Effect of Pea Hull Fiber on Uremic Metabolites and Gut Microbiota Composition in Individuals Undergoing Hemodialysis

Abstract Objectives The objective was to determine the effects of pea hull fiber intake on serum uremic molecules and microbiota composition of individuals undergoing hemodialysis. Methods A randomized, double-blind, placebo-control, crossover study was conducted with individuals undergoing hemodialysis. Following a 1-week baseline, participants consumed muffins with added pea hull fiber (15 g/d) and control muffins daily for 4 weeks in random order, separated by a 4-week washout. Blood and stool samples were collected during each period. Serum p-cresol sulfate (PCS), indoxyl sulfate (IS) and trimethylamine N-oxide (TMAO) were analyzed by LC–MS/MS and fecal microbiome profile by 16S rRNA gene amplicon sequencing. qPCR for taxa of interest (Akkermansia muciniphila, Faecalibacterium prausnitzii, Bifidobacterium, and Roseburia) was performed. QIIME 2 sample-classifier was used to discover a unique microbiota profile due to the consumption of pea hull fiber. Results Of the 18 participants randomized (50 ± 4 y; eGFR 6.6 ± 0.7 ml/min/1.73m2), 13 completed the study. No significant changes from baseline were observed in serum PCS (3256 ± 505 μmol/L), IS (166 ± 23 μmol/L) or TMAO (96 ± 12 μmol/L), or for the relative quantification of A. muciniphila, F. prausnitzii, Bifidobacterium, and Roseburia, taxa thought to be health enhancing. Taxa that most distinguished the microbiota composition during the pea hull fiber intervention from usual diet periods were enriched Gemmiger, Collinsella and depleted Lactobacillus, Ruminococcus, Coprococcus and Mogibacteriaceae. Given that abundance of Collinsella has been inversely associated with dietary fiber, this finding was unexpected. Conclusions In dialysis patients, added pea hull fiber did not reduce the serum levels of targeted uremic molecules but did alter fecal microbiota composition. Future research in this patient population should explore the efficacy of alternate fiber sources or plant-based dietary patterns for reducing serum levels of uremic toxins. Funding Sources Saskatchewan Pulse Growers.

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Supplementation of a lacto-fermented rapeseed-seaweed blend promotes gut microbial- and gut immune-modulation in weaner piglets

Journal of Animal Science and Biotechnology ◽

10.1186/s40104-021-00601-2 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Yan Hui ◽

Paulina Tamez-Hidalgo ◽

Tomasz Cieplak ◽

Gizaw Dabessa Satessa ◽

Witold Kot ◽

...

Keyword(s):

Immune Modulation ◽

Amplicon Sequencing ◽

Saccharina Latissima ◽

Rrna Gene ◽

Microbiota Composition ◽

Colon Mucosa ◽

Weaned Piglets ◽

Brown Macroalgae ◽

Blood Concentrations ◽

Significant Difference

Abstract Background The direct use of medical zinc oxide in feed will be abandoned after 2022 in Europe, leaving an urgent need for substitutes to prevent post-weaning disorders. Results This study investigated the effect of using rapeseed-seaweed blend (rapeseed meal added two brown macroalgae species Ascophylum nodosum and Saccharina latissima) fermented by lactobacilli (FRS) as feed ingredients in piglet weaning. From d 28 of life to d 85, the piglets were fed one of three different feeding regimens (n = 230 each) with inclusion of 0%, 2.5% and 5% FRS. In this period, no significant difference of piglet performance was found among the three groups. From a subset of piglets (n = 10 from each treatment), blood samples for hematology, biochemistry and immunoglobulin analysis, colon digesta for microbiome analysis, and jejunum and colon tissues for histopathological analyses were collected. The piglets fed with 2.5% FRS manifested alleviated intraepithelial and stromal lymphocytes infiltration in the gut, enhanced colon mucosa barrier relative to the 0% FRS group. The colon microbiota composition was determined using V3 and V1-V8 region 16S rRNA gene amplicon sequencing by Illumina NextSeq and Oxford Nanopore MinION, respectively. The two amplicon sequencing strategies showed high consistency between the detected bacteria. Both sequencing strategies indicated that inclusion of FRS reshaped the colon microbiome of weaned piglets with increased Shannon diversity. Prevotella stercorea was verified by both methods to be more abundant in the piglets supplied with FRS feed, and its abundance was positively correlated with colonic mucosa thickness but negatively correlated with blood concentrations of leucocytes and IgG. Conclusions FRS supplementation relieved the gut lymphocyte infiltration of the weaned piglets, improved the colon mucosa barrier with altered microbiota composition. Increasing the dietary inclusion of FRS from 2.5% to 5% did not lead to further improvements.

