AUTHOR=Liang Yuanjun , Chen Yang , Lin Yanzhao , Huang Wei , Qiu Qinwei , Sun Chen , Yuan Jiamin , Xu Ning , Chen Xinyan , Xu Fuping , Shang Xiaoxiao , Deng Yusheng , Liu Yanmin , Tan Fei , He Chunxiang , Li Jiasheng , Deng Qinqin , Zhang Xiaoxuan , Guan Huahua , Liang Yongzhu , Fang Xiaodong , Jiang Xuanting , Han Lijuan , Huang Li , Yang Zhimin 

TITLE=The increased tendency for anemia in traditional Chinese medicine deficient body constitution is associated with the gut microbiome

JOURNAL=Frontiers in Nutrition

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1359644

DOI=10.3389/fnut.2024.1359644

ISSN=2296-861X

ABSTRACT=<sec id="sec1"><title>Background</title><p>Constitution is a valuable part of traditional Chinese medicine theory; it is defined as the internal foundation for the occurrence, development, transformation and outcome of diseases, and has its characteristic gut microbiota. Previous study showed that deficiency constitution was related to lower Hb counts. However, no research has examined how alterations in the gut microbiome induced by deficiency constitution may increase the tendency for anemia.</p></sec><sec id="sec2"><title>Methods</title><p>We used a multiomics strategy to identify and quantify taxonomies and compounds found under deficient constitution individuals and further explore the possible pathological factors that affect red blood cell indices.</p></sec><sec id="sec3"><title>Results</title><p>① People with deficient constitution showed lower hemoglobin (Hb), more Firmicutes, less Bacteroidetes, and higher α diversity. ② We identified <italic>Escherichia coli</italic>, <italic>Clostridium bolteae</italic>, <italic>Ruminococcus gnavus</italic>, <italic>Streptococcus parasanguinis</italic> and <italic>Flavonifractor plautii</italic> as potential biomarkers of deficient constitution. ③ <italic>Slackia piriformis</italic>, <italic>Clostridium_sp_L2_50</italic> and <italic>Bacteroides plebeius</italic> were enriched in balanced-constitution individuals, and <italic>Parabacteroides goldsteinii</italic> was the key bacterial marker of balanced constitution. ④ <italic>Flavonifractor plautii</italic> may be a protective factor against the tendency for anemia among deficient individuals. ⑤ <italic>Ruminococcus gnavus</italic> may be the shared microbe base of deficiency constitution-related the tendency for anemia. ⑥ The microorganism abundance of the anaerobic phenotype was lower in deficient constitution group. ⑦ Alterations in the microbiome of deficient-constitution individuals were associated with worse health status and a greater risk of anemia, involving intestinal barrier function, metabolism and immune responses, regulated by short-chain fatty acids and bile acid production.</p></sec><sec id="sec4"><title>Conclusion</title><p>The composition of the gut microbiome was altered in people with deficient constitution, which may explain their poor health status and tendency toward anemia.</p></sec>