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de Noronha SISR, de Moraes LAG, Hassell JE, Stamper CE, Arnold MR, Heinze JD, Foxx CL, Lieb MM, Cler KE, Karns BL, Jaekel S, Loupy KM, Silva FCS, Chianca-Jr DA, Lowry CA, de Menezes RC. High-fat diet, microbiome-gut-brain axis signaling, and anxiety-like behavior in male rats. Biol Res 2024; 57:23. [PMID: 38705984 PMCID: PMC11071217 DOI: 10.1186/s40659-024-00505-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/23/2024] [Indexed: 05/07/2024] Open
Abstract
Obesity, associated with the intake of a high-fat diet (HFD), and anxiety are common among those living in modern urban societies. Recent studies suggest a role of microbiome-gut-brain axis signaling, including a role for brain serotonergic systems in the relationship between HFD and anxiety. Evidence suggests the gut microbiome and the serotonergic brain system together may play an important role in this response. Here we conducted a nine-week HFD protocol in male rats, followed by an analysis of the gut microbiome diversity and community composition, brainstem serotonergic gene expression (tph2, htr1a, and slc6a4), and anxiety-related defensive behavioral responses. We show that HFD intake decreased alpha diversity and altered the community composition of the gut microbiome in association with obesity, increased brainstem tph2, htr1a and slc6a4 mRNA expression, including in the caudal part of the dorsomedial dorsal raphe nucleus (cDRD), a subregion previously associated with stress- and anxiety-related behavioral responses, and, finally, increased anxiety-related defensive behavioral responses. The HFD increased the Firmicutes/Bacteroidetes ratio relative to control diet, as well as higher relative abundances of Blautia, and decreases in Prevotella. We found that tph2, htr1a and slc6a4 mRNA expression were increased in subregions of the dorsal raphe nucleus in the HFD, relative to control diet. Specific bacterial taxa were associated with increased serotonergic gene expression in the cDRD. Thus, we propose that HFD-induced obesity is associated with altered microbiome-gut-serotonergic brain axis signaling, leading to increased anxiety-related defensive behavioral responses in rats.
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Affiliation(s)
- Sylvana I S Rendeiro de Noronha
- Department of Biological Sciences, Laboratory of Cardiovascular Physiology, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Lauro Angelo Gonçalves de Moraes
- Department of Biological Sciences, Laboratory of Cardiovascular Physiology, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
- Computing Department, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
| | - James E Hassell
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Christopher E Stamper
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Mathew R Arnold
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Jared D Heinze
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Christine L Foxx
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Margaret M Lieb
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Kristin E Cler
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Bree L Karns
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Sophia Jaekel
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Kelsey M Loupy
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Fernanda C S Silva
- Department of Biological Sciences, Laboratory of Cardiovascular Physiology, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
| | - Deoclécio Alves Chianca-Jr
- Department of Biological Sciences, Laboratory of Cardiovascular Physiology, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
| | - Christopher A Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Rodrigo Cunha de Menezes
- Department of Biological Science Laboratory of Cardiovascular Physiology, Campus Morro do Cruzeiro s/n, Ouro Preto, 35400-000, MG, Brazil.