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Multi-Strain Probiotic Supplementation with a Product Containing Human-Native S. salivarius K12 in Healthy Adults Increases Oral S. salivarius

Nutrients ◽

10.3390/nu13124392 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4392

Author(s):

Karina Cernioglo ◽

Karen M. Kalanetra ◽

Anna Meier ◽

Zachery T. Lewis ◽

Mark A. Underwood ◽

...

Keyword(s):

Controlled Trial ◽

Amplicon Sequencing ◽

Healthy Adults ◽

Oral Microbiome ◽

Placebo Control ◽

Upper Respiratory Tract ◽

Double Blind ◽

16S Rrna Amplicon Sequencing ◽

Supplementation Period ◽

Tract Infections

Streptococcus salivarius (S. salivarius) K12 supplementation has been found to reduce the risk of recurrent upper respiratory tract infections. Yet, studies have not reported the effect of supplementation on oral S. salivarius K12 levels or the salivary microbiome. This clinical trial was designed to determine how supplementation with S. salivarius K12 influences the oral microbiome. In a randomized, double-blind, placebo-controlled trial, 13 healthy adults received a probiotic powder (PRO) containing Lactobacillus acidophilus, Bifidobacterium lactis, and S. salivarius K12 and 12 healthy adults received a placebo-control powder (CON) (n = 12) for 14 consecutive days. Oral S. salivarius K12 and total bacteria were quantified by qPCR and the overall oral microbiome was measured using 16S rRNA amplicon sequencing. Supplementation significantly increased mean salivary S. salivarius K12 levels by 5 logs compared to baseline for the PRO group (p < 0.0005), which returned to baseline 2 weeks post-supplementation. Compared with the CON group, salivary S. salivarius K12 was 5 logs higher in the PRO group at the end of the supplementation period (p < 0.001). Neither time nor supplementation influenced the overall oral microbiome. Supplementation with a probiotic cocktail containing S. salivarius K12 for two weeks significantly increased levels of salivary S. salivarius K12.

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Osteopontin-Enriched Algae Modulates the Gut Microbiota Composition in Weaning Piglets Infected with Enterotoxigenic Escherichia Coli (P06-069-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz031.p06-069-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Mei Wang ◽

Brooke Smith ◽

Brock Adams ◽

Miller Tran ◽

Ryan Dilger ◽

...

Keyword(s):

