Latest news with #gutmicrobiome
Medscape
4 days ago
- Health
- Medscape
Shaping the Microbiome to Improve Cancer Immunotherapy
WASHINGTON — For years, oncologist Jonathan Peled, MD, PhD, and his colleagues at Memorial Sloan Kettering Cancer Center (MSKCC) in New York City have been documenting gut microbiota disruption during allogeneic hematopoietic stem cell transplantation (allo-HSCT) and its role in frequent and potentially fatal bloodstream infections (BSIs) in the first 100 days after transplant. Modulating microbiome composition to improve outcomes after allo-HSCT for hematological malignancies is a prime goal, and at the Gut Microbiota for Health (GMFH) World Summit 2025, Peled shared two new findings. In one study, his team found that sucrose can exacerbate antibiotic-induced microbiome injury in patients undergoing allo-HSCT — a finding that 'raises the question of whether our dietary recommendations [for] allo-HSCT patients are correct,' said Peled, assistant attending at MSKCC, during a session on the gut microbiome and oncology. And in another study, they found that a rationally designed probiotic formulation may help lower the incidence of bacterial BSIs. In December 2024, the probiotic formulation (SER-155, Seres Therapeutics, Inc.) was granted breakthrough therapy designation by the FDA. With immunotherapies more broadly, researchers are increasingly looking at diet and modulation of the microbiome to improve both treatment tolerance and efficacy, experts said at the meeting convened by the American Gastroenterological Association and the European Society of Neurogastroenterology and Motility. 'Cancer patients and caregivers are asking, 'What should I eat?'' said Carrie Daniel-MacDougall, PhD, MPH, a nutritional epidemiologist at the University of Texas MD Anderson Cancer Center in Houston. 'They're not just focused on side effects — they want a good outcome for their treatment, and they're exploring a lot of dietary strategies [for which there] is not a lot of evidence.' Clinicians are challenged by the fact that 'we don't typically collect dietary data in clinical trials of cancer drugs,' leaving them to extrapolate from evidence-based diet guidelines for cancer prevention, Daniel-MacDougall said. But 'I think that's starting to shift,' she said, with the microbiome being increasingly recognized for its potential influences on therapeutic response and clinical trials underway looking at 'a healthy dietary pattern not just for prevention but survival.' Diet and Probiotics After allo-HSCT The patterns of microbiota disruption during allo-HSCT — a procedure that includes antibiotic administration, chemotherapy, and sometimes irradiation — are characterized by loss of diversity and the expansion of potentially pathogenic organisms, most commonly Enterococcus , said Peled. This has been demonstrated across transplantation centers. In a multicenter, international study published in 2020, the patterns of microbiota disruption and their impact on mortality were similar across MSK and other transplantation centers, with higher diversity of intestinal microbiota associated with lower mortality. Other studies have shown that Enterococcus domination alone (defined arbitrarily as > 30% of fecal microbial composition) is associated with graft vs host disease and higher mortality after allo-HSCT and that intestinal domination by Proteobacteria coincides temporally with BSIs, he said. Autologous fecal microbiota transplantation (FMT) has been shown to largely restore the microbiota composition the patient had before antibiotic treatment and allo-HSCT, he said, making fecal sample banking and posttreatment FMT a potential approach for reconstituting the gut microbiome and improving outcomes. But 'lately we've been very interested in diet for modulating [harmful] patterns' in the microbiome composition, Peled said. In the new study suggesting a role for sugar avoidance, published last year as a bioRxiv preprint, Peled and his colleagues collected real-time dietary intake data (40,702 food entries) from 173 patients hospitalized for several weeks for allo-HSCT at MSK and analyzed it alongside longitudinally collected fecal samples. They used a Bayesian mixed-effects model to identify dietary components that may correlate with microbial disruption. 'What jumped out as very predictive of a low diversity fecal sample [and expansion of Enterococcus ] in the 2 days prior to collection was the interaction between antibiotics and the consumption of sweets' — foods rich in simple sugars, Peled said. The relationship between sugar and the microbiome occurred only during periods of antibiotic exposure. 'And it was particularly perplexing because the foods that fall into the 'sweets' category are foods we encourage people to eat clinically when they're not feeling well and food intake drops dramatically,' he said. This includes foods like nutritional drinks or shakes, Italian ice, gelatin dessert, and sports drinks. (In a mouse model of post-antibiotic Enterococcus expansion, Peled and his co-investigators then validated the findings and ruled out the impact of any reductions in fiber.) In addition to possibly revising dietary recommendations for patients undergoing allo-HSCT, the findings raise the question of whether avoiding sugar intake while on antibiotics, in general, is a way to mitigate antibiotic-induced dysbiosis, he said. To test the role of probiotics, Peled and colleagues collaborated with Seres Therapeutics on a phase 1b trial of an oral combination (SER-155) of 16 fermented strains 'selected rationally,' he said, for their ability to decolonize gut pathogens, improve gut barrier function (in vitro), and reduce gut inflammation and local immune activation. After a safety lead-in, patients were randomized to receive SER-155 (20) or placebo (14) three times — prior to transplant, upon neutrophil engraftment (with vancomycin 'conditioning'), and after transplant. 