Microbiome-driven IBS metabotypes influence response to the low FODMAP diet: insights from the faecal volatome

作者：Thomas Edward Conley, Rachael Slater, Stephen Moss, David Colin Bulmer, Juan De La Revilla Negro, Umer Zeeshan Ijaz, David Mark Pritchard, Miles Parkes, Christopher S. Probert · 发表于：EBioMedicine · 年份：2024 · DOI：10.1016/j.ebiom.2024.105282 · 被引用次数：27 · 研究领域：Gastrointestinal motility and disorders、Gut microbiota and health、Inflammatory Bowel Disease

BACKGROUND: Irritable bowel syndrome (IBS) is a common and debilitating disorder manifesting with abdominal pain and bowel dysfunction. A mainstay of treatment is dietary modification, including restriction of FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols). A greater response to a low FODMAP diet has been reported in those with a distinct IBS microbiome termed IBS-P. We investigated whether this is linked to specific changes in the metabolome in IBS-P. METHODS: Solid phase microextraction gas chromatography-mass spectrometry was used to examine the faecal headspace of 56 IBS cases (each paired with a non-IBS household control) at baseline, and after four-weeks of a low FODMAP diet (39 pairs). 50% cases had the IBS-P microbial subtype, while the others had a microbiome that more resembled healthy controls (termed IBS-H). Clinical response to restriction of FODMAPs was measured with the IBS-symptom severity scale, from which a pain sub score was calculated. FINDINGS: Two distinct metabotypes were identified and mapped onto the microbial subtypes. IBS-P was characterised by a fermentative metabolic profile rich in short chain fatty acids (SCFAs). After FODMAP restriction significant reductions in SCFAs were observed in IBS-P. SCFA levels did not change significantly in the IBS-H group. The magnitude of pain and overall symptom improvement were significantly greater in IBS-P compared to IBS-H (p = 0.016 and p = 0.026, respectively). Using just ...