РОЛЬ КИШЕЧНОЙ МИКРОБИОТЫ В РАЗВИТИИ ОЖИРЕНИЯ
Авторы
- В. А. Воловникова Санкт-Петербургский государственный университет
- А. Д. Котрова Санкт-Петербургский государственный университет
- К. А. Иванова Санкт-Петербургский государственный университет
- Е. И. Ермоленко Санкт-Петербургский государственный университет; Институт экспериментальной медицины
- А. Н. Шишкин Санкт-Петербургский государственный университет
https://doi.org/10.32415/jscientia.2019.06.01
Ключевые слова:
ожирение, кишечная микробиота, пребиотики, пробиотики, бариатрическая хирургия, трансплантация фекальной микробиотыАннотация
Ожирение является глобальной эпидемией современности и имеет серьезные последствия для здоровья, так как является важнейшим фактором риска развития таких хронических заболеваний, как артериальная гипертензия, сахарный диабет 2 типа, дислипидемии, атеросклероз и его осложнения. Изучение факторов риска, патогенетических механизмов, а также поиск новых методов лечения и профилактики данной патологии является актуальной задачей современной медицины. На сегодняшний день известно, что определенную роль в развитии ожирения и ряда метаболических расстройств играют состав и функция микробиоты кишечника. Одним из направлений профилактики раннего возникновения и развития ассоциированных с ожирением заболеваний может быть поддержание нормального состава и коррекция нарушений экосистемы кишечника. В данном обзоре рассмотрены известные на сегодняшний день взаимосвязи изменений состава кишечной микробиоты и ожирения, проанализированы исследования, проведенные с целью оценки состава микробинома кишечника взрослого человека при ожирении. Представлены имеющиеся на сегодняшний день данные по коррекции избыточной массы и ожирения путем воздействия на состав кишечной микробиоты.
Библиографические ссылки
Bischoff SC, Boirie Y, Cederholm T, et al. Towards a multidisciplinary approach to understand and manage obesity and related diseases. Clin. Nutr. 2017;36:917-938. Doi: 10.1016/j.clnu.2016.11.007.
Engin A. The Definition and Prevalence of Obesity and Metabolic Syndrome. Adv. Exp. Med. Biol. 2017;960:1-17. Doi: 10.1007/978-3-319-48382-5_1.
World Health Organization. Obesity: Preventing and Managing the Global Epidemic. World Health Organization; Geneva, Switzerland: 2000.
Шендеров Б.А. Медицинская микробная экология: некоторые итоги и перспективы исследований // Вестник Российской Академии медицинских наук. 2005. № 12. С. 13-17. [SHenderov BA. Medicinskaya mikrobnaya ekologiya: nekotorye itogi i perspektivy issledovanij. Annals of the Russian academy of medical sciences. 2005;12:13-17. (In Russ).]
Ардатская М.Д., Минушкин О.Н. Современные принципы диагностики и фармакологической коррекции // Гастроэнтерология (Прил.). 2006. № 02. C. 4-17. [Ardatskaya MD, Minushkin ON. Sovremennye principy diagnostiki i farmakologicheskoj korrekcii. Consilium Medicum. Gastroenterologiya. (Suppl.) 2006;02:4-17. (In Russ).]
Гриневич В.Б., Захарченко М.М. Современные представления о значении кишечного микробиоценоза человека и способы коррекции его нарушений // Новые Санкт-Петербургские врачебные ведомости. 2003. № 3. С. 13–20. [Grinevich VB, Zaharchenko MM. Sovremennye predstavleniya o znachenii kishechnogo mikrobiocenoza cheloveka i sposoby korrekcii ego narushenij. Novye Sankt-Peterburgskie vrachebnye vedomosti. 2003;3:13-20. (In Russ).]
Cani PD, Delzenne NM. The role of the gut microbiota in energy metabolism and metabolic disease. Curr Pharm Des. 2009;15(13):1546-58.
Tilg H, Moschen AR, Kaser A. Obesity and the microbiota. Gastroenterology. 2009;136(5):1476-83. Doi: 10.1053/j.gastro.2009.03.030.
