Abstract
This study aims to characterize the gut microbiota in depressed patients with bipolar disorder (BD) compared with healthy controls (HCs), to examine the effects of quetiapine treatment on the microbiota, and to explore the potential of microbiota as a biomarker for BD diagnosis and treatment outcome. Analysis of 16S‐ribosomal RNA gene sequences reveals that gut microbial composition and diversity are significantly different between BD patients and HCs. Phylum Bacteroidetes and Firmicutes are the predominant bacterial communities in BD patients and HCs, respectively. Lower levels of butyrate‐producing bacteria are observed in untreated patients. Microbial composition changes following quetiapine treatment in BD patients. Notably, 30 microbial markers are identified on a random forest model and achieve an area under the curve (AUC) of 0.81 between untreated patients and HCs. Ten microbial markers are identified with the AUC of 0.93 between responder and nonresponder patients. This study characterizes the gut microbiota in BD and is the first to evaluate microbial changes following quetiapine monotherapy. Gut microbiota‐based biomarkers may be helpful in BD diagnosis and predicting treatment outcome, which need further validations.
Highlights
Bipolar disorder (BD), a chronic and recurrent disease, has a worldwide prevalence of around 0.8%.[1,2] BD is associated with severe impairment in cognitive and social functions,[2] and increased risk of disability and suicide, especially in young individuals.[3]
Our results indicated that BD patients and healthy controls (HCs) could potentially be distinguished by the gut microbiota, and treatment outcome might be predicted by microbial markers
This study indicated significant alterations in gut microbiota in depressed drug-free BD patients, which may be related to multiple factors, including metabolic pathways, depressive severity, and pharmacological treatment
Summary
Bipolar disorder (BD), a chronic and recurrent disease, has a worldwide prevalence of around 0.8%.[1,2] BD is associated with severe impairment in cognitive and social functions,[2] and increased risk of disability and suicide, especially in young individuals.[3] To date, the pathogenesis of BD has not been fully elucidated. Interactions between genetic and environmental factors may play a role,[4] along with biological alterations such as immune activation, metabolic disturbance, oxidative stress, and circadian rhythm abnormality.[5]. The role of the brain– gut–microbiota axis in maintaining physical and mental well-being has attracted accumulated attention. As a bidirectional modulation system, this axis builds a
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