Meta Analysis: Fungal Distribution in the Large Intestine

Amiroh Tus Sholeha M; Syamsu  Rijal; Muh. Irwan  Gunawan

doi:10.37899/journallamedihealtico.v7i2.3214

Amiroh Tus Sholeha M Fakultas Kedokteran Universitas Muslim Indonesia, Makassar, Indonesia
Syamsu Rijal Fakultas Kedokteran, Universitas Muslim Indonesia, Makassar, Indonesia
Muh. Irwan Gunawan Fakultas Kedokteran, Universitas Muslim Indonesia, Makassar, Indonesia

DOI: https://doi.org/10.37899/journallamedihealtico.v7i2.3214

Keywords: Gut Mycobiome, Fungal Distribution, Colon Microbiota, Gastrointestinal Diseases, Meta-analysis

Abstract

The human colon hosts a diverse microbial ecosystem, including fungi (mycobiome), which, although comprising a small proportion of the microbiota, play a crucial role in maintaining gut homeostasis, metabolism, and immune regulation. Imbalances in fungal communities are associated with gastrointestinal disorders such as inflammatory bowel disease and colorectal cancer. This study employed a systematic literature review with meta-analysis following PRISMA guidelines. Data were collected from major databases (2015–2025) using PICO-based keywords. Eligible studies were analyzed using statistical software to calculate pooled effect sizes, heterogeneity (I²), and significance levels. A random-effects model was applied due to high variability among studies. Five studies were included, revealing that fungi are consistently present across all colon segments, with dominant genera including Candida and Saccharomyces. The pooled effect size (0.125; 95% CI: 0.005–0.248; p < 0.001) confirms a stable fungal presence. However, heterogeneity was very high (I² = 97.85%), influenced by differences in populations, methodologies, and disease conditions. Findings highlight the role of fungi in microbial interactions, inflammation, and potential use as biomarkers in gastrointestinal diseases. Colonic fungi are integral to gut health, though highly variable across individuals. Further standardized and longitudinal research is needed to clarify their clinical significance and therapeutic potential.

References

Afzaal M, Saeed F, Shah YA, Hussain M, Rabail R, Socol CT et al.

Auchtung, J. M., Hallen-Adams, H. E., & Hutkins, R. (2025). Microbial interactions and ecology in fermented food ecosystems. Nature Reviews Microbiology, 23(10), 622-634. https://doi.org/10.1038/s41579-025-01191-w

Balderramo, D. C., Romagnoli, P. A., van Beelen Granlund, A., & Catalan-Serra, I. (2023). Fecal fungal microbiota (Mycobiome) study as a potential tool for precision medicine in inflammatory bowel disease. Gut and Liver, 17(4), 505. https://doi.org/10.5009/gnl220537

Belvoncikova, P., Splichalova, P., Videnska, P., & Gardlik, R. (2022). The human mycobiome: colonization, composition and the role in health and disease. Journal of Fungi, 8(10), 1046. https://doi.org/10.3390/jof8101046

Carrillo-Serradell, L., Liu-Tindall, J., Planells-Romeo, V., Aragón-Serrano, L., Isamat, M., Gabaldón, T., ... & Velasco-de Andrés, M. (2025). The human mycobiome: composition, immune interactions, and impact on disease. International Journal of Molecular Sciences, 26(15), 7281. https://doi.org/10.3390/ijms26157281

Chen, S., Yi, M., Yi, X., Zhou, Y., Song, H., & Zeng, M. (2025). Unveiling the fungal frontier: mycological insights into inflammatory bowel disease. Frontiers in Immunology, 16, 1551289. https://doi.org/10.3389/fimmu.2025.1551289

Cruz, G. M., Fraga, A. S., Garcia, M. T., & Junqueira, J. C. (2026). Oral Mycobiome: Composition, Functionality and Clinical Implication.

