The microbiota-gut-brain axis in sleep disorders

Exploring the mechanism of action of Bailemian capsule in the treatment of insomnia based on metabolomics, 16S rRNA with UPLC-QE-Orbitrap-MS/MS

Bailemian capsule (BLMC) is composed of lily bulb, thorny Acanthopanax root, and other traditional Chinese medicines; it is commonly used to treat insomnia in traditional Chinese medicine. However, the active ingredients and mechanisms of action that underlie this treatment ability have not been fully explored. Here, a liquid chromatography-tandem mass spectrometry method was developed to qualitatively analyse the exogenous BLMC components that directly entered the blood and several brain regions after administration of BLMC to mice. A total of 47 compounds that directly entered the blood, including isoleucine. Moreover, there were 33, 34, 36, and 27 compounds distributed in the hypothalamus, hippocampus, frontal cortex, and temporal cortex of the mice, respectively. Subsequently, this study integrated network pharmacology, metabolomics and gut microbiota analysis to explore potential mechanism of BLMC against insomnia. The network pharmacology results suggest that BLMC affects insomnia by modulating the glutamatergic synaptic pathway. And serum and hypothalamic metabolomics analysis indicates that BLMC mainly regulates the metabolic pathways of D-Glutamine and D-Glutamic acid metabolism, significantly upregulating the differential metabolite glutamic acid and downregulating glutamine. In addition, analysis of gut microbiota indicates a close relationship between norank_f_Desulfovibirosaceae and glutamic acid. This study systematically revealed for the first time the potential pharmacological components of BLMC in treating insomnia, and explored its mechanism of action from multiple perspectives, laying the foundation for further exploration of the mechanism of BLMC in treating insomnia.

Beyond organ isolation: The bidirectional crosstalk between cerebral and intestinal ischemia-reperfusion injury via microbiota-gut-brain axis

Ischemia-reperfusion injury (IRI) represents a pathophysiological phenomenon of profound clinical relevance that poses considerable threats to patient safety. IRI may manifest in a variety of clinical contexts including, but not limited to, sepsis, organ transplantation, shock, myocardial infarction, cerebral ischemia, and stroke. Critically, IRI exhibits complex interactions across different organs, with effects that surpass mere localized tissue damage. These impacts can amplify damage to both adjacent and remote organs through pathways such as the gut-brain axis and the gut-lung axis, facilitated by intricate signaling mechanisms. Noteworthy is the interaction between gut IRI and brain IRI, which involves sophisticated neuroendocrine, systemic, and immune mechanisms coordinated through the microbiome-gut-brain axis. This review seeks to delve into the intricate interactions between gut and brain IRI, viewed through the lens of the microbiota-gut-brain axis. It aims to assess its translational potential in clinical settings, provide a theoretical foundation for developing relevant therapeutic strategies, and pinpoint novel directions for research.

Serum levels of 1,3-β-D-glucan is correlated with NLRP3 inflammasome activation and insomnia severity in people with chronic insomnia disorder

This study aimed to explore the correlation between serum levels 1,3-β-D-glucan as a biomarker for gut microbiome imbalance and NLRP3 inflammasome/IL-1β axis activation and insomnia severity in humans with chronic insomnia disorder (CID). Blood samples were collected from 20 people diagnosed with CID based on the Pittsburgh Sleep Quality Index (PSQI) and video-polysomnography and 20 healthy individuals based on PSQI. 1,3-β-D-glucan, IL-1β, and NLRP3 protein serum levels were assayed using enzyme-linked immunosorbent assay (ELISA). 1,3-β-D-glucan, IL-1β, and NLRP3 protein serum concentrations in the CID group were significantly higher than in the control group. Also, we observed a significant positive correlation between the serum levels of these three factors in the CID group and a significant positive correlation between 1,3-β-D-glucan and insomnia severity index. Our findings suggest that 1,3-β-D-glucan may indicate gut microbiome imbalance in people with CID and may play an important role in the pathogenesis of chronic insomnia by activating the NLRP3/IL-1β inflammasome pathway. These results highlight the potential for dual therapeutic strategies targeting gut microbiota modulation and NLRP3 inflammasome inhibition to disrupt the neuroinflammatory cascade driving chronic insomnia.

Echoes in the night: How sleep quality influences auditory health

The intricate relationship between sleep disorders and hearing loss emerges as a burgeoning field of scholarly inquiry. Numerous studies have illuminated a potential correlation between the two, affecting the quality of life and overall health of individuals. Hearing loss, or auditory impairment, serves as a critical indicator of physiological dysfunction, casting a pall over the daily existence and professional endeavors of those affected, potentially leading to irreversible deafness if left untreated. Sleep disorders may cause physical and psychological changes that further affect hearing, while auditory dysfunction may detrimentally impact sleep experienced by individuals. Although certain studies have failed to find a direct link between sleep duration and hearing loss, it is evident that sleep-related issues do increase the risk of hearing loss. Thus, understanding the relationship between sleep disorders and hearing loss, alongside the underlying mechanisms, will help establish interventions aimed at enhancing sleep quality and safeguarding auditory health. This systematic review endeavors to elucidate the correlation between sleep disorders and hearing loss, offering valuable insights and guidance for future basic research and clinical applications.

Enteric nervous system dysfunction as a driver of central nervous system disorders: The Forgotten brain in neurological disease

The Enteric Nervous System (ENS), often called the "second brain," is a complex network of neurons and glial cells within the gastrointestinal (GI) tract. It functions autonomously while maintaining close communication with the central nervous system (CNS) via the gut-brain axis (GBA). ENS dysfunction plays a crucial role in neurodegenerative and neurodevelopmental disorders, including Parkinson's disease, Alzheimer's disease, and autism spectrum disorder. Disruptions such as altered neurotransmission, gut microbiota imbalance, and neuroinflammation contribute to disease pathogenesis. The GBA enables bidirectional communication through the vagus nerve, gut hormones, immune signaling, and microbial metabolites, linking gut health to neurological function. ENS dysregulation is implicated in conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), influencing systemic and CNS pathology through neuroinflammation and impaired barrier integrity. This review highlights emerging therapeutic strategies targeting ENS dysfunction, including prebiotics, probiotics, fecal microbiota transplantation (FMT), and vagus nerve stimulation, which offer novel ways to modulate gut-brain interactions. Unlike previous perspectives that view the ENS as a passive disease marker, this review repositions it as an active driver of neurological disorders. By integrating advances in ENS biomarkers, therapeutic targets, and GBA modulation, this article presents a paradigm shift-emphasizing ENS dysfunction as a fundamental mechanism in neurodegeneration and neurodevelopmental disorders. This perspective paves the way for innovative diagnostics, personalized gut-targeted therapies, and a deeper understanding of the ENS's role in brain health and disease.

Treatment of Insomnia With Traditional Chinese Medicine Presents a Promising Prospect

Insomnia, a prevalent sleep disorder, significantly impacts global health. While Western medications provide temporary relief, their risks of dependency and cognitive impairment have spurred the search for safer alternatives. Traditional Chinese Medicine (TCM) offers a promising approach to treating insomnia by focusing on harmonizing the balance of Yin and Yang and the functions of internal organs. This review explores recent research advances in TCM for insomnia treatment, integrating classical theories with modern scientific understanding of key pathological mechanisms, including neurotransmitter regulation (GABA, monoamines), immune-inflammatory responses, the HPA axis, and interactions with the gut microbiota. Growing clinical evidence supports the effectiveness of classical TCM prescriptions and treatments like acupuncture in improving sleep quality, particularly when combined with Western medications to enhance efficacy and reduce dependency. However, TCM also has its limitations. Future research directions should focus on modernizing TCM applications, addressing comorbidities associated with insomnia, exploring the role of gut microbiota, and optimizing medicinal and edible homologous products. By integrating traditional knowledge with cutting-edge technologies, TCM holds great potential for advancing personalized and effective insomnia treatments globally.

Senility, defecation disorders, sleep disorders, and non-operative spinal infections: A single-center retrospective analysis

BACKGROUND

Non-operative spinal infections (NOSI) are caused by tuberculosis, brucella, and other specific bacteria. The etiology of the disease is insidious, the onset is slow and the diagnosis and treatment are difficult. Identifying the factors associated with spinal infection and early intervention can reduce the occurrence of the disease. At present, the research mainly focuses on the accurate diagnosis and treatment of spinal infection, and there are few studies on the prevention of spinal infection. The concept of "preventive treatment of diseases" in traditional Chinese medicine may help identify the causes and reduce the occurrence of NOSI.

AIM

To determine the association of age, bowel movements, and sleep patterns with NOSI.

METHODS

Data of 69 NOSI patients and 84 healthy controls in a tertiary hospital from January 2019 to June 2024 were collected. Patients with NOSI had imaging evidence (magnetic resonance imaging) of spinal infections (including infections caused by tuberculosis, brucopathy, and other pathogens) and had no history of spinal surgery in the last 1 year were included in the analysis. Patients with spinal infection due to spinal surgery are excluded in the study. Data including age, sex, place of residence, sleeping status, and bowel movements were collected. SPSS22.0 was used for correlation analysis of all data.

RESULTS

The mean age of the NOSI group and the control group was 63.55 ± 14.635 years and 59.18 ± 17.111 years, respectively, without statistical difference (P = 0.096). There was also no statistically significant difference in gender between the two groups. In the NOSI group, 45 (65.22%) were over 60 years old, and 44 (63.77%) were rural residents. Compared with the control group, the NOSI group had more patients with sleep disorder and defecation disorder, accounting for 69.57% and 68.12%, respectively, with significant statistical difference (both P < 0.001). Regression analysis showed that defecation and sleep disorders were closely related to NOSI (both P < 0.001).

CONCLUSION

Most patients with NOSI are older and have sleep disorders and abnormal defecation.