Escherichia Coli ◽

Gut Microbiota ◽

Alpha Diversity ◽

Enterotoxigenic Escherichia Coli ◽

Farm Animals ◽

Future Research ◽

Rrna Gene ◽

Microbiota Composition ◽

Wild Type ◽

Gut Microbiota Composition

Abstract Objectives Enterotoxigenic Escherichia coli (ETEC) are an important cause of diarrhea in human infants and young farm animals. Osteopontin (OPN), a glycoprotein present in high concentration in human milk, has immunomodulatory functions, which could indirectly impact the microbiota. Furthermore, a previous study has shown fecal microbiota composition differs between wild-type and OPN knockout mice. Herein, the effects of OPN-enriched algae on the gut microbiota composition and volatile fatty acid (VFA) concentrations of ETEC-infected piglets were assessed. Methods Naturally-farrowed piglets were sow-reared for 21 days and then randomized to two weaning diets: WT (formula + 1% wild-type algae) or OPN (formula + 1% OPN-enriched algae). On postnatal day (PND) 31, all piglets were infected orally with a live culture of ETEC (1010 colony-forming unit/3 mL dose) daily for three consecutive days. On PND 41, ascending colon (AC) contents were collected. Gut microbiota was assessed by sequencing V3-V4 regions of 16S rRNA gene and VFAs were determined by gas chromatography. Alpha-diversity and VFAs were analyzed using PROC MIXED procedure of SAS. Beta-diversity was evaluated by permutational multivariate analysis of variance (PERMANOVA) and differential abundance analysis on the bacterial genera was performed using DESeq2 package of R. Results Shannon indices were lower in the AC contents of OPN piglets compared to WT piglets. The overall colonic microbiota of OPN piglets differed from that of WT piglets (PERMANOVA P = 0.015). At genus level, OPN-enriched algae increased the abundance of Streptococcus, decreased the abundances of Sutterella, Candidatus Soleaferrea, dga-11 gut group, Rikenellaceae RC9 gut group, Ruminococcaceae UCG-010, unculturedRuminococcaceae, Prevotella 2 and 7 compared to piglets consuming wild-type algae (P < 0. 05). OPN piglets also had higher (P < 0.05) concentrations of acetate, propionate, butyrate and valerate compared to WT. Conclusions In ETEC infected piglets, 1% OPN-enriched algae decreased alpha-diversity and modulated the microbiota composition and VFA profiles compared to 1% WT algae. Other studies have shown that OPN inhibits biofilm formation in vitro, but future research is needed to assess in vivo microbiome-modulation mechanisms. Funding Sources Triton Algae Innovations.

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Comparative Analysis of Fecal Microbiota Composition Between Rheumatoid Arthritis and Osteoarthritis Patients

Genes ◽

10.3390/genes10100748 ◽

2019 ◽

Vol 10 (10) ◽

pp. 748 ◽

Cited By ~ 5

Author(s):

Jin-Young Lee ◽

Mohamed Mannaa ◽

Yunkyung Kim ◽

Jehun Kim ◽

Geun-Tae Kim ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Gut Microbiota ◽

Gut Microbiome ◽

Bacterial Species ◽

Amplicon Sequencing ◽

Fecal Microbiota ◽

Rrna Gene ◽

Microbiota Composition ◽

Stool Samples ◽

Gut Microbiota Composition

The aim of this study was to investigate differences between the gut microbiota composition in patients with rheumatoid arthritis (RA) and those with osteoarthritis (OA). Stool samples from nine RA patients and nine OA patients were collected, and DNA was extracted. The gut microbiome was assessed using 16S rRNA gene amplicon sequencing. The structures and differences in the gut microbiome between RA and OA were analyzed. The analysis of diversity revealed no differences in the complexity of samples. The RA group had a lower Bacteroidetes: Firmicutes ratio than did the OA group. Lactobacilli and Prevotella, particularly Prevotella copri, were more abundant in the RA than in the OA group, although these differences were not statistically significant. The relative abundance of Bacteroides and Bifidobacterium was lower in the RA group. At the species level, the abundance of certain bacterial species was significantly lower in the RA group, such as Fusicatenibacter saccharivorans, Dialister invisus, Clostridium leptum, Ruthenibacterium lactatiformans, Anaerotruncus colihominis, Bacteroides faecichinchillae, Harryflintia acetispora, Bacteroides acidifaciens, and Christensenella minuta. The microbial properties of the gut differed between RA and OA patients, and the RA dysbiosis revealed results similar to those of other autoimmune diseases, suggesting that a specific gut microbiota pattern is related to autoimmunity.

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Higher fiber complementary food alters Fecal microbiota composition and normalizes stool form in Malawian children: A randomized trial

African Journal of Food, Agriculture, Nutrition and Development ◽

10.18697/ajfand.99.20200 ◽

2021 ◽

Vol 21 (04) ◽

pp. 17854-17875

Author(s):

Edda Lungu ◽

◽

J Auger ◽

A Piano ◽

WJ Dahl ◽

...

