maternal Fecal Microbiota Transplantation in Cesarean-Born Infants Rapidly Restores Normal Gut Microbial Development: A Proof-of-Concept Study.

Cell 2020 10 1;183(2):324-334.e5. Epub 2020 Oct 1.

Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; Laboratory of Microbiology, Wageningen University, 6703 WE Wageningen, the Netherlands. Electronic address:

Infants born by vaginal delivery are colonized with maternal fecal microbes. Cesarean section (CS) birth disturbs mother-to-neonate transmission. In this study (NCT03568734), we evaluated whether disturbed intestinal microbiota development could be restored in term CS-born infants by postnatal, orally delivered fecal microbiota transplantation (FMT). We recruited 17 mothers, of whom seven were selected after careful screening. Their infants received a diluted fecal sample from their own mothers, taken 3 weeks prior to delivery. All seven infants had an uneventful clinical course during the 3-month follow-up and showed no adverse effects. The temporal development of the fecal microbiota composition of FMT-treated CS-born infants no longer resembled that of untreated CS-born infants but showed significant similarity to that of vaginally born infants. This proof-of-concept study demonstrates that the intestinal microbiota of CS-born infants can be restored postnatally by maternal FMT. However, this should only be done after careful clinical and microbiological screening.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cell.2020.08.047DOI Listing
October 2020

Shilla Growth Guidance Compared With Magnetically Controlled Growing Rods in the Treatment of Neuromuscular and Syndromic Early-onset Scoliosis.

Spine (Phila Pa 1976) 2020 Dec;45(23):E1604-E1614

Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Study Design: Retrospective review of consecutive series of patients treated at two institutions.

Objective: The aim of this study was to compare the health-related quality of life (HRQoL) and surgical outcomes of Shilla growth guidance and magnetically controlled growing rod (MCGR) treatment in patients with syndromic and neuromuscular early-onset scoliosis (EOS).

Summary Of Background Data: Knowledge of the outcomes of Shilla instrumentation is limited.

Methods: We identified 13 children treated with Shilla and 18 children treated with MCGR with syndromic or neuromuscular EOS (major curve ≥45 degree) before the age of 10 years with minimum 2-year follow-up. Outcome parameters included clinical data, radiographic as well as HRQoL outcomes (EOSQ-24 questionnaire).

Results: Mean preoperative major curves were 64 degree (range, 45-108 degree) in the Shilla group and 58 degree (range, 45-85 degree) in the MCGR group (P = 0.151). At final follow-up, mean major curves were 31 degree (range, 9.4-54 degree ) and 30 degree (range, 16-53 degree), respectively (P = 0.392). The mean major curve correction was 45% in the Shilla group and 48% in the MCGR group during the follow-up (P = 0.383). Spinal (T1-S1) and T1-T12 growth were significantly better (P = 0.006 and 0.042) in the MCGR than in the Shilla group during the distraction period. At final follow-up, 11 (85%) children in the Shilla group and 17 (94%) in the MCGR group had achieved T1-T12 length of ≥18 cm (P = 0.202). There were significantly more surgical procedures in the MCGR group (mean 2.6 vs. 1.4, P = 0.034) with no difference in the number of complications (P = 0.768). EOSQ24 domains were similar at final follow-up.

Conclusion: Shilla growth guidance provided similar correction of spinal deformity, equal number of complications, but with significantly less surgical procedures in patients treated for EOS when compared with MCGR instrumentation. MCGR provided with slightly better spinal growth during the distraction period. There were no significant differences between the quality of life assessments.

Level Of Evidence: 3.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/BRS.0000000000003654DOI Listing
December 2020

The prevention paradox applies to some but not all gambling harms: Results from a Finnish population-representative survey.

J Behav Addict 2020 Jun 7;9(2):371-382. Epub 2020 Jul 7.

3Finnish Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland.

Background And Aims: The Prevention Paradox (PP) suggests that a large proportion of aggregate harm from gambling occurs to people who do not have a gambling disorder. However, it has not yet been tested using a population-representative sample. We aimed to test whether the PP applies to gambling in Finland. The prevalence rates of diverse harmful consequences from gambling were surveyed amongst a population-representative sample of past-year gamblers.

Methods: The study used first wave data (N = 7,186) of Finnish Gambling Harms survey, collected via online and postal surveys in 2017. A subset of 3,795 adults (≥18 years), who had gambled at least monthly in 2016, were selected for analysis.

Measurements: Gambling-related harms were evaluated with the 72-item Harms Checklist. Problem and Pathological Gambling Measure (PPGM) measured respondents' probable disordered gambling from the subset of items for impaired control (4 questions) and other issues (3 questions).

Findings: Consistent with previous findings, the majority of harms were reported by those in the less severe PPGM categories (i.e. scoring <5). However, considering each domain separately, this was true only for financial, emotional/psychological, and work/study harms. The PP was not supported for health, relationship, or social deviance harms.

