Abstract
Intestinal dysmotility is common in many diseases and is correlated with gut microbiota dysbiosis and systemic inflammation. Functional constipation (FC) is the most typical manifestation of intestinal hypomotility and reduces patients’ quality of life. Some studies have reported that fecal micriobiota transplantation (FMT) may be an effective and safe therapy for FC as it corrects intestinal dysbiosis. This study was conducted to evaluate how FMT remodels the gut microbiome and to determine a possible correlation between certain microbes and clinical symptoms in constipated individuals. Data were retrospectively collected on 18 patients who underwent FMT between January 1, 2019 and June 30, 2020. The fecal bacterial genome was detected by sequencing the V3–V4 hypervariable regions of the 16S rDNA gene. Fecal short chain fatty acids (SCFAs) were detected by gas chromatography-mass spectrometry, and serum inflammatory factor concentrations were detected via enzyme-linked immunosorbent assay. Comparing the changes in fecal microbiome compositions before and after FMT revealed a significant augmentation in the alpha diversity and increased abundances of some flora such as Clostridiales, Fusicatenibacter, and Paraprevotella. This was consistent with the patients experiencing relief from their clinical symptoms. Abundances of other flora, including Lachnoanaerobaculum, were decreased, which might correlate with the severity of patients’ constipation. Although no differences were found in SCFA production, the butyric acid concentration was correlated with both bacterial alterations and clinical symptoms. Serum IL-8 levels were significantly lower after FMT than at baseline, but IL-4, IL-6, IL-10, and IL-12p70 levels were not noticeably changed. This study showed how FMT regulates the intestinal microenvironment and affects systemic inflammation in constipated patients, providing direction for further research on the mechanisms of FMT. It also revealed potential microbial targets for precise intervention, which may bring new breakthroughs in treating constipation.
Highlights
Intestinal motility disorder is common with many diseases such as irritable bowel syndrome (IBS), inflammatory bowel diseases, critical illness, and postsurgical intestinal dysfunction
Patients were eligible for inclusion if they were diagnosed with Functional constipation (FC) according to the Rome IV criteria (Drossman and Hasler, 2016; Mearin et al, 2016) and had a Bristol Stool Form Scale (BSFS) of 1 or 2 (Lewis and Heaton, 1997)
Patients were excluded if they were pregnant or breastfeeding; their constipation was secondary to other diseases or intervention; they had histories of organic digestive system diseases or disorders; they had a history of organ surgery; they had a history of systemic diseases; they were definitively diagnosed with a psychiatric disorder; they had an active infection; they were treated with probiotics, prebiotics, antibiotics, or proton pump inhibitors within the last 3 months; or they had a previous history of fecal micriobiota transplantation (FMT) within the last year
Summary
Intestinal motility disorder is common with many diseases such as irritable bowel syndrome (IBS), inflammatory bowel diseases, critical illness, and postsurgical intestinal dysfunction. Intestinal dysmotility is associated with many factors, including neuroimmune interactions and gut microbiota changes (De Jonge et al, 2005; Zhao and Yu, 2016). The intestinal flora may regulate intestinal motility by releasing bacterial metabolites such as short-chain fatty acids (SCFAs), intestinal neuroendocrine factors, and mediators released by the gut immune response (Barbara et al, 2005). Long durations of intestinal dysmotility, such as with chronic constipation, may alter the microbiome composition and intestinal permeability, which may lead to systemic immune system activation and inflammatory status changes (Khalif et al, 2005; de Jong et al, 2016). Intestinal motility disorders involve a series of complex pathophysiological processes in which the gut microbiota may play a key role
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