Keyword(s):

Dietary Intake ◽

Bacterial Species ◽

Amplicon Sequencing ◽

Fecal Microbiota ◽

Stool Frequency ◽

Sub Saharan Africa ◽

Rrna Gene ◽

Microbiota Composition ◽

Linear Discriminant ◽

Stool Form

Dietary fiber favorably modulates gut microbiota and may be protective against diarrhea in sub-Saharan Africa where rates in infants and young children are high. Soybean hull is high in fiber and accessible in rural Africa; however, its use in complementary feeding has not been evaluated. The objective of this study was to determine the acceptability and feasibility of a soybean, soy hull fiber, and maize (SFM) blend food; the primary outcome was compliance to the feeding protocol. Secondary outcomes were stool form and frequency, fecal microbiota composition, growth and dietary intake. In a parallel, single-blind study, children 6-36 months of age from the Lilongwe district of Malawi were randomized to receive daily SFM (n=69) or maize only(n=10) porridge(phala) for 6 months. Anthropometrics were measured monthly, and compliance, stool frequency,and stool form, weekly. At baseline, 3-month,and 6-month (study end) time points, dietary intake (24-h recall) was assessed,and fecal samples were collected. Fecal DNA was analyzed by Real-Time polymerase chain reaction (PCR) for microbes of interest and 16S rRNA gene amplicon sequencing. Mothers accessed the acceptability and feasibility of the study foods at study end. Mothers reported excellent compliance to feeding the SFM porridge, rated it more acceptable than maize,and noted improved appetite, weight, and stool consistency of their children. Stool frequency at baseline (2±1 stools/d) was unchanged with intervention; however, there were significantly fewer diarrhea-type stools reported during study months 4-6 vs.1-3 for the SFM group, whereas no improvement was seen for the maize group. At study end, the fecal abundance ofAkkermansia muciniphila was enriched in children receiving the SFM, compared to maize (p<0.05), and a trend for increased Faecalibacterium prausnitzii (p=0.07) was seen. A comparison of fecal microbiota composition using linear discriminant analysis effect size (LEfSe)showed notable differences in numerous taxa in the SFM group compared to baseline, whereas the maize comparator exhibited fewer changes. Fiber intake was higher for the SFMgroup, compared to maize at 6 months (13.7±3.8 vs. 8.4±4.5 g/day, p<0.01). Weight-for-height and BMI-for-age Z-scores were significantly higher for the SFM group. In young Malawian children, feeding a blend of soybean, soy hulls and maize reduced diarrhea-type stools and increased the abundance of Akkermansia muciniphila, a bacterial species involved in maintaining intestinal health, and thus may provide a feasible means of improving wellness in children in resource-poor settings through the modulation of microbiota composition.

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Metformin induces weight loss associated with gut microbiota alteration in non-diabetic obese women: a randomized double-blind clinical trial

Acta Endocrinologica ◽

10.1530/eje-18-0826 ◽

2019 ◽

Vol 180 (3) ◽

pp. 165-176 ◽

Cited By ~ 14

Author(s):

Hanieh-Sadat Ejtahed ◽

Raul Y Tito ◽

Seyed-Davar Siadat ◽

Shirin Hasani-Ranjbar ◽

Zahra Hoseini-Tavassol ◽

...

Keyword(s):

Clinical Trial ◽

Gut Microbiota ◽

Amplicon Sequencing ◽

Fecal Microbiota ◽

Pharmacological Therapy ◽

Microbiota Composition ◽

Obese Women ◽

Double Blind ◽

Baseline Values ◽

Gut Microbiota Composition

Objective The increasing prevalence of obesity over the past few decades constitutes a global health challenge. Pharmacological therapy is recommended to accompany life-style modification for obesity management. Here, we perform a clinical trial to investigate the effects of metformin on anthropometric indices and gut microbiota composition in non-diabetic, treatment-naive obese women with a low-calorie diet (LCD). Design Randomized double-blind parallel-group clinical trial Methods Forty-six obese women were randomly assigned to the metformin (500 mg/tab) or placebo groups using computer-generated random numbers. Subjects in both groups took two tablets per day for 2 months. Anthropometric measurements and collection of blood and fecal samples were done at the baseline and at the end of the trial. Gut microbiota composition was assessed using 16S rRNA amplicon sequencing. Results Twenty-four and twenty-two subjects were included in the metformin + LCD and placebo + LCD groups, respectively; at the end of trial, 20 and 16 subjects were analyzed. The metformin + LCD and placebo + LCD caused a 4.5 and 2.6% decrease in BMI from the baseline values, respectively (P < 0.01). Insulin concentration decreased in the metformin + LCD group (P = 0.046). The overall fecal microbiota composition and diversity were unaffected in the metformin + LCD group. However, a significant specific increase in Escherichia/Shigella abundance was observed after metformin + LCD intervention (P = 0.026). Fecal acetate concentration, but not producers, was significantly higher in the placebo + LCD group, adjusted for baseline values and BMI (P = 0.002). Conclusions Despite the weight reduction after metformin intake, the overall fecal microbiota composition remained largely unchanged in obese women, with exception of changes in specific proteobacterial groups.