Conclusions: The population prevalence of the most serious harms (e.g. unsafe living conditions) is concentrated among those with severe impaired control issues. However, even excluding the ∼15% of harms occurring to occasional gamblers, most financial, emotional and work/study impacts occur to those with lower levels of control issues. Efforts at harm reduction should focus on the entire spectrum of issues that people experience from their gambling.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1556/2006.2020.00018DOI Listing
June 2020

Impact of short-term overfeeding of saturated or unsaturated fat or sugars on the gut microbiota in relation to liver fat in obese and overweight adults.

Clin Nutr 2021 01 16;40(1):207-216. Epub 2020 May 16.

Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland. Electronic address:

Backgrounds & Aims: Intestinal microbiota may be causally involved in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). We aimed to study the effect of short-term overfeeding on human gut microbiota in relation to baseline and overfeeding-induced liver steatosis. We also asked whether the baseline microbiota composition is associated to the overfeeding-induced increase in liver fat.

Methods: In a randomized trial, 38 overweight and obese subjects were assigned to consume an excess of 1000 kcal/day of diets rich in either saturated fat, unsaturated fat, or simple sugars for 3 weeks. Fasting blood samples and H-MR spectroscopy were used for extensive clinical phenotyping as previously reported (PMID: 29844096). Fecal samples were collected for the analysis of the gut microbiota using 16S rRNA amplicon sequencing, imputed metagenomics and qPCR. Microbiota results were correlated with dietary intakes and clinical measurements before and during overfeeding.

Results: The overall community structure of the microbiota remained highly stable and personalized during overfeeding based on between-sample Bray-Curtis dissimilarity, but the relative abundances of individual taxa were altered in a diet-specific manner: overfeeding saturated fat increased Proteobacteria, while unsaturated fat increased butyrate producers. Sugar overfeeding increased Lactococcus and Escherichia coli. Imputed functions of the gut microbiota were not affected by overfeeding. Several taxa affected by overfeeding significantly correlated with the changes in host metabolic markers. The baseline levels of proteobacterial family Desulfovibrionaceae, and especially genus Bilophila, were significantly associated to overfeeding-induced liver fat increase independently of the diet arm. In general, limited overlap was observed between the overfeeding-induced microbiota changes and the liver fat-associated microbiota features at baseline.

Conclusions: Our work indicates that the human gut microbiota is resilient to short-term overfeeding on community level, but specific taxa are altered on diet composition-dependent manner. Generalizable microbiota signatures directly associated with liver steatosis could not be identified. Instead, the carriage of Bilophila was identified as a potential novel risk factor for diet-induced liver steatosis in humans. Clinical trial registry number: NCT02133144 listed on NIH website: ClinicalTrials.gov.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clnu.2020.05.008DOI Listing
January 2021

The incidence of birth injuries decreased in Finland between 1997 and 2017: A nationwide register study.

Acta Paediatr 2020 12 13;109(12):2562-2569. Epub 2020 Apr 13.

Department of Emergency, Anesthesia and Pain Medicine, Tampere University Hospital, Tampere, Finland.

Aim: Birth injuries are rare complications that can have a significant impact on neonates and their families. This population-based study describes the rates and trends of all birth injuries in Finland over a 21-year period.

Methods: The study is based on a national Medical Birth Register that includes all live-born neonates of more than 22 gestational weeks or 500 g who were born in Finland between 1997 and 2017. The ICD-10 codes of the birth injuries were obtained from the Finnish Medical Birth Register and the Care Register for Health Care. The incidence of birth injury, changes over time and incidence at different gestational ages were determined.

Results: A total of 28 551 birth injuries were diagnosed, and the total incidence decreased from 34.0 to 16.6 per 1000 live births. The incidence of clavicle fracture, cephalohaematoma, and Erb paralysis decreased while the incidence of chignon and epicranial subaponeurotic haemorrhage increased.

Conclusion: The incidence of birth injury halved during the 20-year study period. This was mainly due to a decrease in the number of clavicle fractures. The incidence of birth injury increased with gestational age, and most injuries occurred after 37 weeks of gestation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/apa.15267DOI Listing
December 2020

Randomised clinical trial: effect of low-FODMAP rye bread versus regular rye bread on the intestinal microbiota of irritable bowel syndrome patients: association with individual symptom variation.

BMC Nutr 2019 6;5:12. Epub 2019 Mar 6.

3Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Background: A low intake of Fermentable, Oligo-, Di-, Mono-saccharides and Polyols (FODMAPs) is effective in the symptom control of irritable bowel syndrome (IBS) patients but may exert negative effects on the intestinal microbiota. The microbial effects of increasing regular or non-FODMAP fibre sources are largely unknown. Furthermore, it is not known if the baseline microbiota composition is associated with individual symptom control during the consumption of different rye products in IBS patients. Our objective was to evaluate whether increased consumption of low-FODMAP rye bread or regular rye bread for 4 weeks would alter the intestinal microbiota composition of IBS patients following their habitual diet, and whether these changes associate to symptoms and/or the baseline microbiota.