Tsukumo DM, Carvalho BM, Carvalho Filho MA, Saad MJ. Translational research into gut microbiota: new horizons on obesity treatment: updated 2014. Arch Endocrinol Metab. 2015;59(2):154-60. Doi: 10.1590/2359-3997000000029.
Ascher S, Reinhardt C. The gut microbiota: An emerging risk factor for cardiovascular and cerebrovascular disease. Eur J Immunol. 2018;48(4):564-575. Doi: 10.1002/eji.201646879.
Fialho A, Fialho A, Kochhar G, Schenone AL, et al. Association Between Small Intestinal Bacterial Overgrowth by Glucose Breath Test and Coronary Artery Disease. Dig Dis Sci. 2018;63(2):412-421. Doi: 10.1007/s10620-017-4828-z.
Kasselman LJ, Vernice NA, DeLeon J, Reiss AB. The gut microbiome and elevated cardiovascular risk in obesity and autoimmunity. Atherosclerosis. 2018;271:203-213. Doi: 10.1016/j.atherosclerosis.2018.02.036.
Cerdó T, Ruiz A, Acuña I, Jáuregui R, et al. Gut microbial functional maturation and succession during human early life. Environ Microbiol. 2018;20(6):2160-2177. Doi: 10.1111/1462-2920.14235.
Gilbert JA, Krajmalnik-Brown R, Porazinska DL, Weiss SJ, Knight R. Toward effective probiotics for autism and other neurodevelopmental disorders. Cell. 2013;155(7):1446-8. Doi: 10.1016/j.cell.2013.11.035.
Plaza-Diaz J, Ruiz-Ojeda FJ, Vilchez-Padial LM, Gil A. Evidence of the Anti-Inflammatory Effects of Probiotics and Synbiotics in Intestinal Chronic Diseases. Nutrients. 2017;9(6):555. Doi: 10.3390/nu9060555.
Plaza-Díaz J, Ruiz-Ojeda FJ, Gil-Campos M, Gil A. Immune-Mediated Mechanisms of Action of Probiotics and Synbiotics in Treating Pediatric Intestinal Diseases. Nutrients. 2018;10(1):42. Doi: 10.3390/nu10010042.
Hugon P, Lagier JC, Colson P, et al. Repertoire of human gut microbes. Microb Pathog. 2017;106:103-112. Doi: 10.1016/j.micpath.2016.06.020.
Callaway E. Microbiome privacy risk. Nature. 2015;521(7551):136. Doi: 10.1038/521136a.
Ursell LK, Clemente JC, Rideout JR, et al. The interpersonal and intrapersonal diversity of human-associated microbiota in key body sites. J Allergy Clin Immunol. 2012;129(5):1204-8. Doi: 10.1016/j.jaci.2012.03.010.
Yatsunenko T, Rey FE, Manary MJ, et al. Human gut microbiome viewed across age and geography. Nature. 2012;486(7402):222-7. Doi: 10.1038/nature11053.
Bäckhed F, Ley RE, Sonnenburg JL, Peterson DA, Gordon JI. Host-bacterial mutualism in the human intestine. Science. 2005;307(5717):1915-20. Doi: 10.1126/science.1104816.
Eckburg PB, Bik EM, Bernstein CN, Purdom E, et al. Diversity of the human intestinal microbial flora. Science. 2005;308(5728):1635-8. Doi: 10.1126/science.1110591.
Tap J, Mondot S, Levenez F, Pelletier E, et al. Towards the human intestinal microbiota phylogenetic core. Environ Microbiol. 2009;11(10):2574-84. Doi: 10.1111/j.1462-2920.2009.01982.x.
Halloran K, Underwood MA. Probiotic mechanisms of action. Early Hum Dev. 2019;Jun 4. Doi: 10.1016/j.earlhumdev.2019.05.010.
Ghadimi D, Vrese Md, Heller KJ, Schrezenmeir J. Effect of natural commensal-origin DNA on toll-like receptor 9 (TLR9) signaling cascade, chemokine IL-8 expression, and barrier integritiy of polarized intestinal epithelial cells. Inflamm Bowel Dis. 2010;16(3):410-27. Doi: 10.1002/ibd.21057.
Artis D. Epithelial-cell recognition of commensal bacteria and maintenance of immune homeostasis in the gut. Nat Rev Immunol. 2008;8(6):411-20. Doi: 10.1038/nri2316.
