Microbial signatures in post-infectious irritable bowel syndrome--toward patient stratification for improved diagnostics and treatment

Jonna Jalanka, Anne Salonen, Susana Fuentes, Willem M de Vos, Jonna Jalanka, Anne Salonen, Susana Fuentes, Willem M de Vos

Abstract

Irritable bowel syndrome (IBS) is a multifactorial and heterogeneous disorder estimated to affect over 10% of the Western population. A subset of the patients reports the start of the disease after an episode of gastroenteritis. The alterations in the intestinal microbiota of the post-infectious IBS (PI-IBS) patients were recently investigated in a British cohort and shown to differentiate from the healthy controls and resemble that of diarrhea-predominant IBS (IBS-D) patients. The altered 27 genus-like groups created a microbial signature, which could be used to objectively stratify patients and healthy controls. In this addendum, we combine the microbiota data derived from the British cohort with that of a recently reported Swedish PI-IBS cohort. Remarkably, robust and reproducible microbiota signatures were observed in these PI-IBS patients. We discuss these results with attention on the emerging role of microbiota in the classification, development and treatment of PI-IBS.

Keywords: IMD; PI-IBS; irritable bowel syndrome; microbiota.

Figures

Figure 1.
Figure 1.
Intestinal microbiota of PI-IBS patients is significantly different form that of healthy controls (HC). The difference was measured with baggedRDA that was used to identify a microbial signature that separates HC from PI-IBS patients from the two study cohorts. The 19 taxa responsible for the separation are listed. Abundance of the discriminating taxa creates the so-called Index of Microbial Dysbiosis (IMD).
Figure 2.
Figure 2.
Proposed model on how microbial aberrations could explain the disease etiology in IBS. The PI-IBS patients can be stratified according to the IMD (or more generally the microbial composition) to those with IBS-like microbiota (red) and those with a composition resembling healthy individuals (turquoise). Objective measurements such as low-grade inflammation and altered gene expression correlated with the IMD. Psychological aspects, such as depression or anxiety do not correlate with the IMD and these patients, though diagnosed with IBS, show a healthy-like microbiota profile. The correlations between host response and microbiota aberration identified in our study are indicated in bold.

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