Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
J Dig Dis. 2023 May;24(5):348-358. doi: 10.1111/1751-2980.13203. Epub 2023 Aug 9.
Percutaneous electrical nerve field stimulation (PENFS) has documented efficacy for irritable bowel syndrome (IBS) via plausible vagal neuromodulation effects. The vagus nerve may affect gut microbiome composition via brain-gut-microbiome signaling. We aimed to investigate gut microbiome alterations by PENFS therapy in adolescent IBS patients.
A prospective study of females with IBS aged 11-18 years receiving PENFS therapy for 4 weeks with pre- and post-intervention stool sampling was conducted. Outcome surveys completed pre-therapy, weekly, and post-therapy included IBS-Severity Scoring System (IBS-SSS), Visceral Sensitivity Index (VSI), Functional Disability Inventory (FDI), and the global symptom response scale (SRS). Bacterial DNA was extracted from stool samples followed by 16S rRNA amplification and sequencing. QIIME 2 (version 2022.2) was used for analyses of α and β diversity and differential abundance by group.
Twenty females aged 15.6 ± 1.62 years were included. IBS-SSS, VSI, and FDI scores decreased significantly after PENFS therapy (P < 0.0001, P = 0.0003, P = 0.0004, respectively). No intra- or interindividual microbiome changes were noted pre- versus post-therapy or between responders and non-responders. When response was defined by 50-point IBS-SSS score reduction, α diversity was higher in responders compared with non-responders at week 4 (P = 0.033). There was higher abundance of Blautia in excellent responders versus non-responders.
There were no substantial microbial diversity alterations with PENFS. Subjects with excellent therapeutic response showed an enrichment of relative abundance of Blautia, which may indicate that patients with specific microbial signature have a more favorable response to PENFS.
经推测，经皮电神经刺激（PENFS）通过迷走神经调节作用，对肠易激综合征（IBS）具有明确的疗效。迷走神经可能通过肠-脑-微生物群信号影响肠道微生物群组成。我们旨在研究 PENFS 治疗对青少年 IBS 患者肠道微生物群的影响。
对 11-18 岁的 IBS 女性患者进行前瞻性研究，这些患者接受 PENFS 治疗 4 周，在治疗前和治疗后进行粪便样本采集。在治疗前、每周和治疗后完成的 IBS 严重程度评分系统（IBS-SSS）、内脏敏感性指数（VSI）、功能性残疾指数（FDI）和整体症状反应量表（SRS）完成了调查。从粪便样本中提取细菌 DNA，然后进行 16S rRNA 扩增和测序。使用 QIIME 2（版本 2022.2）分析按组的 α 和 β 多样性和差异丰度。
共纳入 20 名年龄 15.6±1.62 岁的女性。PENFS 治疗后，IBS-SSS、VSI 和 FDI 评分显著降低（P<0.0001、P=0.0003、P=0.0004，分别）。治疗前后或应答者与无应答者之间未观察到个体间或个体内微生物群变化。当以 IBS-SSS 评分降低 50 分为应答标准时，第 4 周时应答者的 α 多样性高于无应答者（P=0.033）。与无应答者相比，优秀应答者的 Blautia 丰度更高。
PENFS 没有引起微生物多样性的实质性改变。治疗效果极好的患者显示出 Blautia 相对丰度的增加，这可能表明具有特定微生物特征的患者对 PENFS 有更有利的反应。
