Patients with breath test positive are necessary to be identified from irritable bowel syndrome:a clinical trial based on microbiomics and rifaximin sensitivity

作     者：Zuojing Liu Shiwei Zhu Meibo He Mo Li Hui Wei Lu Zhang Qinghua Sun Qiong Jia Nan Hu Yuan Fang Lijin Song Chen Zhou Heqing Tao John Y Kao Huaiqiu Zhu Chung Owyang Liping Duan 

作者机构：Department of GastroenterologyPeking University Third HospitalHaidian DistrictBeijing 100191China Department of UltrasoundPeking University Third HospitalHaidian DistrictBeijing 100191China Institute of Systems BiomedicineSchool of Basic Medical SciencesPeking University Health Science CenterBeijing 100191China Department of Biomedical EngineeringCollege of EngineeringPeking UniversityBeijing 100187China Division of GastroenterologyDepartment of Internal MedicineUniversity of Michigan Health System6520 MSRB ISPC 56821150 West Medical Center DriveAnn ArborMI 48109USA 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2022年第135卷第14期

页      面：1716-1727页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：supported by the National Natural Science Foundation of China(No.81670491) the Michigan Medicine-PKUHSC Joint Institute for Translational and Clinical Research(No.BMU20140478) 

主　　题：Irritable bowel syndrome Small intestinal bacterial overgrowth Breath test Gut microbiota Rifaximin 

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 *** overlapping with SIBO respond better to rifaximin therapy than those with IBS-D *** microbiota plays a critical role in both of these two *** aimed to determine the microbial difference between IBS-D overlapping with/without SIBO,and to study the underlying mechanism of its sensitivity to ***:Patients with IBS-D were categorized as BT-negative(IBSN)and BT-positive(IBSP).Healthy volunteers(BT-negative)were enrolled as healthy *** 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 ***:Clinical complaints and microbial abundance were significantly higher in IBSP than in *** contrast,severe systemic inflammation and more active bacterial invasion function that were associated with enrichment of opportunistic pathogens were seen in *** symptoms of IBSP patients were relieved in different degrees after therapy,but the symptoms of IBSN rarely *** also found that the presence of IBSN-enriched genera(Enterobacter and Enterococcus)are unaffected by rifaximin ***:IBS-D patients overlapping with SIBO showed noticeably different fecal microbial composition and function compared with IBS-D *** 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 ***:Chinese Clinical Trial Registry,ChiCTR1800017911.