Washed microbiota transplantation reduces glycemic variability in unstable diabetes

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2023-10-17 DOI:10.1111/1753-0407.13485

Yangyang Li, Qing Liu, Lingyu Zhang, Jing Zou, Rongbo He, Ying Zhou, Chen Qian, Yuxiao Zhu, Rourou Chen, Ying Zhang, Pengpeng Cai, Miao Wang, Wei Shao, Minjun Ji, Hao Wu, Faming Zhang, Zejian Liu, Yu Liu

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Abstract

Background

Dysbiosis of gut microbiota is causally linked to impaired host glucose metabolism. We aimed to study effects of the new method of fecal microbiota transplantation, washed microbiota transplantation (WMT), on reducing glycemic variability (GV) in unstable diabetes.

Methods

Fourteen eligible patients received three allogenic WMTs and were followed up at 1 week, 1 month, and 3 months. Primary outcomes were daily insulin dose, glucose excursions during meal tests, and GV indices calculated from continuous monitoring or self-monitoring glucose values. Secondary outcomes were multiomics data, including 16S rRNA gene sequencing, metagenomics, and metabolomics to explore underlying mechanisms.

Results

Daily insulin dose and glucose excursions markedly dropped, whereas GV indices significantly improved up to 1 month. WMT increased gut microbial alpha diversity, beta diversity, and network complexity. Taxonomic changes featured lower abundance of genera Bacteroides and Escherichia-Shigella, and higher abundance of genus Prevotella. Metagenomics functional annotations revealed enrichment of distinct microbial metabolic pathways, including methane biosynthesis, citrate cycle, amino acid degradation, and butyrate production. Derived metabolites correlated significantly with improved GV indices. WMT did not change circulating inflammatory cytokines, enteroendocrine hormones, or C-peptide.

Conclusions

WMT showed strong ameliorating effect on GV, raising the possibility of targeting gut microbiota as an effective regimen to reduce GV in diabetes.

Abstract Image

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冲洗微生物群移植可降低不稳定型糖尿病患者的血糖变异性。

背景：肠道微生物群的失调与宿主葡萄糖代谢受损有因果关系。我们旨在研究粪便微生物群移植的新方法，即冲洗微生物群移植（WMT）对降低不稳定型糖尿病血糖变异性（GV）的影响。方法：14名符合条件的患者接受了三次同种异体WMT，并在1 周，1 月，和3 月。主要结果是每日胰岛素剂量、膳食测试期间的葡萄糖偏移以及通过连续监测或自我监测葡萄糖值计算的GV指数。次要结果是多组学数据，包括16S rRNA基因测序、宏基因组学和代谢组学，以探索潜在机制。结果：每日胰岛素剂量和葡萄糖偏移显著下降，而GV指数显著改善，最高可达1 月WMT增加了肠道微生物α多样性、β多样性和网络复杂性。分类变化表现为拟杆菌属和志贺氏杆菌属丰度较低，普雷沃氏菌属丰度较高。宏基因组学功能注释揭示了不同微生物代谢途径的富集，包括甲烷生物合成、柠檬酸盐循环、氨基酸降解和丁酸盐产生。衍生代谢产物与GV指数的改善显著相关。WMT不会改变循环炎症细胞因子、肠内分泌激素或C肽。结论：WMT对GV有很强的改善作用，增加了靶向肠道微生物群作为降低糖尿病GV的有效方案的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.