Maternal sleep and psychological status in the postpartum period are associated with functional protein alterations in breast milk:a mother-infant cohort study

BACKGROUND & AIMS

Postpartum sleep disorder and mental disorders are common unpleasant conditions faced by women after delivery, and they have many adverse effects on both mothers and infants. It is unclear whether breast milk composition is affected by maternal sleep, psychological state, diet and gut microbiome. This study aims to explore the effects of these key factors on the functional protein components of breast milk.

METHODS

With a prospective design, this pilot study included a total of 41 postpartum women. Breast milk and maternal faecal samples collected at 42 days and 3 months postpartum were tested by liquid chromatography-mass spectrometry and 16S RNA sequencing, respectively. Sleep state, psychological state and dietary intake data were also collected from the mothers with validated questionnaires.

RESULTS

In the early postpartum period, sleep disorders and depression were associated with a decrease in the functional proteins in breast milk. Disordered sleep was significantly negatively correlated with α-lactalbumin (cor = -0.578, p < 0.001), osteopontin (cor = -0.522, p < 0.01) and κ-casein (cor = -0.451, p < 0.01). Depression was negatively correlated with αs1-casein (cor = -0.422, p < 0.01), β-casein (cor = -0.317, p < 0.05) and casein (cor = -0.318, p < 0.05). In 3 months postpartum, most associations were disappeared. But a positive correlation was observed between β-casein (cor = 0.414, p < 0.01), casein (cor = 0.372, p < 0.05), total protein (cor = 0.376, p < 0.05) and depression, while a positive correlation was found between total protein (cor = 0.357, p < 0.05) and disordered sleep at 3 months postpartum. Faecal microbiome data illustrated that changes in the gut microbiome at early postpartum were associated with sleep disorders/depression, but not with the diet. Furthermore, functional pathway analysis revealed metabolic regulation in the amino acid synthesis and metabolic pathways associated with specific microbes was involved in the reduction of breast milk protein.

CONCLUSION

Sleep disorders/depression could lead to significant changes in breast milk profiles at 42 days postpartum. Maternal gut microbiome might affect breast milk protein composition through regulating amino acid synthesis and metabolic pathways.

Interplay between gut microbiota and exosome dynamics in sleep apnea

Sleep-disordered breathing (SDB) is characterized by recurrent reductions or interruptions in airflow during sleep, termed hypopneas and apneas, respectively. SDB impairs sleep quality and is linked to substantive health issues including cardiovascular and metabolic disorders, as well as cognitive decline. Recent evidence suggests a link between gut microbiota (GM) composition and sleep apnea. Indeed, GM, a community of microorganisms residing in the gut, has emerged as a potential player in various diseases, and several studies have identified associations between sleep apnea and GM diversity along with shifts in bacterial populations. Additionally, the concept of "leaky gut," a compromised intestinal barrier with potentially increased inflammation, has emerged as another key player in the potential bidirectional relationship between GM and sleep apnea. One of the potential effectors could be extracellular vesicles (EVs) underlying gut-brain communication pathways that are relevant to sleep regulation and function. Thus, therapeutic implications afforded by targeting the GM or exosomes for sleep apnea management have surfaced as promising areas of research. This review explores current understanding of the relationship between GM, exosomes and sleep apnea, highlighting key research dynamics and potential mechanisms. A comprehensive review of the literature was conducted, focusing on studies investigating GM composition, intestinal barrier function and gut-brain communication in relation to sleep apnea.

Association between oral microbiome and sleep disorders in U.S. adults: analysis of NHANES database 2009-2012

BACKGROUND

The microbiome, especially the gut microbiome, contributes to the regulation, etiology, and pathogenesis of sleep disorder. However, limited evidence regarding the oral microbiome's role in sleep disorder. Therefore, this study aimed to investigate the association between sleep disorder and oral microbial diversity and whether oral microbiota is associated with all-cause mortality in people with sleep disorder.

METHODS

The study included 4,729 individuals in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2012 and mortality data until 2019. Sleep disorder was assessed by structured questionnaire. The oral microbiome was characterized by 16 S ribosomal RNA gene sequencing. Logistic regression models were conducted to quantify the association of α-diversity with different sleep status controlling for potential confounding variables, and principal coordinate analysis along with permutational multivariate analysis of variance for β-diversity. The association between the oral microbiome and all-cause mortality was assessed using Cox proportional hazard models.

RESULTS

The α-diversity showed that a lower number of operational taxonomic units (OTUs) (adjusted odds ratio [aOR] = 0.996; 95% confidence interval [CI] = 0.994-0.998), less Faith's phylogenetic diversity (aOR = 0.954, 95% CI = 0.934-0.975), and a lower Shannon-Weiner index (aOR = 0.854, 95% CI = 0.772-0.944) were associated with sleep disorder. β-diversity revealed different oral microbiome communities between the two groups, as measured by the Bray-Curtis dissimilarity (R2 = 0.358%, P = 0.001), unweighted UniFrac distance (R2 = 0.450%, P = 0.001) and weighted UniFrac distance (R2 = 0.709%, P = 0.001). Furthermore, the OTUs (odds ratio [OR] = 0.999; 95% CI = 0.998-0.999; P < 0.05), Faith's phylogenetic diversity (OR = 0.987; 95% CI = 0.975-0.998; P < 0.05), Shannon-Weiner index (OR = 0.924; 95% CI = 0.873-0.979; P < 0.05), and the inverse Simpson index (OR = 0.553; 95% CI = 0.306-0.997; P < 0.05) were all associated with a significant increase in the risk of all-cause death in participants with sleep disorder.

CONCLUSIONS

Intra-population richness, inter-population dispersion, and the phylogenetic diversity of the oral microbiome have all been linked to sleep disorder and all-cause mortality. Overall, these results will help to better understand the etiology and pathogenesis of sleep disorder. Further studies are required to determine the mechanisms underlying the role of microbiome in the pathogenesis of sleep disorder.

Bridging the gap between gut microbiota and sleep disorders through intermediary metabolites

BACKGROUND

Research has suggested an interaction between gut microbiota and sleep, yet the causal relationships between gut microbiota, metabolites, and sleep disorders remain unclear. This study aims to uncover these relationships.

METHODS

We obtained genome-wide data for 196 gut microbiota (GM) species (N = 18,340), 1,400 metabolites (N = 8,299), and sleep disorders (N = 361,194). Mendelian randomization(MR) analyses were conducted using the Inverse Variance Weighted (IVW) method, MR-Egger, Weighted Median method, Weighted Mode method, and Simple Mode method to infer causality. The IVW method was used for primary analysis results. Significant microbiota and causal metabolites were further analyzed to clarify the associations between the three. All results were tested for heterogeneity, pleiotropy, and sensitivity to assess the stability of the findings.

RESULTS

The Mendelian randomization results revealed causal relationships between four gut microbiota species and sleep disorders: Genus.Dorea, Genus.Parasutterell, Genus.Slackia, and Order.Bacillales. Additionally, we identified 39 causal metabolites Related to sleep disorders, with 7 of these being associated with 3 causal microbiota species at the genus level. All results showed no heterogeneity or horizontal pleiotropy.

CONCLUSION

Through two-sample Mendelian randomization studies, we identified three gut microbiota species at the genus level genetically linked to sleep disorders through seven plasma metabolites, revealing causal relationships between these three factors. These biomarkers provide new insights into the mechanisms of sleep disorders and may contribute to their prevention, diagnosis, and treatment.

The human gut microbiome and sleep across adulthood: associations and therapeutic potential

Sleep is an essential homeostatic process that undergoes dynamic changes throughout the lifespan, with distinct life stages predisposed to specific sleep pathologies. Similarly, the gut microbiome also varies with age, with different signatures associated with health and disease in the latest decades of life. Emerging research has shown significant cross-talk between the gut microbiota and the brain through several pathways, suggesting the microbiota may influence sleep, though the specific mechanisms remain to be elucidated. Here, we critically examine the existing literature on the potential impacts of the gut microbiome on sleep and how this relationship varies across adulthood. We suggest that age-related shifts in gut microbiome composition and immune function may, in part, drive age-related changes in sleep. We conclude with an outlook on the therapeutic potential of microbiome-targeted interventions aimed at improving sleep across adulthood, particularly for individuals experiencing high stress or with sleep complaints.

Postbiotics Made From Selected Lactic Acid Bacteria Improves Chronic Restraint Stress-Induced Anhedonia and Sleep Disorders

Sleep disorders have become one of the most prevalent neuropsychiatric disorders in recent years. This study aimed to investigate the effects of postbiotics derived from selected lactic acid bacteria on anhedonia and sleep disorders in chronic restraint stress (CRS)-induced mice, as well as their potential mechanisms. Mice were orally administered normal saline, low, medium, or high doses of postbiotics for 30 days, with CRS applied from days 1 to 21. The medium dose of postbiotics significantly increased the sucrose preference index, and the high dose of postbiotics significantly increased sleep duration. Postbiotic treatment effectively restored the diversity and composition of the gut microbiota to levels comparable to those observed in the vehicle (Veh) group. Furthermore, low and medium doses of postbiotics significantly reduced serum corticosterone levels, and medium and high doses significantly reduced serum IL-1β levels. Additionally, postbiotics administration significantly increased glutamate and GABA levels in both the prefrontal cortex and hypothalamus, as well as GABA levels in the feces. These results indicate that postbiotics alleviate CRS-induced anhedonia and sleep disorders in a dose-dependent manner. This effect may be mediated through the restoration of homeostasis in the MGB axis, HPA axis, inflammation pathways, and neurotransmitter balance.

Association of rotating shift work with incident irritable bowel syndrome: a large population-based prospective cohort study

Objectives

Limited epidemiological study has examined the association between rotating shift work and risk of irritable bowel syndrome (IBS). This study aimed to investigate the association between shift work and risk of IBS and explore the potential mediating factors for the association.