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Wild CJ, Heinze JD, Dorf ER. Intermuscular lipoma in the supraspinatus fossa: a case report. JSES Rev Rep Tech 2024; 4:91-95. [PMID: 38323197 PMCID: PMC10840575 DOI: 10.1016/j.xrrt.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Affiliation(s)
- Carrie J. Wild
- Department of Orthopaedic Surgery, Lincoln Memorial University- DeBusk College of Osteopathic Medicine, Harrogate, TN, USA
| | - Jared D. Heinze
- Vail-Summit Orthopaedics and Neurosurgery, Vail, CO, USA
- Vail-Summit Orthopaedics and Neurosurgery, Research and Education Foundation, Vail, CO, USA
| | - Erik R. Dorf
- Vail-Summit Orthopaedics and Neurosurgery, Vail, CO, USA
- Vail-Summit Orthopaedics and Neurosurgery, Research and Education Foundation, Vail, CO, USA
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Pavelich GM, Brena KR, Heinze JD, Dorf E. A Comparative Study of Thumb Metacarpal Morphology and Shape Categorization. J Hand Surg Am 2023; 48:308.e1-308.e4. [PMID: 34937669 DOI: 10.1016/j.jhsa.2021.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 07/19/2021] [Accepted: 09/22/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To describe the shape of a biplanar thumb metacarpal (MC) head and identify how it differs morphologically from previously described flat and round MC heads. METHODS Lateral radiographs of the thumb were collected retrospectively from our patient database. Patients were included in the study if they had an appropriate lateral radiograph, met the age criteria (range; 18-75 years), and did not have severe metacarpophalangeal (MCP) joint arthritis. Metacarpal heads were categorized as flat or round by dividing the distance measured from the volar to the dorsal edge of the articular surface by the radius of curvature of the articular surface. A ratio of 1.7 or greater indicated a round MC head, whereas a ratio of less than 1.7 indicated a flat MC head. RESULTS Among the 210 study participants, 110 were female and the average age was 47.3 years. During the measurement and classification process, it was determined by a board-certified hand surgeon that a subset of MCs did not meet the criteria for being categorized as either flat or round because of the inability to appropriately measure the radius of curvature of the MCP joint. Of the participants 113, 79, and 18, were classified as having either round, flat, or biplanar MC head shapes, respectively. CONCLUSIONS We have identified a third, biplanar MC head shape. The biplanar head shape is more triangular and has two distinct planes on the articular surface that converge into an apex. CLINICAL RELEVANCE The shape of the MC head has been shown to influence the range of motion of the MCP joint which may have an influence on the types of injuries that occur at the MCP joint. Further studies are required to understand how shape classification of MC heads may be useful and relevant to range of motion and risk of injury.
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Affiliation(s)
- Gretchen M Pavelich
- Vail-Summit Orthopaedic Foundation, Vail-Summit Orthopaedics and Neurosurgery, Vail, CO
| | - Kyle R Brena
- Vail-Summit Orthopaedic Foundation, Vail-Summit Orthopaedics and Neurosurgery, Vail, CO
| | - Jared D Heinze
- Vail-Summit Orthopaedic Foundation, Vail-Summit Orthopaedics and Neurosurgery, Vail, CO
| | - Erik Dorf
- Vail Summit Orthopaedic and Neurosurgery, Vail, CO.
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Korgan AC, Foxx CL, Hashmi H, Sago SA, Stamper CE, Heinze JD, O'Leary E, King JL, Perrot TS, Lowry CA, Weaver ICG. Effects of paternal high-fat diet and maternal rearing environment on the gut microbiota and behavior. Sci Rep 2022; 12:10179. [PMID: 35715467 PMCID: PMC9205913 DOI: 10.1038/s41598-022-14095-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 06/01/2022] [Indexed: 11/17/2022] Open
Abstract
Exposing a male rat to an obesogenic high-fat diet (HFD) influences attractiveness to potential female mates, the subsequent interaction of female mates with infant offspring, and the development of stress-related behavioral and neural responses in offspring. To examine the stomach and fecal microbiome's potential roles, fecal samples from 44 offspring and stomach samples from offspring and their fathers were collected and bacterial community composition was studied by 16 small subunit ribosomal RNA (16S rRNA) gene sequencing. Paternal diet (control, high-fat), maternal housing conditions (standard or semi-naturalistic housing), and maternal care (quality of nursing and other maternal behaviors) affected the within-subjects alpha-diversity of the offspring stomach and fecal microbiomes. We provide evidence from beta-diversity analyses that paternal diet and maternal behavior induced community-wide shifts to the adult offspring gut microbiome. Additionally, we show that paternal HFD significantly altered the adult offspring Firmicutes to Bacteroidetes ratio, an indicator of obesogenic potential in the gut microbiome. Additional machine-learning analyses indicated that microbial species driving these differences converged on Bifidobacterium pseudolongum. These results suggest that differences in early-life care induced by paternal diet and maternal care significantly influence the microbiota composition of offspring through the microbiota-gut-brain axis, having implications for adult stress reactivity.
