Therapeutic Uses of Microorganisms

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Acknowledgement

I would take this opening to express gratitude my study supervisor, family and associates for their support and guidance without which this study would not have been possible.

DECLARATION

I, [type your full first titles and last name here], declare that the contents of this dissertation/thesis represent my own unaided work, and that the dissertation/thesis has not previously been submitted for learned examination in the direction of any qualification. Furthermore, it represents my own attitudes and not inevitably those of the University.

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Abstract

Recurrent C. difficile infection is an increasingly common clinical challenge, with a number of patients unable to clear their infection, despite multiple courses of conventional or standard therapies. Other options for these patients include alternate antibiotics (such as rifaximin), probiotics, intravenous immunoglobulin, and now increasingly, Fecal Flora Reconstitution, with an increasing body of uncontrolled evidence supporting its safety and efficacy. A number of studies have shown promising results after donor feces are used to repopulate the affected patient's colon. The assumption is that donated healthy fecal flora repopulates the colon, restoring colonization resistance, which presumably protects against C. difficile, a socalled Fecal Flora Reconstitution. Case reports of FFR in patients with ulcerative colitis, inflammatory bowel disease, irritable bowel syndrome, and chronic constipation have suggested efficacy but sample sizes are small. Routes of administration of FFR have included fecal enemas, nasogastric tubes, and through a colonoscope with generally good success in case reports and small case series. A 2004 review of 17 reports suggests that in treating recurrent C. difficile cases fecal bacteriotherapy is the most reliable of choices, surveying a collective 92% success rate for the patients in the included studies quite similar to our results reported.

Contents

CHAPTER 1: INTRODUCTION6

Innate and adaptive immunity6

CHAPTER 2: LITERATURE REVIEW6

Virus6

Lytic and Lysogenic Cycles of Bacteriophage7

CHAPTER 3: METHODOLOGY11

Qualitative Research11

CHAPTER 4: DISCUSSION AND ANALYSIS13

Bacteria: Anatomy of simple bacteria13

Overview of cytokines21

Overview of macrophages23

Biomimetic immune evasive biomaterials25

Viral immune evasion36

Viral surface secretions37

Cytokine inhibitors38

Cytokine homologues (virokines)40

Cytokine receptor homologues (viroreceptors)42

Complement inhibitors43

Bacterial immune evasion44

Suspended bacterial evasive tactics45

Formation of a capsule or biofilm45

Bacterial elicitation of cytokine secretion51

Applications to biomaterial science Current techniques53

Coating of material surfaces with non-biofouling substrata53

Release of anti-inflammatory drugs55

The release of pro-wound healing or anti-inflammatory factors56

Immobilization of pro-wound healing or anti-inflammatory cytokines onto implant surfaces61

Cell-based implant surface modifications63

Biomimetic techniques63

Application of viral techniques Precedent technologies64

Application of bacterial techniques Precedent technologies81

CHAPTER 5: CONCLUSION82

Future directions82

WORK CITED86

Therapeutic Uses of Microorganisms

Chapter 1: Introduction

Innate and adaptive immunity

One of the chief clinical fears of medical implants is the major clinical concern with medical implants is the concern of exacerbated inflammation in the tissue of the surrounding parts. Whether chronic or acute in nature, such types of inflammation compromises both effective life of the implant as well as the patient well-being. The immune system coordinates these inflammatory events, the role of whome it is to recognize non-self and dispose of non-self foreign bodies from the self in a multi-faceted and controlled manner. Once the foreign object are begun to be interrogated in the body, the objects will sought to be isolated by the immune ...