Methods

A total of 268,290 participants from the UK Biobank were included. Cox proportional hazards model was used to examine the associations between shift work and the incidence of IBS. The mediation analyses were performed to investigate the mediating effects.

Results

Participants engaged in always/usually shift work showed a significantly increased risk of developing IBS (HR: 1.12, 95% CI: 1.03-1.23). Joint analysis indicated that, participants with both always/usually shift work and inadequate sleep duration had a 54% increased risk of IBS (HR: 1.54, 95% CI: 1.35-1.82) compared to those with adequate sleep duration and never/rarely shift work; while participants with both always/usually shift work and insomnia-always had a 65% increased risk of IBS (HR: 1.65, 95% CI: 1.43-1.90) compared to those with never/rarely shift work and never/sometimes insomnia. Mediation analysis revealed that sleep quality and anxiety/depression partially mediated the relationship between shift work and IBS incidence, contributing 16.1% (6.8-25.4%) and 3.6% (0.4-6.8%) of the mediation effect, respectively.

Conclusion

This study found that participants with always/usually shiftwork status had significantly increased risk of IBS, and this association may partially be mediated by anxiety/depression and sleep quality. Moreover, inadequate sleep duration and usually insomnia may intensify the effect of rotating shift work on the risk of incident IBS.

Anxiolytic, Antidepressant and Healthy Sleep-Promoting Potential of Rosmarinic Acid: Mechanisms and Molecular Targets

The etiology of psychiatric disorders is complex and results from intricate interactions among multiple neurobiological, psychological, environmental, and genetic factors. Furthermore, the roles of gut microbiome dyshomeostasis in their pathogeneses are just beginning to be uncovered, adding to another level of complexity. In recent years, significant efforts have been directed toward discovering multimodal yet safe therapeutics to counteract psychological deficits. Rosmarinic acid (RA), a polyphenol found in several medicinal herbs, has received considerable attention as a potential multifaceted therapeutic agent, particularly for neuropsychiatric conditions. In order to critically evaluate this aspect, data was compiled and consolidated after extensive searches on scholarly databases like PubMed, Google Scholar, and Web of Science. Peer-reviewed publications which focused on RA as a therapeutic agent for psychiatric disorders were included regardless of the year of publication and country of origin. Based on pre-clinical and clinical evidence, this review delves into the various mechanistic aspects of the antidepressant, anxiolytic, and sleep-promoting functions of RA. The beneficial effects of RA on the gut-microbiome-brain (GMB) axis and their implications for the regulation of neuroprotective pathways are also discussed, with a particular focus on exploiting them to ameliorate neuropsychiatric conditions. Our assessment indicated that RA is a multimodal neuroprotectant against psychiatric conditions and beneficially influences a plethora of targets related to redox, inflammatory, synaptic, cell death, neurotrophic, and cell signaling pathways. As a dietary agent, RA may also be relevant in favorably altering the GMB axis, indicating its prospects as a potential multimodal adjuvant therapeutic agent in regulating the pathogenic mechanisms underlying neuropsychiatric conditions. However, more extensive clinical studies are required to ascertain the neuromodulatory actions of RA in neuronal pathophysiologies, including psychiatric ailments.

Traumatic Brain Injury and Gut Microbiome: The Role of the Gut-Brain Axis in Neurodegenerative Processes

PURPOSE OF REVIEW

A deeper understanding of the communication network between the gut microbiome and the central nervous system, termed the gut-brain axis (GBA), has revealed new potential targets for intervention to prevent the development of neurodegenerative disease associated with tramatic brain injury (TBI). This review aims to comprehensively examine the role of GBA post-traumatic brain injury (TBI).

RECENT FINDINGS

The GBA functions through neural, metabolic, immune, and endocrine systems, creating bidirectional signaling pathways that modulate brain and gastrointestinal (GI) tract physiology. TBI perturbs these signaling pathways, producing pathophysiological feedback loops in the GBA leading to dysbiosis (i.e., a perturbed gut microbiome, impaired brain-blood barrier, impaired intestinal epithelial barrier (i.e., "leaky gut"), and a maladaptive, systemic inflammatory response. Damage to the CNS associated with TBI leads to GI dysmotility, which promotes small intestinal bacterial overgrowth (SIBO). SIBO has been associated with the early stages of neurodegenerative conditions such as Parkinson's and Alzheimer's disease. Many of the bacteria associated with this overgrowth promote inflammation and, in rodent models, have been shown to compromise the structural integrity of the intestinal mucosal barrier, causing malabsorption of essential nutrients and further exacerbating dysbiosis. TBI-induced pathophysiology is strongly associated with an increased risk of neurodegenerative diseases, including Parkinson's and Alzheimer's diseases, which represents a significant public health burden and challenge for patients and their families. A healthy gut microbiome has been shown to promote improved recovery from TBI and prevent the development of neurodegenerative disease, as well as other chronic complications. The role of the gut microbiome in brain health post-TBI demonstrates the potential for microbiome-targeted interventions to mitigate TBI-associated comorbidities. Promising new evidence on prebiotics, probiotics, diet, and fecal microbiota transplantation may lead to new therapeutic options for improving the quality of life for patients with TBI. Still, many of these preliminary findings must be explored further in clinical settings. This review covers the current understanding of the GBA in the setting of TBI and how the gut microbiome may provide a novel therapeutic target for treatment in this patient population.

Exploring the evolving frontiers of sleep deprivation research in the post-COVID-19 era

Sleep deprivation research (SDR) has undergone substantial transformations in the aftermath of the COVID-19 pandemic. This comprehensive study explores the SDR's evolving trends, hotspots, and conceptual structure in the post-COVID-19 era. Using bibliometric analysis with VOSviewer and Bibliometrix software, we examined the SDR publications from January 2020 to December 2023. Core sources were identified using Bradford law, and a dataset of 4578 English-based data-driven studies was retrieved from the Scopus database. Our analysis revealed a remarkable annual growth rate of 37.92% in SDR from 2020 to 2023, indicating a heightened research focus in this domain. Among prolific authors, Shao emerged as a key contributor, while Sleep ranked prominently as a leading publication venue. The United States and China have emerged as the most impactful countries for advancing SDR research. Uncovering the most cited documents sheds light on various focal points within SDR, including sleep duration, mental health implications, cardiovascular events, the impact of COVID-19 on sleep patterns, dementia, resilience in children, and sleep patterns among preschoolers. Noteworthy keywords that emerged from the analysis encompassed "sleep deprivation," "depression," "insomnia," "COVID-19," "anxiety," "fatigue," and "obesity." Using a thematic mapping approach, we delineated distinct themes characterized by niche, basic, emerging, and declining patterns. Clusters of SDR research were observed in areas such as "Fatigue," "Sleep apnea," "Sleep," "Sleep deprivation," "Migraine," "Caffeine," and "Recovery." Furthermore, trending themes in SDR encompassed "Sleep disturbance," "excessive daytime sleepiness," and "Gamma-Aminobutyric Acid." These comprehensive findings provide valuable insights into the current landscape of SDR, illuminating emerging trends, identifying hotspots, and offering directions for future research in this critical field.

Deciphering the Therapeutic Efficacy and Underlying Mechanisms of Dendrobium officinale Polysaccharides in the Intervention of Alzheimer's Disease Mice: Insights from Metabolomics and Microbiome

As a traditional drug-food homologous plant, Dendrobium officinale is widely recognized for its nutritional and medicinal value. Specifically, D. officinale polysaccharide (DOP) has garnered attention as a potential prebiotic for its protective effects on gut microbiota and the nervous system. However, the underlying mechanism by which DOP improves cognitive dysfunction in Alzheimer's disease (AD) remains unclear. This study intends to elucidate the beneficial effects of DOP on AD mice from the perspectives of metabolomics and the intestinal microbiome. The results showed that DOP significantly ameliorated cognitive dysfunction, attenuated hippocampal neuronal damage and Aβ plaque deposition, and restored intestinal barrier integrity in AD mice. The antibiotic-cocktail-induced germ-free mouse model confirmed that the neuroprotective effect of DOP was dependent on gut microbiota. Further investigations demonstrated that DOP influenced the composition of gut microbiota and restored its diversity. Additionally, DOP reshaped metabolic profile disorders in AD mice and increased the short-chain fatty acids (SCFAs) content. Correlation analysis further highlighted that specific gut microbiota was associated with the metabolism of AD mice. In conclusion, this study sheds light on the positive impact of DOP in reshaping the gut microbiota and enhancing cognitive function, offering important perspectives for the possible advancement and utilization of DOP.

Impact of sleep deprivation on colon cancer: Unraveling the KynA-P4HA2-HIF-1α axis in tumor lipid metabolism and metastasis

OBJECTIVE

There is growing evidence that sleep deprivation promotes cancer progression. In addition, colon cancer patients often experience sleep deprivation due to factors such as cancer pain and side effects of treatment. The occurrence of liver metastases is an important factor in the mortality of colon cancer patients. However, the relationship between sleep deprivation and liver metastases from colon cancer has not been elucidated.

METHODS

A sleep deprivation liver metastasis model was constructed to evaluate the effect of sleep deprivation on liver metastasis of colon cancer. Subsequently, mice feces were collected for untargeted metabolomics to screen and identify the key mediator, Kynurenic acid (KynA). Furthermore, HILPDA was screened by transcriptomics, and its potential mechanism was explored through ChIP, co-IP, ubiquitination experiments, phenotyping experiments, etc. RESULTS: Sleep deprivation promotes liver metastases in colon cancer. Functionally, sleep deprivation aggravates lipid accumulation and decreases the production of the microbiota metabolite KynA. In contrast, KynA inhibited colon cancer progression in vitro. In vivo, KynA supplementation reversed the promoting effects of sleep deprivation on liver metastases from colon cancer. Mechanistically, KynA downregulates the expression of P4HA2 to promote the ubiquitination and degradation of HIF-1α, which leads to a decrease in the transcription of HILPDA, and ultimately leads to an increase in lipolysis of colon cancer cells.