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Affiliation(s)
- Austin C Korgan
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME, 04609, USA
| | - Christine L Foxx
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
- Oak Ridge Institute for Science and Education Research Participation Program, Oak Ridge, TN, 37830, USA
- U.S. Department of Agriculture (USDA), National Animal Health Laboratory Network (NAHLN), Animal and Plant Health Inspection Service (APHIS), Ames, IA, 50010, USA
| | - Heraa Hashmi
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Saydie A Sago
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Christopher E Stamper
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
- Rocky Mountain MIRECC for Veteran Suicide Prevention, 1700 N Wheeling St, G-3-116M, Aurora, CO, 80045, USA
| | - Jared D Heinze
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Elizabeth O'Leary
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Jillian L King
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME, 04609, USA
| | - Tara S Perrot
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Brain Repair Centre, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
- Department of Psychology and Neuroscience and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
- Department of Physical Medicine and Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), The Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, 80045, USA
- Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Aurora, CO, 80045, USA
| | - Ian C G Weaver
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
- Brain Repair Centre, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
- Department of Pathology, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
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Braxton EE, Brena KR, Spears H, Conrad E, Heinze JD. Ultrasound-guided bilateral erector spinae plane nerve blocks: a novel application for the management of acute postoperative pain in awake spine surgery. Illustrative case. Journal of Neurosurgery: Case Lessons 2022; 3:CASE21633. [PMCID: PMC9379654 DOI: 10.3171/case21633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/09/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND
Postoperative pain management is a limiting factor for early ambulation and discharge following spine fusion surgery. Awake spinal surgery, when combined with minimally invasive transforaminal lumbar interbody fusion, is associated with enhanced recovery in well-selected patients. Some neurosurgeons have recently aimed to further improve outcomes by utilizing erector spinae plane block catheters, allowing for a continuous infusion of local anesthetic to improve the management of acute postoperative pain following minimally invasive transforaminal lumbar interbody fusion.
OBSERVATIONS
A patient who underwent a minimally invasive transforaminal lumbar interbody fusion with perioperatively placed erector spinae plane catheters at the T12 level ambulated 30 minutes after surgery and was discharged the same day (length of stay, 4.6 hours). The total amount of narcotics administered during the hospital stay was 127.5 morphine milligram equivalents.
LESSONS
The placement of bilateral erector spine plane nerve block catheters at the T12 level with an ambulatory infusion pump may help to improve acute postoperative pain management for patients undergoing lumbar spinal fusion.
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Affiliation(s)
- Ernest E. Braxton
- Department of Orthopaedics and Neurosurgery, Vail-Summit Orthopaedics and Neurosurgery, Vail, Colorado
- Vail-Summit Orthopaedics and Neurosurgery Research and Education Foundation, Vail-Summit Orthopaedics and Neurosurgery, Vail, Colorado; and
| | - Kyle R. Brena
- Department of Orthopaedics and Neurosurgery, Vail-Summit Orthopaedics and Neurosurgery, Vail, Colorado
- Vail-Summit Orthopaedics and Neurosurgery Research and Education Foundation, Vail-Summit Orthopaedics and Neurosurgery, Vail, Colorado; and
| | - Holley Spears
- Department of Orthopaedics and Neurosurgery, Vail-Summit Orthopaedics and Neurosurgery, Vail, Colorado
| | - Emerson Conrad
- Department of Anesthesiology, Anesthesia Partners of Colorado, Vail, Colorado
| | - Jared D. Heinze
- Department of Orthopaedics and Neurosurgery, Vail-Summit Orthopaedics and Neurosurgery, Vail, Colorado
- Vail-Summit Orthopaedics and Neurosurgery Research and Education Foundation, Vail-Summit Orthopaedics and Neurosurgery, Vail, Colorado; and
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White B, Sterrett JD, Grigoryan Z, Lally L, Heinze JD, Alikhan H, Lowry CA, Perez LJ, DeSipio J, Phadtare S. Characterization of gut microbiome and metabolome in Helicobacter pylori patients in an underprivileged community in the United States. World J Gastroenterol 2021; 27:5575-5594. [PMID: 34588753 PMCID: PMC8433610 DOI: 10.3748/wjg.v27.i33.5575] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/02/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori), a bacterium that infects approximately half of the world’s population, is associated with various gastrointestinal diseases, including peptic ulcers, non-ulcer dyspepsia, gastric adenocarcinoma, and gastric lymphoma. As the burden of antibiotic resistance increases, the need for new adjunct therapies designed to facilitate H. pylori eradication and reduce negative distal outcomes associated with infection has become more pressing. Characterization of the interactions between H. pylori, the fecal microbiome, and fecal fatty acid metabolism, as well as the mechanisms underlying these interactions, may offer new therapeutic approaches.
AIM To characterize the gut microbiome and metabolome in H. pylori patients in a socioeconomically challenged and underprivileged inner-city community.
