Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2019; 25(25): 3242-3255
Published online Jul 7, 2019. doi: 10.3748/wjg.v25.i25.3242
Gut microbiota contributes to the distinction between two traditional Chinese medicine syndromes of ulcerative colitis
Ya-Li Zhang, Li-Ting Cai, Jun-Yi Qi, Yun-Zheng Lin, Yan-Cheng Dai, Na Jiao, You-Lan Chen, Lie Zheng, Bei-Bei Wang, Li-Xin Zhu, Zhi-Peng Tang, Rui-Xin Zhu
Ya-Li Zhang, Jun-Yi Qi, You-Lan Chen, Zhi-Peng Tang, Institute of Digestive Diseases, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Li-Ting Cai, Yun-Zheng Lin, Na Jiao, Bei-Bei Wang, Rui-Xin Zhu, Department of Bioinformatics, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
Yan-Cheng Dai, Department of Gastroenterology, Shanghai Traditional Chinese Medicine-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
Lie Zheng, Department of Gastroenterology, Traditional Chinese Medicine Hospital of Shanxi Province, Xi’an 710000, Shanxi Province, China
Li-Xin Zhu, Genome, Environment and Microbiome Community of Excellence, the State University of New York at Buffalo, Buffalo, NY 14214, United States
Author contributions: Zhang YL and Cai LT contributed equally to this work, and both performed the majority of research; Qi JY, Lin YZ, Dai YC, Jiao N, Chen YL, Zheng L, and Wang BB performed the research and analyzed the data; Zhu LX, Zhu RX, and Tang ZP designed and coordinated the research; Zhang YL and Cai LT wrote and revised the paper.
Supported by the National Natural Science Foundation of China, No. 81704009, No. 81873253, No. 81573892, and No. 81770571; and the Project of Shanghai Municipal Health and Family Planning Commission, No. 201640122.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest related to this study
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhi-Peng Tang, PhD, Doctor, Professor, Institute of Digestive Diseases, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, 725 Wanping Road, Shanghai 200032, China. zhipengtang@sohu.com
Telephone: +86-21-6438-5700
Received: April 12, 2019
Peer-review started: April 15, 2019
First decision: May 16, 2019
Revised: June 2, 2019
Accepted: June 8, 2019
Article in press: June 9, 2019
Published online: July 7, 2019
Processing time: 84 Days and 22.7 Hours
Abstract
BACKGROUND

Ulcerative colitis (UC) is considered to be closely associated with alteration of intestinal microorganisms. According to the traditional Chinese medicine (TCM) theory, UC can be divided into two disease syndromes called Pi-Xu-Shi-Yun (PXSY) and Da-Chang-Shi-Re (DCSR). The relationships among gut microbiota, TCM syndromes, and UC pathogenesis have not been well investigated.

AIM

To investigate the role of gut microbiota in UC and the distinction of microbiota dysbiosis between PXSY and DCSR syndromes.

METHODS

From May 2015 to February 2016, UC patients presenting to LongHua Hospital who met the established inclusion and exclusion criteria were enrolled in this retrospective study. Fresh stool specimens of UC patients with PXSY or DCSR were collected. The feces of the control group came from the health examination population of Longhua Hospital. The composition of gut bacterial communities in stool samples was determined by the pyrosequencing of 16S ribosomal RNA. The high-throughput sequencing reads were processed with QIIME, and biological functions were predicted using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States.

RESULTS

The composition of gut bacterial communities in 93 stool samples (30 healthy controls, 32 patients with PXSY syndrome, and 31 patients with DCSR syndrome) was determined by the pyrosequencing of 16S ribosomal RNA. Beta diversity showed that the composition of the microbiota was different among the three groups. At the family level, Porphyromonadaceae, Rikeneliaceae, and Lachnospiraceae significantly decreased while Enterococcus, Streptococcus, and other potential pathogens significantly increased in UC patients compared to healthy subjects. At the genus level, Parabacteroides, Dorea, and Ruminococcus decreased while Faeca-libacterium showed increased abundance in UC compared to healthy controls. Five differential taxa were identified between PXSY and DCSR syndromes. At the genus level, a significantly increased abundance of Streptococcus was observed in DCSR patients, while Lachnoclostridium increased in PXSY patients. The differential functional pathways of the gut microbiome between the PXSY and DCSR groups mainly included lipid metabolism, immunity, and the metabolism of polypeptides.

CONCLUSION

Our study suggests that the gut microbiota contributes to the distinction between the two TCM syndromes of UC.

Keywords: Ulcerative colitis; Intestinal microbiota; Pi-Xu-Shi-Yun syndrome; Da-Chang-Shi-Re syndrome; Traditional Chinese medicine

Core tip: Ulcerative colitis (UC) is considered to be closely associated with alteration of intestinal microorganisms. According to the traditional Chinese medicine (TCM) theory, UC can be divided into Pi-Xu-Shi-Yun syndrome (syndrome of spleen deficiency and dampness, PXSY) and Da-Chang-Shi-Re syndrome (syndrome of dampness-heat in the large intestine, DCSR). This study showed that the gut microbiota was different between patients with PXSY syndrome and those with DCSR syndrome. The genus Streptococcus was significantly more abundant in DCSR patients than in PXSY patients, while Lachnoclostridium increased in PXSY patients. Our study suggests that the gut microbiota contributes to the distinction between the two TCM syndromes of UC.