Methods: The study was conducted as a randomized double blind controlled cross-over study ( = 50). Microbiota was analysed by 16S rRNA gene sequencing and associated with gastrointestinal symptoms. Both microbial changes and their associations to symptoms were secondary outcomes.

Results: The consumption of the test breads did not alter microbiota diversity. Compared to baseline, consumption of the low FODMAP rye bread decreased the abundance of , , and and showed a trend towards increased bifidobacteria, whereas the regular rye bread decreased the abundance of When comparing between the two test breads, was decreased after low-FODMAP rye bread intake Patients whose symptoms decreased during the low-FODMAP rye bread displayed more and less at baseline.

Conclusions: Consumption of low-FODMAP rye bread had modest, potentially beneficial effects on patients' microbiota while increasing their intake of fibre substantially. The baseline microbiota composition was associated with the variable degrees of symptom relief experienced by the patients. Consumption of a low-FODMAP rye bread might be one way to increase dietary fibre intake and improve the mild dysbiosis often observed among patients with IBS.

Trial Registration: ClinicalTrials.gov: NCT02161120. Retrospectively registered 11 June 2014.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s40795-019-0278-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050854PMC
March 2019

Antibiotics in early life associate with specific gut microbiota signatures in a prospective longitudinal infant cohort.

Pediatr Res 2020 09 18;88(3):438-443. Epub 2020 Jan 18.

Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Background: The effects of antibiotics on infant gut microbiota are unclear. We hypothesized that the use of common antibiotics results in long-term aberration in gut microbiota.

Methods: Antibiotic-naive infants were prospectively recruited when hospitalized because of a respiratory syncytial virus infection. Composition of fecal microbiota was compared between those receiving antibiotics during follow-up (prescribed at clinicians' discretion because of complications such as otitis media) and those with no antibiotic exposure. Fecal sampling started on day 1, then continued at 2-day intervals during the hospital stay, and at 1, 3 and 6 months at home.

Results: One hundred and sixty-three fecal samples from 40 patients (median age 2.3 months at baseline; 22 exposed to antibiotics) were available for microbiota analyses. A single course of amoxicillin or macrolide resulted in aberration of infant microbiota characterized by variation in the abundance of bifidobacteria, enterobacteria and clostridia, lasting for several months. Recovery from the antibiotics was associated with an increase in clostridia. Occasionally, antibiotic use resulted in microbiota profiles associated with inflammatory conditions.

Conclusions: Antibiotic use in infants modifies especially bifidobacterial levels. Further studies are warranted whether administration of bifidobacteria will provide health benefits by normalizing the microbiota in infants receiving antibiotics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41390-020-0761-5DOI Listing
September 2020

Quantitative PCR provides a simple and accessible method for quantitative microbiota profiling.

PLoS One 2020 15;15(1):e0227285. Epub 2020 Jan 15.

Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

The use of relative abundance data from next generation sequencing (NGS) can lead to misinterpretations of microbial community structures, as the increase of one taxon leads to the concurrent decrease of the other(s) in compositional data. Although different DNA- and cell-based methods as well as statistical approaches have been developed to overcome the compositionality problem, and the biological relevance of absolute bacterial abundances has been demonstrated, the human microbiome research has not yet adopted these methods, likely due to feasibility issues. Here, we describe how quantitative PCR (qPCR) done in parallel to NGS library preparation provides an accurate estimation of absolute taxon abundances from NGS data and hence provides an attainable solution to compositionality in high-throughput microbiome analyses. The advantages and potential challenges of the method are also discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227285PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961887PMC
May 2020

Vaginal microbiota in pregnancy: Role in induction of labor and seeding the neonate''s microbiota?

J Biosci 2019 Oct;44(5)

Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Compared to other human microbiota, vaginal microbiota is fairly simple with low bacterial diversity and high relative abundance of Lactobacillus species. Lactobacillus dominance is even more pronounced during pregnancy. Genetic factors, such as ethnicity, along with environmental, individual and lifestyle factors all have an impact on vaginal microbiota composition. The composition of the vaginal microbiota appears to play an important role in pregnancy as recent studies have linked it to adverse obstetric outcomes such as preterm birth, a leading cause of neonatal morbidity and mortality worldwide. However, the same vaginal microbiota does not seem to cause the same response in all women, calling for future research to fully understand the complex host-microbiota interplay in normal and complicated pregnancies.
View Article and Find Full Text PDF

Download full-text PDF

Source
October 2019

The Winners and the Losers: Tax Incidence of Gambling in Finland.

J Gambl Stud 2020 Dec;36(4):1183-1204

Department of Public Health Solutions, Alcohol, Drugs and Addictions Unit, Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271, Helsinki, Finland.