METHODS Stool samples from 19 H. pylori patients and 16 control subjects were analyzed. 16S rRNA gene sequencing was performed on normalized pooled amplicons using the Illumina MiSeq System using a MiSeq reagent kit v2. Alpha and beta diversity analyses were performed in QIIME 2. Non-targeted fatty acid analysis of the samples was carried out using gas chromatography-mass spectrometry, which measures the total content of 30 fatty acids in stool after conversion into their corresponding fatty acid methyl esters. Multi-dimensional scaling (MDS) was performed on Bray-Curtis distance matrices created from both the metabolomics and microbiome datasets and a Procrustes test was performed on the metabolomics and microbiome MDS coordinates.
RESULTS Fecal microbiome analysis showed that alpha diversity was lowest in H. pylori patients over 40 years of age compared to control subjects of similar age group. Beta diversity analysis of the samples revealed significant differences in microbial community structure between H. pylori patients and control subjects across all ages. Thirty-eight and six taxa had lower and higher relative abundance in H. pylori patients, respectively. Taxa that were enriched in H. pylori patients included Atopobium, Gemellaceae, Micrococcaceae, Gemellales and Rothia (R. mucilaginosa). Notably, relative abundance of the phylum Verrucomicrobia was decreased in H. pylori patients compared to control subjects. Procrustes analysis showed a significant relationship between the microbiome and metabolome datasets. Stool samples from H. pylori patients showed increases in several fatty acids including the polyunsaturated fatty acids (PUFAs) 22:4n6, 22:5n3, 20:3n6 and 22:2n6, while decreases were noted in other fatty acids including the PUFA 18:3n6. The pattern of changes in fatty acid concentration correlated to the Bacteroidetes:Firmicutes ratio determined by 16S rRNA gene analysis.
CONCLUSION This exploratory study demonstrates H. pylori-associated changes to the fecal microbiome and fecal fatty acid metabolism. Such changes may have implications for improving eradication rates and minimizing associated negative distal outcomes.
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Affiliation(s)
- Brian White
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ 08103, United States
| | - John D Sterrett
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, United States
| | - Zoya Grigoryan
- Department of Internal Medicine, Lenox Hill Hospital, NYC, NY 10075, United States
| | - Lauren Lally
- Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States
| | - Jared D Heinze
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, United States
| | - Hyder Alikhan
- Department of Biological Sciences, Rowan University, Glassboro, NJ 08028, United States
| | - Christopher A Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, United States
| | - Lark J Perez
- Department of Chemistry and Biochemistry, Rowan University, Glassboro, NJ 08028, United States
| | - Joshua DeSipio
- Department of Gastroenterology, Cooper University Hospital, Camden, NJ 08103, United States
| | - Sangita Phadtare
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ 08103, United States
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7
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Appiah SA, Foxx CL, Langgartner D, Palmer A, Zambrano CA, Braumüller S, Schaefer EJ, Wachter U, Elam BL, Radermacher P, Stamper CE, Heinze JD, Salazar SN, Luthens AK, Arnold AL, Reber SO, Huber-Lang M, Lowry CA, Halbgebauer R. Evaluation of the gut microbiome in association with biological signatures of inflammation in murine polytrauma and shock. Sci Rep 2021; 11:6665. [PMID: 33758228 PMCID: PMC7988149 DOI: 10.1038/s41598-021-85897-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/05/2021] [Indexed: 12/03/2022] Open
Abstract
Severe injuries are frequently accompanied by hemorrhagic shock and harbor an increased risk for complications. Local or systemic inflammation after trauma/hemorrhage may lead to a leaky intestinal epithelial barrier and subsequent translocation of gut microbiota, potentially worsening outcomes. To evaluate the extent with which trauma affects the gut microbiota composition, we performed a post hoc analysis of a murine model of polytrauma and hemorrhage. Four hours after injury, organs and plasma samples were collected, and the diversity and composition of the cecal microbiome were evaluated using 16S rRNA gene sequencing. Although cecal microbial alpha diversity and microbial community composition were not found to be different between experimental groups, norepinephrine support in shock animals resulted in increased alpha diversity, as indicated by higher numbers of distinct microbial features. We observed that the concentrations of proinflammatory mediators in plasma and intestinal tissue were associated with measures of microbial alpha and beta diversity and the presence of specific microbial drivers of inflammation, suggesting that the composition of the gut microbiome at the time of trauma, or shortly after trauma exposure, may play an important role in determining physiological outcomes. In conclusion, we found associations between measures of gut microbial alpha and beta diversity and the severity of systemic and local gut inflammation. Furthermore, our data suggest that four hours following injury is too early for development of global changes in the alpha diversity or community composition of the intestinal microbiome. Future investigations with increased temporal-spatial resolution are needed in order to fully elucidate the effects of trauma and shock on the gut microbiome, biological signatures of inflammation, and proximal and distal outcomes.
