Microbiome Minute returns with quick research recaps

Altered microbial transcription in long-term proton pump inhibitor use: findings from a United States cohort study

Published in Gastroenterology

Proton pump inhibitors (PPIs) are one of the most commonly prescribed medications in the U.S., primarily for the treatment of GERD. While previous research has shown that PPIs can disrupt the gut microbiome by promoting the translocation of oral bacterial into the intestinal tract, the functional consequences of these changes remain poorly understood. To address this, Kim, et al. examined stool metagenomics and metatranscriptomics from individuals exposed to PPIs, revealing significant alterations in key bacterial metabolic pathways. These changes were largely driven by increased transcriptional activity of oral-associated microbes, likely a bacterial response to the acid-suppressed environment induced by PPIs. This study offers new insights into the microbiome's physiological response to PPIs, which may have important implications for host health and disease susceptibility.

Gut pathobiont-derived outer membrane vesicles drive liver inflammation and fibrosis in PSC-IBD

Published in Gastroenterology

Dorner, et al., present a comprehensive experimental case for the role of bacterial components (outer membrane vesicles) in liver pathogenicity in a mouse model of primary sclerosing cholangitis. The concept of OMV-induced host injury has been considered for a long time, and it is not easy to differentiate between a normal bacterial process (OMV shedding) and an actual delivery system for virulence factors. This work, with its thorough analysis of in vitro, in vivo (mouse model) and limited, but important, human correlation helps substantiate that OMVs from bacteria of gut origin belong to the causal pathway of liver injury. We look forward to future work to determine if OMVs contribute to organ injury by delivering specific pathogenic payloads, and/or the lipid-heavy spheres of the PMVs themselves.

Diet and microbiome-directed therapy 2.0 for IBD

Published in Clinical Gastroenterology and Hepatology

IBD is understood to develop from genetic risk factors as well as modifiable risk factors, including the microbiome and diet. This review by Ananthakrishnan, et al. summarizes the current knowledge of how the microbiome and/or diet could be used as a treatment for IBD. They summarize that:

• Microbiota transplants are showing efficacy for promoting remission of ulcerative colitis, while more evidence is needed for other types of microbiome-based therapeutics.
• Dietary risk factors including high sugar, emulsifiers, and ultra-processed food consumption and low fiber, fruit, zinc, n-3 PUFAs, and antioxidant consumption suggest dietary interventions that could treat IBD.
• After further study is completed, controlled diet plans including exclusion diets, the Mediterranean diet, and specific carbohydrate diets may present highly palatable alternatives to standard treatment approaches that use enteral nutrition.
• Future studies are needed and numerous experimental, clinical, manufacturing, and regulatory challenges must be overcome to realize the potential of diet and microbial-based therapeutics to treat IBD.

Faecal microbiota transplantation for sleep disturbance in post-acute COVID-19 syndrome

Published in Clinical Gastroenterology and Hepatology

In the study by Lau andSu,et al., they investigate the efficacy of fecal microbiota transplantation (FMT) in treating sleep disturbances associated with post-acute COVID-19 syndrome (PACS) or "long COVID". In a non-randomized open-label trial involving 60 patients, those receiving FMT showed significant improvements in insomnia, sleep quality, anxiety, and cortisol levels compared to the control group with corresponding changes in gut microbiome composition. The study suggests that FMT could be a safe and promising treatment for PACS-related insomnia.