The commensal gut microbiota is a dynamic entity that is influenced by a variety of factors. Previous study 1 has reported considerable individual variability in the bacterial content between related and unrelated individuals, which makes it difficult to identify candidate microorganisms for specific diseases. However, findings from monozygotic (MZ) twins have revealed a high degree of similarity in the composition of gut microbiota between twins. 1 Therefore, MZ twins discordant for a particular disease phenotype represent an attractive model for studying relationships between a disease and the microbiome.Bipolar disorder is a common and severe psychiatric illness characterized by at least one episode of hypomania and at least one episode of major depression. Despite the apparently high heritability of BD, there is considerable discordance between MZ twin pairs, which suggests that nongenetic and presumably environmental factors also play a role. Over the past decade, mounting evidence from animal studies has indicated that the gut microbiota is essential for brain function. In one recent study, 2 Evans et al characterized the fecal microbiome of 115 patients with bipolar disorder, and found decreased fractional representation of Faecalibacterium and an unclassified member from the Ruminococcaceae family compared to those of healthy control subjects. However, that study was limited to a single timepoint and thus did not capture the dynamics of the gut microbiome over time. Moreover, the detection of patterns in the gut microbiota may be complicated by variations in the severity of symptoms and the effects of antipsychotic drugs. As a result, it is of critical importance to study the intestinal microbiome over the whole process of a disease to identify whether there are microbial signatures related to that disorder. This can be achieved by longitudinal studies that begin at diagnosis and include follow-up assessments throughout treatment and that occur in parallel with clinical characterization.Thus, the primary aims of the present study were as follows: (1) to determine whether the gut microbiota of a single pair of MZ twins discordant for BD would have a lower degree of similarity than those of two healthy spouses; (2) to investigate whether there are differences in the composition and function of the gut microbiota during the active state of BD compared to that of healthy individuals; (3) and, in particular, to evaluate changes in the compositional and functional profiles of the microbiota of the affected twin according to disease state over a 7-month follow-up period.
| C A S E-PR E S E NTATI O NThe subjects included one pair of MZ twins discordant for bipolar depression (BD) and two pair of spouses recruited from Hangzhou who were used as a healthy control (HC) group. The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang University (Zhejiang, China), and the written consent of all subjects was obtained prior to sample collection and the subsequent analyses. The ...