Department of Gastroenterology, Fujian Provincial Hospital South Branch, No. 516, South, Jinrong Road, Cangshan District, Fuzhou, 350000, Fujian, China.
Shengli Clinical Medical College, Fujian Medical University, No.134, East Street, Gulou District, Fuzhou, 350000, Fujian, China.
Microb Cell Fact. 2021 Dec 28;20(1):233. doi: 10.1186/s12934-021-01720-1.
Anxiety and depression are complications in Irritable bowel syndrome (IBS) patients. In this study, we recruited 18 IBS patients with mild-modest anxiety and depression behaviors, and after the screening, we defined the FMT treatment group (n = 9) and the control group (n = 9). The IBS symptom severity scale (IBS-SSS), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Irritable Bowel Syndrome Quality of Life (IBS-QOL) and Bristol stool scale (BSS) were evaluated one week before FMT (baseline), one-week-, one-month-, two-month-, and three-month-following FMT. Meanwhile, we determined the SCFAs in the patient's feces and serum and continued the metagenomic analysis of the microorganisms in the patient's feces.
The results showed that the patient's anxiety and depression behavior gradually improved with FMT treatment. Moreover, the illness and quality of life had also been relieved significantly. The content of isovaleric acid and valeric acid was significantly reduced in the FMT group compared to the Col group. Metagenomic analysis showed that FMT treatment decreased the abundance of Faecalibacterium, Eubacterium and Escherichia. From KEGG functional analysis, we confirmed that the top five abundant pathways were "bacterial chemotaxis, "flagellar assembly", "glycine, serine and threonine metabolism", "apoptosis", and "bacterial invasion of epithelial cells".
FMT treatment can effectively alleviate the anxiety and depression behaviors of IBS-D patients and reduce the IBS-SSS score, indicating that FMT can improve patients' symptoms. The high throughput sequencing results show that Bifidobacterium and Escherichia play the most critical role in the formation and recovery of IBS-D patients. The GC/MS data indicated that faeces isovaleric acid and valeric acid might be more suitable as a metabolic indicator of IBS-D remission. Trial registration ChiCTR, ChiCTR1900024924, Registered 3 August 2019, https://www.chictr.org.cn/showproj.aspx?proj=41676 .
焦虑和抑郁是肠易激综合征（IBS）患者的并发症。在这项研究中，我们招募了 18 名有轻度至中度焦虑和抑郁行为的 IBS 患者，经过筛选，我们将 FMT 治疗组（n=9）和对照组（n=9）定义为 FMT 治疗组。在 FMT 前一周（基线）、FMT 后一周、一个月、两个月和三个月评估 IBS 症状严重程度量表（IBS-SSS）、汉密尔顿焦虑量表（HAM-A）、汉密尔顿抑郁量表（HAM-D）、肠易激综合征生活质量（IBS-QOL）和布里斯托粪便量表（BSS）。同时，我们测定了患者粪便和血清中的 SCFAs，并继续对患者粪便中的微生物进行宏基因组分析。
结果显示，患者的焦虑和抑郁行为随 FMT 治疗逐渐改善，同时疾病和生活质量也明显缓解。与 Col 组相比，FMT 组异戊酸和戊酸含量明显降低。宏基因组分析显示，FMT 治疗降低了粪杆菌、真杆菌和大肠杆菌的丰度。从 KEGG 功能分析中，我们证实了前 5 个丰富的途径是“细菌趋化性”、“鞭毛组装”、“甘氨酸、丝氨酸和苏氨酸代谢”、“细胞凋亡”和“细菌入侵上皮细胞”。
FMT 治疗能有效缓解 IBS-D 患者的焦虑和抑郁行为，降低 IBS-SSS 评分，表明 FMT 能改善患者症状。高通量测序结果显示，双歧杆菌和大肠杆菌在 IBS-D 患者的形成和恢复中起着最为关键的作用。GC/MS 数据表明，粪便异戊酸和戊酸可能更适合作为 IBS-D 缓解的代谢指标。
ChiCTR，ChiCTR1900024924，注册于 2019 年 8 月 3 日，https://www.chictr.org.cn/showproj.aspx?proj=41676。