'The strains succeeded in grafting in the [gastrointestinal] GI tract…and some of them persisted all the way through to day 100,' Peled said. The incidence of pathogen domination was substantially lower in the probiotic recipients compared to an MSK historical control cohort, and the incidence of BSIs was significantly lower compared to the placebo arm (10% vs 43%, respectively, representing a 77% relative risk reduction), he said. Diet and Immunotherapy Response: Trials at MD Anderson One of the first trials Daniel-MacDougall launched at MD Anderson on diet and the microbiome randomized 55 patients who were obese and had a history of colorectal cancer or precancerous polyps to add a cup of beans to their usual diet or to continue their usual diet without beans. There was a crossover at 8 weeks in the 16-week BE GONE trial; stool and fasting blood were collected every 4 weeks. 'Beans are a prebiotic super-house in my opinion, and they're also something this population would avoid,' said Daniel-MacDougall, associate professor in the department of epidemiology at MD Anderson and faculty director of the Bionutrition Research Core and Research Kitchen. 'We saw a modest increase in alpha diversity [in the intervention group] and similar trends with microbiota-derived metabolites' that regressed when patients returned to their usual diet, she said. The researchers also documented decreases in proteomic biomarkers of intestinal and systemic immune and inflammatory response. The impact of diet on cancer survival was shown in subsequent research, including an observational study published in Science in 2021 of patients with melanoma receiving immune checkpoint blockade (ICB) treatment. 'Patients who consumed insufficient dietary fiber at the start of therapy tended to do worse [than those reporting sufficient fiber intake],' with significantly lower progression-free survival, Daniel-MacDougall said. 'And interestingly, when we looked at dietary fiber [with and without] probiotic use, patients who had sufficient fiber but did not take probiotics did the best,' she said. [The probiotics were not endorsed or selected by their physicians.] Now, the researchers at MD Anderson are moving into 'precision nutrition' research, Daniel-MacDougall said, with a phase 2 randomized, double-blind trial of high dietary fiber intake (a target of 50 g/d from whole foods) vs a healthy control diet (20 g/d of fiber) in patients with melanoma receiving ICB. The study, which is underway, is a fully controlled feeding study, with all meals and snacks provided by MD Anderson and macronutrients controlled. Researchers are collecting blood, stool, and tumor tissue (if available) to answer questions about the microbiome, changes in systemic and tissue immunity, disease response and immunotherapy toxicity, and other issues.
Health Line
6 days ago
- Health
- Health Line
Can ADHD Raise Your Risk of Irritable Bowel Syndrome? Study Offers Clues
A new study indicates there may be an association between attention deficit hyperactivity disorder (ADHD) and irritable bowel syndrome (IBS). Researchers say an altered gut microbiome may be one of the main factors for this connection. Further study is warranted, as one expert doesn't believe there is a correlation between the two conditions. In a new meta-analysis, scientists say they have established a 'significant positive association' between attention deficit hyperactivity disorder (ADHD) and a higher risk of irritable bowel syndrome (IBS). The researchers said an altered gut microbiome may be the 'potential link that bridges the gap between ADHD and intestinal disorder.' Their findings were published recently in the journal Scientific Reports. The researchers said their analysis has significance in the daily lives of people with ADHD. 'IBS considerably affects quality of life in affected patients. Its presence in ADHD patients may further complicate the management of ADHD,' they wrote. 'Our results suggest that gut microbiome may explain the link between ADHD and IBS. Our finding of the positive association between ADHD and IBS suggests that clinicians should be aware of gastrointestinal symptoms in children and adults with ADHD,' they added. The researchers noted there were several limitations to their analysis. They said that nearly half of the studies they examined were from Asia and only two studies included people of all ages. One expert not involved in the study is highly critical of the research. 'I am highly critical of the study design, findings, and conclusions. The studies included into this meta-analysis are very heterogenous in terms of age, geographical region, study size, study design and probably in terms of diagnostic criteria used for IBS and ADHD,' said Emeran Mayer, MD, a professor of psychology medicine at the University of California Los Angeles and the director of the UCLA Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress. 