Gut Microbial Dysbiosis in the Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies

Wang, Lin; Alammar, Nuha; Singh, Rajdeep; Nanavati, Julie; Song, Yiran; Chaudhary, Rahul; Mullin, Gerard E.

doi:10.1016/j.jand.2019.05.015

Cited by 127 publications

(123 citation statements)

References 87 publications

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“…Using real‐time polymerase chain reaction and next‐generation sequencing, several studies, mostly using fecal sample, showed gut microbiota dysbiosis among patients with IBS compared with healthy controls 24, 31 . In a recent meta‐analysis of 23 case–control studies on 1340 participants, patients with IBS had lower levels of good bacteria of genera Lactobacillus and Bifidobacterium and marginally higher levels of bad bugs of genera Enterobacter compared with the controls 32 …”

Section: Gut Microbiota Dysbiosis In Irritable Bowel Syndromementioning

confidence: 99%

Marshall and Warren Lecture 2019: A paradigm shift in pathophysiological basis of irritable bowel syndrome and its implication on treatment

Ghoshal

2020

J of Gastro and Hepatol

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Irritable bowel syndrome (IBS), a common functional gastrointestinal disorder (FGID), has often been considered rather inappropriately as psychogenic in the past. Though psychological issues are important comorbidities in a proportion of IBS patients, the evidences are far from enough to label this condition as psychogenic only. In the recent past, evidences are emerging that underscores the concept supporting pure psychogenic theory of IBS and suggest this disorder to be rather microorganic. Accordingly, a move of Rome IV Committee attempting to delete the term "functional" and designating these to be disorders of "gut-brain interaction" rather than that of "brain-gut interaction," it emphasizes the importance of the gut over the brain in the pathogenesis. The introduction of the concept of multidimensional clinical profile in Rome IV requires attention to diagnostic category of FGID, overlap, severity, psychological issues, and physiological dysfunction or biomarkers; this attempts to recognize clinical variability and multidimensionality of pathophysiology and management of these disorders. The recognition of the biological factors in the pathogenesis of IBS is a significant paradigm shift in the recent time. This is somewhat similar to the progress in the pathogenesis of peptic ulcer disease from psychological factor to acid to Helicobacter pylori infection. It is expected that in the near future, therapeutic modalities targeting the different pathogenic mechanisms of different subtypes of IBS may bring revolution in management of the disorder.

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Section: Gut Microbiota Dysbiosis In Irritable Bowel Syndromementioning

confidence: 99%

Marshall and Warren Lecture 2019: A paradigm shift in pathophysiological basis of irritable bowel syndrome and its implication on treatment

Ghoshal

2020

J of Gastro and Hepatol

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“…Early life nutrition and the microbiome: Over the last decade it has become clear that once the microbiome is established it is shaped by the exposome and the~9 million microbial genes it encodes and play a crucial role in determining host development and health [14,[51][52][53]. Modulating the host most probably protects the natural enteric symbiotic microbial community, and disturbing the established microbiome, producing a dysbiosis, results in disease and may even be fatal [54,55]. The microbiome established is dependent on the route of birth, and is then modulated by nutritional intake, living conditions, the polluted environment and the presence of pets [56,57].…”

Section: Early Life-infectionsmentioning

confidence: 99%

The COVID-19 Pandemic: Does Our Early Life Environment, Life Trajectory and Socioeconomic Status Determine Disease Susceptibility and Severity?

