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Abstract：
BACKGROUND: Dysbiosis of the gut microbiota is pivotal in Crohn\'s disease (CD) and modulated by host physiological conditions. Hyperbaric oxygen therapy (HBOT) is a promising treatment for CD that can regulate gut microbiota. The relationship between HBOT and the gut microbiota in CD remains unknown.
METHODS: CD patients were divided into an HBOT group (n = 10) and a control group (n = 10) in this open-label prospective interventional study. The fecal samples before and after HBOT were used for 16 S rRNA gene sequencing and fecal microbiota transplantation (FMT). A colitis mouse model was constructed using dextran sulfate sodium, and intestinal and systematic inflammation was evaluated. The safety and long-term effect of HBOT were observed.
RESULTS: HBOT significantly reduced the level of C-reactive protein (CRP) (80.79 ± 42.05 mg/L vs. 33.32 ± 18.31 mg/L, P = 0.004) and the Crohn\'s Disease Activity Index (CDAI) (274.87 ± 65.54 vs. 221.54 ± 41.89, P = 0.044). HBOT elevated the declined microbial diversity and ameliorated the altered composition of gut microbiota in patients with CD. The relative abundance of Escherichia decreased, and that of Bifidobacterium and Clostridium XIVa increased after HBOT. Mice receiving FMT from donors after HBOT had significantly less intestinal inflammation and serum CRP than the group before HBOT. HBOT was safe and well-tolerated by patients with CD. Combined with ustekinumab, more patients treated with HBOT achieved clinical response (30%vs.70%, P = 0.089) and remission (20%vs.50%, P = 0.160) at week 4.
CONCLUSIONS: HBOT modulates the dysbiosis of gut microbiota in CD and ameliorates intestinal and systematic inflammation. HBOT is a safe option for CD and exhibits a promising auxiliary effect to ustekinumab.
BACKGROUND: Chinese Clinical Trial Registry, ChiCTR2200061193. Registered 15 June 2022, https://www.chictr.org.cn/showproj.html?proj=171605 .
METHODS: CD patients were divided into an HBOT group (n = 10) and a control group (n = 10) in this open-label prospective interventional study. The fecal samples before and after HBOT were used for 16 S rRNA gene sequencing and fecal microbiota transplantation (FMT). A colitis mouse model was constructed using dextran sulfate sodium, and intestinal and systematic inflammation was evaluated. The safety and long-term effect of HBOT were observed.
RESULTS: HBOT significantly reduced the level of C-reactive protein (CRP) (80.79 ± 42.05 mg/L vs. 33.32 ± 18.31 mg/L, P = 0.004) and the Crohn\'s Disease Activity Index (CDAI) (274.87 ± 65.54 vs. 221.54 ± 41.89, P = 0.044). HBOT elevated the declined microbial diversity and ameliorated the altered composition of gut microbiota in patients with CD. The relative abundance of Escherichia decreased, and that of Bifidobacterium and Clostridium XIVa increased after HBOT. Mice receiving FMT from donors after HBOT had significantly less intestinal inflammation and serum CRP than the group before HBOT. HBOT was safe and well-tolerated by patients with CD. Combined with ustekinumab, more patients treated with HBOT achieved clinical response (30%vs.70%, P = 0.089) and remission (20%vs.50%, P = 0.160) at week 4.
CONCLUSIONS: HBOT modulates the dysbiosis of gut microbiota in CD and ameliorates intestinal and systematic inflammation. HBOT is a safe option for CD and exhibits a promising auxiliary effect to ustekinumab.
BACKGROUND: Chinese Clinical Trial Registry, ChiCTR2200061193. Registered 15 June 2022, https://www.chictr.org.cn/showproj.html?proj=171605 .
摘要：
背景：肠道微生物群的菌群失调在克罗恩病（CD）中至关重要，并受宿主生理条件的调节。高压氧疗法（HBOT）是一种有前途的CD治疗方法，可以调节肠道微生物群。HBOT与CD中肠道微生物群之间的关系仍然未知。
方法：在这项开放性前瞻性干预研究中，将CD患者分为HBOT组（n=10）和对照组（n=10）。将HBOT前后的粪便样品用于16SrRNA基因测序和粪便微生物群移植（FMT）。使用葡聚糖硫酸钠构建结肠炎小鼠模型，并评估肠道和系统性炎症。观察HBOT的安全性和远期疗效。
结果：HBOT显着降低C反应蛋白（CRP）水平（80.79±42.05mg/Lvs.33.32±18.31mg/L,P=0.004）和克罗恩病活动指数（CDAI）（274.87±65.54vs.221.54±41.89,P=0.044)。HBOT提高了CD患者的微生物多样性下降，并改善了肠道菌群组成的改变。大肠杆菌的相对丰度下降，HBOT后，双歧杆菌和XIVa梭菌的含量增加。HBOT后接受供体FMT的小鼠肠道炎症和血清CRP明显低于HBOT前。HBOT是安全的，CD患者耐受性良好。结合ustekinumab，更多接受HBOT治疗的患者获得了临床缓解(30%vs.70%,P=0.089）和缓解（20%vs.50%，P=0.160）在第4周。
结论：HBOT调节CD中肠道菌群的菌群失调，改善肠道和系统炎症。HBOT是CD的安全选择，对ustekinumab具有良好的辅助作用。
背景：中国临床试验注册中心，ChiCTR2200061193。2022年6月15日注册，https://www。chictr.org.cn/showproj.html?proj=171605。
方法：在这项开放性前瞻性干预研究中，将CD患者分为HBOT组（n=10）和对照组（n=10）。将HBOT前后的粪便样品用于16SrRNA基因测序和粪便微生物群移植（FMT）。使用葡聚糖硫酸钠构建结肠炎小鼠模型，并评估肠道和系统性炎症。观察HBOT的安全性和远期疗效。
结果：HBOT显着降低C反应蛋白（CRP）水平（80.79±42.05mg/Lvs.33.32±18.31mg/L,P=0.004）和克罗恩病活动指数（CDAI）（274.87±65.54vs.221.54±41.89,P=0.044)。HBOT提高了CD患者的微生物多样性下降，并改善了肠道菌群组成的改变。大肠杆菌的相对丰度下降，HBOT后，双歧杆菌和XIVa梭菌的含量增加。HBOT后接受供体FMT的小鼠肠道炎症和血清CRP明显低于HBOT前。HBOT是安全的，CD患者耐受性良好。结合ustekinumab，更多接受HBOT治疗的患者获得了临床缓解(30%vs.70%,P=0.089）和缓解（20%vs.50%，P=0.160）在第4周。
结论：HBOT调节CD中肠道菌群的菌群失调，改善肠道和系统炎症。HBOT是CD的安全选择，对ustekinumab具有良好的辅助作用。
背景：中国临床试验注册中心，ChiCTR2200061193。2022年6月15日注册，https://www。chictr.org.cn/showproj.html?proj=171605。
