Abstract
Objective
Little is known about association between the efficacy of probiotics and baseline gut microbiota in irritable bowel syndrome (IBS). We aimed to explore gut microbiota in diarrhea-predominant IBS (IBS-D) and whether baseline gut microbiota was related to the efficacy of Bacillus subtilis and Enterococcus faecium (BE).
Methods
This study recruited 19 healthy controls (HC) and 50 IBS-D patients, among whom 19 patients were administrated 500 mg BE orally three times daily for 2 weeks. Clinical data and fecal samples were collected from patients before and after treatment. 16S rRNA sequencing was performed to obtain fecal bacterial data.
Results
There was no significant difference of alpha diversity, beta diversity, profiles of microbial phyla and genera between HC and IBS. BE improved IBS-SSS (IBS severity scoring system) and stool consistency, and altered Enterococcus, Blautia, Lachnoclostridium and Fusobacterium without significant impact on microbial structure in IBS-D. Notably, baseline fecal bacterial composition differed between non-responders and responders to BE concerning abdominal pain and bloating, with Atopobium, Pyramidobacter, Ruminococcus gnavus and Peptostreptococcus enriched in responders in terms of abdominal pain. There was reduced abundance of Prevotella, Ruminococcaceae UCG, Eubacterium eligens, Faecalibacterium and Eubacterium coprostanoligenes in responders compared with non-responders. Furthermore, BE increased beneficial bacteria including Faecalibacterium, Blautia and Butyricicoccus, decreased Lachnoclostridium and Bilophila, and influenced some microbial metabolic pathways in responders, such as mineral absorption, metabolism of arachidonic acid, d-arginine, D-ornithine, phenylalanine and vitamin B6.
Conclusion
Baseline fecal microbiome is associated with the efficacy of BE in attenuating abdominal pain and bloating in IBS-D.
Acknowledgments
This study was funded by grants from the National Natural Science Foundation of China (NSFC), China (Nos. 81330014, 81570486, 81800463, 81800480, 81500415, 81800465, 81974062, 81720108006).
Author contribution
Hong G and Li Y recruited participants, collected samples, analyzed the data and drafted the manuscript; Yang M, Li G, Jin Y, Qian W and Xiong H helped for collecting samples; Hou X and Ding Z designed and supervised the study, and obtained grants.
Ethical aspects
This study was approved by the Institutional Ethical Review Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, and registered in Chinese Clinical Trials Registry (Registration No. ChiCTR2000034041).
Disclosure statement
No potential conflict of interest was reported by the authors.