Gambling markets have grown rapidly for the last few decades. As a result, gambling is also a very important and common source of tax income for many governments these days. This raises a question about the overall fairness of the gambling taxation systems. In this paper, we aim to study the tax incidence of gambling in Finland. First, we analyse who are the expected payers of the gambling taxes and second, who are expected to be the receivers of the gambling-tax based contributions. In the first part of the study, we analyse the demographic incidence of gambling taxation by using the Finnish gambling 2015 population survey combined with registry based variables. Our data contains 3776 individuals. In the second part of the study, we use data of county level gambling-taxation based contributions to different organisations to analyse how the gambling expenditures are distributed back to citizens in a form of public spending. This study shows that different socio-demographic factors have diverse association with the decisions whether or how much to gamble. The results also suggest that more disadvantaged, i.e. lower income, less educated and rural area living, individuals are expected to be the "losers" of the Finnish gambling taxation system. In other words, the Finnish gambling system is found to be regressive by nature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10899-019-09899-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674355PMC
December 2020

Problem gambling and support preferences among Finnish prisoners: a pilot study in an adult correctional population.

Int J Prison Health 2019 12 16;15(4):316-331. Epub 2019 Aug 16.

Alcohol Drugs and Addictions Unit, National Institute for Health and Welfare, Helsinki, Finland.

Purpose: The purpose of this paper is to explore the prevalence of potential problem gambling among Finnish prisoners; the associations between problem gambling and demographics, substance use and crime-related factors; and problem gamblers' support preferences.

Design/methodology/approach: Prisoners (=96) from two Finnish prisons were recruited between December 2017 and January 2018. The estimated response rate was 31 percent. Gambling problems were measured using the Brief Biosocial Gambling Screen. The participants were asked to report their gambling both for one year prior to their incarceration and for the past year. The independent variables were demographics (age, gender and marital status), substance use (alcohol, smoking and narcotics) and crime-related factors (crime type, prison type and previous sentence). Statistical significance () was determined using Fischer's exact test.

Findings: Past-year pre-conviction problem gambling prevalence was 16.3 percent and past-year prevalence 15 percent. Age, gender, smoking, alcohol or illicit drug use were not associated with past-year problem gambling before sentencing. One-third of the prisoners (33.3 percent) who were sentenced for a property crime, financial crime or robbery were problem gamblers. One-quarter (24 percent) of all participants showed an interest in receiving support by identifying one or more support preferences. The most preferred type of support was group support in its all forms.

Research Limitations/implications: It is recommended that correctional institutions undertake systematic screening for potential problem gambling, and implement tailored intervention programs for inmates with gambling problems.

Originality/value: This study provides a deeper understanding of problem gambling in prisons. Problem gambling is associated with crime and also seems to be linked with serving a previous sentence. Early detection and tailored interventions for problem gambling may help to reduce reoffending rates.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1108/IJPH-07-2018-0041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761914PMC
December 2019

Treating gambling disorder with as needed administration of intranasal naloxone: a pilot study to evaluate acceptability, feasibility and outcomes.

BMJ Open 2019 08 21;9(8):e023728. Epub 2019 Aug 21.

Alcohol, Drugs and Addictions Unit, Terveyden ja hyvinvoinnin laitos, Helsinki, Finland.

Background And Aim: There is growing interest in the use of medication-assisted treatments for gambling disorder (GD). Opioid receptor antagonists are hypothesised to blunt the craving associated with gambling. This study was designed to assess the feasibility of using an intranasal naloxone spray to treat GD.

Design: An 8-week, open-label, uncontrolled pilot study.

Setting: A single study site in the capital region of Finland.

Subjects: Twenty problem gamblers (nine men) were randomised into two groups. Group A (n=10) took one dose into one nostril (2 mg naloxone), as needed, with a maximum of 4 doses/day (max. 8 mg/day). Group B (n=10) took one dose into each nostril (4 mg naloxone) as needed, with a maximum of 4 doses/day (max. 16 mg/day).

Intervention: Naloxone hydrochloride nasal spray.

Measures: Acceptability and feasibility of the intervention were assessed. Use of study medication, adverse events, gambling frequency and gambling expenditure were recorded in a mobile diary. Problem gambling: South Oaks Gambling Screen (SOGS), depressive symptoms: Beck Depression Inventory (BDI) and alcohol use: Alcohol Use Disorders Identification Test were recorded.

Results: Study completion rate was 90%. Acceptability and feasibility scores were high. Group B used intranasal naloxone more frequently than group A, and consequently used more naloxone. No serious adverse events were reported. The postintervention SOGS scores were lower (median=4 (IQR=3.75) versus preintervention scores (median=12 (IQR=4.75)). Depressive symptoms were reduced during the trial (preintervention BDI median=9, IQR=9 vs postintervention BDI median=6, IQR=6).

Conclusions: The acceptability and feasibility of using intranasal naloxone were high, and no serious adverse events were reported. Preliminary results suggest mixed results in terms of gambling behaviour (ie, reduced frequency but not expenditure) and decreased depressive symptoms.

Trial Registration Number: EudraCT2016-001828-56.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-023728DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707653PMC
August 2019

Cohort profile: Finnish Health and Early Life Microbiota (HELMi) longitudinal birth cohort.