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Affiliation(s)
- Sandra A Appiah
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Christine L Foxx
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Dominik Langgartner
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University Ulm, 89081, Ulm, Germany
| | - Annette Palmer
- Institute of Clinical and Experimental Trauma Immunology, Centre for Biomedical Research, University Hospital Ulm, University Ulm, Helmholtzstr. 8/1, 89081, Ulm, Germany
| | - Cristian A Zambrano
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Sonja Braumüller
- Institute of Clinical and Experimental Trauma Immunology, Centre for Biomedical Research, University Hospital Ulm, University Ulm, Helmholtzstr. 8/1, 89081, Ulm, Germany
| | - Evan J Schaefer
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Ulrich Wachter
- Institute for Anaesthesiological Pathophysiology and Process Development, University of Ulm, Ulm, Germany
| | - Brooke L Elam
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Peter Radermacher
- Institute for Anaesthesiological Pathophysiology and Process Development, University of Ulm, Ulm, Germany
| | - Christopher E Stamper
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Jared D Heinze
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Stephanie N Salazar
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Amalia K Luthens
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Andrea L Arnold
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Stefan O Reber
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University Ulm, 89081, Ulm, Germany
| | - Markus Huber-Lang
- Institute of Clinical and Experimental Trauma Immunology, Centre for Biomedical Research, University Hospital Ulm, University Ulm, Helmholtzstr. 8/1, 89081, Ulm, Germany.
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, 80309, USA
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
- Department of Physical Medicine and Rehabilitation and Center for Neuroscience, University of Colorado Anschutz, Medical Campus, Aurora, CO, 80045, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, 80045, USA
- Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Aurora, CO, 80045, USA
| | - Rebecca Halbgebauer
- Institute of Clinical and Experimental Trauma Immunology, Centre for Biomedical Research, University Hospital Ulm, University Ulm, Helmholtzstr. 8/1, 89081, Ulm, Germany
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Foxx CL, Heinze JD, González A, Vargas F, Baratta MV, Elsayed AI, Stewart JR, Loupy KM, Arnold MR, Flux MC, Sago SA, Siebler PH, Milton LN, Lieb MW, Hassell JE, Smith DG, Lee KAK, Appiah SA, Schaefer EJ, Panitchpakdi M, Sikora NC, Weldon KC, Stamper CE, Schmidt D, Duggan DA, Mengesha YM, Ogbaselassie M, Nguyen KT, Gates CA, Schnabel K, Tran L, Jones JD, Vitaterna MH, Turek FW, Fleshner M, Dorrestein PC, Knight R, Wright KP, Lowry CA. Effects of Immunization With the Soil-Derived Bacterium Mycobacterium vaccae on Stress Coping Behaviors and Cognitive Performance in a "Two Hit" Stressor Model. Front Physiol 2021; 11:524833. [PMID: 33469429 PMCID: PMC7813891 DOI: 10.3389/fphys.2020.524833] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022] Open
Abstract
Previous studies demonstrate that Mycobacterium vaccae NCTC 11659 (M. vaccae), a soil-derived bacterium with anti-inflammatory and immunoregulatory properties, is a potentially useful countermeasure against negative outcomes to stressors. Here we used male C57BL/6NCrl mice to determine if repeated immunization with M. vaccae is an effective countermeasure in a "two hit" stress exposure model of chronic disruption of rhythms (CDR) followed by acute social defeat (SD). On day -28, mice received implants of biotelemetric recording devices to monitor 24-h rhythms of locomotor activity. Mice were subsequently treated with a heat-killed preparation of M. vaccae (0.1 mg, administered subcutaneously on days -21, -14, -7, and 27) or borate-buffered saline vehicle. Mice were then exposed to 8 consecutive weeks of either stable normal 12:12 h light:dark (LD) conditions or CDR, consisting of 12-h reversals of the LD cycle every 7 days (days 0-56). Finally, mice were exposed to either a 10-min SD or a home cage control condition on day 54. All mice were exposed to object location memory testing 24 h following SD. The gut microbiome and metabolome were assessed in fecal samples collected on days -1, 48, and 62 using 16S rRNA gene sequence and LC-MS/MS spectral data, respectively; the plasma metabolome was additionally measured on day 64. Among mice exposed to normal LD conditions, immunization with M. vaccae induced a shift toward a more proactive behavioral coping response to SD as measured by increases in scouting and avoiding an approaching male CD-1 aggressor, and decreases in submissive upright defensive postures. In the object location memory test, exposure to SD increased cognitive function in CDR mice previously immunized with M. vaccae. Immunization with M. vaccae stabilized the gut microbiome, attenuating CDR-induced reductions in alpha diversity and decreasing within-group measures of beta diversity. Immunization with M. vaccae also increased the relative abundance of 1-heptadecanoyl-sn-glycero-3-phosphocholine, a lysophospholipid, in plasma. Together, these data support the hypothesis that immunization with M. vaccae stabilizes the gut microbiome, induces a shift toward a more proactive response to stress exposure, and promotes stress resilience.