'It is also highly likely that different diagnostic criteria were used for some of the IBS studies. Previous well-designed studies have shown no correlation between IBS and ADHD,' Mayer told Healthline. Are IBS and ADHD linked? To reach their conclusions, the researchers analyzed 11 past studies with 3.8 million individuals, including about 175,000 people with ADHD. The 11 studies that were examined were all published within the past 25 years. The researchers reported that the risk of IBS in people with ADHD was 1.63 times greater than in people who don't have ADHD. They added their research did not demonstrate an association between ADHD and other intestinal disorders. The scientists noted that an altered gut microbiome has been implicated in a variety of neuropsychiatric disorders, including Parkinson's disease, multiple sclerosis, and Alzheimer's disease. They added that children with ADHD tend to have more gastrointestinal issues, such as constipation and flatulence, than children without the condition. They said these past studies have indicated that there is a connection between the gut-brain axis and ADHD. Mayer isn't convinced. 'The study is purely correlational and does not provide any evidence for a causal relationship between ADHD and IBS, or between gut microbiome and ADHD prevalence,' he said. 'On the other hand, given the high comorbidity of ADHD with other psychiatric disorders, including anxiety, and the high comorbidity of IBS with anxiety and depression, a correlation between IBS and ADHD is likely. IBS is a disorder of altered gut-brain interactions characterized by higher anxiety levels. Consistent alteration in the gut microbiome in IBS patients has not been reported.' Max Wiznitzer, MD, pediatric neurologist at Rainbow Babies & Children's Hospital, professor of pediatrics and neurology at Case Western Reserve University in Cleveland, and co-chair of the Professional Advisory Board at the Children and Adults with Attention Deficit Hyperactive Disorder (CHADD), said there are other better explanations for the association between ADHD and IBS. Wiznitzer wasn't involved in the study. 'It is likely due to comorbid anxiety and/or depression,' Wiznitzer told Healthline. 'With the failure [of the researchers] to recognize or comment on the likely association with comorbid depression or anxiety by Ng et al in the Scientific Reports, the value of their conclusions is questionable (i.e., it is likely that the comorbid condition and not the ADHD is the reason for the association). Furthermore, they focus so much on gut microbiota that they overlook other potential reasons,' he noted. What to know about ADHD Attention-deficit hyperactivity disorder is described as a mental health condition that can cause impulsive behaviors. Symptoms of ADHD include: difficulty focusing on a task being easily distracted unable to sit still for an extended period time interrupting people while they are talking The American Psychiatric Association lists three different types of ADHD. They are: predominantly inattentive predominantly hyperactivity-impulsive a combination of both types Scientists are still uncertain of the underlying cause of ADHD, although they believe genetics may be involved. The researchers in the current study note that ADHD has been linked to a wide range of consequences for individuals. These included an increased risk of smoking, substance-related disorders, sexual risk-taking behavior, greater driving risk, and suicidal behavior. They added that the chronic condition also poses a significant economic burden on families and society. ADHD is generally diagnosed in children, although the condition can be present in adults. The condition is more prevalent in boys than in girls. Treatments for ADHD include behavioral therapy and medication. A balanced diet, regular exercise, adequate sleep, and limiting screen time on phones, computers, and television are also recommended. Mayer said there are therapies that can be beneficial. 'There is a number of behavioral techniques that have been used successfully in patients with ADHD. Similar cognitive behavioral techniques have been shown to benefit patients with IBS,' he said. What to know about IBS Irritable bowel syndrome is a group of intestinal symptoms that can include abdominal cramping, bloating, gas, diarrhea, and constipation. The condition is more common in women than in men. It also tends to affect younger adults more often than older adults. The symptoms are mild in some people but can be serious enough in other people to disrupt their daily lives. The exact cause of IBS is not known, although an oversensitive colon and immune system difficulties are potential factors. Triggers for IBS can include stress and anxiety. Some foods can also trigger IBS. They include: beans onions fruits certain dairy products certain carbohydrate-rich products There are ways to help relieve IBS symptoms. These include: regular exercise limiting consumption of caffeinated beverages minimizing stress taking probiotics quitting smoking Some nutritionists recommend that people with IBS adhere to a low FODMAP diet, an eating plan that focuses on avoiding certain carbohydrates. 'I recommend a multi-component treatment plan including personalized dietary recommendations, behavioral techniques, including self-relaxation techniques, mindfulness-based stress reduction, and cognitive behavioral therapy,' said Mayer. 'In more refractory cases, centrally acting medications like low dose tricyclic antidepressants. In patients with severe psychiatric comorbidity (anxiety or depression, less than 10% of all patients), I prescribed SSRIs,' he added. Wiznitzer shared some simple advice for people with IBS. 'Manage the anxiety and depression, and the IBS should improve,' he said.
