Differences in the Microbial Composition of Hemodialysis Patients Treated with and without β-Blockers

Yi-Chun Tsai,Rachel Ann Delicano,Ting-Yun Lin,Mei-Chuan Kuo,Yun-Shiuan Chuang,Wei-Chun Hung,Szu-Chun Hung,Yi-Ting Lin,Wei-Chung Tsai,Ping-Hsun Wu,Po-Yu Liu,Yi-Wen Chiu

doi:10.3390/jpm11030198

Abstract

β-blockers are commonly prescribed to treat cardiovascular disease in hemodialysis patients. Beyond the pharmacological effects, β-blockers have potential impacts on gut microbiota, but no study has investigated the effect in hemodialysis patients. Hence, we aim to investigate the gut microbiota composition difference between β-blocker users and nonusers in hemodialysis patients. Fecal samples collected from hemodialysis patients (83 β-blocker users and 110 nonusers) were determined by 16S ribosomal RNA amplification sequencing. Propensity score (PS) matching was performed to control confounders. The microbial composition differences were analyzed by the linear discriminant analysis effect size, random forest, and zero-inflated Gaussian fit model. The α-diversity (Simpson index) was greater in β-blocker users with a distinct β-diversity (Bray–Curtis Index) compared to nonusers in both full and PS-matched cohorts. There was a significant enrichment in the genus Flavonifractor in β-blocker users compared to nonusers in full and PS-matched cohorts. A similar finding was demonstrated in random forest analysis. In conclusion, hemodialysis patients using β-blockers had a different gut microbiota composition compared to nonusers. In particular, the Flavonifractor genus was increased with β-blocker treatment. Our findings highlight the impact of β-blockers on the gut microbiota in hemodialysis patients.

Highlights

The gut microbiota has a crucial role in metabolic, nutritional, physiological, defensive, and immunological processes in the human body, with its composition linked to human health and the development of diseases [1,2]
Gut Microbiota Profile Differs in Hemodialysis Patients with and without β Blocker Treatment The rarefaction curves were close to asymptotic based on the number of operational taxonomic units (OTU) observed
Hemodialysis patients treated with β-blockers had a higher αdiversity and a distinct β-diversity compared to nonusers

Summary

Introduction

The gut microbiota has a crucial role in metabolic, nutritional, physiological, defensive, and immunological processes in the human body, with its composition linked to human health and the development of diseases [1,2]. Human-microbiome association can be considered as integration in evolution. The microbiome can modulate and restore human health [3]. Changes in this microbial equilibrium, that is, dysbiosis, promotes and influences the course of many intestinal and extra-intestinal diseases [4,5,6]. Drug-microbiome-host interactions are complex and multifactorial, impacting host metabolism [14,15]. They should be part of the core phenotype set for human gut microbiota research [16]

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