Fourteen patients with experienced symptom improvement and increased plasma 5-HT levels after four weeks of treatment.
Fecal microbiota richness and diversity were increased in patients with functional constipation before treatment.
Baseline fecal metabolomic analysis showed elevated branched-chain in functional constipation patients compared to healthy controls.
Transcutaneous neuromodulation treatment did not significantly change short chain fatty acid levels.
A correlation between the gut bacteria Blautia and serotonin was observed in functional constipation patients but disappeared after treatment.
Simplified
OBJECTIVES: (TN) has been reported effective for (FC). The underlying mechanism remains unclear. In this study, we aimed to investigate the gut microbiota (GM) and (SCFAs) metabolism changed in FC patients due to TN treatment. The correlation between GM and 5-HT was evaluated.
METHODS: Fourteen FC patients were recruited, and the FC related symptoms were evaluated by questionnaires before and after 4-week TN treatment. Blood and fecal samples were collected to assess the fecal microbiome and SCFAs.
RESULTS: The richness and diversity of fecal microbiota were both found to be increased in FC patients before TN treatment. Fecal metabolomic differences between FC patients and healthy controls were observed at baseline, including elevated branched-chain SCFAs (isobutyric, isovaleric, and valeric acids) in FC. TN treatment did not significantly alter SCFA levels but improved constipation symptoms and increased plasma 5-HT. The correlation of Blautia-serotonin and 5-HT was observed in FC patients (r = 0.574, P = 0.035) and disappeared after TN treatment (r = 0.160, P = 0.584).
CONCLUSION: TN treatment significantly improved the symptoms of FC patients and increased their plasma 5-HT expression levels. The correlation between 5-HT and Blautia-serotonin (which changed after TN treatment) indicated that the 5-HT changes caused by TN treatment might have a potential interaction with the dynamic changes of the intestinal microbiota.
Key numbers
1.5 to 3.0
Increase in Bristol Stool Score
Median score before and after 4-week treatment
~29.2 ng/ml
Increase in plasma 5-HT levels
Plasma 5-HT levels before and after treatment
30.65% vs. 6.85%
Higher abundance of Bacteroidetes
Relative abundance of Bacteroidetes in vs. healthy control group
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Declarations. Ethics approval and consent to participate: The study protocol was approved by the Ethics Committee of First Affiliated Hospital of Dalian Medical University (No. LCKY2016-31) and registered in Chinese Clinical Trail Registry (No. ChiCTR-OOC-16010259; Date:2016/12/26). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All participants have signed the informed consent forms and were free to quit the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