Ahmadmehrabi S, Tang WHW. Gut microbiome and its role in cardiovascular diseases. Curr Opin Cardiol. 2017;32(6):761-766. Doi: 10.1097/HCO.0000000000000445.
Gózd-Barszczewska A, Kozioł-Montewka M, Barszczewski P, Młodzińska A, Humińska K. Gut microbiome as a biomarker of cardiometabolic disorders. Ann Agric Environ Med. 2017;24(3):416-422. Doi: 10.26444/aaem/75456.
Яковлев М.Ю. Элементы эндотоксиновой теории физиологии и патологии человека // Физиол. человека. 2003. Т. 29. № 4. С. 476-485. [Yakovlev MY. Elementy endotoksinovoj teorii fiziologii i patologii cheloveka. Human Physiology. 2003;4:476-485. (In Russ).]
Ковальчук Л.В. Роль TOLL-подобных рецепторов и дефенсинов в противомикробной защите урогенитального тракта женщин // Журнал микробиологии, эпидемиологии и иммунобиологии. 2008. № 1. С. 46-50. [Koval'chuk LV. Rol' TOLL-podobnyh receptorov i defensinov v protivomikrobnoj zashchite urogenital'nogo trakta zhenshchin. Journal of Microbiology, Epidemiology and Immunobiology. 2008;1:46-50. (In Russ).]
Jovanovich A, Isakova T, Stubbs J. Microbiome and Cardiovascular Disease in CKD. Clin J Am Soc Nephrol. 2018;May 9. Doi: 10.2215/CJN.12691117.
Meijers B, Jouret F, Evenepoel P. Linking gut microbiota to cardiovascular disease and hypertension: Lessons from chronic kidney disease. Pharmacol Res. 2018;30(133):101-107. Doi: 10.1016/j.phrs.2018.04.023.
Yan Q, Gu Y, Li X, Yang W, et al. Alterations of the Gut Microbiome in Hypertension. Front Cell Infect Microbiol. 2017;24(7):381. Doi: 10.3389/fcimb.2017.00381.
Wu ZX, Li SF, Chen H, Song JX, et al. The changes of gut microbiota after acute myocardial infarction in rats. PLoS One. 2017;12(7):e0180717. Doi: 10.1371/journal.pone.0180717.
Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006;444(7122):1027-31. Doi: 10.1038/nature05414.
Sanchez-Alcoholado L, Castellano-Castillo D, Jordán-Martínez L, Moreno-Indias I, et al. Role of Gut Microbiota on Cardio-Metabolic Parameters and Immunity in Coronary Artery Disease Patients with and without Type-2 Diabetes Mellitus. Front Microbiol. 2017;8:1936. Doi: 10.3389/fmicb.2017.01936.
Goodrich JK, Waters JL, Poole AC, et al. Human genetics shape the gut microbiome. Cell. 2014;159:789-799. Doi: 10.1016/j.cell.2014.09.053.
Wang S, Charbonnier LM, Noval Rivas M, Georgiev P, et al. MyD88 Adaptor-Dependent Microbial Sensing by Regulatory T Cells Promotes Mucosal Tolerance and Enforces Commensalism. Immunity. 2015;43:289-303. Doi: 10.1016/j.immuni.2015.06.014.
Backhed F, Roswall J, Peng Y, Feng Q, et al. Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life. Cell Host Microbe. 2015;17:690-703. Doi: 10.1016/j.chom.2015.05.012.
Hsiao A, Ahmed AM, Subramanian S, Griffin NW, et al. Members of the human gut microbiota involved in recovery from Vibrio cholerae infection. Nature. 2014;515:423-426. Doi: 10.1038/nature13738.
David LA, Maurice CF, Carmody RN, Gootenberg DB, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505:559-563. Doi: 10.1038/nature12820.
Драпкина О.М., Корнеева О.Н. Кишечная микробиота и ожирение. Патогенетические взаимосвязи и пути нормализации кишечной микрофлоры // Терапевтический архив. 2016. Т. 88. № 9. С. 135-142. [Drapkina OM, Korneeva ON. Gut microbiota and obesity: Pathogenetic relationships and ways to normalize the intestinal microflora. Ter Arkh. 2016;88(9):135-142. (In Russ).] Doi: 10.17116/terarkh2016889135-142.