BMJ Open 2019 06 27;9(6):e028500. Epub 2019 Jun 27.

Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Purpose: HELMi (Health and Early Life Microbiota) is a longitudinal, prospective general population birth cohort, set up to identify environmental, lifestyle and genetic factors that modify the intestinal microbiota development in the first years of life and their relation to child health and well-being.

Participants: The HELMi cohort consists of 1055 healthy term infants born in 2016-2018 mainly at the capital region of Finland and their parents. The intestinal microbiota development of the infants is characterised based on nine, strategically selected, faecal samples and connected to extensive online questionnaire-collected metadata at weekly to monthly intervals focusing on the diet, other exposures and family's lifestyle as well as the health and growth of the child. Motor and cognitive developmental screening takes place at 18 months. Infant's DNA sample, mother's breast milk sample and both parent's spot faecal samples have been collected.

Findings To Date: The mean age of the mothers was 32.8 (SD 4.1) and fathers/coparents 34.8 (5.3) years at the time of enrolment. Seventeen percentage (n=180) of the infants were born by caesarean section. Just under half (49%) were firstborns; 50.7% were males. At 3 months of age, 86% of the babies were exclusively breastfed and 2% exclusively formula-fed.

Future Plans: The current follow-up from pregnancy to first 24 months will be completed in March 2020, totalling to over 10 000 biological samples and over 50 000 questionnaire entries. The results are expected to identify environmental and host factors that affect early gut microbiota development and health, and hence give indications of how to prevent or reverse microbiota perturbations in infancy. This prospective cohort will be followed up further to identify how the early microbiota relates to later health outcomes, especially weight gain, infections and allergic and other chronic diseases.

Trial Registration Number: NCT03996304; Pre-results.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-028500DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609051PMC
June 2019

Vaginal Microbiota Composition Correlates Between Pap Smear Microscopy and Next Generation Sequencing and Associates to Socioeconomic Status.

Sci Rep 2019 05 23;9(1):7750. Epub 2019 May 23.

Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Recent research on vaginal microbiota relies on high throughput sequencing while microscopic methods have a long history in clinical use. We investigated the correspondence between microscopic findings of Pap smears and the vaginal microbiota composition determined by next generation sequencing among 50 asymptomatic women. Both methods produced coherent results regarding the distinction between Lactobacillus-dominant versus mixed microbiota, reassuring gynaecologists for the use of Pap smear or wet mount microscopy for rapid evaluation of vaginal bacteria as part of diagnosis. Cytologic findings identified women with bacterial vaginosis and revealed that cytolysis of vaginal epithelial cells is associated to Lactobacillus crispatus-dominated microbiota. Education and socio-economic status were associated to the vaginal microbiota variation. Our results highlight the importance of including socio-economic status as a co-factor in future vaginal microbiota studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-019-44157-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533281PMC
May 2019

The Effect of Allogenic Versus Autologous Fecal Microbiota Transfer on Symptoms, Visceral Perception and Fecal and Mucosal Microbiota in Irritable Bowel Syndrome: A Randomized Controlled Study.

Clin Transl Gastroenterol 2019 04;10(4):e00034

Nutrition-Gut-Brain Interactions Research Centre, Faculty of Health and Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden.

Objectives: Fecal microbiota transfer (FMT) is suggested as a potential treatment for patients with irritable bowel syndrome (IBS). We aimed to study the effect of allogenic and autologous FMT on IBS symptoms, visceral sensitivity, and compositional changes in fecal and mucosa-adherent microbiota.

Methods: Seventeen patients with IBS were randomized either to receive fecal material from a healthy donor (allogenic) or to receive their own fecal material (autologous). The fecal material was administered into the cecum by whole colonoscopy after bowel cleansing.

Results: No significant differences were found between the allogenic and the autologous FMT regarding symptom scores. However, symptom scores of patients receiving allogenic fecal material significantly decreased after FMT compared with baseline (P = 0.02), which was not the case in the autologous group (P = 0.16). Visceral sensitivity was not affected except for a small beneficial effect on urge scores in the autologous group (P < 0.05). While both fecal and mucosa-adherent microbiota of some patients shifted to their respective donor's fecal microbiota, some patients showed no relevant microbial changes after allogenic FMT. Large compositional shifts in fecal and mucosa-adherent microbiota also occurred in the autologous group.

Conclusions: This study showed that a single FMT by colonoscopy may have beneficial effects in IBS; however, the allogenic fecal material was not superior to the autologous fecal material. This suggests that bowel cleansing prior to the colonoscopy and/or processing of the fecal material as part of the FMT routine contribute to symptoms and gut microbiota composition changes in IBS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14309/ctg.0000000000000034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602784PMC
April 2019

Gambling involvement, type of gambling and grade point average among 18-29-year-old Finnish men and women.

Nordisk Alkohol Nark 2019 Apr 9;36(2):190-202. Epub 2019 Apr 9.