CONCLUSIONS

Our findings reveal that sleep deprivation impairs intracellular lipolysis by KynA, leading to lipid droplets accumulation in colon cancer cells. This process ultimately promotes colon cancer liver metastasis. This suggests a promising strategy for colon cancer treatment.

The Bidirectional Relationship Between the Gut Microbiome and Mental Health: A Comprehensive Review

The gut microbiome plays a fundamental role in mental health, influencing mood, cognition, and emotional regulation through the gut-brain axis. This bidirectional communication system connects the gastrointestinal and CNS, facilitated by microbial metabolites, neurotransmitters, and immune interactions. Recent research highlights the association between gut dysbiosis and psychiatric disorders, including anxiety, depression, and stress-related conditions. Key findings indicate that altered microbial diversity, decreased short-chain fatty acid (SCFA) production, and increased neuroinflammation contribute to mental health disturbances. This paper explores the mechanism linking the gut microbiome to brain function, including microbial neurotransmitter synthesis, vagus nerve signaling, and hypothalamic-pituitary-adrenal (HPA) axis modulation. Additionally, it evaluates the potential of microbiome-targeted interventions, such as probiotics, prebiotics, dietary modifications, and fecal microbiota transplantation (FMT), in alleviating psychiatric symptoms. Microbiome sequencing and bioinformatics advances further support the development of personalized microbiome-based mental health interventions. Despite promising evidence, challenges such as inter-individual variability, methodological inconsistencies, and the need for longitudinal studies remain. Future research should focus on standardizing microbiome assessment techniques and optimizing therapeutic applications. Integrating precision psychiatry with microbiome-based diagnostics holds immense potential in transforming mental health treatment.

Elucidating the mechanism of the first Chinese herbal formula Shuangxia Decoction to alleviate insomnia using multi-omics technologies

BACKGROUND

Shuangxia Decoction (SXD), evolved from " Banxia Shumi Decoction", is composed of Pinellia ternata (Thunb.) Makino and Prunella vulgarisl. SXD has been used to treat insomnia and is considered the first traditional Chinese herbal formula developed specifically for the treatment of insomnia.

PURPOSE

This study aimed to investigate the mechanism underlying SXD's effects against insomnia using multi-omics technologies.

METHODS

Network pharmacology was employed to predict the active components and core targets of SXD in treating insomnia, utilizing 17 active compounds. The pharmacodynamics of SXD were further validated in sleep-deprived mice. UPLC-QE-Orbitrap-MS was utilized to analyze serum metabolomics and hypothalamic tissue metabolomics of the sleep-deprived mice, revealing the biological mechanism of SXD against sleep deprivation. Rosmarinic acid (RA), a representative component of SXD, was selected to further investigate its anti-sleep deprivation mechanism, including intestinal ROS activity assays, intestinal metabolite analysis, serum metabolomics, gut microbiota analysis, and western blotting.

RESULTS

Through network pharmacology analysis, three active compounds and four targets were identified as key contributors to the therapeutic effects of SXD on insomnia. In the sleep deprivation (SD) model regulated by SXD, metabolomics studies revealed 28 differential serum metabolites and 20 differential metabolites in hypothalamic tissues. Among these, three shared differential metabolites (Hypoxanthine, Pyrroline hydroxycarboxylic acid, Hydroxyphenyllactic acid) and two critical metabolic pathways (purine metabolism and arginine and proline metabolism) were identified. In the SD model regulated by RA, varying doses of RA effectively reduced SD-induced ROS accumulation in both the small and large intestines. Analysis of RA metabolites in the intestines revealed 57 putative metabolites, most of which were oxidized products. Serum metabolomics analysis of RA against SD showed 58 differential metabolites, with purine metabolism and phenylalanine metabolism pathways being notably involved. Hypoxanthine was identified as a potential marker for clinical sleep deprivation by integrating serum and hypothalamic tissue metabolomics data from SXD and serum metabolomics data from RA. 16S rRNA sequencing demonstrated that SD significantly altered the abundance of eight gut microbiota species. RA exhibited a restorative effect on specific imbalanced gut microbiota, independent of dosage. Western blotting analysis revealed that RA preserved intestinal epithelial integrity by modulating the expression of tight junction proteins, including ZO-1, occludin and claudin. Meanwhile, RA effectively alleviated SD-induced oxidative stress by activating the Nrf2 signaling pathway, promoting nuclear translocation of Nrf2 and increasing the expression of its downstream antioxidant proteins HO-1 and NQO-1 in the small and large intestines.

CONCLUSION

Our study demonstrates that SXD has significant efficacy in alleviating SD. RA, as the representative compound of SXD, can eliminate the accumulation of intestines ROS in SD mice and improve gut microbiota imbalance caused by oxidative stress by upregulating tight junction proteins ZO-1, Occludin, and Claudin, and regulating the Nrf2 signaling pathway. Furthermore, hypoxanthine has been identified as a promising and reliable biomarker for SD.

Sleep and circadian disturbances in children with neurodevelopmental disorders

Sleep is essential for brain development and overall health, particularly in children with neurodevelopmental disorders (NDDs). Sleep disruptions can considerably impact brain structure and function, leading to dysfunction of neurotransmitter systems, metabolism, hormonal balance and inflammatory processes, potentially contributing to the pathophysiology of NDDs. This Review examines the prevalence, types and mechanisms of sleep disturbances in children with NDDs, including autism spectrum disorder, attention-deficit hyperactivity disorder and various genetic syndromes. Common sleep disorders in these populations include insomnia, hypersomnia, circadian rhythm disorders, sleep-related breathing disorders and parasomnias, with underlying factors often involving genetic, neurobiological, environmental and neurophysiological influences. Sleep problems such as insomnia, night awakenings and sleep fragmentation are closely linked to both internalizing symptoms such as anxiety and depression, and externalizing behaviours such as hyperactivity and aggression. Assessment of sleep in children with NDDs presents unique challenges owing to communication difficulties, comorbid conditions and altered sensory processing. The Review underscores the importance of further research to unravel the complex interactions between sleep and neurodevelopment, advocating for longitudinal studies and the identification of predictive biomarkers. Understanding and addressing sleep disturbances in NDDs is crucial for improving developmental outcomes and the overall quality of life for affected individuals and their families.

Sleep deprivation-induced shifts in gut microbiota: Implications for neurological disorders

Sleep deprivation is a prevalent issue in contemporary society, with significant ramifications for both physical and mental well-being. Emerging scientific evidence illuminates its intricate interplay with the gut-brain axis, a vital determinant of neurological function. Disruptions in sleep patterns disturb the delicate equilibrium of the gut microbiota, resulting in dysbiosis characterized by alterations in microbial composition and function. This dysbiosis contributes to the exacerbation of neurological disorders such as depression, anxiety, and cognitive decline through multifaceted mechanisms, including heightened neuroinflammation, disturbances in neurotransmitter signalling, and compromised integrity of the gut barrier. In response to these challenges, there is a burgeoning interest in therapeutic interventions aimed at restoring gut microbial balance and alleviating neurological symptoms precipitated by sleep deprivation. Probiotics, dietary modifications, and behavioural strategies represent promising avenues for modulating the gut microbiota and mitigating the adverse effects of sleep disturbances on neurological health. Moreover, the advent of personalized interventions guided by advanced omics technologies holds considerable potential for tailoring treatments to individualized needs and optimizing therapeutic outcomes. Interdisciplinary collaboration and concerted research efforts are imperative for elucidating the underlying mechanisms linking sleep, gut microbiota, and neurological function. Longitudinal studies, translational research endeavours, and advancements in technology are pivotal for unravelling the complex interplay between these intricate systems.

Chemical interplay between gut microbiota and epigenetics: Implications in circadian biology

Circadian rhythms are intrinsic molecular mechanisms that synchronize biological functions with the day/night cycle. The mammalian gut is colonized by a myriad of microbes, collectively named the gut microbiota. The microbiota impacts host physiology via metabolites and structural components. A key mechanism is the modulation of host epigenetic pathways, especially histone modifications. An increasing number of studies indicate the role of the microbiota in regulating host circadian rhythms. However, the mechanisms remain largely unknown. Here, we summarize studies on microbial regulation of host circadian rhythms and epigenetic pathways, highlight recent findings on how the microbiota employs host epigenetic machinery to regulate circadian rhythms, and discuss its impacts on host physiology, particularly immune and metabolic functions. We further describe current challenges and resources that could facilitate research on microbiota-epigenetic-circadian rhythm interactions to advance our knowledge of circadian disorders and possible therapeutic avenues.

Change in sleep, gastrointestinal symptoms, and mood states at high altitude (4500m) for 6 months

PURPOSE

This study aimed to investigate the alterations in sleep quality and sleep patterns among military personnel at altitudes ranging from 1500 to 4500 m, as well as the associated factors influencing their sleep.

METHODS

This study employed a longitudinal prospective survey conducted over a period of six months, from November 2023 to June 2024. A total of 90 soldiers were recruited for participation. Initially, demographic data and sleep conditions were collected through a questionnaire administered to participants at an altitude of 1,500 m. Subsequently, participants were monitored continuously to gather data over seven days at an altitude of 4,500 m, specifically during the 7 days of the 6-month survey period), and the 1st month at an altitude of 4,500 m (on the 1st month of the six-month survey period. Spearman's rank correlation was utilized to investigate the relationships among sleep quality, gastrointestinal symptoms, and mood states.