Globe and Mail
7 days ago
- Health
- Globe and Mail
Managing your blood sugar? Add these high-fibre foods to your diet
Diets plentiful in fibre have been tied to a lower risk of heart disease, stroke, Type 2 diabetes, colorectal cancer, breast cancer and diverticulitis. A high-fibre diet has also consistently been shown to promote a healthy gut microbiome, which plays a crucial role in overall health. And for people with prediabetes and diabetes, fibre is an essential dietary component that helps control blood glucose levels. Here's what to know about fibre and blood sugar, plus a list of fibre- and nutrient-packed foods that, as part of a healthy diet, can help stabilize glucose levels. There are two types of dietary fibre: soluble and insoluble. Both are present in varying proportions in different foods, but some foods can be rich in one or the other. While both support blood glucose control, studies suggest the metabolic benefit is greatest for viscous (sticky) soluble fibre. A 2019 review of 28 clinical trials conducted by Canadian researchers found that consuming an average of 13 grams of soluble fibre daily significantly reduced hemoglobin A1c levels in people with Type 2 diabetes. Can eating chocolate help ward off Type 2 diabetes? Yes, suggests a new Harvard study A hemoglobin A1c test measures your average blood glucose level over the past three months. It's used to diagnose prediabetes and diabetes, as well as help guide diabetes management. Once consumed, viscous soluble fibre dissolves in water to form a gel-like substance in your stomach, slowing the rate food is emptied into the small intestine. Doing so, in turn, delays the absorption of carbohydrates (glucose) into the bloodstream, which helps prevent blood sugar spikes after eating. Soluble fibre is also fermented by gut microbes, which leads to the production of short chain fatty acids, beneficial compounds shown to improve hemoglobin A1c and the secretion of insulin. Health Canada recommends adults, ages 19 to 50, consume 25 g (women) and 38 g (men) of total fibre each day. Older women and men are advised to consume 21 g and 30 g daily, respectively. More recent research has suggested that consuming at least 30 g of fibre per day is needed to guard against heart disease, stroke, Type 2 diabetes and colorectal cancer. Aim to include at least 10 g of fibre in each meal. Foods high in viscous soluble fibre include oats, barley, pulses, carrots, okra, eggplant, berries, citrus fruit, apples and pears. Psyllium husk powder is also an excellent source. In addition, consider adding the following five foods to your regular diet. Besides lots of fibre, they supply other key nutrients that play a role in balancing blood sugar. Lentils. One cup of cooked lentils provides 15.6 g of fibre, both soluble and insoluble, along with 18 g of satiating protein, low glycemic carbohydrates and a decent amount of magnesium, a mineral that helps regulate insulin secretion. A cup of lentils also delivers 90 per cent of a day's worth of the B vitamin folate. Studies conducted in people with Type 2 diabetes suggest folate helps improve the body's ability to effectively respond to insulin. Semaglutide, or Ozempic, reduces symptoms of feared diabetes' complication, study finds Blackberries. This dark coloured berry provides 7.5 g of fibre per one cup. Because so much of the carbohydrate in blackberries comes from undigested fibre, a one-cup serving provides only 6 g of net carbohydrates. (Net carbs are the amount of carbohydrates that your body can absorb.) Blackberries are also a good source of vitamin C (30 mg per cup), a nutrient that promotes insulin sensitivity by reducing oxidative stress and inflammation. Raspberries are a great alternative, providing nearly identical amounts of fibre, net carbs and vitamin C. Chia seeds. Two tablespoons of these tiny seeds deliver 10 g of fibre, 5 g of protein and 95 mg of blood-sugar-regulating magnesium. (Women and men need 320 mg and 420 mg of magnesium, respectively.) Chia seeds are also an outstanding source of alpha linolenic acid (ALA), an anti-inflammatory omega-3 fat; you'll find more than one day's worth in a tablespoon. Ground flaxseed, also a food source of fibre and ALA, provides more soluble fibre than chia seeds. Green peas. Per one cup, these legumes offer 9 g of fibre, nearly one-third of it soluble fibre, and 8.5 g of protein. Thanks to their fibre and protein content, green peas are ranked low on the glycemic index scale. Plus, they're good sources of several nutrients that support insulin sensitivity, including magnesium, zinc, folate and vitamin C. Artichoke hearts. One half-cup of artichoke hearts contains 5 g of fibre, including a good amount of inulin, a viscous soluble fibre. Inulin also acts as a prebiotic, feeding beneficial gut bacteria. You'll also find folate and magnesium – and only 5 g of net carbs – in a half-cup of artichoke hearts. Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on X @LeslieBeckRD
