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The analysis of gut microbiota in patients with bile acid diarrhoea treated with colesevelam
Kumar, Aditi Quraishi, Mohammed Nabil Al-Hassi, Hafid Omar El-Asrag, Mohammed E. Segal, Jonathan P. Jain, Manushri Butterworth, Jeffrey Farmer, Adam McLaughlin, John
Kumar, Aditi
Quraishi, Mohammed Nabil
Al-Hassi, Hafid Omar
El-Asrag, Mohammed E.
Segal, Jonathan P.
Jain, Manushri
Butterworth, Jeffrey
Farmer, Adam
McLaughlin, John
Editors
Other contributors
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Epub Date
Issue Date
2023-03-17
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Abstract
Introduction: Bile acid diarrhoea (BAD) is a common disorder that results from an increased loss of primary bile acids and can result in a change in microbiome. The aims of this study were to characterise the microbiome in different cohorts of patients with BAD and to determine if treatment with a bile acid sequestrant, colesevelam, can alter the microbiome and improve microbial diversity. Materials and methods: Patients with symptoms of diarrhoea underwent 75-selenium homocholic acid (75SeHCAT) testing and were categorised into four cohorts: idiopathic BAD, post-cholecystectomy BAD, post-operative Crohn’s disease BAD and 75SeHCAT negative control group. Patients with a positive 75SeHCAT (<15%) were given a trial of treatment with colesevelam. Stool samples were collected pre-treatment, 4-weeks, 8-weeks and 6–12 months post-treatment. Faecal 16S ribosomal RNA gene analysis was undertaken. Results: A total of 257 samples were analysed from 134 patients. α-diversity was significantly reduced in patients with BAD and more specifically, in the idiopathic BAD cohort and in patients with severe disease (SeHCAT <5%); p < 0.05. Colesevelam did not alter bacterial α/β-diversity but patients who clinically responded to treatment had a significantly greater abundance of Fusobacteria and Ruminococcus, both of which aid in the conversion of primary to secondary bile acids. Conclusion: This is the first study to examine treatment effects on the microbiome in BAD, which demonstrated a possible association with colesevelam on the microbiome through bile acid modulation in clinical responders. Larger studies are now needed to establish a causal relationship with colesevelam and the inter-crosstalk between bile acids and the microbiome.
Citation
Kumar A, Quraishi MN, Al-Hassi HO, El-Asrag ME, Segal JP, Jain M, Steed H, Butterworth J, Farmer A, Mclaughlin J, Beggs A and Brookes MJ (2023) The analysis of gut microbiota in patients with bile acid diarrhoea treated with colesevelam. Frontiers in Microbiology, 14, 1134105. doi: 10.3389/fmicb.2023.1134105
Publisher
Journal
Research Unit
PubMed ID
37007510 (pubmed)
PubMed Central ID
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Journal article
Language
en
Description
© 2023 The Authors. Published by Frontiers Media. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3389/fmicb.2023.1134105
Series/Report no.
ISSN
1664-302X
EISSN
1664-302X
ISBN
ISMN
Gov't Doc #
Sponsors
The research department of MB received project funding from Bowel and Cancer Research for part of this work. The research department of MB received project funding from an unrestricted grant from Tillotts Pharma for part of this work.
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Licence for published version: Creative Commons Attribution 4.0 International