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Monday 20 May 2019
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Microbiome science may help deliver more effective, personalised treatment to children with IBS

To improve the treatment of children with IBS, investigators have developed a sophisticated way to analyse the microbial and metabolic contents of the gut. 
 
A report published in the Journal of Molecular Diagnostics has described how a new battery of tests enables researchers to distinguish patients with IBS from healthy children and identifies correlations between certain microbes and metabolites with abdominal pain.1 With this information, doctors envision tailoring nutritional and targeted therapies that address a child's specific gastrointestinal problems.
 
"This research highlights the importance of the microbiome-gut-brain axis and our understanding of chronic abdominal pain. Development of new disease classifiers based on microbiome data enables precision diagnostics to be developed for IBS and similar disorders. Although other studies have found differences in the gut microbiomes of patients with IBS, this study is the first to combine deep microbiome analysis with development of new diagnostic strategies," explained James Versalovic, MD, PhD, of the Department of Pathology & Immunology at Baylor College of Medicine and the Department of Pathology at Texas Children's Hospital, USA. 
 
Samples for this study were obtained from 23 preadolescent children with IBS (age 7 to 12 years) and 22 healthy controls. Participants were asked to maintain daily pain and stool diaries for two weeks and to provide stool (faecal) samples.
 
Investigators found that there are differences in bacterial composition, bacterial genes, and faecal metabolites in children with IBS compared to healthy controls. In addition to identifying correlations of these factors with abdominal pain, they generated a highly accurate classifier using metagenomic and metabolic markers that distinguishes children with IBS from healthy controls with 80% or greater accuracy. This classifier assesses specific metabolites, types of bacteria, functional pathways, and other factors. "This disease classifier represents a significant advance in the diagnosis of IBS and could be clinically impactful," commented Dr Versalovic.
 
This microbiome-based classifier can potentially help identify subpopulations of children with IBS that are more likely to benefit from microbiome-related therapies including diet modification, while guiding others to alternative appropriate treatment plans. The investigators also provide insights into how specific microbiome-related findings may be related to abdominal pain, thus opening up potential novel treatment approaches.
 
"Microbiome-based diagnosis and disease stratification of patients with IBS means that we create hope for tailored nutrition and targeted therapies in the future, leading to better outcomes for patients with chronic disease," noted Dr Versalovic.
 
Reference
  1. Hollister EB et al. Leveraging human microbiome features to diagnose and stratify children with irritable bowel syndrome. J Mol Diagn 2019;21(3):449-61.