Gizmodo
13-06-2025
- Health
- Gizmodo
Poop Transplants Not All They're Cracked Up to Be
Fecal transplants have emerged as a potential treatment for a wide range of conditions, including irritable bowel syndrome, diabetes, and even depression. These so-called poop transplants have understandably received a lot of attention, but new research casts a bit of a wet blanket over the practice. The procedure involves taking microbes from the poop of a healthy person and transferring them into a patient's colon. This should restore balance to their gut microbiome, but according to a study published June 6 in the journal Cell, transplanted microbes may colonize the wrong parts of the digestive system. This can result in long-lasting unintended health consequences, the researchers warn. 'I think it's a bit of a wakeup call to the field that maybe we shouldn't willy-nilly put large bowel microbes into different parts of the intestine that shouldn't be there.' 'I think it's a bit of a wakeup call to the field that maybe we shouldn't willy-nilly put large bowel microbes into different parts of the intestine that shouldn't be there,' said lead author Orlando 'Landon' DeLeon, a postdoctoral researcher at the University of Chicago, in a statement. DeLeon led a team of researchers through a series of experiments on mice to determine how fecal matter transplants affect different parts of the intestine. The mice were separated into three groups. One received microbes from the jejunum (the middle part of the small intestine), the second received microbes from the cecum (a pouch that connects the small intestine to the colon), and the third received a standard fecal transplant from the colon. Each part of the digestive system contains uniquely adapted microbiota. The researchers wanted to see if the microbes would stick to their respective niches once inside the mice. In fact, they found that each of the transplants successfully colonized the full intestinal tract, creating regional gut 'mismatches' that lasted for up to three months after the procedure. Microbes that colonized parts of the gut where they didn't belong triggered metabolic changes in these intestinal regions, with the potential to affect a patient's health and behavior. The researchers observed changes in the mice's eating habits, activity, and energy expenditure following the transplants. They also documented changes in gene activity associated with immune function, which in turn led to changes in liver metabolism. Most surprising was the manner in which these foreign microbes altered gene and protein expression in the intestinal lining to make the mismatched gut region more suitable for them. 'It's like they're engineering or terraforming their environments to help them fit in,' DeLeon said. To determine whether these mismatches could occur in actual fecal transplant patients, he and his colleagues conducted additional tests using human tissue samples. Results showed that transplanted gut bacteria can colonize parts of the human digestive system where they don't naturally belong. 'If we're designing good therapeutics, we should be aware of the importance of matching the regional microbiota to their proper environments, so that we provide better overall health benefits,' DeLeon said. For example, the findings suggest it may be safer to use microbes retrieved from all the parts of the digestive system, according to the researchers. The Food and Drug Administration (FDA) only recommends fecal transplants for treating repeated infections of Clostridium difficile, or C. diff. This bacterium—which can cause severe gastrointestinal symptoms—most commonly sickens hospital patients who have been treated with antibiotics. Fecal transplants have proven to be highly effective for treating these infections, and those results have encouraged researchers to investigate other applications for this procedure. A wave of new research suggests that fecal transplants could treat conditions that go beyond the gut. Indeed, studies have found that this procedure could benefit patients with neurodevelopmental and psychiatric disorders, multiple sclerosis, type 2 diabetes, and more. DeLeon's findings suggest that doctors need to better understand the risks of fecal matter transplants before this treatment can be used for diseases other than C. diff. He plans to keep investigating how different microbes affect each part of the intestine and explore ways to restore altered regions to their original state. This study shows that when it comes to gut microbes, location really matters. Getting the right bugs in the right place could unlock the full potential of fecal transplants.
