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Gut Microbes Could Soon Diagnose and Explain The Cause of IBS and IBD

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IBD and IBS

(Credit: sedat seven/shutterstock)

Doctors have long scratched their heads over the causes and cures for two common diseases of the digestive system: IBS and IBD. But research out today in Science Translational Medicine takes a leap forward in explaining these conditions, thanks to a major undertaking to sequence the gut microbiomes of almost 2,000 people.

Difference Between IBS and IBD

Irritable Bowel Syndrome, or IBS, is thought to affect as much as 20 percent of the world’s population, while its cousin, Inflammatory Bowel Disease or IBD, is less common (fewer than 1 percent of the population) but more severe. The two have similar symptoms, but because one is characterized by its namesake inflammation (IBD) and the other isn’t (IBS), their treatments are very different.

When a patient reports abdominal pain, constipation or diarrhea, doctors conduct invasive tests like blood samples and colonoscopies to look for signs of inflammation. If they find it, the patient has IBD, and treatments are aimed at reducing that inflammation. Crohn’s disease and ulcerative colitis are both types of IBD.

But if doctors find nothing? That’s IBS. IBS is a bit of a catch-all diagnosis for when there’s no inflammation — and really no other abnormalities that might explain a patient’s symptoms. Current IBS treatments revolve around alleviating symptoms and hoping for the best.

Although scientists recently identified a possible genetic trigger of IBD in mice, the root causes of both diseases are currently unknown.

Poop Microbes Reflect Colon Microbes

Mounting evidence shows that microbes play a role in gut health, and previous research has showed that IBS and IBD patients have different microbiota than healthy people. That’s why a research team in the Netherlands wondered how the two would compare to each other, and if they could be used for diagnosis.

“We thought, let’s see if the microbiome, or gut composition, can become a biomarker so we can design new tests in order to distinguish these two diagnoses,” says Arnau Vich Vila, computational biologist at the University Medical Center Groningen in the Netherlands.

“We would reduce the number of colonoscopies; saving time, saving money and also improving the diagnosis so that the patient doesn’t have to go through this kind of procedure,” says Vich Vila.

The team set about sequencing the microbiomes from almost 1,800 people: 350 with IBD, 410 with IBS, and 1,000 healthy people as a comparison. But to do this, they needed to collect 1,800 microbiomes. That’s a lot of poop.

They found their participants through three different established banks of volunteers with well-established medical information for use in population studies. If you’ve ever peed in a cup at the doctor’s office, you can use your imagination to figure out how fecal samples are collected. But as an added challenge, fecal samples can’t be kept at room temperature, because that would allow certain bacteria to grow, interfering with the study results.

“So we asked all of them to collect the sample at home, put it in the freezer, and then we were driving around the Netherlands to pick up these samples,” says Vich Vila.

They used a genetic tool called shotgun metagenomic sequencing to sequence the DNA of the bacteria living in each sample, a common technique used to identify bacteria species in big samples. But they didn’t just identify the species – they looked at how abundant each was, how fast each grew, and what functions each performs in the gut.

upset stomach IBD and IBS symptoms

(Credit: Emily Frost/shutterstock)

IBD Bacteria, Different from IBS Bacteria

They found that people with IBD and IBS had substantial overlap in which microbes they had in their guts, and both were different than their healthy peers. And Vich Vila says the group was surprised to find such an overlap in the IBS and IBD microbes, because of how fundamentally different the two diseases are.

But the researchers also found consistent microbial differences between IBS and IBD patients, suggesting microbiome analysis could soon be used to diagnose IBS and IBD – and could start to explain the differences in the conditions.

For instance, both IBS and IBD patients had reduced numbers of some known beneficial gut bacteria, while only patients with Crohn’s disease had increases in bacteria like Escherichia, known to invade the gut’s mucus lining and cause problems (you know this one from the “E” in E. coli.) Likewise, there were certain bacteria that only the IBS patients had in increased amounts.