Damianos, J., Abdelnaem, N., & Camilleri, M. (2025). Gut goo: physiology, diet, and therapy of intestinal mucus and biofilms in gastrointestinal health and disease. Clinical Gastroenterology and Hepatology, 23(2), 205-215. https://doi.org/10.1016/j.cgh.2024.09.007

Deng X, Li H, Wu A, He J, Mao X, Dai Z et al. Composition, Influencing Factors, and Effects on Host Nutrient Metabolism of Fungi in Gastrointestinal Tract of Monogastric Animals. Animals. 2025; 15. doi:10.3390/ani15050710.

Guglietta, S., Li, X., & Saxena, D. (2025). Role of fungi in tumorigenesis: promises and challenges. Annual Review of Pathology: Mechanisms of Disease, 20(1), 459-482. https://doi.org/10.1146/annurev-pathmechdis-111523-023524

Guo, Z. L., Cui, M. W., Dong, Y. L., & Wang, S. (2026). The oral microbiome as a regulatory hub for systemic health: a systematic review of mechanistic links and clinical implications. Journal of Oral Microbiology, 18(1), 2635233. https://doi.org/10.1080/20002297.2026.2635233

Houshyar, Y., Zhang, F., Tavakoli, P., Grimm, M. C., & Hold, G. L. (2026). Neglected kingdoms: the gut virome, mycobiome and their role in inflammatory bowel disease. Gut Microbes, 18(1), 2653288. https://doi.org/10.1080/19490976.2026.2653288

Huang, Z., Liu, Y., Wu, Y., Zhang, F., Yu, L., Gao, S., ... & Zuo, T. (2026). Gut mucosal mycobiome profiling in Crohn’s disease uncovers an AMP-mediated anti-inflammatory effect of Cladosporium sphaerospermum. Nature Metabolism, 1-21.

Human gut microbiota in health and disease: Unveiling the relationship. Front Microbiol. 2022; 13. doi:10.3389/fmicb.2022.999001.

Jena, R., Singh, N. A., Ahmed, N., & Choudhury, P. K. (2025). Bifidobacteria in antibiotic-associated dysbiosis: Restoring balance in the gut microbiome. World Journal of Microbiology and Biotechnology, 41(8), 297. https://doi.org/10.1007/s11274-025-04517-1

Kęder, K., Kukulska, M., Latocha, J., Sobieska, A., & Grzelak, D. (2026). Advances in the Diagnosis and Treatment of Irritable Bowel Syndrome and Small Intestinal Bacterial Overgrowth. Nutrition Today, 61(2), 68-76. https://doi.org/10.1097/NT.0000000000000794

Khaled, R., Tourret, M., Theysgeur, S., Dussert, E., Taminiau, B., Daube, G., ... & Lucau-Danila, A. (2025). Exploring the Microbial Diversity and Bioactivity of Lebanese Artisanal Dairy Products Running title: Microbial Diversity in Lebanese Dairy Products. Food & Nutrition Journal, 10(1). https://doi.org/10.29011/2575-7091.100221

Kulis, E., Cvitkovic, I., Pavlovic, N., Kumric, M., Rusic, D., & Bozic, J. (2025). A comprehensive review of antibiotic resistance in the oral microbiota: mechanisms, drivers, and emerging therapeutic strategies. Antibiotics, 14(8), 828. https://doi.org/10.3390/antibiotics14080828

Li, A., Kiani, F. A., Liao, J., Liu, F., & Chang, Y. F. (2025). The role of gut microbiota in animal gastrointestinal diseases. Frontiers in Cellular and Infection Microbiology, 15, 1554277. https://doi.org/10.3389/fcimb.2025.1554277

Li, F., Gao, Y., Cheng, W., Su, X., & Yang, R. (2023). Gut fungal mycobiome: a significant factor of tumor occurrence and development. Cancer letters, 569, 216302. https://doi.org/10.1016/j.canlet.2023.216302

Liu, H. Y., Li, S., Ogamune, K. J., Ahmed, A. A., Kim, I. H., Zhang, Y., & Cai, D. (2025). Fungi in the gut microbiota: interactions, homeostasis, and host physiology. Microorganisms, 13(1), 70. https://doi.org/10.3390/microorganisms13010070

Milanda, T., & Kusuma, S. A. F. (2026). Kefir as a functional probiotic: microbial composition and health effects. Frontiers in Food Science and Technology, 5, 1725280. https://doi.org/10.3389/frfst.2025.1725280