RESULTS

The total score of the Pittsburgh Sleep Quality Index (PSQI) exhibited an increase, indicating impaired sleep quality among soldiers stationed at an altitude of 4,500 m for durations 7 days, 1 month, 3 months, and 6 months. Notably, after 7 days of soldiers, there was a significant gradual in the number of military soldiers experiencing gastrointestinal symptoms, such as diarrhea, abdominal distention, and constipation, which subsequently stabilized with prolonged exposure to the altitude. Furthermore, a significant rise in the incidence of depression was observed after days of rapid exposure 4,500 above sea level, and the emotional state of military personnel tended to tend towards mild depression over the duration of time Correlation. Correlation analysis showed that the PSQI score was closely related to the Athens Insomnia Scale(AIS) total score, Epworth Sleepiness Scale(ESS) total score, Self-Rating Anxiety Scale(SAS) total score, Self-Rating Depression Scale(SDS) total score, difficulty in falling asleep, easy to wake up or wake up early at night, poor breathing and snoring (on the 1st month, the 3rd month and the 6th month at the altitude of 4500 m respectively: rs = 0.868, 0.648, 0.483, 0.459, 0.472, 0.364, 0.613, 0.75; rs = 0.856, 0.521, 0.481, 0.354, 0.768, 0.720, 0.511, 0.535; rs = 0.756, 0.490, 0.496, 0.352, 0.708, 0.737, 0.424, 0.408, p < 0.01 or p < 0.05); Positively correlated with heart rate (at 4500 m 7 days at altitude: rs = 0.233, p = 0.027), diarrhea (at 4500 m 1-month at altitude: rs = 0.237) bloating and constipation (at 4500 m 1 month and 3months respectively: rs = 0.472; rs = 0.364; rs = 0.341, 0.273, p < 0.05); and with age, sex, marital status, education were significantly positive correlation (rs = 0.463, 0.251, 0.255, 0.230, p < 0.05).

CONCLUSIONS

The impaired sleep quality, gastrointestinal symptoms, and anxiety and depression in military personnel changed with the extension of the time of stationing at 4500 m altitude, which was most prominent when stationed at high altitude for 7 days; the sleep quality of those stationed at high altitude had a close relationship with the gastrointestinal symptoms, the type of sleep(insomnia and drowsiness), and the heart rate, but it varied with the duration of the stationing at high altitude; our study provides new information for the prevention of sleep disturbance, gastrointestinal symptoms, and negative emotions in high-altitude military personnel.

Tryptophan metabolism-related gene CYP1B1 serves as a shared biomarker for both Parkinson's disease and insomnia

Parkinson's disease (PD) and insomnia are prevalent neurological disorders, with emerging evidence implicating tryptophan (TRP) metabolism in their pathogenesis. However, the precise mechanisms by which TRP metabolism contributes to these conditions remain insufficiently elucidated. This study explores shared tryptophan metabolism-related genes (TMRGs) and molecular mechanisms underlying PD and insomnia, aiming to provide insights into their shared pathogenesis. We analyzed datasets for PD (GSE100054) and insomnia (GSE208668) obtained from the Gene Expression Omnibus (GEO) database. TMRGs were obtained from the Molecular Signatures Database (MSigDB) and the Genecards database. Tryptophan metabolism-related differentially expressed genes (TM-DEGs) were identified by intersecting TMRGs with shared differentially expressed genes (DEGs) from these datasets. Through Protein-Protein Interaction (PPI) network analysis, Support Vector Machine-Recursive Feature Elimination (SVM-RFE) , and Extreme Gradient Boosting (XGBoost) machine learning, we identified Cytochrome P4501B1 (CYP1B1) and Electron Transfer Flavoprotein Alpha (ETFA) as key hub genes. Subsequently, we employed CIBERSORT and single-sample gene set enrichment analysis (ssGSEA) to further investigate the association between hub genes and peripheral immune activation and inflammatory response. Additionally, gene interaction, Drug-mRNA, Transcription Factor (TF)-mRNA, and competing endogenous RNA (ceRNA) networks centered on these hub genes were constructed to explore regulatory mechanisms and potential drug interactions. Finally, validation through bioinformatics and animal experiments identified CYP1B1 as a promising biomarker associated with both PD and insomnia.

Characteristic alterations of gut microbiota and serum metabolites in patients with chronic tinnitus: a multi-omics analysis

Chronic tinnitus is a central nervous system disorder. Currently, the effects of gut microbiota on tinnitus remain unexplored. To explore the connection between gut microbiota and tinnitus, we conducted 16S rRNA sequencing of fecal microbiota and serum metabolomic analysis in a cohort of 70 patients with tinnitus and 30 healthy volunteers. We used the weighted gene co-expression network method to analyze the relationship between the gut microbiota and the serum metabolites. The random forest technique was utilized to select metabolites and gut taxa to construct predictive models. A pronounced gut dysbiosis in the tinnitus group, characterized by reduced bacterial diversity, an increased Firmicutes/Bacteroidetes ratio, and some opportunistic bacteria including Aeromonas and Acinetobacter were enriched. In contrast, some beneficial gut probiotics decreased, including Lactobacillales and Lactobacillaceae. In serum metabolomic analysis, serum metabolic disturbances in tinnitus patients and these differential metabolites were enriched in pathways of neuroinflammation, neurotransmitter activity, and synaptic function. The predictive models exhibited great diagnostic performance, achieving 0.94 (95% CI: 0.85-0.98) and 0.96 (95% CI: 0.86-0.99) in the test set. Our study suggests that changes in gut microbiota could potentially influence the occurrence and chronicity of tinnitus, and exert regulatory effects through changes in serum metabolites. Overall, this research provides new perceptions into the potential role of gut microbiota and serum metabolite in the pathogenesis of tinnitus, and proposes the "gut-brain-ear" concept as a pathomechanism underlying tinnitus, with significant clinical diagnostic implications and therapeutic potential.IMPORTANCETinnitus affects millions of people worldwide. Severe cases may lead to sleep disorders, anxiety, and depression, subsequently impacting patients' lives and increasing societal healthcare expenditures. However, tinnitus mechanisms are poorly understood, and effective therapeutic interventions are currently lacking. We discovered the gut microbiota and serum metabolomics changes in patients with tinnitus, and provided the potential pathological mechanisms of dysregulated gut flora in chronic tinnitus. We proposed the innovative concept of the "gut-brain-ear axis," which underscores the exploration of gut microbiota impact on susceptibility to chronic tinnitus through serum metabolic profile modulation. We also reveal novel biomarkers associated with chronic tinnitus, offering a new conceptual framework for further investigations into the susceptibility of patients, potential treatment targets for tinnitus, and assessing patient prognosis. Subsequently, gut microbiota and serum metabolites can be used as molecular markers to assess the susceptibility and prognosis of tinnitus.Furthermore, fecal transplantation may be used to treat tinnitus.

gutMGene v2.0: an updated comprehensive database for target genes of gut microbes and microbial metabolites

The gut microbiota is essential for various physiological functions in the host, primarily through the metabolites it produces. To support researchers in uncovering how gut microbiota contributes to host homeostasis, we launched the gutMGene database in 2022. In this updated version, we conducted an extensive review of previous papers and incorporated new papers to extract associations among gut microbes, their metabolites, and host genes, carefully classifying these as causal or correlational. Additionally, we performed metabolic reconstructions for representative gut microbial genomes from both human and mouse. gutMGene v2.0 features an upgraded web interface, providing users with improved accessibility and functionality. This upgraded version is freely available at http://bio-computing.hrbmu.edu.cn/gutmgene. We believe that this new version will greatly advance research in the gut microbiota field by offering a comprehensive resource.

Appraising the Effects of Gut Microbiota on Insomnia Risk Through Genetic Causal Analysis

BackgroundInsomnia is a common neurological disorder that exhibits connections with the gut microbiota; however, the exact causal relationship remains unclear. MethodsWe conducted a Mendelian randomization (MR) study to systematically evaluate the causal effects of genus-level gut microbiota on insomnia risk in individuals of European ancestry. Summary-level datasets on gut microbiota were sourced from the genome-wide association study (GWAS) of MiBioGen, while datasets on insomnia were obtained from the GWAS of Neale Lab and FinnGen. The primary analytical approach used was the inverse-variance weighted (IVW) method, supplemented by MR-Egger, maximum likelihood, MR-robust adjusted profile score, and weighted median. Sensitivity analyses were conducted to ensure robustness. ResultsThe microbial taxa Enterorhabdus, Family XIII AD3011 group, Paraprevotella, and Lachnospiraceae UCG004 were associated with an increased risk of insomnia, whereas Coprococcus1, Coprobacter, Desulfovibrio, Flavonifractor, Olsenella, Odoribacter, and Oscillibacter were linked to a decreased risk. Regarding the insomnia phenotype characterized by trouble falling asleep, the microbial taxon Eisenbergiella was correlated with an increased risk, while Haemophilus and the Eubacterium brachy group were associated with a reduced risk. Furthermore, for the insomnia phenotype characterized by waking too early, the microbial taxa Family XIII UCG001, Lachnospiraceae FCS020 group, and Olsenella were linked to an increased risk, whereas the Eubacterium brachy group and Victivallis were associated with a lower risk. The results remained robust across all sensitivity analyses. ConclusionOur MR study identified multiple genus-level gut microbial taxa that may exhibit potential causal effects on insomnia from a genetic perspective. These findings provide evidence supporting the theory of the microbiota-gut-brain axis and offer new insights into potential prevention and therapeutic targets for insomnia.

Mapping the 9-year sleep trajectory and its implications for chronic disease risks among middle-aged and older adults

OBJECTIVE

To identify the 9-year trajectories of sleep duration and to assess the relationship between time-dependent sleep duration and sleep trajectories with 14 chronic diseases in adults.