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Segregation of age-related skin microbiome characteristics by functionality

Scientific Reports ◽

10.1038/s41598-019-53266-3 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 10

Author(s):

Hye-Jin Kim ◽

Jin Ju Kim ◽

Nu Ri Myeong ◽

Taeyune Kim ◽

DooA Kim ◽

...

Keyword(s):

Chinese Women ◽

Age Groups ◽

Amplicon Sequencing ◽

Skin Aging ◽

Future Research ◽

Rrna Gene ◽

Skin Microbiome ◽

Age Related ◽

Functional Pathways ◽

Two Age Groups

AbstractAlthough physiological changes are the most evident indicators of skin aging by alteration of the skin’s structure and function, we question whether skin aging is also affected by the structure and assembly process of the skin microbiome. We analysed the skin microbiomes of 73 healthy Chinese women in two age groups (25–35 years old and 56–63 years old) using 16S rRNA gene amplicon sequencing; the overall microbiome structure was significantly different between the two age groups. An analysis using ecological theory to evaluate the process of microbial community assembly processes revealed that the microbiomes of the older group were formed under a greater influence of the niche-based process, with the network of microbes being more collapsed than that of the younger group. Inferred metagenomic functional pathways associated with replication and repair were relatively more predominant in the younger group whereas, among the various metabolism-related pathways, those associated with biodegradation were more predominant in the older group. Interestingly, we found two segregated sub-typing patterns in the younger group which were also observed in the skin microbiomes of young Chinese women living in four other cities in China. The results of our study highlights candidate microbes and functional pathways that are important for future research into preventing skin aging and which could lead to a comprehensive understanding of age-related skin microbiome characteristics.

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Sugar Beet Pectin Supplementation Did Not Alter Profiles of Fecal Microbiota and Exhaled Breath in Healthy Young Adults and Healthy Elderly

Nutrients ◽

10.3390/nu11092193 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2193 ◽

Cited By ~ 4

Author(s):

Ran An ◽

Ellen Wilms ◽

Agnieszka Smolinska ◽

Gerben D.A. Hermes ◽

Ad A.M. Masclee ◽

...

Keyword(s):

Young Adults ◽

Sugar Beet ◽

Healthy Aging ◽

Fecal Microbiota ◽

Rrna Gene ◽

Exhaled Breath ◽

Microbiota Composition ◽

Microbial Composition ◽

Double Blind ◽

Healthy Elderly

Aging is accompanied with increased frailty and comorbidities, which is potentially associated with microbiome perturbations. Dietary fibers could contribute to healthy aging by beneficially impacting gut microbiota and metabolite profiles. We aimed to compare young adults with elderly and investigate the effect of pectin supplementation on fecal microbiota composition, short chain fatty acids (SCFAs), and exhaled volatile organic compounds (VOCs) while using a randomized, double-blind, placebo-controlled parallel design. Fifty-two young adults and 48 elderly consumed 15 g/day sugar beet pectin or maltodextrin for four weeks. Fecal and exhaled breath samples were collected before and after the intervention period. Fecal samples were used for microbiota profiling by 16S rRNA gene amplicon sequencing, and for analysis of SCFAs by gas chromatography (GC). Breath was used for VOC analysis by GC-tof-MS. Young adults and elderly showed similar fecal SCFA and exhaled VOC profiles. Additionally, fecal microbiota profiles were similar, with five genera significantly different in relative abundance. Pectin supplementation did not significantly alter fecal microbiota, SCFA or exhaled VOC profiles in elderly or young adults. In conclusion, aside from some minor differences in microbial composition, healthy elderly and young adults showed comparable fecal microbiota composition and activity, which were not altered by pectin supplementation.