The microbiomes were different in other ways, too. The genetic diversity within individual bacteria species was sometimes different, as were the growth rates. Patients with IBS and IBD also had much more virulent bacteria than people with healthy guts – bacteria that do things like evade or suppress their host’s immune system. And patients with Crohn’s, specifically, had more bacteria that had antibiotic resistance genes than any of the other groups.

They also compared the diagnostic abilities of their new microbiome data to that of a currently used diagnostic test for IBD: whether a patient’s stool contains a biomarker of inflammation called calprotectin. Their microbiome test did better at predicting whether a patient had IBS or IBD than did the old test.

What Bacteria Do In Your Gut

What a bacterium does is programmed in its DNA just like any other living organism. So the researchers also wanted to know if their huge genomic dataset could tell us not just which bacteria are in which person’s gut, but what they are up to – especially if what they’re up to is making people sick. Figuring this out would really blow open the possibilities for understanding these two rather mysterious conditions.

They found many functional changes between the IBS, IBD, and healthy patients. For instance, in patients with Crohn’s disease, there were more bacteria breaking down sugars and fewer kickstarting fermentation. That causes the inflammation. Meanwhile, in patients with IBS, there were more bacteria than normal focused on fermentation and breaking down carbs.

This latter point caught the attention of William Chey, University of Michigan professor and practicing IBS specialist, who was not involved in this study. “It’s something I’ve been wondering about for quite a while,” says Chey, explaining that IBS patients often complain of bloating, and bloating is often caused by fermentation. “A question’s always been, could the microbiome provide an explanation for that?”

“So what they found – alterations in the microbiome which would explain increased levels of fermentation or altered fermentation in IBS patients – is really interesting,” says Chey.

Gut Solutions For The Future?

Valerie Collij, co-lead on the study, researches and practices medicine at University Medical Center Groningen. “As a clinician, I would say that this is the base for future treatments,” she says. “We can use this information to get dietary interventions, or pro- and prebiotics, or even fecal transplants that are based on the gut microbiome composition. That would be great. But we are nowhere near there, yet, I would say.”

“But what we are really close to now is using microbiota as a diagnostic tool,” adds Vich Vila.

Chey is excited about where these findings could lead IBS and IBD research in the future. “It’s really been the Holy Grail, looking for the characteristics of the microbiomes that might be linked to the pathology that we see in the clinic,” he says.

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Ecology

Globe Climate: Canada’s resource reckoning is coming

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Good afternoon, and welcome to Globe Climate, a newsletter about climate change, environment and resources in Canada.

This afternoon, the Alberta government announced that it is restoring a coal mining policy it revoked last spring. At the time, the move provoked a widespread public backlash detailed by The Globe. The original decision, which opened up more than 1.4 million hectares to exploration, was made without public consultation. Premier Jason Kenney previously defended the changes.

Lots more on coal and Canada’s resources industry in this week’s newsletter edition.

Now, let’s catch you up on other news.

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Ecology

‘Incredibly destructive’: Canada’s Prairies to see devastating impact of climate change

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As the climate continues to warm at an alarming rate, experts warn if dramatic steps to mitigate global warming are not taken, the effects in Canada’s Prairie region will be devastating to the country’s agriculture sector.

According to Environment and Climate Change Canada, the country is warming, on average, about double the global rate.

Scientists with the National Oceanic and Atmospheric Administration in the U.S. recently found 2020 was earth’s second-hottest year on record, with the average land and ocean surface temperature across the globe at 0.98 of a degree C above the 20th-century average.

However, the agency found the northern hemisphere saw its hottest year on record, at 1.28 degrees C above the average.

“(In Canada) we are looking at about 6.4C degrees of warming this century, which isn’t much less than one degree per decade, which is just a terrifying rate of warming,” Darrin Qualman, the director of climate crisis policy and action at the National Farmer’s Union said.