National Institute for Health and Welfare, Helsinki, Finland.

Aims: This study explores the associations between gambling involvement, type of gambling, at-risk and problem gambling (ARPG) and register-based grade point average (GPA), among Finnish people aged 18-29 years ( = 676). It is assumed that high gambling involvement and engaging in certain types of gambling are linked to ARPG, and that low school achievement is positively associated with these measures.

Methods: A nationwide cross-sectional random sample was collected in 2015. The data were weighted based on gender, age and region. Analyses were carried out using logistic regression models.

Results: Frequent gambling, playing several game types, online gambling and ARPG were more common among men than women. Those with low GPA played fast and low-paced daily lottery games and used online casinos significantly more often than men and women with average/high GPA. Men with a low GPA were also more likely to gamble on a weekly basis and played casino games and online poker more often. For women with a low GPA online gambling and playing slot machines were more common than for women with an average/high GPA. When controlling for sociodemographic variables and gambling involvement, men's participation in daily lottery games and online poker was significantly associated with a low GPA, but among women none of the game types remained statistically significant. Among women, playing several different game types was linked with a low GPA.

Conclusions: It seems that poorer school achievement is associated not only with frequent gambling, a large number of game types played and online gambling, but also, to some extent at least, with game type preferences.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1455072518800189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434129PMC
April 2019

Probiotic supplementation restores normal microbiota composition and function in antibiotic-treated and in caesarean-born infants.

Microbiome 2018 10 16;6(1):182. Epub 2018 Oct 16.

Immunobiology Research Programme, Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland.

Background: Infants born by caesarean section or receiving antibiotics are at increased risk of developing metabolic, inflammatory and immunological diseases, potentially due to disruption of normal gut microbiota at a critical developmental time window. We investigated whether probiotic supplementation could ameliorate the effects of antibiotic use or caesarean birth on infant microbiota in a double blind, placebo-controlled randomized clinical trial. Mothers were given a multispecies probiotic, consisting of Bifidobacterium breve Bb99 (Bp99 2 × 10 cfu) Propionibacterium freundenreichii subsp. shermanii JS (2 × 10cfu), Lactobacillus rhamnosus Lc705 (5 × 10 cfu) and Lactobacillus rhamnosus GG (5 × 10 cfu) (N = 168 breastfed and 31 formula-fed), or placebo supplement (N = 201 breastfed and 22 formula-fed) during pregnancy, and the infants were given the same supplement. Faecal samples of the infants were collected at 3 months and analyzed using taxonomic, metagenomic and metaproteomic approaches.

Results: The probiotic supplement had a strong overall impact on the microbiota composition, but the effect depended on the infant's diet. Only breastfed infants showed the expected increase in bifidobacteria and reduction in Proteobacteria and Clostridia. In the placebo group, both birth mode and antibiotic use were significantly associated with altered microbiota composition and function, particularly reduced Bifidobacterium abundance. In the probiotic group, the effects of antibiotics and birth mode were either completely eliminated or reduced.

Conclusions: The results indicate that it is possible to correct undesired changes in microbiota composition and function caused by antibiotic treatments or caesarean birth by supplementing infants with a probiotic mixture together with at least partial breastfeeding.

Trial Registration: clinicaltrials.gov NCT00298337 . Registered March 2, 2006.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s40168-018-0567-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192119PMC
October 2018

Fucosylated oligosaccharides in mother's milk alleviate the effects of caesarean birth on infant gut microbiota.

Sci Rep 2018 09 13;8(1):13757. Epub 2018 Sep 13.

Immunobiology Research Programme, Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland.

One of the most abundant components in human milk is formed by oligosaccharides, which are poorly digested by the infant. The oligosaccharide composition of breast milk varies between mothers, and is dependent on maternal secretor (FUT2) genotype. Secretor mothers produce milk containing α1-2 fucosylated human milk oligosaccharides, which are absent in the milk of non-secretor mothers. Several strains of bacteria in the infant gut have the capacity to utilise human milk oligosaccharides (HMOs). Here we investigate the differences in infant gut microbiota composition between secretor (N = 76) and non-secretor (N = 15) mothers, taking into account birth mode. In the vaginally born infants, maternal secretor status was not associated with microbiota composition. In the caesarean-born, however, many of the caesarean-associated microbiota patterns were more pronounced among the infants of non-secretor mothers compared to those of secretor mothers. Particularly bifidobacteria were strongly depleted and enterococci increased among the caesarean-born infants of non-secretor mothers. Furthermore, Akkermansia was increased in the section-born infants of secretor mothers, supporting the suggestion that this organism may degrade HMOs. The results indicate that maternal secretor status may be particularly influential in infants with compromised microbiota development, and that these infants could benefit from corrective supplementation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-018-32037-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137148PMC
September 2018

Trends in gambling participation and gambling severity among Finnish men and women: cross-sectional population surveys in 2007, 2010 and 2015.

