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References

Testing of Children References

1. Diet, Microbiota, and Gut Permeability—The Unknown Triad in Rheumatoid Arthritis (Guerreiro et al, 2018)        

It has been established that Rheumatoid Arthritis (RA) patients exhibit a distinct gut microbiota composition at the point of diagnosis, when compared to healthy individuals, with their microbiome undergoing further alterations as the disease develops. Diet however, appears to have a positive impact upon the physiopathology of RA, particularly with a mediterranean type dietary approach, possibly lowering disease activity and improving the outcome.


2. What is the Microbiome? (Amon & Sanderson, 2017)      
The human microbiome has an estimated 100 trillion microbes, the bulk of which live in our gut.


3. Gut microbiota’s effect on mental health: The gut-brain axis (Clapp et al, 2017)   
This 2017 literature review demonstrated the importance of a healthy microbiome, for individuals with anxiety and depression, as dysbiosis and inflammation within the central nervous system have been associated as
potential causes of mental illness. A number of studies contained within this review have shown that probiotics eased anxiety and depressive symptoms comparable to conventional prescription medications. 


4. Interaction between the gut microbiome and mucosal immune system  (Shi et al, 2017)                                                      
Recent data reveal the crucial role of intestinal microbiota in mucosal immunity. Studies have demonstrated an association between the pathogenesis of inflammatory diseases and the diminished interaction between intestinal microbiota and the mucosal immune system. This highlights the importance of investigating the function of the microbiome in such conditions, to identify potential future treatment strategies for chronic
inflammatory diseases.  


5. Skin-gut axis: The relationship between intestinal bacteria and skin health (Vaughn et al, 2017)   
The integral relationship between the gut microbiome and skin health is becoming an important topic in both gastroenterological and dermatological circles. It is particularly important to appreciate the influence that diet,
medications and stress can have upon alterations to gut microbial communities, which may affect skin health.
Psoriatic arthritis patients are at increased risk of developing IBD, with subclinical evidence of gut inflammation. A recent clinical study analysing the gut microbiome across three groups (psoriasis, psoriatic arthritis and healthy controls) found less diversity in both the psoriasis and psoriatic arthritis groups. Vaughn et al (2017) found that Bifidobacterium Infantis supplementation for eight weeks improved the inflammatory markers C-
reactive protein (CRP), TNF-alpha and IL-6 levels, suggesting that probiotic supplementation can modulate inflammation in this disorder.


6. Intestinal dysbiosis is common in systemic sclerosis and associated
with gastrointestinal and extraintestinal features of disease (Andréasson et al, 2016)       Recent evidence suggests an association between autoimmunity and
the microbiome in several rheumatic diseases including systemic sclerosis.
The objective of this study was to investigate the prevalence of intestinal

dysbiosis in individuals with this particular condition, 95% of whom, also have
Raynaud's. 


7. The Healthy Human Microbiome (Lloyd-Price et al, 2016)
Dysbioses in the microbiome have been associated with numerous diseases, including inflammatory bowel disease, multiple sclerosis, diabetes (types 1 and 2), allergies, asthma, autism, and cancer.


8. Serological Investigation of Food Specific Immunoglobulin G Antibodies
in Patients with Inflammatory Bowel Diseases (Cai et al, 2014) 
The study demonstrates a high prevalence of serum IgG antibodies to specific food allergens in patients with IBD. sIgG antibodies may potentially indicate disease status in clinical and be utilized to guide diets for patients.

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