METHODS

This study used five waves of data of the China Health and Retirement Longitudinal Survey. Participants with complete sleep duration data and at least one record of 14 chronic diseases were included. The group-based trajectory model was used to identify sleep trajectories from 2011 to 2020. Time-dependent survival analysis and logistic regression were used to examine the relationship between time-dependent sleep duration and sleep trajectories with chronic diseases.

RESULTS

A total of 9063 participants were included, with a mean (standard deviation, SD) sleep duration of 6.37 (1.83) h/d. Sleeping <7 h/d predicted higher risks of 11 chronic diseases at follow-up, with hazard ratios (HR) and 95 % confidence intervals (CI) ranging from 1.71 (1.26-2.33) for psychiatric disease to 1.15 (1.04-1.27) for dyslipidemia. Five sleep trajectories were identified and labeled as group 1-5 based on ascending order of sleep duration. Consistently sleeping <4 h/d (group 1) and 4-6 h/d predicted higher risks of most chronic diseases, with the highest HR (95 %CI) of 3.50 (1.73-6.92) and 2.94 (1.82-4.49) for psychiatric diseases, respectively. Consistently sleeping 6-7 h/d (group 3) predicted higher risks of digestive diseases and arthritis. Decreasing sleep (group 4) predicted higher risks of psychiatric diseases and memory-related diseases.

CONCLUSIONS

Consistently sleeping <6 h/d predicted higher risks of most chronic diseases, especially psychiatric diseases. Digestive disease and arthritis were more sensitive to consistently inadequate sleep.

Novel insights into Cntnap4 in Alzheimer's disease: Intestinal flora interaction

Alzheimer's disease (AD) is a neurodegenerative disorder with unclear etiology. This study employs single-cell RNA sequencing (scRNA-seq), high-throughput transcriptome sequencing, 16s rRNA sequencing, and animal experiments to investigate the role of the contactin-associated protein like-4 (Cntnap4) gene in AD and its interaction with intestinal flora. We found that Cntnap4 deficiency in AD mice led to increased Tau protein phosphorylation, amyloid-beta plaque accumulation, and neuronal loss. Astrocytes in Cntnap4-/- mice showed impaired amyloid-beta processing. 16 s rRNA sequencing revealed distinct intestinal flora compositions between Cntnap4-/- and control mice, indicating a potential link between gut microbiota and AD progression. Notably, GABA supplementation improved cognitive impairment, restored synaptic currents, reduced amyloid-beta plaques, and increased neuronal counts. This study highlights Cntnap4's critical role in AD and suggests gut-brain axis involvement, offering novel insights for potential therapeutic strategies.

Appraising the role of biotics and fermented foods in gut microbiota modulation and sleep regulation

Sleep disturbances are increasingly prevalent, significantly impacting physical and mental health. Recent research reveals a bidirectional relationship between gut microbiota and sleep, mediated through the microbiota-gut-brain axis. This review examines the role of gut microbiota in sleep physiology and explores how biotics, including probiotics, prebiotics, synbiotics, postbiotics, and fermented foods, can enhance sleep quality. Drawing from animal and human studies, we discuss neurobiological mechanisms by which biotics may influence sleep, including modulation of neurotransmitters, immune responses, and hormonal regulation. Key microbial metabolites, such as short-chain fatty acids, are highlighted for their role in supporting sleep-related neurochemical processes. Additionally, this review presents dietary strategies and food processing technologies, like fermentation, as innovative approaches for sleep enhancement. Although promising, the available research has limitations, including small sample sizes, variability in biotic strains and dosages, and reliance on subjective sleep assessments. This review underscores the need for standardized protocols, objective assessments such as polysomnography, and personalized biotic interventions. Emerging findings highlight the therapeutic potential of gut microbiota modulation for sleep improvement, though further large-scale human trials are essential to refine strain selection, dosage, and formulation. This interdisciplinary exploration seeks to advance food-based interventions and holistic strategies for managing sleep disorders and improving quality of life.

The Microbiota-Gut-Brain Axis: Key Mechanisms Driving Glymphopathy and Cerebral Small Vessel Disease

The human microbiota constitute a very complex ecosystem of microorganisms inhabiting both the inside and outside of our bodies, in which health maintenance and disease modification are the main regulatory features. The recent explosion of microbiome research has begun to detail its important role in neurological health, particularly concerning cerebral small vessel disease (CSVD), a disorder associated with cognitive decline and vascular dementia. This narrative review represents state-of-the-art knowledge of the intimate, complex interplay between microbiota and brain health through the gut-brain axis (GBA) and the emerging role of glymphatic system dysfunction (glymphopathy) and circulating cell-derived microparticles (MPs) as mediators of these interactions. We discuss how microbial dysbiosis promotes neuroinflammation, vascular dysfunction, and impaired waste clearance in the brain, which are critical factors in the pathogenesis of CSVD. Further, we discuss lifestyle factors that shape the composition and functionality of the microbiota, focusing on sleep as a modifiable risk factor in neurological disorders. This narrative review presents recent microbiome research from a neuroscientific and vascular perspective to establish future therapeutic avenues in targeting the microbiota to improve brain health and reduce the burden of CSVD.

Gut microbiome and orthopaedic health: Bridging the divide between digestion and bone integrity

The gut microbiome, a complex ecosystem of microorganisms in the digestive tract, has emerged as a critical factor in human health, influencing metabolic, immune, and neurological functions. This review explores the connection between the gut microbiome and orthopedic health, examining how gut microbes impact bone density, joint integrity, and skeletal health. It highlights mechanisms linking gut dysbiosis to inflammation in conditions such as rheumatoid arthritis and osteoarthritis, suggesting microbiome modulation as a potential therapeutic strategy. Key findings include the microbiome's role in bone metabolism through hormone regulation and production of short-chain fatty acids, crucial for mineral absorption. The review also considers the effects of diet, probiotics, and fecal microbiota transplantation on gut microbiome composition and their implications for orthopedic health. While promising, challenges in translating microbiome research into clinical practice persist, necessitating further exploration and ethical consideration of microbiome-based therapies. This interdisciplinary research aims to link digestive health with musculoskeletal integrity, offering new insights into the prevention and management of bone and joint diseases.

Gut microbiota regulate insomnia-like behaviors via gut-brain metabolic axis

Sleep interacts reciprocally with the gut microbiota. However, mechanisms of the gut microbe-brain metabolic axis that are responsible for sleep behavior have remained largely unknown. Here, we showed that the absence of the gut microbiota can alter sleep behavior. Sleep deprivation reduced butyrate levels in fecal content and the hypothalamus in specific pathogen-free mice but not in germ-free mice. The microbial metabolite butyrate can promote sleep by modulating orexin neuronal activity in the lateral hypothalamic area in mice. Insomnia patients had lower serum butyrate levels and a deficiency in butyrate-producing species within the gut microbiota. Transplantation of the gut microbiota from insomnia patients to germ-free mice conferred insomnia-like behaviors, accompanied by a decrease in serum butyrate levels. The oral administration of butyrate rescued sleep disturbances in recipient mice. Overall, these findings reveal the causal role of microbial metabolic pathways in modulating insomnia-like behaviors, suggesting potential therapeutic strategies for treating sleep disorders.

Microbiome-Based Therapeutics for Insomnia

Insomnia poses considerable risks to both physical and mental health, leading to cognitive impairment, weakened immune function, metabolic dysfunction, cardiovascular issues, and reduced quality of life. Given the significant global increase in insomnia and the growing scientific evidence connecting gut microbiota to this disorder, targeting gut microbiota as an intervention for insomnia has gained popularity. In this review, we summarize current microbiome-based therapeutics for insomnia, including dietary modifications; probiotic, prebiotic, postbiotic, and synbiotic interventions; and fecal microbiota transplantation. Moreover, we assess the capabilities and weaknesses of these technologies to offer valuable insights for future studies.

Linking Gut Microbiota, Oral Microbiota, and Serum Metabolites in Insomnia Disorder: A Preliminary Study

Purpose

Despite recent findings suggesting an altered gut microbiota in those suffering from insomnia disorder (ID), research into the gut microbiota, oral microbiota, serum metabolites, and their interactions in patients with ID is sparse.

Patients and Methods

We collected a total of 114 fecal samples, 133 oral cavity samples and 20 serum samples to characterize the gut microbiota, oral microbiota and serum metabolites in a cohort of 76 ID patients (IDs) and 59 well-matched healthy controls (HCs). We assessed the microbiota as potentially biomarkers for ID for ID by 16S rDNA sequencing and elucidated the interactions involving gut microbiota, oral microbiota and serum metabolites in ID in conjunction with untargeted metabolomics.

Results

Gut and oral microbiota of IDs were dysbiotic. Gut and oral microbial biomarkers could be used to differentiate IDs from HCs. Eleven significantly altered serum metabolites, including adenosine, phenol, and phenol sulfate, differed significantly between groups. In multi-omics analyses, adenosine showed a positive correlation with genus_Lachnospira (p=0.029) and total sleep time (p=0.016). Additionally, phenol and phenol sulphate had a negative correlation with genus_Coprococcus (p=0.0059; p=0.0059) and a positive correlation with Pittsburgh Sleep Quality Index (p=0.006; p=0.006) and Insomnia Severity Index (p=0.021; p=0.021).

Conclusion

Microbiota and serum metabolite changes in IDs are strongly correlated with clinical parameters, implying mechanistic links between altered bacteria, serum metabolites and ID. This study offers novel perspective into the interaction among gut microbiota, oral microbiota, and serum metabolites for ID.

