典型文献
Patients with breath test positive are necessary to be identified from irritable bowel syndrome: a clinical trial based on microbiomics and rifaximin sensitivity
文献摘要：
Background::As a non-invasive and effective diagnostic method for small intestinal bacterial overgrowth (SIBO), wild-use of breath test (BT) has demonstrated a high comorbidity rate in patients with diarrhea-predominant irritable bowel syndrome (IBS-D) and SIBO. Patients overlapping with SIBO respond better to rifaximin therapy than those with IBS-D only. Gut microbiota plays a critical role in both of these two diseases. We aimed to determine the microbial difference between IBS-D overlapping with/without SIBO, and to study the underlying mechanism of its sensitivity to rifaximin.Methods::Patients with IBS-D were categorized as BT-negative (IBSN) and BT-positive (IBSP). Healthy volunteers (BT-negative) were enrolled as healthy control. The patients were clinically evaluated before and after rifaximin treatment (0.4 g bid, 4 weeks). Blood, intestine, and stool samples were collected for cytokine assessment and gut microbial analyses.Results::Clinical complaints and microbial abundance were significantly higher in IBSP than in IBSN. In contrast, severe systemic inflammation and more active bacterial invasion function that were associated with enrichment of opportunistic pathogens were seen in IBSN. The symptoms of IBSP patients were relieved in different degrees after therapy, but the symptoms of IBSN rarely changed. We also found that the presence of IBSN-enriched genera (
Enterobacter and
Enterococcus) are unaffected by rifaximin therapy.
Conclusions::IBS-D patients overlapping with SIBO showed noticeably different fecal microbial composition and function compared with IBS-D only. The better response to rifaximin in those comorbid patients might associate with their different gut microbiota, which suggests that BT is necessary before IBS-D diagnosis and use of rifaximin.Registration::Chinese Clinical Trial Registry, ChiCTR1800017911.
文献关键词：
Irritable bowel syndrome;Small intestinal bacterial overgrowth;Breath test;Gut microbiota;Rifaximin
中图分类号：
作者姓名：
Liu Zuojing;Zhu Shiwei;He Meibo;Li Mo;Wei Hui;Zhang Lu;Sun Qinghua;Jia Qiong;Hu Nan;Fang Yuan;Song Lijin;Zhou Chen;Tao Heqing;Y Kao John;Zhu Huaiqiu;Owyang Chung;Duan Liping
作者机构：
Department of Gastroenterology, Peking University Third Hospital, Haidian District, Beijing 100191, China;Department of Ultrasound, Peking University Third Hospital, Haidian District, Beijing 100191, China;Institute of Systems Biomedicine, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China;Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100187, China;Division of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, 6520 MSRB I, SPC 5682, 1150 West Medical Center Drive, Ann Arbor, MI 48109, USA
文献出处：
引用格式：
[1]Liu Zuojing;Zhu Shiwei;He Meibo;Li Mo;Wei Hui;Zhang Lu;Sun Qinghua;Jia Qiong;Hu Nan;Fang Yuan;Song Lijin;Zhou Chen;Tao Heqing;Y Kao John;Zhu Huaiqiu;Owyang Chung;Duan Liping-.Patients with breath test positive are necessary to be identified from irritable bowel syndrome: a clinical trial based on microbiomics and rifaximin sensitivity)[J].中华医学杂志（英文版）,2022(14):1716-1727
A类：
microbiomics,rifaximin,IBSN,ChiCTR1800017911,Rifaximin
B类：
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AB值：
0.498118
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