Publications by authors named "Emad M El-Omar"

Article Synopsis
  • A pilot study aimed to identify a microbial signature for endometriosis as a non-invasive diagnostic tool was conducted in Australia, involving 64 participants divided into three groups: healthy controls, non-endometriosis patients, and those with confirmed endometriosis.
  • Self-collected samples from the oral cavity, stool, and vagina were analyzed using advanced sequencing techniques to uncover differences in microbial composition among the groups, with significant findings from both oral and stool microbiota.
  • Results revealed distinct microbiota profiles, particularly highlighting that Fusobacterium was more abundant in the oral samples of patients with moderate to severe endometriosis, suggesting the potential of using microbiome analysis for diagnosis and treatment strategies in endometriosis.
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  • The text discusses how changes in the microbiome can impact chronic diseases and therapies, leading to the development of microbiota-centered treatments like probiotics and faecal microbiota transplantation.
  • It highlights the confusion surrounding the term 'dysbiosis' and the challenge of defining what a 'healthy microbiome' is, questioning which group of individuals truly represents health.
  • The review emphasizes the need for a more nuanced understanding of gut health, considering various individual, dietary, and environmental factors, as well as the complexities in measuring gut function.
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Objective: During the last decade, the management of gastric intestinal metaplasia (GIM) has been addressed by several distinct international evidence-based guidelines. In this review, we aimed to synthesise these guidelines and provide clinicians with a global perspective of the current recommendations for managing patients with GIM, as well as highlight evidence gaps that need to be addressed with future research.

Design: We conducted a systematic review of the literature for guidelines and consensus statements published between January 2010 and February 2023 that address the diagnosis and management of GIM.

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  • Chemotherapy can lead to premature ovarian insufficiency (CIPOI) in women, causing loss of fertility and no effective treatments currently exist.
  • Fecal microbiota transplantation studies in mice show that an unhealthy gut microbiome contributes to ovarian problems in CIPOI, particularly due to a decrease in certain beneficial bacteria (Limosilactobacillus reuteri) and its byproducts.
  • Supplementing with L. reuteri or its compound β-resorcylic acid (β-RA) helps protect ovarian health, maintains hormone balance, and prevents apoptosis of key ovarian cells, suggesting new avenues for preserving fertility during cancer treatment.
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At the end of the last century, a far-sighted 'working party' held in Sydney, Australia addressed the clinicopathological issues related to gastric inflammatory diseases. A few years later, an international conference held in Houston, Texas, USA critically updated the seminal Sydney classification. In line with these initiatives, Kyoto Global Consensus Report, flanked by the Maastricht-Florence conferences, added new clinical evidence to the gastritis clinicopathological puzzle.

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  • The study evaluated the global prevalence of Helicobacter pylori (H pylori) infection in adults and children/adolescents, linking it to gastric cancer rates.
  • After reviewing nearly 17,000 articles, researchers found that H pylori infection prevalence dropped from 52.6% to 43.9% in adults but remained at 35.1% in children and adolescents from 2015 to 2022.
  • The decline in H pylori in adults was significant in certain regions, while the relationship between H pylori prevalence and decreasing gastric cancer incidence prompts the need for further large-scale clinical trials to confirm these findings.
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Cholangiocarcinoma (CCA) is a serious health problem worldwide. The gut and bile microbiota have not been clearly characterized in patients with CCA, and better noninvasive diagnostic approaches for CCA need to be established. The aim of this study was to investigate the characteristics of the gut and bile microbiota in CCA patients.

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Background: We previously showed rising primary antibiotic resistance of Helicobacter pylori during 1990-2015 in the Asia-Pacific region. However, whether primary antibiotic resistance continues to rise is unknown. Therefore, we aimed to assess the latest prevalence of H pylori antibiotic resistance in this region.

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  • The study investigates the connection between the microbiome and adverse perinatal health outcomes, aiming to understand how dysbiosis affects pregnancy and postpartum health.
  • To achieve this, 2000 Australian women will be recruited and monitored over a span of 7 years, with samples collected regularly before, during, and after pregnancy.
  • Data will include multiple biological samples and assessments on health, lifestyle, and environmental factors, allowing for comprehensive analysis of the microbiome's influence on maternal and child health.
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Background: The results of human observational studies on the correlation between gut microbiota perturbations and polycystic ovary syndrome (PCOS) have been contradictory. This study aimed to perform the first systematic review and meta-analysis to evaluate the specificity of the gut microbiota in PCOS patients compared to healthy women.

