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The gut microbiota and host health: a new clinical frontier
  1. Julian R Marchesi1,2,
  2. David H Adams3,
  3. Francesca Fava4,
  4. Gerben D A Hermes5,6,
  5. Gideon M Hirschfield3,
  6. Georgina Hold7,
  7. Mohammed Nabil Quraishi3,
  8. James Kinross8,
  9. Hauke Smidt5,
  10. Kieran M Tuohy4,
  11. Linda V Thomas9,
  12. Erwin G Zoetendal5,6,
  13. Ailsa Hart10
  1. 1School of Biosciences, Museum Avenue, Cardiff University, Cardiff, UK
  2. 2Centre for Digestive and Gut Health, Imperial College London, London, UK
  3. 3NIHR Biomedical Research Unit, Centre for Liver Research, University of Birmingham, Birmingham, UK
  4. 4Nutrition and Nutrigenomics Group, Department of Food Quality and Nutrition, Research and Innovation Centre, Trento, Italy
  5. 5Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
  6. 6Top Institute Food and Nutrition (TIFN), Wageningen, The Netherlands
  7. 7Division of Applied Medicine, School of Medicine and Dentistry, University of Aberdeen, Institute of Medical Sciences, Aberdeen, UK
  8. 8Section of Computational and Systems Medicine, Faculty of Medicine, Imperial College London, London, UK
  9. 9Yakult UK Limited, Middlesex, UK
  10. 10IBD Unit, St Mark's Hospital and Imperial College London, London, UK
  1. Correspondence to Dr Ailsa Hart, IBD Unit, St Mark's Hospital and Imperial College London, Watford Road, London HA13UJ, UK; ailsa.hart{at}


Over the last 10–15 years, our understanding of the composition and functions of the human gut microbiota has increased exponentially. To a large extent, this has been due to new ‘omic’ technologies that have facilitated large-scale analysis of the genetic and metabolic profile of this microbial community, revealing it to be comparable in influence to a new organ in the body and offering the possibility of a new route for therapeutic intervention. Moreover, it might be more accurate to think of it like an immune system: a collection of cells that work in unison with the host and that can promote health but sometimes initiate disease. This review gives an update on the current knowledge in the area of gut disorders, in particular metabolic syndrome and obesity-related disease, liver disease, IBD and colorectal cancer. The potential of manipulating the gut microbiota in these disorders is assessed, with an examination of the latest and most relevant evidence relating to antibiotics, probiotics, prebiotics, polyphenols and faecal microbiota transplantation.


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