Medscape
11-06-2025
- Health
- Medscape
Pediatric HS Linked to Gut Microbiome Changes
Emerging evidence suggests the gut microbiome may play a contributing role in the development of inflammatory skin diseases — including hidradenitis suppurativa (HS). The evidence incudes a small prospective study recently published in JAMA Dermatology , which found significant differences in gut microbial composition in pediatric patients with HS compared with matched healthy control participants, offering new insights into possible disease mechanisms that may extend beyond the skin. This follow-up to prior microbiome studies included pediatric participants for the first time. 'Overall, we found significant differences in gut microbiome composition of pediatric patients with HS compared with pediatric control participants and adult patients with HS, suggesting that gut microbiome dysregulation may extend to pediatric patients with HS and should be investigated further,' wrote the authors, from the Department of Dermatology at Boston University School of Medicine, Boston. Gut Dysbiosis and Reduced Microbial Diversity in HS The study included 16 participants — eight participants with HS and eight matched control participants — half of whom were younger than 18 years. Although beta diversity (variation between individuals) was similar across groups, a decrease in alpha diversity (diversity within an individual's gut microbiome) was observed in participants with HS, as measured using Pielou evenness. 'This may indicate gut dysbiosis,' the authors noted. In pediatric patients with HS, there were notable shifts in microbial composition. Bifidobacterium adolescentis was present in all pediatric patients with HS but absent in all adults with HS. 'As B adolescentis abundance typically increases with age, its absence in adults with HS may indicate dysregulation in gut microbiome maturation,' the authors explained. Other notable findings in the pediatric patients with HS included increases in Ruminococcus , Clostridium , and Bilophila . An increase in the beneficial bacterium Faecalibacterium prausnitzii was also noted compared with pediatric control participants. Clinical Implications and Future Directions Asked to comment on this emerging research, Tamia Harris-Tryon, MD, PhD, associate professor of dermatology and immunology at UT Southwestern Medical Center in Dallas, said the results highlight a nutritional component to HS that warrants greater attention. 'HS patients often have diets that are deficient in fiber and other nutrients,' she explained. 'The gut microbiome is directly linked to diet. A diet low in fiber will be deficient in microbes that ferment fiber. Fiber fermentation influences the immune system.' Harris-Tryon added that the new findings, particularly in children, emphasize the need for diet-based interventions. 'HS patients, especially pediatric patients, need to be meeting with a nutritionist,' she said. 'The emphasis should be on increasing fiber and nutrient-dense foods in the diet, while dropping high-glycemic index foods such as candy, soda, fruit juice, sweet teas, and cutting packaged and ultraprocessed foods.' While microbiome-targeted treatments such as probiotics are often discussed in chronic inflammatory skin conditions, Harris-Tryon advised caution. 'There is no data for microbiome-directed therapies in HS yet,' she said. 'But there is significant data on the benefits of a nutrient-dense, fiber-rich diet in pediatric patients and the influence of diet on the gut microbiome. Diets from all over the world with components similar to the Mediterranean diet have been shown to be the most beneficial for human health, including skin health. Fermented foods are an excellent time-tested source of beneficial microbes — including low sugar yogurt, kimchi, and kefir.' In a recent episode of the Medscape InDiscussion podcast series on HS and the microbiome, Harris-Tryon emphasized that 'understanding how the gut, skin, and immune system talk to each other is going to be key to developing future treatments for HS' and noted that this area of research 'is really just beginning to open up.' The study authors also encouraged future studies to examine potential interactions between the gut and the brain. ' B adolescentis produces gamma-aminobutyric acid [GABA], a mediator of the gut-brain axis that has been associated with anxiety and depression disorders through direct modulation of neural signals from the gut,' they wrote. 'As HS can affect mental health, particularly in vulnerable pediatric populations, it may be worthwhile to incorporate mental health screenings in future studies and assess correlations with GABA-producing microbes.' Noting that the study had limitations, such as a small sample size and the lack of matching by BMI or disease duration, the authors concluded that there were significant differences in the gut microbiome of pediatric patients with HS compared with pediatric control participants and adults with HS. The authors also referred to their previous study, which observed an increase in Bilophila and a decrease in Pielou evenness alpha diversity in both pediatric and adult patients with HS compared to control participants, pointing to potential gut dysbiosis. Collectively, the authors noted these findings suggest that 'gut microbiome dysregulation may extend to pediatric patients with HS and should be investigated further.' The study was independently supported by institutional grants from Boston University. The authors reported having no conflicts of interest. Harris-Tryon disclosed serving or having served as a director, officer, partner, employee, advisor, consultant, or trustee for Mirofend and Johnson & Johnson; serving as a speaker or a member of a speaker bureau for Tamia; and receiving research grants from LEO Pharmaceuticals.
