F. prausnitzii may serve as marker for thiamine response in quiescent IBD, chronic fatigue
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Key takeaways:
- Gut microbiota was similar in patients with quiescent IBD with or without chronic fatigue.
- However, Faecalibacterium prausnitzii and Roseburia hominis were more abundant in patients who responded to thiamine.
An abundance of Faecalibacterium prausnitzii or Roseburia hominis may predict the effectiveness of high-dose thiamine treatment to alleviate chronic fatigue in quiescent inflammatory bowel disease, according to research.
“Recent studies that investigated factors contributing to chronic fatigue in IBD focused on the gut-brain axis and the associated microbiota,” Sandra Bermúdez-Sánchez, MSc, PhD, a postdoctoral researcher at the National Food Institute at Technical University of Denmark, and colleagues wrote in Gastro Hep Advances. “In a pilot study including 12 patients with IBD and normal blood thiamine levels, high-dose thiamine significantly improved chronic fatigue.”
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They continued, “The present study was conducted to unravel potential pathways connecting gut microbiota to the observed positive impact of high oral thiamine intake on chronic fatigue in patients with [quiescent IBD (qIBD)].”
In a double-blind, placebo-controlled, crossover trial, Bermúdez-Sánchez and colleagues enrolled 40 patients with quiescent IBD and chronic fatigue, who were randomly assigned 1:1 to high-dose oral thiamine (600-1,800 mg/day) or placebo for 4 weeks, followed by 4-week washout and crossover treatment periods. Twenty control patients, who had quiescent IBD but no fatigue, also were included.
The researchers collected fecal samples at baseline and weeks 4, 8 and 12 from the 40 patients, which were compared with samples collected at baseline from the 20 controls, to determine differences in microbiota and short-chain fatty acid (SCFA) concentrations between those with and without fatigue. The IBD-fatigue questionnaire section 1 (IBD-FQ1) was used to assess fatigue severity.
According to results, microbiota composition and SCFA concentrations did not differ significantly between patients with and without chronic fatigue. In addition, thiamine had no significant effect on microbiota or SCFA concentrations among those treated.
However, when analyzing specific species linked to chronic fatigue, the researchers found that patients who experienced improvement in IBD-FQ1 scores had significantly more abundant Faecalibacterium prausnitzii in both pretreatment (P = .019) and posttreatment (P = .038) periods compared with non-responders. This inverse association with IBD-FQ1 scores also was reported with Roseburia hominis, another species associated with chronic fatigue.
“We found no differences in gut microbiota between patients with qIBD with or without chronic fatigue,” Bermúdez-Sánchez and colleagues wrote. “The structure and stability of the fecal microbiota were not affected by thiamine or associated with improvement of fatigue symptoms. Importantly, the correlation between change in IBD-FQ1 and relative abundance of Faecalibacterium prausnitzii or Roseburia hominis indicated that Faecalibacterium prausnitzii or Roseburia hominis might serve as predictors of thiamine treatment effect for chronic fatigue, likely because they are markers of a better general gut health in patients who respond to high-dose thiamine.”
They continued: “Validation studies conducted in large cohorts are essential to apply these insights in clinical settings.”
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