Microbiota, Microbial Metabolites, and Barrier Function in A Patient with Anorexia Nervosa after Fecal Microbiota Transplantation.

Prochazkova Prochazkova,Tlaskalova-Hogenova Tlaskalova-Hogenova,Papezova Papezova,Cermakova Cermakova,Meisnerova Meisnerova,Lambertova Lambertova,Bilej Bilej,Sediva Sediva,Tomasova Tomasova,Kuzma Kuzma,Hrabak Hrabak,Dvorak Dvorak,Bulant Bulant,Roubalova Roubalova

doi:10.3390/microorganisms7090338

Abstract

The change in the gut microbiome and microbial metabolites in a patient suffering from severe and enduring anorexia nervosa (AN) and diagnosed with small intestinal bacterial overgrowth syndrome (SIBO) was investigated. Microbial gut dysbiosis is associated with both AN and SIBO, and therefore gut microbiome changes by serial fecal microbiota transplantation (FMT) is a possible therapeutic modality. This study assessed the effects of FMT on gut barrier function, microbiota composition, and the levels of bacterial metabolic products. The patient treatment with FMT led to the improvement of gut barrier function, which was altered prior to FMT. Very low bacterial alpha diversity, a lack of beneficial bacteria, together with a great abundance of fungal species were observed in the patient stool sample before FMT. After FMT, both bacterial species richness and gut microbiome evenness increased in the patient, while the fungal alpha diversity decreased. The total short-chain fatty acids (SCFAs) levels (molecules presenting an important source of energy for epithelial gut cells) gradually increased after FMT. Contrarily, one of the most abundant intestinal neurotransmitters, serotonin, tended to decrease throughout the observation period. Overall, gut microbial dysbiosis improvement after FMT was considered. However, there were no signs of patient clinical improvement. The need for an in-depth analysis of the donor´s stool and correct selection pre-FMT is evident.

Highlights

Increasing research evidence is documenting the importance of the role of the gut microbiome in the regulation of behavior, mood, gastrointestinal symptomology, appetite, satiety, and nutrient metabolism
The objectives of the present work were to investigate the change in the gut microbiome and microbial metabolites in an anorexia nervosa (AN) patient diagnosed with SIBO, and to evaluate the effect of fecal microbiota transplantation (FMT) on the patient’s psychiatric conditions
These pathological changes were detected in patients with inflammatory bowel diseases (IBD), various autoimmune diseases, liver cirrhosis, severe acute pancreatitis, and other metabolic diseases [34]

Summary

Introduction

Increasing research evidence is documenting the importance of the role of the gut microbiome in the regulation of behavior, mood, gastrointestinal symptomology, appetite, satiety, and nutrient metabolism. These are specific and non-specific core symptoms altered in anorexia nervosa (AN) patients. The studies have demonstrated significant changes in the microbial composition in individuals with AN in comparison with healthy or overweight individuals [1]. Specific alterations vary between studies [2]. The most common bacterial species in human gut microbiota are members of the Firmicutes and Bacteroidetes phyla. The F/B ratio is increased in obese people compared to lean people, and tends to decrease with weight loss [3,4]

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