Methods: Literature through May 22, 2023, was searched on PubMed, Web of Science, Medline, Embase, Cochrane Library, and Wiley Online Library databases.

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Background: Helicobacter pylori infection is an important causal factor of gastric cancer and peptic ulcer disease and is associated with immune thrombocytopenic purpura and functional dyspepsia. In H pylori strains, point mutations in the 23S rRNA and gyrA genes are associated with clarithromycin resistance and levofloxacin resistance, respectively. Whether the efficacy of molecular testing-guided therapy is non-inferior to that of susceptibility testing-guided therapy for H pylori eradication is unclear.

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Recent research suggests that dysbiosis of the oral microbial community is associated with head and neck cancer (HNC). It remains unclear whether this dysbiosis causes chemo-radiotherapy (CRT)-related complications. However, to address this question, it is essential to determine the most representative oral site for microbiome sampling.

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Background: Levofloxacin-based therapy or bismuth-based quadruple therapy are the recommended second-line regimens for Helicobacter pylori eradication after failure of clarithromycin-based therapy. However, resistance to levofloxacin has increased in the past decade. Furthermore, little is known about the long-term effects of H pylori eradication on the antibiotic resistome.

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The gut microbiome is involved in metabolic disorders. Osteopontin (OPN), as a key cytokine, contributes to various inflammation-related diseases. The underlying role of OPN in the microbiome remains poorly understood.

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Background: Extrauterine growth restriction (EUGR) in preterm birth infants could have long-term adverse impacts on health. Less is known about the gut microbiota regarding its establishment in early life and its role in long-term growth in preterm birth infants.

Methods: A prospective, longitudinal observational study was conducted with 67 preterm infants in a level III neonatal intensive care unit.

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The mechanistic role of the airway microbiome in chronic obstructive pulmonary disease (COPD) remains largely unexplored. We present a landscape of airway microbe-host interactions in COPD through an in-depth profiling of the sputum metagenome, metabolome, host transcriptome and proteome from 99 patients with COPD and 36 healthy individuals in China. Multi-omics data were integrated using sequential mediation analysis, to assess in silico associations of the microbiome with two primary COPD inflammatory endotypes, neutrophilic or eosinophilic inflammation, mediated through microbial metabolic interaction with host gene expression.

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Infection is formally recognised as an infectious disease, an entity that is now included in the International Classification of Diseases 11th Revision. This in principle leads to the recommendation that all infected patients should receive treatment. In the context of the wide clinical spectrum associated with gastritis, specific issues persist and require regular updates for optimised management.

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Musculoskeletal conditions of traumatic and non-traumatic origin represent an ongoing health challenge. While the last three decades have seen significant advancement in our understanding of musculoskeletal conditions, the mechanisms of a delayed or lack of recovery are still a mystery. Here, we present an expansion of the integrated stress-diathesis model through the inclusion of the gut microbiome.

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Objective: An international meeting was organised to develop consensus on (1) the landmarks to define the gastro-oesophageal junction (GOJ), (2) the occurrence and pathophysiological significance of the cardiac gland, (3) the definition of the gastro-oesophageal junctional zone (GOJZ) and (4) the causes of inflammation, metaplasia and neoplasia occurring in the GOJZ.

Design: Clinical questions relevant to the afore-mentioned major issues were drafted for which expert panels formulated relevant statements and textural explanations.A Delphi method using an anonymous system was employed to develop the consensus, the level of which was predefined as ≥80% of agreement.

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Article Synopsis
  • The study investigates the relationship between gut microbiota and microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients to predict MVI development through microbiome analysis.
  • Fecal samples from 59 HCC patients (24 with MVI, 16 healthy controls) were analyzed, revealing significant differences in gut bacteria between those with MVI and those without.
  • A microbial prediction model demonstrated a high diagnostic accuracy (94.81% AUC) for MVI, indicating that specific gut microbiota signatures are linked to increased M2-type tumor-associated macrophages in the tumor microenvironment.
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