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dc.contributor.authorVervier, Kevin
dc.contributor.authorMoss, Stephen
dc.contributor.authorKumar, Nitin
dc.contributor.authorAdoum, Anne
dc.contributor.authorBarne, Meg
dc.contributor.authorBrowne, Hilary
dc.contributor.authorKaser, Arthur
dc.contributor.authorKiely, Christopher J
dc.contributor.authorNeville, B Anne
dc.contributor.authorPowell, Nina
dc.contributor.authorRaine, Tim
dc.contributor.authorStares, Mark D
dc.contributor.authorZhu, Ana
dc.contributor.authorDe La Revilla Negro, Juan
dc.contributor.authorLawley, Trevor D
dc.contributor.authorParkes, Miles
dc.date.accessioned2021-10-29T14:15:57Z
dc.date.available2021-10-29T14:15:57Z
dc.date.issued2021-11-22
dc.date.submitted2021-05-17
dc.identifier.issn0017-5749
dc.identifier.othergutjnl-2021-325177
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330040
dc.description.abstractOBJECTIVE: Reducing FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) can be clinically beneficial in IBS but the mechanism is incompletely understood. We aimed to detect microbial signatures that might predict response to the low FODMAP diet and assess whether microbiota compositional and functional shifts could provide insights into its mode of action. DESIGN: We used metagenomics to determine high-resolution taxonomic and functional profiles of the stool microbiota from IBS cases and household controls (n=56 pairs) on their usual diet. Clinical response and microbiota changes were studied in 41 pairs after 4 weeks on a low FODMAP diet. RESULTS: Unsupervised analysis of baseline IBS cases pre-diet identified two distinct microbiota profiles, which we refer to as IBSP (pathogenic-like) and IBSH (health-like) subtypes. IBSP microbiomes were enriched in Firmicutes and genes for amino acid and carbohydrate metabolism, but depleted in Bacteroidetes species. IBSH microbiomes were similar to controls. On the low FODMAP diet, IBSH and control microbiota were unaffected, but the IBSP signature shifted towards a health-associated microbiome with an increase in Bacteroidetes (p=0.009), a decrease in Firmicutes species (p=0.004) and normalisation of primary metabolic genes. The clinical response to the low FODMAP diet was greater in IBSP subjects compared with IBSH (p=0.02). CONCLUSION: 50% of IBS cases manifested a 'pathogenic' gut microbial signature. This shifted towards the healthy profile on the low FODMAP diet; and IBSP cases showed an enhanced clinical responsiveness to the dietary therapy. The effectiveness of FODMAP reduction in IBSP may result from the alterations in gut microbiota and metabolites produced. Microbiota signatures could be useful as biomarkers to guide IBS treatment; and investigating IBSP species and metabolic pathways might yield insights regarding IBS pathogenic mechanisms.
dc.languageen
dc.publisherBMJ
dc.rightsEmbargo: ends 2021-09-28
dc.subjectGut microbiota
dc.subject1506
dc.subject1612
dc.subject2312
dc.subjectintestinal microbiology
dc.subjectdiet
dc.subjectirritable bowel syndrome
dc.titleTwo microbiota subtypes identified in irritable bowel syndrome with distinct responses to the low FODMAP diet.
dc.typeArticle
dc.date.updated2021-10-29T14:15:56Z
prism.publicationNameGut
dc.identifier.doi10.17863/CAM.77484
dcterms.dateAccepted2021-09-09
rioxxterms.versionofrecord10.1136/gutjnl-2021-325177
rioxxterms.versionVoR
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
rioxxterms.licenseref.startdate2021-09-28
dc.contributor.orcidVervier, Kevin [0000-0002-8497-4907]
dc.contributor.orcidRaine, Tim [0000-0002-5855-9873]
dc.contributor.orcidParkes, Miles [0000-0002-6467-0631]
dc.identifier.eissn1468-3288
pubs.funder-project-idNational Institute for Health Research (NIHRDH-IS-BRC-1215-20014)
cam.issuedOnline2021-11-22
rioxxterms.freetoread.startdate2021-09-28


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