Meydan Cem, Afshinnekoo Ebrahim, Rickard Nate, Daniels Guy, Kunces Laura, Hardy Theresa, Lili Loukia, Pesce Sarah, Jacobson Paul, Mason Christopher E, Dudley Joel, Zhang Bodi
Onegevity Health, 152 W 57th, New York, NY 10019, USA.
Precis Clin Med. 2020 Jun;3(2):136-146. doi: 10.1093/pcmedi/pbaa013. Epub 2020 Apr 29.
Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorder worldwide, and the most common reason for referral to gastroenterology clinics. However, the pathophysiology is still not fully understood and consequently current management guidelines are very symptom-specific, leading to mixed results. Here we present a study of 88 individuals with IBS who had baseline sequencing of their gut microbiome (stool samples), received targeted interventions that included dietary, supplement, prebiotic/probiotic, and lifestyle recommendations for a 30-day period, and a follow-up sequencing of their gut microbiome. The study's objectives were to demonstrate unique metagenomic signatures across the IBS phenotypes and to validate whether metagenomic-guided interventions could lead to improvement of symptom scores in individuals with IBS. Enrolled subjects also completed a baseline and post-intervention questionnaire that assessed their symptom scores. The average symptom score of an individual with IBS at baseline was 160 and at the endpoint of the study the average symptom score of the cohort was 100.9. The mixed IBS subtype showed the most significant reduction in symptom scores across the different subtypes (average decrease by 102 points, = 0.005). The metagenomics analysis reveals shifts in the microbiome post-intervention that have been cross-validated with the literature as being associated with improvement of IBS symptoms. Given the complex nature of IBS, further studies with larger sample sizes, more targeted analyses, and a broader population cohort are needed to explore these results further.
肠易激综合征（IBS）是全球最普遍的功能性胃肠疾病，也是转诊至胃肠病诊所的最常见原因。然而，其病理生理学仍未被完全理解，因此当前的管理指南非常针对症状，导致结果参差不齐。在此，我们展示了一项针对88名IBS患者的研究，这些患者进行了肠道微生物群（粪便样本）的基线测序，接受了为期30天的针对性干预，包括饮食、补充剂、益生元/益生菌和生活方式建议，并进行了肠道微生物群的随访测序。该研究的目的是证明IBS各表型独特的宏基因组特征，并验证宏基因组指导的干预措施是否能改善IBS患者的症状评分。入选的受试者还完成了一份基线和干预后的问卷，以评估他们的症状评分。IBS患者在基线时的平均症状评分为160分，在研究终点时，该队列的平均症状评分为100.9分。混合性IBS亚型在不同亚型中症状评分下降最为显著（平均下降102分， = 0.005）。宏基因组分析揭示了干预后微生物群的变化，这些变化已通过文献交叉验证与IBS症状的改善相关。鉴于IBS的复杂性，需要进一步开展更大样本量、更有针对性的分析以及更广泛人群队列的研究，以进一步探索这些结果。
