Gut Microbiome in Synchrony With Symptoms of Inflammatory Bowel Disease

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Highlights:

• Scientists have identified that inflammatory disease patients suffer from fluctuation in microbiome associated with changes in severity of symptoms
• There are lower number of beneficial microbes in people with inflammatory bowel disease
• Alteration in the gut microbiome of inflammatory disease patients could help improve the condition

There are dramatic shifts in the microbiome community in patients with inflammatory bowel disease (IBD) than among healthy people, according to a study published in the journal Nature Microbiology. The difference in bacterial and other microbial culture among patients suffering from IBD have been known for a long time; however, this is the first conclusive study that monitored the microbiome for a long period of time. The research team involved in the study claim that a "volatile dysbiosis" or a fluctuation in the microbiome of the patients existed, which was the biggest difference between the microbiome of IBD patients and that of healthy subjects.

The study will aid scientists as well as physicians in understanding the disease better and providing new ways to monitor patients as well as to track the path of the disease.

‘Probiotic yogurt could improve beneficial microbiome in patients with inflammatory bowel disease.’

Dr. Janet Jansson from the Pacific Northwest National Laboratory of the Department of Energy (PNNL) said that the scientists knew that there were some important and beneficial microbes which are present in lower numbers in people with inflammatory bowel disease. The difference between healthy individuals and patients were substantial, with patients having a less stable gut microbiome. Dr. Jansson is the study's corresponding author but she was assisted by scientists from Germany, United States, Sweden and Spain.

Fluctuations in the Gut Microbiome

Inflammatory bowel disease belongs to a group of diseases where the immune system of the patient targets the microbes in the host gut resulting in a chronic inflammatory disease. There are two main types of IBD, Crohn's disease and ulcerative colitis. The main symptoms of both the types of inflammatory bowel disease are

• Swelling, cramps or pain in the stomach
• Bloody diarrhea
• Fatigue
• Weight loss
• Anemia
• Vomiting
• Fever

The symptoms that are associated with IBD are not consistent; there could be periods of intense symptoms, termed flare-ups, and periods where there are no symptoms, termed remission.

The treatment for inflammatory bowel disease involves the administration of anti-inflammatory drugs as well as steroids. In extreme cases, surgery would have to be considered.

Difference between Microbiome of Intestinal Bowel Disease (IBD) Patients and Healthy people:

It has always been known that the microbiome of people with inflammatory bowel disease

• had fewer beneficial microbes
• was more likely to have E. coli and Enterobacteriaceae

Dr. Colin Brislawn who was associated with the statistical analysis and is a PNNL scientist said that the study was designed to identify not only what microbes were present in patients with inflammatory bowel disease but how the microbial community changed as the symptoms of the patient became worse. The study showed that there was a dynamic nature of the disease which correlated with the dynamic nature of the microbes in the gut.

Studying the Gut Microbiome

Gastroenterologist, D. Jonas Halfvarson from the �rebro University and colleagues analyzed 137 people, which included patients with ulcerative colitis, ileal disease and Crohn's disease, as well as healthy controls, for a period of two years.

• Fecal samples were collected for two years, once every three months
• Symptoms of the patients were monitored
• Totally, the study resulted in the collection of 683 fecal samples
• Genetic sequencing technique was utilized to identify the microbes

The findings of the study were, while the gut microbial community was stable over time among healthy participants, in patients with IBD

• Gut microbiome was inconsistent
• There were dramatic shifts in microbiomes
• Certain bacteria were almost absent at some point
• A considerable population of microbiome was replaced by other microbes in just a few months
• People with Ileal disease showed maximum discrepancy in microbiome community
• Patients who consumed steroids were faced with more microbiome fluctuations
• Flare-ups in symptoms were also associated with microbiome fluctuations

The study can be used to identify the course of the disease and analyze the effectiveness of the medications administered using the microbiome of the intestine.

Dr. Halfvarson said that the results were an important step in identifying how the microbiome was associated with the dynamism of the inflammatory bowel disease. Alterations in the microbiome by mirroring the microbiome of healthy individuals could aid in better treatment.

The scientists involved in the study claim that avoiding immune suppressants could play a key role in preventing flare-ups while the addition of beneficial microbiome in the intestine of patients with the inflammatory bowel disease could maintain patients in remission.

It has always been fascinating to understand the intricacy of the relationship between gut microbiome and the health of an individual. The current study that focuses on the relevance of gut microbiome on the symptoms associated with inflammatory bowel disease highlights the need to actively maintain a �beneficial' species of microbiome.

References:

1. Inflammatory Bowel Diseases - (http://www.nhs.uk/conditions/inflammatory-bowel-disease/pages/introduction.aspx)

Source: Medindia

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