Study Protocol for a Randomized Controlled Trial Investigating the Effects of the Daily Consumption of Ruminant Milk on Digestive Comfort and Nutrition in Older Women: The YUMMI Study

BACKGROUND

Age-related changes can lead to dietary insufficiency in older adults. The inclusion of high-quality, nutrient-dense foods such as ruminant milks can significantly improve health outcomes. However, many older adults worldwide do not meet daily milk intake recommendations because of digestive discomfort and health concerns. Ovine and caprine milks are increasingly popular for their perceived digestive and nutritional benefits. While preclinical studies suggest differences in milk digestion, human studies investigating acute postprandial responses remain inconclusive, and the impacts of sustained milk consumption remain uncertain.

OBJECTIVES

Hence, we present a randomized controlled trial investigating how the sustained consumption of bovine, caprine, or ovine milk influences digestion, nutrition, and metabolism in older women.

METHODS

A total of 165 healthy older women were randomized to receive bovine, caprine, or ovine milk, or no milk, twice daily for 12 weeks. The primary outcome is the impact of milk consumption on digestive comfort assessed via the Gastrointestinal Syndrome Rating Scale (GSRS). Secondary outcomes include changes in nutrient intake, plasma amino acid and lipid appearance, bowel habits, the gut microbiota, cardiometabolic health, physical function, physical activity, sleep, mood, sensory perception, and emotional response.

CONCLUSIONS

The findings could inform dietary recommendations for older women and facilitate the development of targeted functional food products.

Acupuncture Treats Sepsis through Immune Modulation and Organ Protection

Sepsis is a secondary condition resulting from severe systemic infections. It is a significant contributor to mortality in critically ill patients with rapid onset and severe symptoms. Acupuncture is a traditional Chinese medical treatment. Recent clinical studies have demonstrated that acupuncture, as an important synergistic therapy, has promising therapeutic effects in the treatment of sepsis. This paper reviews the mechanisms of immunomodulation and target organ protection associated with acupuncture and synergistic drug acupuncture in the treatment of sepsis. It also integrates existing studies to elucidate the modulation of the immune system and the protective effect of acupuncture on target organs.

Insomnia, OSA, and Mood Disorders: The Gut Connection

PURPOSE OF REVIEW

With the growing body of research examining the link between sleep disorders, including insomnia and obstructive sleep apnea (OSA), and the gut microbiome, this review seeks to offer a thorough overview of the most significant findings in this emerging field.

RECENT FINDINGS

Current evidence suggests a complex association between imbalances in the gut microbiome, insomnia, and OSA, with potential reciprocal interactions that may influence each other. Notably, specific gut microbiome species, whether over- or under-abundant, have been associated with variation in both sleep and mood in patients diagnosed with, e.g., major depressive disorder or bipolar disorder. Further studies are needed to explore the potential of targeting the gut microbiome as a therapeutic approach for insomnia and its possible effects on mood. The variability in current scientific literature highlights the importance of establishing standardized research methodologies.

Sleep dysfunction and gut dysbiosis related amino acids metabolism disorders in cynomolgus monkeys after middle cerebral artery occlusion

INTRODUCTION

This study aimed to explore the characteristics of post-stroke sleep dysfunction and verify their association with gut dysbiosis and the related amino acid metabolism disorders. This was achieved by using fecal microbiota transplantation (FMT) in a non-human primate stroke model.

METHODS

Twenty adult male cynomolgus monkeys were divided into the sham (n = 4), middle cerebral artery occlusion (MCAO, n = 5), MCAO + FMT (n = 3), and donor (n = 8) groups. The MCAO+FMT group received FMT at post-MCAO week 4. Sleep parameters, gut microbiota, gamma-aminobutyric acid (GABA), and glutamine (Gln) in the cerebrospinal fluid (CSF) were measured at baseline and postoperative weeks 4, 8, and 12.

RESULTS

At postoperative weeks 4, 8, and 12, the MCAO group showed decreased sleep efficiency, measured as the percentage of sleep during the whole night (82.3 ± 3.2 % vs 91.3 ± 2.5 %, 79.0 ± 3.75 % vs 90.8 ± 3.2 %, and 69.5 ± 4.8 % vs 90.5 ± 2.7 %; all P < 0.05), lower relative abundance of Lactobacillus (all P < 0.05), and reduced GABA concentrations in the CSF (317.3 ± 30.6 nmol/L vs 437.7 ± 25.6 nmol/L, 303.1 ± 48.9 nmol/L vs 4 40.9 ± 37.8 nmol/L, and 337.9 ± 49.4 nmol/L vs 457.4 ± 39.2 nmol/L; all P < 0.05) compared with the sham group. Sleep efficiency at post-FMT weeks 4 and 8 (84.7 ± 1.1 % vs 79.0 ± 3.75 %, and 84.1 ± 2.0 % vs 69.5 ± 4.8 %; both P < 0.05) and GABA concentration in the CSF at post-FMT week 4 (403.1 ± 25.4 nmol/L vs 303.1 ± 48.9 nmol/L, P < 0.05) was higher in the MCAO+FMT group than in the MCAO group.

CONCLUSIONS

Post-stroke sleep dysfunction in monkeys is characterized by impaired sleep coherence, associated with decreased levels of probiotics such as Lactobacillus, GABA, and Gln in the CSF and can be ameliorated using FMT.

Intestinal flora composition and fecal metabolic phenotype in elderly patients with sleep disorders combined with type 2 diabetes

Objectives

This study aimed to determine whether type 2 diabetes (T2D) is an independent risk factor for sleep disorders in the elderly and explore the possible intestinal flora factors of sleep disorders combined with T2D in this population.

Methods

All hospitalized patients with sleep disorders aged ≥65 years between June and November 2023 were retrospectively analyzed, and they were divided into a sleep disorder group (n = 134) and a control group (n = 109). The logistic regression method was utilized to clarify the causal relationship between T2D and sleep disorders. For stool analyses, 42 patients were randomly extracted, which included the control group (n = 14), diabetes group (n = 14), and elderly patients with sleep disorders combined with the T2D group (ESdD) (n = 14). The composition feature of intestinal flora and metabolomics in the ESdD group was described through high-throughput 16S rDNA sequencing and nontargeted analysis based on liquid chromatography-mass spectrometry.

Results

Gender, body mass index (BMI), T2D, intestinal discomfort, and anxiety depression were independent risk factors for sleep disorders in the elderly. Notably, older individuals with T2D were 3.3 times more likely to experience sleep disorders than normal individuals. Compared with the control group, the ESdD group had decreased relative abundance of Barnesiella and Marvinbryantia, with 47 metabolites upregulated and 53 metabolites downregulated. The ESdD group showed a decrease in Lachnospiraceae_UCG_010, with 62 metabolites upregulated and 43 metabolites downregulated, compared with the diabetes group.

Conclusions

Diabetes is an independent risk factor for sleep disorders in the elderly patients. Variations in intestinal flora and metabolism significantly influence the onset and progression of the ESdD group.

Ozone rectal insufflation mitigates chronic rapid eye movement sleep deprivation-induced cognitive impairment through inflammation alleviation and gut microbiota regulation in mice

A range of sleep disorders has the potential to adversely affect cognitive function. This study was undertaken with the objective of investigating the effects of ozone rectal insufflation (O3-RI) on cognitive dysfunction induced by chronic REM sleep deprivation, as well as elucidating possible underlying mechanisms. O3-RI ameliorated cognitive dysfunction in chronic REM sleep deprived mice, improved the neuronal damage in the hippocampus region and decreased neuronal loss. Administration of O3-RI may protect against chronic REM sleep deprivation induced cognitive dysfunction by reversing the abnormal expression of Occludin and leucine-rich repeat and pyrin domain-containing protein 3 inflammasome as well as interleukin-1β in the hippocampus and colon tissues. Moreover, the microbiota diversity and composition of sleep deprivation mice were significantly affected by O3-RI intervention, as evidenced by the reversal of the Firmicutes/Bacteroidetes abundance ratio and the relative abundance of the Bacteroides genus. In particular, the relative abundance of the Bacteroides genus demonstrated a pronounced correlation with cognitive impairment and inflammation. Our findings suggested that O3-RI can improve cognitive dysfunction in sleep deprivation mice, and its mechanisms may be related to regulating gut microbiota and alleviating inflammation and damage in the hippocampus and colon.

Insomnia and intestinal microbiota: a narrative review

PURPOSE

The intestinal microbiota and insomnia interact through the microbiota-gut-brain axis. The purpose of this review is to summarize and analyze the changes of intestinal microbiota in insomnia, the interaction mechanisms between intestinal microbiota and insomnia and the treatment methods based on the role of microbiota regulation in insomnia, in order to reveal the feasibility of artificial intervention of intestinal microbiota to improve insomnia.

METHODS

Pubmed/ Embase were searched through March 2024 to explore the relevant studies, which included the gut microbiota characteristics of insomnia patients, the mechanisms of interaction between insomnia and gut microbiota, and the relationship between gut microbiota and insomnia treatment.

RESULTS

Numerous studies implicated insomnia could induce intestinal microbiota disorder by activating the immune response, the hypothalamic-pituitary-adrenal axis, the neuroendocrine system, and affecting bacterial metabolites, resulting in intestinal ecological imbalance, intestinal barrier destruction and increased permeability. The intestinal microbiota exerted an influence on the central nervous system through its interactions with intestinal neurons, releasing neurotransmitters and inflammatory factors, which in turn, can exacerbate symptoms of insomnia. Artificial interventions of gut microbiota included probiotics, traditional Chinese medicine, fecal microbiota transplantation, diet and exercise, whose main pathway of action is to improve sleep by affecting the release of neurotransmitters and gut microbial metabolites.

CONCLUSION

There is an interaction between insomnia and gut microbiota, and it is feasible to diagnose and treat insomnia by focusing on changes in the gut microbiota of patients with insomnia. Large cross-sectional studies and fecal transplant microbiota studies are still needed in the future to validate its safety and efficacy.

