McGuinness Amelia J, O'Hely Martin, Stupart Douglas, Watters David, Dawson Samantha L, Hair Christopher, Berk Michael, Mohebbi Mohammadreza, Loughman Amy, Guest Glenn, Jacka Felice N
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, VIC 3220, Australia.
Murdoch Children's Research Institute, Parkville, VIC 3052, Australia.
Microorganisms. 2024 Sep 27;12(10):1960. doi: 10.3390/microorganisms12101960.
Mechanical bowel preparation (MBP) is essential for visualisation of the colon during colonoscopy. Previous studies have identified changes in gut microbiota composition after MBP and colonoscopy. Considering the gut microbiota is increasingly implicated in psychiatry, we explored the potential impact of this intervention on mood and the microbiota-gut-brain axis. We conducted a pre-post intervention study in adults, with timepoints of one week before and one month after MBP and colonoscopy. Our primary outcome was change in average Hospital Anxiety and Depression Scale depression sub-scores. We examined changes in average anxiety, stress, and quality of life scores and gut microbiota composition using 16S rRNA sequencing. We further explored associations between changes in depressive symptoms and gut microbiota and conducted post hoc analyses to explore potential effect modifiers. Average depressive symptom scores decreased one month post-procedure compared to baseline (n = 59; adjusted β = -0.64; 95%CI: -1.18, -0.11). Irritable bowel syndrome (IBS) appeared to moderate this relationship (β = 1.78; 95%CI: 0.292, 3.26); depressive symptoms increased in those with, and decreased in those without, IBS. Reduced alpha diversity, modest effects on beta-diversity, and increases in health-associated genera were observed one month post-procedure. Increases in the CLR-transformed abundances of were associated with improvements in depressive symptoms. There is preliminary evidence of a potential mental health effect of MBP and colonoscopy, particularly for those with IBS, which may be associated with changes to the gut microbiota. Further research is required to confirm these findings and their clinical relevance.
机械性肠道准备（MBP）对于结肠镜检查时观察结肠至关重要。先前的研究已经确定了MBP和结肠镜检查后肠道微生物群组成的变化。鉴于肠道微生物群与精神病学的关联日益密切，我们探讨了这种干预对情绪以及微生物群-肠-脑轴的潜在影响。我们对成年人进行了一项干预前后研究，时间点为MBP和结肠镜检查前一周以及检查后一个月。我们的主要结局是医院焦虑抑郁量表抑郁子量表平均得分的变化。我们使用16S rRNA测序检查了平均焦虑、压力和生活质量得分以及肠道微生物群组成的变化。我们进一步探讨了抑郁症状变化与肠道微生物群之间的关联，并进行了事后分析以探索潜在的效应修饰因素。与基线相比，术后一个月平均抑郁症状得分下降（n = 59；调整后的β = -0.64；95%置信区间：-1.18，-0.11）。肠易激综合征（IBS）似乎调节了这种关系（β = 1.78；95%置信区间：0.292，3.26）；IBS患者的抑郁症状增加，无IBS患者的抑郁症状减少。术后一个月观察到α多样性降低、对β多样性有适度影响以及与健康相关的菌属增加。[此处原文缺失具体菌属名称]的CLR转换丰度增加与抑郁症状改善相关。有初步证据表明MBP和结肠镜检查对心理健康有潜在影响，特别是对IBS患者，这可能与肠道微生物群的变化有关。需要进一步研究来证实这些发现及其临床相关性。
