Microbiota in health and disease

The student will learn/understand:
The importance of microbiota in humans, its establishment during the early stages of life, the synbiotic relationship with the host and its role depending on its localization (amniotic liquid, placenta, vagina, breastmilk, skin, conjuntive, lung tissue, oral mucose, digestive tube).
The process of microbial establishment in the intestine during human development, the factors affecting its functional and structural development, the methodology for its study and interpretation and its capital role on human health and disease.

The student will be able to:
Know the microbiota present in different tissues and its role on health during human growth and development.
Know the intestinal ecology (microbiome, virome, micobiome) and its relationship with health.
Know the factors affecting the establishment, maturation and functionality of intestinal microbiota.
Know the techniques used for the identification of intestinal microbiota and its interpretation.
Know and differentiate potential types of illness in which intestinal microbiota is involved (colostatic syndrome, chronic lung disease, food intolerance, necrotizing enterocolitis, ulcerative colitis, Chron disease, chronic bowel inflammatory disease, irritable colon, immunopathology, osteopenia) and know the strategies of medical application. To know the types and applications of functional foods (probiotics, prebiotics, ...)
Develop critical and analytical abilities to design novel studies or strategies based on intestional microbiota to improve human health.

1. Importance of microbiota on human beings: its establishment during the early stages of life, su establecimiento durante la vida precoz, la relación sim its establishment during the early stages of life, the synbiotic relationship with the host and its role depending on its localization (amniotic liquid, placenta, vagina, breastmilk, skin, conjuntive, lung tissue, oral mucose, digestive tube).
1.1. Microbiota during the 1.000 first days of life.
2. Establishment of intestinal microbiota during human development: factors affecting its functional and structural development, the methodology for its study and interpretation and its capital role on human health and disease.
3. Microbiota present in different tissues and its role on health during human growth and development.
3.1. Disbiosis and immune system development.
3.2. Disbiosis and risk of illness in children.
4. Intestinal ecology (microbiome, virome, micobiome) and its relationship with human health.
5. Factors affecting the establishment, maturation and functionality of intestinal microbiota.
6. Techniques used for the identification of intestinal microbiota and its interpretation.
7. Types of illness in which intestinal microbiota is involved: colostatic syndrome, chronic lung disease, food intolerance, necrotizing enterocolitis, ulcerative colitis, Chron disease, chronic bowel inflammatory disease, irritable colon, immunopathology, osteopenia.
8. Probiotics, prebiotics and synbiotics: characteristics and effects on human health.
8.1. Types of biotics
8.2. Biotics and health promotion.

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• Díaz Martín JJ, González Jiménez D. Aplicaciones en gastroenterología. Nutr Hosp. 2015;31:21-5.
• Dinleyici EC; PROBAGE Study Group, Vandenplas Y. Lactobacillus reuteri DSM 17938 effectively reduces the duration of acute diarrhoea in hospitalized children. Acta Paediatr. 2014;103:e300-5.
• Guarino A, Ashkenazi S, Gendrel D, Lo Vecchio A, Shamir R, Szajewska H. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014;59:132-52.
• Guía Práctica de la Organización Mundial de Gastroenterología: Probióticos y prebióticos. En: Organización Mundial de Gastroenterología [en línea]. Disponible en:
http://www.worldgastroenterology.org/UserFiles/file/guidelines/probioti… [consultado el 17/11/2015].
• Johnston BC, Goldenberg JZ, Vandvik PO, Sun X, Guyatt GH. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2011;(11):CD004827
• Liu, D. Molecular detection of human bacterial pathogens. CRC Press, Boca Ratón, FL. 2011
• Quigley M, Embleton ND, McGuire W. Formula versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev. 2018;6:CD002971.
https://www.ncbi.nlm.nih.gov/pubmed/29926476
• Segarra Cantón O, Redecillas Ferreiro S, Clemente Bautista S, eds. Guía nutrición pediátrica hospitalaria. 4ª Ed. ERGON. Madrid; 2016.
• Szajewska H, Guarino A, Hojsak I, Indrio F, Kolacek S, Shamir R, et al. Use of probiotics for management of acute gastroenteritis: a position paper by the ESPGHAN Working Group for Probiotics and Prebiotics. J Pediatr Gastroenterol Nutr. 2014;58:531-9.
• Szajewska H, Kołodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2015;42:793-801.
• Szajewska H, Skórka A, Dylag M. Meta-analysis: Saccharomyces boulardii for treating acute diarrhoea in children. Aliment Pharmacol Ther. 2007;25:257-64. Erratum en: Aliment Pharmacol Ther. 2009;29:800.
• Szajewska H, Skórka A, Ruszczyński M, Gieruszczak-Białek D. Meta-analysis: Lactobacillus GG for treating acute gastroenteritis in children--updated analysis of randomised controlled trials. Aliment Pharmacol Ther. 2013;38:467-76.
• Szajewska H, Skórka A. Saccharomyces boulardii for treating acute gastroenteritis in children: updated meta-analysis of randomized controlled trials. Aliment Pharmacol Ther. 2009;30:960-1.
• Szajewska H, Urbańska M, Chmielewska A, Weizman Z, Shamir R. Meta-analysis: Lactobacillus reuteri strain DSM 17938 (and the original strain ATCC55730) for treating acute gastroenteritis in children. Benef Microbes. 2014;5:285-93.
• Toftlund LH, Halken S, Agertoft L, Zachariassen G. Early nutrition and signs of metabolic syndrome at 6 y of age in children born very preterm. Am J Clin Nutr. 2018;107:717–24. https://www.ncbi.nlm.nih.gov/pubmed/29722837
• Williams T, Nair H, Simpson J, Embleton N. Use of donor human milk and maternal breastfeeding rates: a systematic review. J Hum Lact. 2016; 32: 212–20. https://www.ncbi.nlm.nih.gov/pubmed/26887844

To be able to develop an advance use of the tools for the search of relevant information from primary and secondary sources, these including on-line search.
To know the suitable methodologies to analyze information both quantitatively and qualitatively, solve problems and take decisions on the bases of both types of information.
To identify the need of communicating the scientific discoveries. To be able to have oral and written skills of the research results, using the terminology and techniques inherent to the professionals of the sector.
To develop initiative and autonomy to undertake the tasks inherent to the research activity.
To acquire and understand the knowledge necessary to have original skills in the development and/or application of ideas, frequently in a research context.
To apply the acquired knowledge and the capacity of solving problems in new or less known situations in wider contexts (or multidisciplinary situations) related to this area of study.
To integrate the knowledge and to face the complexity of formulate judgements from information that, being incomplete or limited, includes reflections on the social and ethical reponsabilities linked to the application of their knowledge and judgement.
To communicate the conclusions, knowledge and last reasons on which they are supported to specialized and non-specialized public in a clear and unambiguous way.
To develop learning skills that allows students keep on studying in a self-directed and autonomous way..

Expositive classes (virtual presentations)
Discussion and debate sessions (on-line)
Virtual seminars
On-line works in group
On line individual works
On-line self-evaluation questionnaires

Final evaluation of reports, works, proyects (in group or individual): 50%
Participation in debates and in gathering information: 10%
Resolution of practical cases, clinical cases, delivery of reports and works through the on-line platform (individual or in group): 40%

The overall time recommended for the students to comply with all the duties and study associated to this subject is 75 h.

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