Falony G, Joossens M, Vieira-Silva S, Wang J, et al. Population-level analysis of gut microbiome variation. Science. 2016;352:560-564. Doi: 10.1126/science.aad3503.
Plaza-Diaz J, Ruiz-Ojeda FJ, Gil-Campos M, Gil A. Mechanisms of action of probiotics. Adv. Nutr. 2019;10:S49-S66. Doi: 10.1093/advances/nmy063.
Rothschild D, Weissbrod O, Barkan E, Kurilshikov A, et al. Environment dominates over host genetics in shaping human gut microbiota. Nature. 2018;555(7695):210-215. Doi: 10.1038/nature25973.
Huang T, Hu FB. Gene‐environment interactions and obesity: Recent developments and future directions. BMC Med Genomics. 2015;8(Suppl 1):S2. Doi: 10.1186/1755-8794-8-S1-S2.
Mustelin L, Silventoinen K, Pietilainen K, Rissanen A, Kaprio J. Physical activity reduces the influence of genetic effects on bmi and waist circumference: A study in young adult twins. Int J Obes (Lond). 2009;33(1):29-36. Doi: 10.1038/ijo.2008.258.
Корниенко Е.А. Современные представления о взаимосвязи ожирения и кишечной микробиоты // Педиатр. 2013. № 3. С. 3-14. [Kornienko EA. Contemporary Concepts Regarding Obesity – Intestinal Microbiota Relationship. Pediatr (St.-Peterbg.). 2013;(3):3-14. (In Rus).]
Backhed F, Manchester JK, Semenkovich CF, Gordon JI. Mechanisms underlying the resistance to diet‐induced obesity in germ‐free mice. Proceedings of the National Academy of Sciences. 2007;104(3):979-984. Doi: 10.1073/pnas.0605374104.
Ruth E. Ley, Fredrik Backhed, Peter Turnbaugh, Catherine A, et al. Obesity alters gut microbial ecology. Proceedings of the National Academy of Sciences. 2005;102(31):11070-11075. Doi: 10.1073/pnas.0504978102.
Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature. 2006;444(7122):1022-3. Doi: 10.1038/4441022a.
Ridaura VK, Faith JJ, Rey FE, Cheng J, Duncan AE, Kau AL, et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science. 2013;341(6150):1241214. Doi: 10.1126/science.1241214.
Ruan JW, Statt S, Huang CT, Tsai YT, Kuo CC, Chan HL, et al. Dual‐specificity phosphatase 6 deficiency regulates gut microbiome and transcriptome response against diet‐induced obesity in mice. Nat Microbiol. 2016;2:1622. Doi: 10.1038/nmicrobiol.2016.220.
Ridaura VK, Faith JJ, Rey FE, Cheng J, Duncan AE, Kau AL, et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science. 2013;341(6150):1241214. Doi: 10.1126/science.1241214.
Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: Human gut microbes associated with obesity. Nature. 2006;444:1022-1023. Doi: 10.1038/4441022a.
Turnbaugh PJ, Backhed F, Fulton L, Gordon JI. Diet-induced obesity is linked to marked but reversible alterations in the mouse distal gut microbiome. Cell Host Microbe. 2008;3:213-223.
Turnbaugh PJ, Hamady M, Yatsunenko T, Cantarel BL, et al. A core gut microbiome in obese and lean twins. Nature. 2009;457(7228):480-4. Doi: 10.1038/nature07540.
Marko Kalliomäki, Maria Carmen Collado, Seppo Salminen, Erika Isolauri. Early differences in fecal microbiota composition in children may predict overweight. Am J Clin Nutr. 2008;87(3):534-8. Doi: 10.1093/ajcn/87.3.534.
Santacruz A, Collado MC, García-Valdés L, Segura MT, et al. Gut microbiota composition is associated with body weight, weight gain and biochemical parameters in pregnant women. Br J Nutr. 2010;104(1):83-92. Doi: 10.1017/S0007114510000176.
Fei N, Zhao L. An opportunistic pathogen isolated from the gut of an obese human causes obesity in germfree mice. ISME J. 2013;7(4):880-4. Doi: 10.1038/ismej.2012.153.
