Effect of microbiota-targeted therapy on intestinal microbiota in patients with irritable bowel syndrome

Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-07-26 Cooperative journals: 《中国全科医学》

张晋东 郑浩楠 张涛 段丽萍

Abstract： Background The role of gut microbiota in the pathogenesis and treatment of irritable bowel syndrome (IBS) has attracted attention at home and abroad, and a variety of therapeutic methods targeting the microbiota have been used in clinic. Objective To analyze the effect of therapy targeting microbiota on gut microbiota in patients with IBS, and to provide reference for optimizing the intervention strategy. Methods The web of science core collection, PubMed, EMBASE and Cochrane databases were searched from the establishment of the database to May 20, 2022. The literatures on the changes of gut microbiota after treatment with a single kind of probiotics, prebiotics, antibiotics and fecal microbiota transplantation (FMT) were screened and reported. The data were extracted, and the research results were summarized and reported. Results A total of 3044 articles were retrieved, and 41 articles were included after screening by inclusion and exclusion criteria, including 11 studies on probiotics, 8 studies on prebiotics, 5 studies on antibiotics and 17 studies on FMT. Randomized controlled trials, Rome III, diarrhea predominant IBS and 16S rRNA amplicon sequencing were the most commonly used trial types, diagnostic criteria, IBS subtypes and mcirobiota detection methods. Lactobacillus is the most used probiotic species, which can maintain its activity in the feces of IBS patients. Prebiotics can promote the colonization of probiotics (mainly Bifidobacteria) in feces and colonic mucosa. Rifaximin, an antibiotic acting locally in the intestine, could reduce the species richness of the microbiota, but had no significant effect on the microbial structure. After FMT, the microbial structure of IBS patients tended to move towards that of donors, which can increase the probiotics and reduce the abundance of pathogenic bacteria. Conclusion Treatment targeting microbiota is helpful for the improvement and reconstruction of intestinal microenviroment in IBS patients. In the future, more accurate changes of microbiota after these treatment methods can be further obtained by unifying diagnostic criteria, using more advanced detection technology, and prolonging the follow-up sampling time, so as to provide a basis for clinical development of accurate microbiota-targeted intervention strategies.

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