Thiamine-reduced Fatigue in Quiescent Inflammatory Bowel Disease is Linked to Faecalibacterium Prausnitzii Abundance
GASTRO HEP ADVANCES（2025）
Tech Univ Denmark | Aarhus Univ Hosp | Dept Hepatol & Gastroenterol
Abstract
BACKGROUND AND AIMS: Chronic fatigue is common in patients with inflammatory bowel disease (IBD). The gut micro- biota, specifically, microbial diversity and butyrate-producing bacteria have been linked to the fatigue pathogenesis. High-dose oral thiamine reduces fatigue, potentially through gut microbiota modification. In this study, we investigated how the gut micro- biota influences the efficacy of high-dose thiamine in alleviating chronic fatigue in quiescent IBD (qIBD). METHODS: We analyzed the microbiota and short-chain fatty acids concentrations in fecal samples from patients with qIBD, with (n- 40) or without (n- 20) chronic fatigue. The 40 patients with qIBD and fatigue were included in a randomized, placebo-controlled, crossover trial to assess a 4-week high-oral-dose thiamine regimen. RESULTS: Butyrate and butyrate-producing bacteria were similar in patients with and without fatigue and did not change with high-dose thiamine treatment. Notably, Faecalibacterium prausnitzii was more abundant in thiamine responders compared with nonresponders both pretreatment (P- .019) and post-treatment (P- .038). The relative abundances of Faecalibacterium prausnitzii and Roseburia hominis, both pretreatment and post-treatment, inversely correlated with IBD fatigue score changes for patients with chronic fatigue (PRE; R-- 0.48, P- .004, and R-- 0.40, P- .018; POST; R-- 0.42, P- .012, and R-- 0.40, P- .017) respectively. CONCLUSION: Faecalibacterium prausnitzii and Roseburia hominis may serve as markers for response to high-dose thiamine in alleviating chronic fatigue in patients with qIBD. The mechanistic role of gut bacteria and butyrate in patients with chronic fatigue and qIBD should be further explored.
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Key words
Gut Microbiota,Chronic Fatigue,Crohn’s Disease,Colitis,Ulcerative,Thiamine
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