Qualman said there is “massive change coming” to Canada’s Prairies, which will be “incredibly destructive.”

“It’s not going too far to say that if we made that happen, parts of the Prairies wouldn’t be farmable anymore,” he said.

According to the federal government, in 2018 Canada’s agriculture and agri-food system generated $143 billion, accounting for 7.4 per cent of the country’s GDP.

The sector employed 2.3 million people in 2018. The majority of the 64.2 million hectares of farmland in Canada is concentrated in the Prairies and in southern Ontario.

The effects of climate change are already being felt on the ground in the Prairies, Qualman said, adding that the NFU has already heard from farmers complaining of “challenging weather.”

“People are sharing pictures of flattened crops and buildings, et cetera, that have been damaged,” he said. “And we’re still at the beginning of this.”

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Ecology

Insect-based dog food aims to cut your pet’s carbon pawprint

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Meat has an enormous carbon footprint, with livestock liable for about 15 per cent of worldwide emissions, as we have beforehand mentioned on this e-newsletter. That is prompted specialists to suggest consuming much less meat for sustainability (and well being) causes.

However what about your pet? One research discovered that the methane and nitrous oxide emissions generated by canine and cat meals within the U.S. alone had been equal to about 64 million tonnes of CO2, or roughly the quantity produced by 13.6 million automobiles. And it might be getting worse, with a development towards feeding pets “human-grade” meat.

That is prompted some pet meals makers to look to lower-carbon protein sources — together with bugs.

Research present that producing insect-based meals requires far much less feed, land and water and generates far fewer greenhouse fuel emissions per kilogram than meats comparable to beef, pork or rooster.

That is one of many causes increasingly more pet meals containing insect protein are hitting the market. Purina, a model owned by multinational Nestlé, launched a line of canine and cat meals containing black soldier fly larvae in Switzerland in November.

In Canada, Montreal-based Wilder Harrier began promoting canine treats made with cricket protein in 2015 and pet food made with black soldier fly larvae in 2019. It plans to broaden to launch a line of insect-based cat treats later this yr and cat meals in 2022 due to “a ton of demand,” mentioned firm co-founder Philippe Poirier.

Wilder Harrier initially labored with animal nutritionists on insect-based merchandise to unravel a unique downside — specifically, the founders’ canines had allergy symptoms to frequent meats utilized in canine meals. Poirier mentioned now about half its prospects hunt down the product due to their pets’ allergy symptoms and about half for environmental causes.

Dr. Cailin Heinze, a U.S.-based veterinary nutritionist licensed by the American School of Veterinary Vitamin, has written concerning the environmental influence of pet meals. She mentioned we’re typically “not as involved as we probably ought to [be]” concerning the environmental footprint of pets.

Alternatively, she famous that the longer-term influence of newer diets, comparable to vegan meals and people containing bugs, hasn’t been nicely examined in comparison with conventional pet meals.

Maria Cattai de Godoy, an assistant professor of animal sciences on the College of Illinois who research novel proteins for pet meals (together with bugs, yeast and plant-based substances), mentioned such substances are rigorously examined to find out their security and diet earlier than being added to pet meals. 

“This can be a very extremely regulated trade,” she mentioned, however admitted it is also evolving.

Relating to bugs, she mentioned constructive information “reveals promise in direction of utilizing them increasingly more in pet meals.” Insect-based proteins have additionally earned the endorsement of the British Veterinary Affiliation, which says some insect-based meals could also be higher for pets than prime steak.

However Godoy famous that there isn’t any one-size-fits-all resolution, and pet homeowners ought to take into consideration the wants of their very own particular person pet and analysis whether or not a specific weight loss plan can be appropriate.

She mentioned that other than the kind of protein, issues like packaging and manufacturing strategies may also make a distinction. For instance, utilizing meat byproducts that may in any other case turn into waste would not drive elevated meat manufacturing the identical approach as utilizing human-grade meat.

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