Holuka

Merz

Fernandes

et al. 2020

IJMS

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A poor socioeconomic environment and social adversity are fundamental determinants of human life span, well-being and health. Previous influenza pandemics showed that socioeconomic factors may determine both disease detection rates and overall outcomes, and preliminary data from the ongoing coronavirus disease (COVID-19) pandemic suggests that this is still true. Over the past years it has become clear that early-life adversity (ELA) plays a critical role biasing the immune system towards a pro-inflammatory and senescent phenotype many years later. Cytotoxic T-lymphocytes (CTL) appear to be particularly sensitive to the early life social environment. As we understand more about the immune response to SARS-CoV-2 it appears that a functional CTL (CD8+) response is required to clear the infection and COVID-19 severity is increased as the CD8+ response becomes somehow diminished or exhausted. This raises the hypothesis that the ELA-induced pro-inflammatory and senescent phenotype may play a role in determining the clinical course of COVID-19, and the convergence of ELA-induced senescence and COVID-19 induced exhaustion represents the worst-case scenario with the least effective T-cell response. If the correct data is collected, it may be possible to separate the early life elements that have made people particularly vulnerable to COVID-19 many years later. This will, naturally, then help us identify those that are most at risk from developing the severest forms of COVID-19. In order to do this, we need to recognize socioeconomic and early-life factors as genuine medically and clinically relevant data that urgently need to be collected. Finally, many biological samples have been collected in the ongoing studies. The mechanisms linking the early life environment with a defined later-life phenotype are starting to be elucidated, and perhaps hold the key to understanding inequalities and differences in the severity of COVID-19.

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“…Our observation implied that it may take a while after tonsillectomy to develop IBS, and repetitive pathogens exposure or altered gut flora over time after tonsillectomy might be the possible explanations. Many studies have demonstrated that dysbiosis of the intestinal microbiome plays important roles in the pathogenesis of IBS [22,23]. A reproducible finding in IBS patients is a decrease in bacterial diversity and an increase in the temporal instability of the intestinal microbiota [24].…”

Section: Plos Onementioning

confidence: 99%

Impact of tonsillectomy on irritable bowel syndrome: A nationwide population-based cohort study

Sheng‐Kai

Wang

et al. 2020

PLoS ONE

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Tonsillectomy is a commonly performed surgical procedure worldwide; however, the possible long-term consequences have not been fully explored. The tonsils are secondary lymphoid tissue providing a defensive barrier against pathogens. There are few data in the literature on the relationship between prior tonsillectomy and the risk of irritable bowel syndrome (IBS). The aim of this study was to evaluate the risk of developing IBS in patients who underwent tonsillectomy using a nationwide longitudinal population-based cohort. We identified 1300 patients with tonsillectomy and 2600 matched controls from the Longitudinal Health Insurance Research Database of the National Health Insurance Research Database in Taiwan. Propensity score analysis was used for matching age, gender, comorbidities, medications, and index year at a ratio of 1:2. Multiple Cox regression analysis was used to estimate the adjusted hazard ratio of IBS. Furthermore, sensitivity tests and a stratified analysis were conducted. The incidence of IBS was 3 per 1,000 person-years in tonsillectomy patients, which was higher than the rate of 1.8 per 1,000 person-years found in non-tonsillectomy patients. After adjustment for patients' age, gender, comorbidities, and medications, patients who underwent tonsillectomy had a 1.84-fold risk of developing IBS compared to those without tonsillectomy (adjusted hazard ratio [HR]:1.84; 95% CI, 1.09-3.09). Stratified analysis revealed that a higher adjusted HR of 3.79 (95% CI, 1.35-10.64) in patients �50 years old, and there was a marginally significantly higher adjusted HR of 1.98 (95% CI, 0.99-3.95) of developing IBS when the follow-up period was longer than 3 years. Tonsillectomy was associated with a higher risk of developing IBS. Physicians should provide appropriate monitoring of IBS in patients undergoing tonsillectomy.

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Gut Microbial Dysbiosis in the Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies

Cited by 127 publications

References 87 publications

Marshall and Warren Lecture 2019: A paradigm shift in pathophysiological basis of irritable bowel syndrome and its implication on treatment

Marshall and Warren Lecture 2019: A paradigm shift in pathophysiological basis of irritable bowel syndrome and its implication on treatment

The COVID-19 Pandemic: Does Our Early Life Environment, Life Trajectory and Socioeconomic Status Determine Disease Susceptibility and Severity?

Impact of tonsillectomy on irritable bowel syndrome: A nationwide population-based cohort study

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