Liu R, Hong J, Xu X, Feng Q, et al. Gut microbiome and serum metabolome alterations in obesity and after weight-loss intervention. Nat Med. 2017;23(7):859-868. Doi: 10.1038/nm.4358.
Trasande L, Blustein J, Liu M, Corwin E, Cox LM, Blaser MJ. Infant antibiotic exposures and early-life body mass. Int. J. Obes. 2013;37:16-23. Doi: 10.1038/ijo.2012.132.
Ajslev TA, Andersen CS, Gamborg M, Sorensen TI, Jess T. Childhood overweight after establishment of the gut microbiota: The role of delivery mode, pre-pregnancy weight and early administration of antibiotics. Int. J. Obes. 2011;35:522-529. Doi: 10.1038/ijo.2011.27.
Yallapragada SG, Nash CB, Robinson DT. Early-Life. Exposure to Antibiotics, Alterations in the Intestinal Microbiome, and Risk of Metabolic Disease in Children and Adults. Pediatr. Ann. 2015;44:e265-e269 Doi: 10.3928/00904481-20151112-09.
Reinhardt C, Reigstad CS, Bäckhed F. Intestinal microbiota during infancy and its implications for obesity. J. Pediatr. Gastroenterol. Nutr. 2009;48: 249-256.
Brown JM, Hazen SL. Microbial modulation of cardiovascular disease. Nat Rev Microbiol. 2018;16(3):171-181. Doi: 10.1038/nrmicro.2017.149.
John GK, Mullin GE. The Gut Microbiome and Obesity. Curr Oncol Rep. 2016;18(7):45. Doi: 10.1007/s11912-016-0528-7.
Cox AJ, West NP, Cripps AW. Obesity, inflammation, and the gut microbiota. Lancet Diabetes Endocrinol. 2015;3:207-215. Doi: 10.1016/S2213-8587(14)70134-2.
He M, Shi B. Gut microbiota as a potential target of metabolic syndrome: the role of probiotics and prebiotics. Cell Biosci. 2017;7:54. Doi: 10.1186/s13578-017-0183-1.
Morelli L, Capurso L. FAO/WHO guidelines on probiotics: 10 years later. J. Clin. Gastroenterol. 2012;46:S1-S2. Doi: 10.1097/MCG.0b013e318269fdd5.
Huaman J-W, Mego M, Manichanh C, Cañellas N, et al. Effects of prebiotics vs. a diet low in FODMAPs in patients with functional gut disorders. Gastroenterology. 2018;155:1004-1007. Doi: 10.1053/j.gastro.2018.06.045.
Gustaw W, Kozioł J, Radzki W, Skrzypczak K, et al. The effect of addition of selected milk protein preparations on the growth of Lactobacillus acidophilus and physicochemical properties of fermented milk. Acta Sci Pol Technol Aliment. 2016;15(1):29-36. Doi: 10.17306/J.AFS.2016.1.3.
Parnell JA, Raman M, Rioux KP, Reimer RA. The potential role of prebiotic fibre for treatment and management of non-alcoholic fatty liver disease and associated obesity and insulin resistance. Liver Int. 2012;32:701-711. Doi: 10.1111/j.1478-3231.2011.02730.x.
Avolio E, Gualtieri P, Romano L, Pecorella C, et al. Obesity and body composition in man and woman: associated diseases and new role of gut microbiota. Curr Med Chem. 2019 Mar 25. Doi: 10.2174/0929867326666190326113607.
Müller TD, Clemmensen C, Finan B, DiMarchi RD, Tschöp MH. Anti-Obesity Therapy: from Rainbow Pills to Polyagonists. Pharmacol Rev. 2018 ;70(4):712-746. Doi: 10.1124/pr.117.014803.
Yu LC, Wang JT, Wei SC, Ni YH. Host-microbial interactions and regulation of intestinal epithelial barrier function: From physiology to pathology. World J Gastrointest Pathophysiol. 2012;3(1):27-43. Doi: 10.4291/wjgp.v3.i1.27.
Barengolts E. Gut microbiota, prebiotics, probiotics, and synbiotics in management of obesity and prediabetes: review of randomized controlled trials. Endocr Pract. 2016;22(10):1224-1234. Doi: 10.4158/EP151157.RA.
