An irritable bowel syndrome subtype defined by species-specific alterations in faecal microbiota

Jeffery, Ian B.; O’Toole, Paul W.; Öhman, Lena; Claesson, Marcus J.; Deane, Jennifer; Quigley, Eamonn Martin; Simrén, Magnus

doi:10.1136/gutjnl-2011-301501

Cited by 731 publications

(642 citation statements)

References 51 publications

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“…Another study identified microbiota associated with a distinct subset of IBS patients that did not correspond to IBS subtypes defined by the Rome II criteria (Jeffery et al. 2012). …”

Section: Introductionmentioning

confidence: 99%

Mutual reinforcement of pathophysiological host‐microbe interactions in intestinal stasis models

Touw

Ringus

Hubert

et al. 2017

Physiological Reports

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Chronic diseases arise when there is mutual reinforcement of pathophysiological processes that cause an aberrant steady state. Such a sequence of events may underlie chronic constipation, which has been associated with dysbiosis of the gut. In this study we hypothesized that assemblage of microbial communities, directed by slow gastrointestinal transit, affects host function in a way that reinforces constipation and further maintains selection on microbial communities. In our study, we used two models – an opioid‐induced constipation model in mice, and a humanized mouse model where germ‐free mice were colonized with stool from a patient with constipation‐predominant irritable bowel syndrome (IBS‐C) in humans. We examined the impact of pharmacologically (loperamide)‐induced constipation (PIC) and IBS‐C on the structural and functional profile of the gut microbiota. Germ‐free (GF) mice were colonized with microbiota from PIC donor mice and IBS‐C patients to determine how the microbiota affects the host. PIC and IBS‐C promoted changes in the gut microbiota, characterized by increased relative abundance of Bacteroides ovatus and Parabacteroides distasonis in both models. PIC mice exhibited decreased luminal concentrations of butyrate in the cecum and altered metabolic profiles of the gut microbiota. Colonization of GF mice with PIC‐associated mice cecal or human IBS‐C fecal microbiota significantly increased GI transit time when compared to control microbiota recipients. IBS‐C‐associated gut microbiota also impacted colonic contractile properties. Our findings support the concept that constipation is characterized by disease‐associated steady states caused by reinforcement of pathophysiological factors in host‐microbe interactions.

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“…Another study identified microbiota associated with a distinct subset of IBS patients that did not correspond to IBS subtypes defined by the Rome II criteria (Jeffery et al. 2012). …”

Section: Introductionmentioning

confidence: 99%

Mutual reinforcement of pathophysiological host‐microbe interactions in intestinal stasis models

Touw

Ringus

Hubert

et al. 2017

Physiological Reports

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“…A significant increase in the quantity of aerobic bacteria and Lactobacillus was noted in IBS-D fecal samples but not in mucosal ones [82]. Elevation in the level of Ruminococcus, Clostridium, Dorea species and a decrease in the quantity of Bifidobacterium and Faecalibacterium species have been demonstrated in IBS [80,[83][84][85][86][87][88][89]. In children, a fecal microbiome characterized by a significantly high percentage of Gamma Proteobacteria and an increased number of several bacterial taxa from the genus Alistipes has been reported in the IBS setting [90].…”

Section: Gastrointestinal Illnesses A) Clostridium Difficile Infectionmentioning

confidence: 80%

Commensal Bugs from the Gut-Shaping Human Health and Disease

Chowdhury¹

2014

JIG

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“…As well as alterations in specific microbial taxa, reduced diversity, richness and temporal instability are reported in IBS patients v. controls (57)(58)(59)(60) , as well as a greater instability in response to dietary change (61) .…”

Section: Irritable Bowel Syndrome and The Gastrointestinal Microbiotamentioning

confidence: 99%

Altered gastrointestinal microbiota in irritable bowel syndrome and its modification by diet: probiotics, prebiotics and the low FODMAP diet

Staudacher

Whelan

2016

Proc. Nutr. Soc.

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Irritable bowel syndrome (IBS) is a functional bowel disorder characterised by abdominal pain or discomfort with disordered defecation. This review describes the role of the gastrointestinal (GI) microbiota in the pathogenesis of IBS and how dietary strategies to manage symptoms impact on the microbial community. Evidence suggests a dysbiosis of the luminal and mucosal colonic microbiota in IBS, frequently characterised by a reduction in species of Bifidobacteria which has been associated with worse symptom profile. Probiotic supplementation trials suggest intentional modulation of the GI microbiota may be effective in treating IBS. A smaller number of prebiotic supplementation studies have also demonstrated effectiveness in IBS whilst increasing Bifidobacteria. In contrast, a novel method of managing IBS symptoms is the restriction of short-chain fermentable carbohydrates (low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet). Studies consistently demonstrate clinical effectiveness of the low FODMAP diet in patients with IBS. However, one unintentional consequence of this dietary intervention is its impact on the microbiota. This leads to an interesting paradox; namely, increasing luminal Bifidobacteria through probiotic supplementation is associated with a reduction in IBS symptoms while in direct conflict to this, the low FODMAP diet has clinical efficacy but markedly reduces luminal Bifidobacteria concentration. Given the multifactorial aetiology of IBS, the heterogeneity of symptoms and the complex and diverse nature of the microbiome, it is probable that both interventions are effective in patient subgroups. However combination treatment has never been explored and as such, presents an exciting opportunity for optimising clinical management, whilst preventing potentially deleterious effects on the GI microbiota. Irritable bowel syndrome: Prebiotic: Probiotic: FODMAP Irritable bowel syndromeFunctional bowel disorders are characterised by chronic lower gastrointestinal (GI) symptoms in the absence of alarm features that suggest presence of other disease (1,2) . The criteria for irritable bowel syndrome (IBS), one of the most common functional bowel disorders, requires the presence of abdominal pain or discomfort together with an alteration in stool output (1) . IBS is a common condition worldwide, contributes up to 30 % of gastroenterology consultations in the UK (3) , affects more females than males and is more prevalent in those under 40 years of age (4) . A pooled prevalence of IBS in 14 % of females and 9 % of males has been reported in a large systematic review and meta-analysis of fifty-five studies conducted across America, Asia, Europe and Africa (4) .Four different IBS subtypes exist based on predominant stool form, and each may differ in their aetiology.

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An irritable bowel syndrome subtype defined by species-specific alterations in faecal microbiota

Abstract: Detailed microbiota analysis of a well-characterised cohort of IBS patients identified several clear associations with clinical data and a distinct subset of IBS patients with alterations in their microbiota that did not correspond to IBS subtypes, as defined by the Rome II criteria.

Cited by 731 publications

References 51 publications

Mutual reinforcement of pathophysiological host‐microbe interactions in intestinal stasis models

Mutual reinforcement of pathophysiological host‐microbe interactions in intestinal stasis models

Commensal Bugs from the Gut-Shaping Human Health and Disease

Altered gastrointestinal microbiota in irritable bowel syndrome and its modification by diet: probiotics, prebiotics and the low FODMAP diet

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