Frémont en collega's hebben de samenstelling van de ontlasting geanalyseerd
op basis van bacterie-specifieke genen (16S ribosomale RNA)
van 43 CVS-patienten (18 Belgische en 25 Noorse patiënten) en
36 gezonde mensen (18 Belgische en 25 Noorse proefpersonen).
Op basis van die analyse konden Noorse CVS-patiënten en gezonde proefpersonen goed van elkaar onderscheiden worden,
met name op basis van grotere Ethanoligenens en Moryella-populaties
en beduidend kleinere Ruminococcus, Eubacterium, Holdemania and Turicibacter-populaties.
Belgische CVS-patienten konden iets minder goed van gezonde Belgische proefpersonen onderscheiden worden,
alhoewel het onderscheid de grenzen van significantie naderde.
Een aantal bacteriegeslachten die uiterst relevant was voor
het onderscheid tussen Noorse CVS-patienten en gezonde Noorse proefpersonen
was ook relevant voor het kunnen maken van
het onderscheid tussen Belgische CVS-patienten en gezonde Belgische proefpersonen
(Ethanoligenens, Ruminococcus en Eubacterium, geslachten binnen de bacteriestam Firmicutes).
De kernvraag blijft natuurlijk nog steeds (ook voor de auteurs):
is de gewijzigde darmflora de oorzaak van ME/CVS of
is de afwijkende samenstelling van de darmen het gevolg van andere afwijkingen?
Voor een Nederlandstalige vertaling van de samenvatting, klik op onderstaand logo:
De belangrijkste verschillen tussen patienten en gezonde proefpersonen in Noorwegen en België:
3.3. Alterations of intestinal microbiota in Norwegian patients
Discriminant function analysis achieved
a highly significant separation (p < 0.001)
between Norwegian controls and Norwegian patients.
Variations in sub-populations of the Firmicutes phylum
(namely relative proportions of the genera Moryella, Ethanoligenens,
Ruminococcus, Eubacterium, Holdemania and Turicibacter)
were main contributing factors of this separation.
In patients,
populations of Ethanoligenens and Moryella are increased,
populations of Ruminococcus, Eubacterium, Holdemania and Turicibacter are decreased.
Between Norwegian controls and Norwegian patients,
the most significant differences obtained by the Mann-Whitney test were for
the Firmicutes genera Holdemania (50-fold decrease, p = 0.0001),
Lactonifactor (20-fold increase, p = 0.003),
Syntrophococcus (2.5-fold decrease, p = 0.015),
but also for the Bacteroidetes Alistipes (3.8-fold increase, p = 0.013).
3.4. Alterations of intestinal microbiota in Belgian patients
In Belgian subjects the patient/control distinction was less pronounced.
The separation obtained by discriminant function analysis was not significant
(although borderline, p = 0.072).
Interestingly however,
some of the variables which contributed most to this separation
were the same as the ones which could also
discriminate Norwegian patients from Norwegian controls:
proportions of Ethanoligenens, Ruminococcus, Eubacterium
were again main contributors in the discriminant function
(together with Blautia, Lactobacillus and Megasphera).
Using the Mann-Whitney test,
only two variables were found to differ significantly
between Belgian controls and Belgian patients:
the percentage of Asaccharobacter,
a member of the Actinobacteria phylum (4-fold decrease, p = 0.041),
and also, remarkably, the percentage of Lactonifactor
which was again strongly increased in patients (45-fold increase, p = 0.006).
Clinical microbiology high-throughput 16S rRNA gene sequencing
reveals alterations of intestinal microbiota
in myalgic encephalomyelitis/chronic fatigue syndrome patients.
Anaerobe. 2013 Jun 18. doi: 10.1016/j.anaerobe.2013.06.002.
Frémont M, Coomans D, Massart S, de Meirleir K.
Article info
Article history:
Received 29 June 2012
Received in revised form 5 March 2013
Accepted 10 June 2013
Available 18 June 2013
Keywords:
Intestinal microbiota
High-throughput sequencing
Chronic fatigue syndrome
Myalgic encephalomyelitis
Abstract
Human intestinal microbiota
plays an important role in the maintenance of host health
by providing energy, nutrients, and immunological protection.
Intestinal dysfunction is a frequent complaint
in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients,
and previous reports suggest that dysbiosis,
i.e. the overgrowth of abnormal populations of bacteria in the gut,
is linked to the pathogenesis of the disease.
We used high-throughput 16S rRNA gene sequencing to investigate
the presence of specific alterations in the gut microbiota of ME/CFS patients
from Belgium and Norway.
43 ME/CFS patients and 36 healthy controls were included in the study.
Bacterial DNA was extracted from stool samples,
PCR amplification was performed on 16S rRNA gene regions, and
PCR amplicons were sequenced using Roche FLX 454 sequencer.
The composition of the gut microbiota was found to differ
between Belgian controls and Norwegian controls:
Norwegians
showed higher percentages of specific Firmicutes populations (Roseburia, Holdemania)
and lower proportions of most Bacteroidetes genera.
A highly significant separation could be achieved
between Norwegian controls and Norwegian patients:
patients presented
increased proportions of Lactonifactor and Alistipes, as well as
a decrease in several Firmicutes populations.
In Belgian subjects the patient/control separation was less pronounced,
however some abnormalities observed in Norwegian patients
were also found in Belgian patients.
These results show that
intestinal microbiota is altered in ME/CFS.
High-throughput sequencing is a useful tool
to diagnose dysbiosis in patients and
could help designing treatments
based on gut microbiota modulation (antibiotics, pre and probiotics supplementation).
http://www.sciencedirect.com/science/article/pii/S1075996413000929
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