Suzumura EA, Bersch-Ferreira ÂC, Torreglosa CR, da Silva JT, et al. Effects of oral supplementation with probiotics or synbiotics in overweight and obese adults: a systematic review and meta-analyses of randomized trials. Nutr Rev. 2019 Mar 28. Doi: 10.1093/nutrit/nuz001.
Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis. 2015;60 Suppl 2:S129-34. Doi: 10.1093/cid/civ085.
Cerdó T, García-Santos JA, G Bermúdez M, Campoy C. The Role of Probiotics and Prebiotics in the Prevention and Treatment of Obesity. Nutrients. 2019;11(3). Doi: 10.3390/nu11030635.
Nicoletti CF, Cortes-Oliveira C, Pinhel MAS, Nonino CB. Bariatric Surgery and Precision Nutrition. Nutrients. 2017;9:974. Doi: 10.3390/nu9090974.
Magouliotis DE, Tasiopoulou VS, Sioka E, Chatedaki C, Zacharoulis D. Impact of Bariatric Surgery on Metabolic and Gut Microbiota Profile: A Systematic Review and Meta-analysis. Obes. Surg. 2017;27:1345-1357. Doi: 10.1007/s11695-017-2595-8.
Anhe FF, Varin TV, Schertzer JD, Marette A. The Gut Microbiota as a Mediator of Metabolic Benefits after Bariatric Surgery. Can. J. Diabetes. 2017;41:439-447. Doi: 10.1016/j.jcjd.2017.02.002.
Zheng S, Shi J, Wu X, Peng Z, Xin C, et al. Presence of Torque teno sus virus 1 and 2 in porcine circovirus 3-positive pigs. Transbound. Emerg. Dis. 2018;65:327-330. Doi: 10.1111/tbed.12792.
Liou AP, Paziuk M, Luevano JM Jr, Machineni S, et al. Conserved shifts in the gut microbiota due to gastric bypass reduce host weight and adiposity. Sci. Transl. Med. 2013;5:178ra141. Doi: 10.1126/scitranslmed.3005687.
Palleja A, Kashani A, Allin KH, Nielsen T, et al. Roux-en-Y gastric bypass surgery of morbidly obese patients induces swift and persistent changes of the individual gut microbiota. Genome Med. 2016;8:67. Doi: 10.1186/s13073-016-0312-1.
Choi HH, Cho YS. Fecal Microbiota Transplantation: Current Applications, Effectiveness, and Future Perspectives. Clin Endosc. 2016;49:257-265. Doi: 10.5946/ce.2015.117.
Gundling F, Tiller M, Agha A, Schepp W, Iesalnieks I. Successful autologous fecal transplantation for chronic diversion colitis. Tech Coloproctol. 2015;19:51-52. Doi: 10.1007/s10151-014-1220-2.
Zoller V, Laguna AL, Prazeres Da Costa O, Buch T, et al. Fecal microbiota transfer (FMT) in a patient with refractory irritable bowel syndrome. Dtsch Med Wochenschr. 2015;140:1232-1236. Doi: 10.1055/s-0041-103798.
Bajaj JS, Kassam Z, Fagan A, et al. Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial. Hepatology. 2017;66:1727-1738. Doi: 10.1002/hep.29306.
Zhang F, Cui B, He X, et al. Microbiota transplantation: concept, methodology and strategy for its modernization. Protein Cell. 2018;9:462-473. Doi: 10.1007/s13238-018-0541-8.
Vrieze A, Van Nood E, Holleman F, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterol. 2012;143:913-916. Doi: 10.1053/j.gastro.2012.06.031.
Alang N, Kelly CR. Weight gain after fecal microbiota transplantation. Open Forum Infect Dis. 2015;2. Doi: 10.1093/ofid/ofv004.
Gundling F, Roggenbrod S, Schleifer S, Sohn M, Schepp W. Patient perception and approval of faecal microbiota transplantation (FMT) as an alternative treatment option for obesity. Obes Sci Pract. 2019;5(1):68-74. Doi: 10.1002/osp4.302.
Опубликован
Как цитировать
Выпуск
Раздел
Лицензия
Это произведение доступно по лицензии Creative Commons «Attribution» («Атрибуция») 4.0 Всемирная.