Nardone, G. P., Cicero, A. F. G., Gallelli, L., & Berni Canani, R. (2026). Managing Gut Dysbiosis: Clinical Evidence and Perspectives on Saccharomyces boulardii CNCM I-745 for Diarrhoeal Conditions in Adults and Children. Microorganisms, 14(1), 150. https://doi.org/10.3390/microorganisms14010150

Niriella, M. A., Jayasundara, H. D., Samarawickrama, V. T., Prabagar, K., & De Silva, H. J. (2025). Belching, bloating, and flatulence: pitfalls and challenges in evaluating and managing symptoms of intestinal gas and how to avoid them. Expert Review of Gastroenterology & Hepatology, 19(7), 805-815. https://doi.org/10.1080/17474124.2025.2514239

Peroumal, D., Sahu, S. R., Kumari, P., Utkalaja, B. G., & Acharya, N. (2022). Commensal fungus Candida albicans maintains a long-term mutualistic relationship with the host to modulate gut microbiota and metabolism. Microbiology Spectrum, 10(5), e02462-22. https://doi.org/10.1128/spectrum.02462-22

Puoti, M. G., Assa, A., Benninga, M. A., Broekaert, I., Dolinsek, J., Homan, M., ... & Gastrointestinal Committee of ESPGHAN. (2025). Small intestinal bacterial overgrowth in children: An expert review by the ESPGHAN Gastroenterology Committee. Journal of pediatric gastroenterology and nutrition, 81(4), 986-999.

Raimondi, S., Amaretti, A., Gozzoli, C., Simone, M., Righini, L., Candeliere, F., ... & Peppoloni, S. (2019). Longitudinal survey of fungi in the human gut: ITS profiling, phenotyping, and colonization. Frontiers in microbiology, 10, 1575. https://doi.org/10.3389/fmicb.2019.01575

Song, J., Yang, X., Liu, X., & Li, J. (2025). Gut bacteria: protective mediators, pathogenic contributors and novel therapeutic targets in Candida albicans infections. Gut Pathogens, 17(1), 77. https://doi.org/10.1186/s13099-025-00755-8

Srb, N., Talapko, J., Meštrović, T., Fureš, R., Stupnišek, M., Srb, A. M., & Škrlec, I. (2025). A Comprehensive Overview of Candida albicans as the Leading Pathogen in Vulvovaginal Candidiasis. Journal of fungi, 11(9), 632. https://doi.org/10.3390/jof11090632

Talapko, J., Včev, A., Meštrović, T., Pustijanac, E., Jukić, M., & Škrlec, I. (2022). Homeostasis and dysbiosis of the intestinal microbiota: comparing hallmarks of a healthy state with changes in inflammatory bowel disease. Microorganisms, 10(12), 2405. https://doi.org/10.3390/microorganisms10122405

Wu X, Xia Y, He F, Zhu C, Ren W. Intestinal mycobiota in health and diseases: from a disrupted equilibrium to clinical opportunities. Microbiome. 2021; 9. doi:10.1186/s40168-021-01024-x.

Yinhang, W., Xueli, J., Zheng, W., Xiaojian, Y., Shu, X., Qingjie, Z., ... & Shuwen, H. (2026). Gut fungal landscape in colorectal cancer and its cross-kingdom interplay with gut microbial ecology. iScience. https://doi.org/10.1016/j.isci.2026.114664

Yunus, A., Mokhtar, N. M., Ali, R. A. R., Kendong, S. M. A., & Ahmad, H. F. (2024). Methods for identification of the opportunistic gut mycobiome from colorectal adenocarcinoma biopsy tissues. MethodsX, 12, 102623. https://doi.org/10.1016/j.mex.2024.102623

Zhou, L., Xu, X., Zhang, Z., Zhang, X., Lin, K., Luo, H., ... & Liu, Z. (2025). Seasonal and environmental influences on the gut microbiota of south China tigers (Panthera tigris amoyensis). Animals, 15(10), 1471. https://doi.org/10.3390/ani15101471