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Affiliation(s)
- Christine L. Foxx
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Jared D. Heinze
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Antonio González
- Department of Pediatrics, School of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Fernando Vargas
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Michael V. Baratta
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Ahmed I. Elsayed
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Jessica R. Stewart
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Kelsey M. Loupy
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Mathew R. Arnold
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - M. C. Flux
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Saydie A. Sago
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Philip H. Siebler
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Lauren N. Milton
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Margaret W. Lieb
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - James E. Hassell
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - David G. Smith
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Kyo A. K. Lee
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Sandra A. Appiah
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Evan J. Schaefer
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Morgan Panitchpakdi
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Nicole C. Sikora
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Kelly C. Weldon
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Christopher E. Stamper
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Dominic Schmidt
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - David A. Duggan
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Yosan M. Mengesha
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Mikale Ogbaselassie
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Kadi T. Nguyen
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Chloe A. Gates
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - K’loni Schnabel
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Linh Tran
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Joslynn D. Jones
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Martha H. Vitaterna
- Center for Sleep and Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, IL, United States
| | - Fred W. Turek
- Center for Sleep and Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, IL, United States
| | - Monika Fleshner
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Pieter C. Dorrestein
- Department of Pediatrics, School of Medicine, University of California, San Diego, La Jolla, CA, United States
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Rob Knight
- Department of Pediatrics, School of Medicine, University of California, San Diego, La Jolla, CA, United States
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States
- Department of Computer Science and Engineering, Jacobs School of Engineering, University of California, San Diego, La Jolla, CA, United States
- Department of Bioengineering, Jacobs School of Engineering, University of California, San Diego, La Jolla, CA, United States
| | - Kenneth P. Wright
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Christopher A. Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States
- Department of Physical Medicine and Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- inVIVO Planetary Health, Worldwide Universities Network, West New York, NJ, United States
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9
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Langgartner D, Zambrano CA, Heinze JD, Stamper CE, Böbel TS, Hackl SB, Jarczok MN, Rohleder N, Rook GA, Gündel H, Waller C, Lowry CA, Reber SO. Association of the Salivary Microbiome With Animal Contact During Early Life and Stress-Induced Immune Activation in Healthy Participants. Front Psychiatry 2020; 11:353. [PMID: 32457661 PMCID: PMC7223923 DOI: 10.3389/fpsyt.2020.00353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 04/07/2020] [Indexed: 12/11/2022] Open
Abstract
The prevalence of stress-associated somatic and psychiatric disorders is increased in environments offering a narrow relative to a wide range of microbial exposure. Moreover, different animal and human studies suggest that an overreactive immune system not only accompanies stress-associated disorders, but might even be causally involved in their pathogenesis. In support of this hypothesis, we recently showed that urban upbringing in the absence of daily contact with pets, compared to rural upbringing in the presence of daily contact with farm animals, is associated with a more pronounced immune activation following acute psychosocial stressor exposure induced by the Trier Social Stress Test (TSST). Here we employed 16S rRNA gene sequencing to test whether this difference in TSST-induced immune activation between urban upbringing in the absence of daily contact with pets (n = 20) compared with rural upbringing in the presence of daily contact with farm animals (n = 20) is associated with differences in the composition of the salivary microbiome. Although we did not detect any differences in alpha or beta diversity measures of the salivary microbiome between the two experimental groups, statistical analysis revealed that the salivary microbial beta diversity was significantly higher in participants with absolutely no animal contact (n = 5, urban participants) until the age of 15 compared to all other participants (n = 35) reporting either daily contact with farm animals (n = 20, rural participants) or occasional pet contact (n = 15, urban participants). Interestingly, when comparing these urban participants with absolutely no pet contact to the remaining urban participants with occasional pet contact, the former also displayed a significantly higher immune, but not hypothalamic-pituitary-adrenal (HPA) axis or sympathetic nervous system (SNS) activation, following TSST exposure. In summary, we conclude that only urban upbringing with absolutely no animal contact had long-lasting effects on the composition of the salivary microbiome and potentiates the negative consequences of urban upbringing on stress-induced immune activation.