Back to Roots: Dysbiosis, Obesity, Metabolic Syndrome, Type 2 Diabetes Mellitus, and Obstructive Sleep Apnea-Is There an Objective Connection? A Narrative Review

In recent decades, it has become clear that the gut is more than just a digestive organ; it also functions as an immune organ with regulatory capabilities and acts as a "second brain" that influences brain function due to the presence and regulatory roles of the gut microbiota (GM). The GM is a crucial component of its host and significantly impacts human health. Dysbiosis, or microbial imbalance, has been closely linked to various diseases, including gastrointestinal, neurological, psychiatric, and metabolic disorders. The aim of this narrative review is to highlight the roles of the GM in maintaining metabolic health. Sleep is a vital biological necessity, with living organisms having evolved an internal sleep-wake rhythm that aligns with a roughly 24 h light/dark cycle, and this is known as the circadian rhythm. This cycle is essential for tissue repair, restoration, and overall optimal body functioning. Sleep irregularities have become more prevalent in modern society, with fast-paced lifestyles often disrupting normal sleep patterns. Urban living factors, such as fast food consumption, shift work, exposure to artificial light and nighttime noise, medications, and social activities, can adversely affect circadian rhythms, with dysbiosis being one of the many factors incriminated in the etiology of sleep disorders.

Gut Microbe-Generated Metabolite Trimethylamine-N-Oxide and Ischemic Stroke

Trimethylamine-N-oxide (TMAO) is a gut microbiota-derived metabolite, the production of which in vivo is mainly regulated by dietary choices, gut microbiota, and the hepatic enzyme flavin monooxygenase (FMO), while its elimination occurs via the kidneys. The TMAO level is positively correlated with the risk of developing cardiovascular diseases. Recent studies have found that TMAO plays an important role in the development of ischemic stroke. In this review, we describe the relationship between TMAO and ischemic stroke risk factors (hypertension, diabetes, atrial fibrillation, atherosclerosis, thrombosis, etc.), disease risk, severity, prognostic outcomes, and recurrence and discuss the possible mechanisms by which they interact. Importantly, TMAO induces atherosclerosis and thrombosis through lipid metabolism, foam cell formation, endothelial dysfunction (via inflammation, oxidative stress, and pyroptosis), enhanced platelet hyper-reactivity, and the upregulation and activation of vascular endothelial tissue factors. Although the pathogenic mechanisms underlying TMAO's aggravation of disease severity and its effects on post-stroke neurological recovery and recurrence risk remain unclear, they may involve inflammation, astrocyte function, and pro-inflammatory monocytes. In addition, this paper provides a summary and evaluation of relevant preclinical and clinical studies on interventions regarding the gut-microbiota-dependent TMAO level to provide evidence for the prevention and treatment of ischemic stroke through the gut microbe-TMAO pathway.

Lacticaseibacillus paracasei 207-27 alters the microbiota-gut-brain axis to improve wearable device-measured sleep duration in healthy adults: a randomized, double-blind, placebo-controlled trial

Objective: Probiotics have been reported to exert beneficial effects on sleep through the gut-brain axis. Therefore, this randomized, double-blind, placebo-controlled trial assessed the effects of Lacticaseibacillus paracasei 207-27 supplementation on sleep quality and its safety and potential mechanisms. Method and study design: Healthy adults under mild stress aged 18-35 years consumed low or high doses of L. paracasei 207-27 or a placebo for 28 days. Fecal samples, blood samples, and questionnaires were collected at the baseline and the end of the intervention. Sleep quality was measured using wearable devices and Pittsburgh sleep quality index (PSQI) questionnaire. Serum inflammatory markers, corticotropin-releasing hormone, adrenocorticotropic hormone (ACTH), cortisol (COR), γ-aminobutyric acid, and 5-hydroxytryptamine levels were detected using enzyme-linked immunosorbent assay. The gut microbiota was analyzed using 16S rRNA sequencing and bioinformatics. Short-chain fatty acids levels were detected using gas chromatography-mass spectrometry. Results: Both the low-dose and high-dose groups exhibited significant improvements in wearable device- measured sleep duration compared to the placebo group. The global scores of PSQI in three groups significantly decreased after intervention without statistical difference between groups. At the phylum level, the low-dose group exhibited a higher relative abundance of Bacteroidota and a lower Firmicutes-to-Bacteroidetes (F/B) ratio. At the genus level, two treatment groups had higher relative abundance of Bacteroides and Megamonas, alongside lower levels of Escherichia-Shigella. Furthermore, the low-dose group exhibited significant increases in acetic acid, propionic acid, butyric acid, and valeric acid levels, while two treatment groups exhibited a significant decrease in COR levels. Correlation analysis revealed that the increased levels of acetic acid and butyric acid in the low-dose group may be associated with decreased ACTH. Conclusion: L. paracasei 207-27 administration in healthy adults resulted in improvements in gut microbiota community and sleep duration. The mechanisms might involve modulation of the gut microbiota structure to regulate the function of the gut-brain axis, including increases in SCFA levels and decreases in hypothalamic-pituitary-adrenal axis activity. The Chinese clinical trial registry number is ChiCTR2300069453 (https://www.chictr.org.cn/showproj.html?proj=191193, registered 16 May 2023 - retrospectively registered).

Integrated gut microbiome and metabolomic analyses elucidate the therapeutic mechanisms of Suanzaoren decoction in insomnia and depression models

Insomnia and depression are psychiatric disorders linked to substantial health burdens. The gut microbiome and metabolomic pathways are increasingly recognized as key contributors to these conditions' pathophysiology. Suanzaoren Decoction (SZRD), a traditional Chinese herbal formulation, has demonstrated significant therapeutic benefits for both insomnia and depression. This study aims to elucidate the mechanistic effects of SZRD on insomnia and depression by integrating gut microbiome and metabolomic analyses and to assess the differential impacts of SZRD dosages. Using ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS), we identified 66 chemical constituents within SZRD. Behavioral assays indicated that low-dose SZRD (LSZRD) significantly ameliorated insomnia symptoms in rat models, whereas high-dose SZRD (HSZRD) markedly improved depressive behaviors. 16S rRNA sequencing revealed that SZRD modulated gut microbiome dysbiosis induced by insomnia and depression, characterized by an increased abundance of short-chain fatty acid (SCFA)-producing genera. Metabolomic profiling demonstrated reduced plasma amino acid metabolites and disrupted γ-aminobutyric acid (GABA) and L-glutamic acid metabolism in the hippocampus of affected rats. SZRD administration restored fecal SCFA levels and ameliorated metabolic imbalances in both plasma and hippocampal tissues. These findings underscore the pivotal role of gut microbiome modulation and metabolic regulation in the therapeutic effects of SZRD, providing a scientific basis for its use in treating insomnia and depression.

Consumption of poly-γ-glutamate-vitamin B6 supplement and urinary microbiota profiles in Korean healthy adults: a randomized, double-blinded, placebo-controlled intervention study

BACKGROUND/OBJECTIVES

Poly-γ-glutamic acid (γ-PGA), a natural polymer found in fermented soybean products, has been reported to play a prebiotic role in the gut. This intervention study investigated the effects of γ-PGA-containing supplement consumption on urinary microbiota in healthy adults because of limited data on such investigation.

SUBJECTS/METHODS

A 4-week parallel trial including 39 male and female Korean adults, who were free of chronic diseases and infection, was designed as a randomized, double-blinded, placebo-controlled study. A total of 30 participants completed the study wherein the intervention group (n = 17) received a mixture supplement containing 600 mg/day of γ-PGA and 100 mg/day of vitamin B6, while the control group (n = 13) received a placebo. Paired datasets (baseline and endpoint data) of microbiota profiles, which were constructed via urinary assays of microbe-derived extracellular vesicles, were analyzed and compared between the two groups.

RESULTS

Only the intervention group yielded significant results for the Bray-Curtis and Jaccard dissimilarity indices between baseline and endpoint data (P < 0.05). In the phylum-level analysis of microbial composition, the Firmicutes to Bacteroidetes ratio (FB ratio) tended to decrease from baseline in the intervention group; however, it increased in the control group. Differences between the baseline and endpoint FB ratios were significant between the two groups (P < 0.05).

CONCLUSION

This study's findings suggest that γ-PGA-vitamin B6 supplementation potentially alters the microbial community composition of a host. Further investigation into the biological consequences of commensal microbiota alteration by γ-PGA-containing supplement consumption is warranted.

State of the art: Alternative overlap syndrome-asthma and obstructive sleep apnea

In the general population, Bronchial Asthma (BA) and Obstructive Sleep Apnea (OSA) are among the most prevalent chronic respiratory disorders. Significant epidemiologic connections and complex pathogenetic pathways link these disorders via complex interactions at genetic, epigenetic, and environmental levels. The coexistence of BA and OSA in an individual likely represents a distinct syndrome, that is, a collection of clinical manifestations attributable to several mechanisms and pathobiological signatures. To avoid terminological confusion, this association has been named alternative overlap syndrome (vs overlap syndrome represented by the chronic obstructive pulmonary disease-OSA association). This comprehensive review summarizes the complex, often bidirectional links between the constituents of the alternative overlap syndrome. Cross-sectional, population, or clinic-based studies are unlikely to elucidate causality or directionality in these relationships. Even longitudinal epidemiological evaluations in BA cohorts developing over time OSA, or OSA cohorts developing BA during follow-up cannot exclude time factors or causal influence of other known or unknown mediators. As such, a lot of pathophysiological interactions described here have suggestive evidence, biological plausibility, potential or actual directionality. By showcasing existing evidence and current knowledge gaps, the hope is that deliberate, focused, and collaborative efforts in the near-future will be geared toward opportunities to shine light on the unknowns and accelerate discovery in this field of health, clinical care, education, research, and scholarly endeavors.