Cognitive behavioral and mindfulness with daily exercise intervention is associated with changes in intestinal microbial taxa and systemic inflammation in patients with Crohn’s disease

Figures & data

Figure 1. Phyla and genera comparison between wait-list and COBMINDEX at T1 demonstrates no significant differences.

Plots of phyla (a) and genera (b) abundances between COBMINDEX (n = 24) and wait-list (n = 25) individuals. LefSe with FDR-adjustment, p < .05.

Table 1. Demographic characteristics at baseline of Crohn’s disease patients undergoing laboratory studies.

	CD COBMINDEX (n = 24)	CD Wait-List (n = 25)
Age, mean years (SD)	33.88 (12.97)	32.59 (8.33)
Women, N (%)	18 (72)	15 (56)
Working, N (%)	22 (88)	20 (74)
Current smoking, N (%)	4 (16)	4 (15)
Illness duration, mean years (SD)	5.82 (5.29)	8.67 (8.2)
Harvey-Bradshaw Index:
Mild disease (5–7), N (%)	11 (44)	10 (37)
Moderate disease (8–16), N (%)	14 (56)	17 (63)
Medications
Antibiotics, N (%) Steroids, N (%)	1 (4) 1 (4)	0 (0) 2 (7.4)
Immunomodulators, N (%)	3 (12)	7 (26)
Biologics, N (%)	13 (52)	10 (37)

Figure 2. Correlations at T1 demonstrate significant ties between microbial abundance and psychological parameters.

Co-occurrence, interactive networks presenting interactions involving gut microbiome species, psychological parameters and inflammatory markers in both study groups at T1. Each node in the network represents an entity, gray nodes represent bacteria, orange nodes represent inflammatory markers, and purple nodes represent psychological parameters. The size of each node reflects the number of edges associated with that node. The connections (edges) between nodes indicate relationships between the entities; green and red lines (i.e., edges) represent significant positive (p < .01) and negative (p < .01) correlation between two nodes, respectively.

Figure 3. Significant changes in microbial abundance among COBMINDEX and wait-list CD patients.

Relative abundances of phyla (a), family (b), and genera (c) over time for wait-list (left plots, n = 23) and COBMINDEX (right plots, n = 23) study groups. Statistically significant changes over time (LefSe with FDR-adjustment, p < .05) are highlighted with an asterisk. Bacteria with only one boxplot indicate a 0 relative abundance at one time point.

Figure 4. Alpha diversity did not differ in COBMINDEX and wait-list groups over time.

Analysis of alpha diversity – Shannon index (a) and Faith’s phylogenetic diversity index (b) – over time for wait-list (left plot, n = 23) and COBMINDEX (right plot, n = 23) study groups. Paired T-test (FDR-adjusted, p < .05).

Figure 5. Beta diversity in COBMINDEX and wait-list CD patients over time.

(a-b) NDMS plot (left) and PERMANOVA (right; 999 permutations, FDR adjusted, p < .05) of weighted unifrac dissimilarity index changes over time for wait-list (n = 23) and COBMINDEX (n = 23) study groups. (c-d) NDMS plot (left) and PERMANOVA (right; 999 permutations, FDR adjusted, p < .05) weighted unifrac dissimilarity index between wait-list and COBMINDEX study groups, at T1 and T2.

Figure 6. Differential correlations between microbial, psychological, and inflammatory markers in COBMINDEX vs wait-list CD patients.

A. Significant correlations at T2 among COBMINDEX reveal microbial-inflammatory-psychological relationships. Co-occurrence, interactive network presenting interactions involving gut microbiome species, psychological parameters, and inflammatory markers at T2. Each node in the network represents an entity, yellow nodes represent bacteria, orange nodes represent inflammatory markers, and purple nodes represent psychological parameters. The size of each node reflects the number of edges associated with that node. The connections (edges) between nodes indicate relationships between the entities. Green and red lines (i.e., edges) represent significant positive (p < .01) and negative (p < .01) correlation between two nodes. B. Significant correlations at T2 among wait-list reveal microbial–psychological relationships. Co-occurrence, interactive network presenting interactions involving the gut microbiome species and psychological parameters at T2. Each node in the network represents an entity, yellow nodes represent bacteria, and purple nodes represent psychological parameters. The size of each node is proportional to its degree, reflecting the number of edges associated with that node. The connections (edges) between nodes indicate relationships between the entities. Green and red lines (i.e., edges) represent significant positive (p < .01) and negative (p < .01) correlation between two nodes, respectively.

Data availability statement

The data supporting this study’s findings of this study are available on request from the corresponding author [A.M]. The data are not publicly available due to their containing information that could compromise the privacy of research participants.