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Affiliation(s)
- Dominik Langgartner
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | - Cristian A Zambrano
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Jared D Heinze
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Christopher E Stamper
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Till S Böbel
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | - Sascha B Hackl
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | - Marc N Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | - Nicolas Rohleder
- Department of Psychology, Friedrich-Alexander University, Erlangen, Germany
| | - Graham A Rook
- Center for Clinical Microbiology, University College London (UCL), London, United Kingdom
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | - Christopher A Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States.,Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States.,Department of Physical Medicine and Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), The Rocky Mountain Regional Medical Center (RMRMC), Aurora, CO, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,inVIVO Planetary Health, Worldwide Universities Network (WUN), West New York, NJ, United States
| | - Stefan O Reber
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
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10
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Hale MW, Lukkes JL, Dady KF, Kelly KJ, Paul ED, Smith DG, Heinze JD, Raison CL, Lowry CA. Interactions between whole-body heating and citalopram on body temperature, antidepressant-like behaviour, and neurochemistry in adolescent male rats. Behav Brain Res 2019; 359:428-439. [DOI: 10.1016/j.bbr.2018.11.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 10/26/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
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11
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Brenner LA, Hoisington AJ, Stearns-Yoder KA, Stamper CE, Heinze JD, Postolache TT, Hadidi DA, Hoffmire CA, Stanislawski MA, Lowry CA. Military-Related Exposures, Social Determinants of Health, and Dysbiosis: The United States-Veteran Microbiome Project (US-VMP). Front Cell Infect Microbiol 2018; 8:400. [PMID: 30510919 PMCID: PMC6252388 DOI: 10.3389/fcimb.2018.00400] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/23/2018] [Indexed: 12/23/2022] Open
Abstract
Significant effort has been put forth to increase understanding regarding the role of the human microbiome in health- and disease-related processes. In turn, the United States (US) Veteran Microbiome Project (US-VMP) was conceptualized as a means by which to serially collect microbiome and health-related data from those seeking care within the Veterans Health Administration (VHA). In this manuscript, exposures related to military experiences, as well as conditions and health-related factors among patients seen in VHA clinical settings are discussed in relation to common psychological and physical outcomes. Upon enrollment in the study, Veterans complete psychometrically sound (i.e., reliable and valid) measures regarding their past and current medical history. Participants also provide skin, oral, and gut microbiome samples, and permission to track their health status via the VHA electronic medical record. To date, data collection efforts have been cross-diagnostic. Within this manuscript, we describe current data collection practices and procedures, as well as highlight demographic, military, and psychiatric characteristics of the first 188 Veterans enrolled in the study. Based on these findings, we assert that this cohort is unique as compared to those enrolled in recent large-scale studies of the microbiome. To increase understanding regarding disease and health among diverse cohorts, efforts such as the US-VMP are vital. Ongoing barriers and facilitators to data collection are discussed, as well as future research directions, with an emphasis on the importance of shifting current thinking regarding the microbiome from a focus on normalcy and dysbiosis to health promotion and disease prevention.
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Affiliation(s)
- Lisa A Brenner
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States.,Departments of Psychiatry and Neurology, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States.,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States
| | - Andrew J Hoisington
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States.,Department of Systems Engineering, Air Force Institute of Technology, Wright-Patterson AFB, OH, United States
| | - Kelly A Stearns-Yoder
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States.,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States
| | - Christopher E Stamper
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Jared D Heinze
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Teodor T Postolache
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States.,Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,VISN 5 MIRECC, Department of Veterans Affairs, Baltimore, MD, United States
| | - Daniel A Hadidi
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States
| | - Claire A Hoffmire
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States
| | - Maggie A Stanislawski
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Epidemiology, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States
| | - Christopher A Lowry
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States.,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States.,Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States.,Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States.,Center for Neuroscience, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States
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