BMJ Open 2018 08 23;8(8):e022129. Epub 2018 Aug 23.

The Alcohol, Drugs and Addictions Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.

Objective: The aim of this study is to evaluate trends in past-year gambling participation and gambling severity among Finnish men and women from 2007 to 2015.

Design: Cross-sectional population surveys from years 2007, 2011 and 2015.

Setting: Data were drawn from the population register and collected using computer-assisted telephone interviews.

Participants: Representative random samples of Finns aged 15-74 were drawn in the study in 2007 (n=5008), 2011 (n=4484) and 2015 (n=4515) with response rates of 58%, 40% and 62%, respectively.

Outcome Measures: The outcome measures were gambling versatility, type of games, gambling intensity and gambling severity. Significance (p) between time points was determined using χ tests. All temporal comparisons between 2007-2011, 2011-2015 and 2007-2015 were performed separately for all respondents aged 15-74 and for women and men.

Results: Gambling participation overall showed a rising trend (6.6 percentage points, 95% CI 4.9 to 8.3) from 2007 to 2015. In 2007-2011 women's gambling participation increased more (7.8 percentage points, 95% CI 5.5 to 10.4) than men's (5.4 percentage points, 95% CI 3.2 to 7.6). The most popular game types since 2007 have been lottery games, scratch cards and electronic gaming machines (EGMs). EGM gambling, on the other hand, has decreased since 2007. Online gambling has increased significantly from 2007 to 2015 in both genders. Men's at-risk gambling decreased from 2007 to 2011, while women's at-risk gambling and problem gambling increased from 2011 to 2015.

Conclusions: Women's increasing gambling participation is causing gender differences in gambling behaviour to narrow. The article concludes with a discussion of the need for gender-specific interventions aimed at preventing gambling-related harm and ultimately at protecting the most vulnerable groups.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-022129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112397PMC
August 2018

Gambling expenditure by game type among weekly gamblers in Finland.

BMC Public Health 2018 06 5;18(1):697. Epub 2018 Jun 5.

Alcohol, Drugs and Addictions Unit, National Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland.

Background: Excessive expenditure and financial harms are core features of problem gambling. There are various forms of gambling and their nature varies. The aim was to measure gambling expenditure by game type while controlling for demographics and other gambling participation factors. A further aim was to find out how each game type was associated with gambling expenditure when the number of game types played is adjusted for.

Methods: Using data from the 2015 Finnish Gambling survey on adult gamblers (n = 3555), multiple log-linear regression was used to examine the effects of demographics, gambling participation, and engaging in different game types on weekly gambling expenditure (WGE) and relative gambling expenditure (RGE).

Results: Male gender, lower education level, higher gambling frequency and higher number of game types increased both WGE and RGE, while younger age decreased WGE but increased RGE. Furthermore, seven specific game types increased both WGE and RGE. Weekly horse race betting and non-monopoly gambling had the strongest increasing effect on expenditure. Betting games and online poker were associated with higher expenditure even when they were played less often than weekly. Among weekly gamblers the highest mean WGE was recorded for those who played non-monopoly games (146.84 €/week), online poker (59.61 €/week), scratch games (51.77 €/week) and horse race betting (48.67 €/week). Those who played only 1-2 game types a week had the highest mean WGE and RGE on horse race betting and other betting games.

Conclusions: It seems that overall gambling frequency is the strongest indicator of high gambling expenditure. Our results showed that different game types had different effect sizes on gambling expenditure. Weekly gambling on horse races and non-monopoly games had the greatest increasing effect on expenditure. However, different game types also varied based on their popularity. The extent of potential harms caused by high expenditure therefore also varies on the population level. Based on our results, future prevention and harm minimization efforts should be tailored to different game types for greater effectiveness.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-018-5613-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989364PMC
June 2018

Gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising in Finland in 2016.

Nordisk Alkohol Nark 2018 Jun 11;35(3):215-234. Epub 2018 Apr 11.

National Institute for Health and Welfare, Finland; and University of Helsinki, Finland.

Background: This report is an overview of results from the 2016 Finnish Gambling Harms Survey covering the population and clinical perspectives. It summarises the main findings on gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising.

Methods: The population sample ( = 7186) was collected from three regions and the clinical sample ( = 119) in a gambling help clinic.

Results: Frequency of gambling in the population sample was characteristically once a week, while in the clinical sample it was daily. Men gambled more often than women only in the population sample. The most common gambling environments were kiosks, grocery stores or supermarkets, and home. The most typical gambling-related harms were financial or emotional/psychological harms; the amount of experienced harm was considerable among the clinical sample. The clinical sample also perceived gambling advertising as obtrusive and as a driving force for gambling.

Conclusions: The results of the clinical sample imply that when gambling gets out of hand, the distinctions between gamblers' habits diminish and become more streamlined, focusing on gambling per se - doing it often, and in greater varieties (different game types). There is a heightened need to monitor gambling and gambling-related harm at the population level, especially amongst heavy consumers, in order to understand what type of external factors pertaining to policy and governance may contribute to the shift from recreational to problem gambling.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1455072518765875DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434154PMC
June 2018

Saturated Fat Is More Metabolically Harmful for the Human Liver Than Unsaturated Fat or Simple Sugars.

