The Interplay Between Use of Biological Therapies, Psychological State, and the Microbiome in IBD

Paris Tavakoli; Ute Vollmer-Conna; Dusan Hadzi-Pavlovic; Xabier Vázquez-Campos; Michael Carl Grimm

doi:10.3389/fmed.2022.788992

The Interplay Between Use of Biological Therapies, Psychological State, and the Microbiome in IBD

Front Med (Lausanne). 2022 Jul 19:9:788992. doi: 10.3389/fmed.2022.788992. eCollection 2022.

Authors

Paris Tavakoli¹, Ute Vollmer-Conna², Dusan Hadzi-Pavlovic², Xabier Vázquez-Campos³, Michael Carl Grimm¹

Affiliations

¹ St. George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia.
² School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
³ School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney, NSW, Australia.

Abstract

Background: This study examines longitudinal bio-psychological dynamics and their interplay in IBD patients undergoing conventional and biological therapies.

Methods: Fifty IBD participants (24 UC, 26 CD) in clinical remission were followed for 12 months. Complete longitudinal datasets, biological samples, validated scores of psychological status were collected monthly for analysis of association. Microbiome analysis was performed to identify microbial dynamics and signatures. Patients were grouped on disease phenotype (CD, UC) and mode of treatment (biological therapies, non-biological treatment). General linear models, mixed models, cluster analysis, and analyses of variance were used to examine the longitudinal trends of the variables and their associations over time. Results were corrected for multiple testing.

Results: Results substantiated different interactions between biological therapy and longitudinal trends of inflammatory biomarkers in remission CD and UC patients as well as significant differences between CD and UC patients in their psychological measures during clinical remission, with UC patients having inferior condition compared to CD. A significant reduction in microbial diversity in CD patients compared to UC was identified. Results characterized considerable differences in longitudinal microbial profile between those taking and not taking biological treatment in UC patients, but not in CD patients.

Conclusion: A different trajectory of interdependence was identified between psychological state, sleep, and microbial dynamics with mode of treatment when compared between CD and UC patients. Further studies should investigate the causal relationships between bio-psychological factors for improved treatment purposes.

Keywords: Crohn's disease; gut microbiome; inflammatory bowel disease; psychological state; ulcerative colitis.