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Fecal microbiome signatures of pancreatic cancer patients

Scientific Reports ◽

10.1038/s41598-019-53041-4 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 5

Author(s):

Elizabeth Half ◽

Nirit Keren ◽

Leah Reshef ◽

Tatiana Dorfman ◽

Ishai Lachter ◽

...

Keyword(s):

Pancreatic Cancer ◽

Early Detection ◽

Screening Method ◽

Amplicon Sequencing ◽

Developed Countries ◽

Fecal Microbiota ◽

Rrna Gene ◽

Alcoholic Fatty Liver ◽

Fecal Microbiome ◽

Chinese Cohort

AbstractPancreatic cancer (PC) is a leading cause of cancer-related death in developed countries, and since most patients have incurable disease at the time of diagnosis, developing a screening method for early detection is of high priority. Due to its metabolic importance, alterations in pancreatic functions may affect the composition of the gut microbiota, potentially yielding biomarkers for PC. However, the usefulness of these biomarkers may be limited if they are specific for advanced stages of disease, which may involve comorbidities such as biliary obstruction or diabetes. In this study we analyzed the fecal microbiota of 30 patients with pancreatic adenocarcinoma, 6 patients with pre-cancerous lesions, 13 healthy subjects and 16 with non-alcoholic fatty liver disease, using amplicon sequencing of the bacterial 16S rRNA gene. Fourteen bacterial features discriminated between PC and controls, and several were shared with findings from a recent Chinese cohort. A Random Forest model based on the microbiota classified PC and control samples with an AUC of 82.5%. However, inter-subject variability was high, and only a small part of the PC-associated microbial signals were also observed in patients with pre-cancerous pancreatic lesions, implying that microbiome-based early detection of such lesions will be challenging.

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FODMAPs, but Not Gluten, Affect Symptoms and the Fecal Environment in Subjects With Irritable Bowel Syndrome. A Double Blinded-Randomized Three-Way Crossover Study

Current Developments in Nutrition ◽

10.1093/cdn/nzab044_032 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 601-601

Author(s):

Elise Nordin ◽

Carl Brunius ◽

Johan Dicksved ◽

Erik Pelve ◽

Rikard Landberg ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Gut Microbiota ◽

Rrna Gene ◽

Microbiota Composition ◽

Double Blind ◽

Funding Sources ◽

Irritable Bowel ◽

Double Blinded ◽

Gut Microbiota Composition ◽

Modest Effect

Abstract Objectives Irritable bowel syndrome (IBS) symptoms have been associated with fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) as well as gluten. We aimed to evaluate the effects of provocations with diets rich in such components on IBS symptoms. We further aimed to study effects of FODMAPs and gluten on microbiota and if the microbiota composition was related to the severity of IBS symptoms. Methods A double-blind, placebo-controlled, randomised three-way crossover design (n = 110) was conducted. From run-in and throughout the study, IBS subjects maintained a diet with minimal FODMAP content and no gluten. Participants were block-randomised to one-week interventions with FODMAPs (50 g/day), gluten (17.3 g/day) or placebo, separated by one week of wash-out. Fecal samples were collected after each study week and analyzed for gut microbiota composition by sequencing of 16S rRNA gene amplicons. IBS symptoms were monitored by the IBS severity scoring system (IBS-SSS). Results In subjects with moderate to severe IBS (n = 103), FODMAPs caused higher total IBS-SSS (mean [SE] = 240 [9]) than placebo (208 [9]; p = 0.00056) or gluten (198 [9]; p = 0.013), but with no difference between gluten and placebo (p = 1.0). Relative abundance of Anaerostipes, Bifidobacterium and Faecalibacterium were higher after FODMAP compared to placebo. We found no difference in gut microbiota composition between gluten and placebo and no significant correlations between genera and severity of IBS-SSS. Conclusions In subjects with IBS, FODMAPs had an adverse but modest effect on typical IBS symptoms, whereas gluten had no effect. The microbiota composition was affected by the FODMAP but not the gluten intervention, in comparison to placebo. None of these differences were correlated to the severity of symptoms reflected in IBS-SSS, suggesting no apparent link between gut microbiota composition and IBS symptoms following intervention. Funding Sources Formas and the Swedish Research Council.

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