Diabetes Care 2018 08 29;41(8):1732-1739. Epub 2018 May 29.

Minerva Foundation Institute for Medical Research, Helsinki, Finland

Objective: Nonalcoholic fatty liver disease (i.e., increased intrahepatic triglyceride [IHTG] content), predisposes to type 2 diabetes and cardiovascular disease. Adipose tissue lipolysis and hepatic de novo lipogenesis (DNL) are the main pathways contributing to IHTG. We hypothesized that dietary macronutrient composition influences the pathways, mediators, and magnitude of weight gain-induced changes in IHTG.

Research Design And Methods: We overfed 38 overweight subjects (age 48 ± 2 years, BMI 31 ± 1 kg/m, liver fat 4.7 ± 0.9%) 1,000 extra kcal/day of saturated (SAT) or unsaturated (UNSAT) fat or simple sugars (CARB) for 3 weeks. We measured IHTG (H-MRS), pathways contributing to IHTG (lipolysis ([H]glycerol) and DNL (HO) basally and during euglycemic hyperinsulinemia), insulin resistance, endotoxemia, plasma ceramides, and adipose tissue gene expression at 0 and 3 weeks.

Results: Overfeeding SAT increased IHTG more (+55%) than UNSAT (+15%, < 0.05). CARB increased IHTG (+33%) by stimulating DNL (+98%). SAT significantly increased while UNSAT decreased lipolysis. SAT induced insulin resistance and endotoxemia and significantly increased multiple plasma ceramides. The diets had distinct effects on adipose tissue gene expression.

Conclusions: Macronutrient composition of excess energy influences pathways of IHTG: CARB increases DNL, while SAT increases and UNSAT decreases lipolysis. SAT induced the greatest increase in IHTG, insulin resistance, and harmful ceramides. Decreased intakes of SAT could be beneficial in reducing IHTG and the associated risk of diabetes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2337/dc18-0071DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082640PMC
August 2018

Intestinal Microbiota in Hirschsprung Disease.

J Pediatr Gastroenterol Nutr 2018 11;67(5):594-600

Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital.

Objectives: The aim of the study was to characterize the microbiota profiles of patients with Hirschsprung disease (HD) and to evaluate this in relation to postoperative bowel function and the incidence of Hirschsprung-associated enterocolitis (HAEC).

Methods: All patients operated on for HD at our center between 1987 and 2011 were invited to answer questionnaires on bowel function and to participate in a clinical follow-up for laboratory investigations, including fecal DNA extraction, fecal calprotectin (FC), and brush border lactase (LCT) genotyping. The microbiota compositions of patients with HD were compared with those of healthy controls aged between 2 and 7 years.

Results: The microbiota composition of eligible patients with HD (n = 34; median age 12 [range, 3-25] years) differed from the healthy controls (n = 141), showing decreased overall microbial richness (P < 0.005). Seventy-seven percent had experienced HAEC. Normal maturation of the intestinal flora was not observed, but patients had a significantly increased abundance of Proteobacteria among other taxa (P < 0.005) resulting in a reduced carbohydrate degradation potential, as predicted by the taxonomic composition. Genetic lactase deficiency was present in 17% and did not correlate with bowel symptoms. No patients reported active HAEC at the time of sampling and FC was within the normal range in all samples.

Conclusions: Patients with HD and HAEC had a significantly altered intestinal microbiome compared to healthy individuals, characterized by a lack of richness and pathologic expansions of taxa, particularly Enterobacteria and Bacilli. Further evaluation is needed to identify whether these observations are intrinsic to HD or secondary to the recurrent use of antibiotics during early childhood.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MPG.0000000000001999DOI Listing
November 2018

Towards standards for human fecal sample processing in metagenomic studies.

Nat Biotechnol 2017 Nov 2;35(11):1069-1076. Epub 2017 Oct 2.

Danone Nutricia Research, Palaiseau, France.

Technical variation in metagenomic analysis must be minimized to confidently assess the contributions of microbiota to human health. Here we tested 21 representative DNA extraction protocols on the same fecal samples and quantified differences in observed microbial community composition. We compared them with differences due to library preparation and sample storage, which we contrasted with observed biological variation within the same specimen or within an individual over time. We found that DNA extraction had the largest effect on the outcome of metagenomic analysis. To rank DNA extraction protocols, we considered resulting DNA quantity and quality, and we ascertained biases in estimates of community diversity and the ratio between Gram-positive and Gram-negative bacteria. We recommend a standardized DNA extraction method for human fecal samples, for which transferability across labs was established and which was further benchmarked using a mock community of known composition. Its adoption will improve comparability of human gut microbiome studies and facilitate meta-analyses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/nbt.3960DOI Listing
November 2017