The analysis of gut microbiota in patients with bile acid diarrhoea treated with colesevelam.

Bile acid diarrhoea (BAD) is a common disorder that results from an increased loss of primary bile acids and can result in a change in microbiome. The aims of this study were to characterise the microbiome in different cohorts of patients with BAD and to determine if treatment with a bile acid sequestrant, colesevelam, can alter the microbiome and improve microbial diversity. Patients with symptoms of diarrhoea underwent 75-selenium homocholic acid ( A total of 257 samples were analysed from 134 patients. α-diversity was significantly reduced in patients with BAD and more specifically, in the idiopathic BAD cohort and in patients with severe disease (SeHCAT <5%); This is the first study to examine treatment effects on the microbiome in BAD, which demonstrated a possible association with colesevelam on the microbiome through bile acid modulation in clinical responders. Larger studies are now needed to establish a causal relationship with colesevelam and the inter-crosstalk between bile acids and the microbiome.

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Copyright © 2023 Kumar, Quraishi, Al-Hassi, El-Asrag, Segal, Jain, Steed, Butterworth, Farmer, Mclaughlin, Beggs and Brookes.

Déclaration de conflit d'intérêts

MB has received grants and travel expenses from Vifor International and Tillotts Pharma, outside of the submitted work. The research department of MB also received funding from Tillotts Pharma to support part of the described work. HS has received travel and conference expenses from Tillotts Pharma, Norgine, MSD, Abbvie and Janssen outside of the submitted work. JS has received speaker fees for Abbvie, Takeda and Janssen outside of the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.