Sabine Hazan, MD1, Jordan Daniels, MS1, Adriana Vidal, PhD1, Robert Clancy, MD2 1ProgenaBiome, Ventura, CA; 2The University of New Castle, Newcastle, Tasmania, Australia Introduction: Bipolar Disorder (BD) is a biphasic disturbance of mood characterized by periods of mania, depression, and normality. Recent observations by our group in studies of subjects with neuropsychiatric dysfunction found two parameters that appeared to be of clinical value: a gap between colonization levels of Bacteroides and Bifidobacteria reflecting disease activity; and an association between refloralization with Bifidobacteria species and clinical improvement. We have established a prospective program with BP as the best model of spontaneous mood change, to validate the Bifidobacteria/Bacteroides gap as a diagnostic aid and specific Bifidobacteria replacement as a therapy of value. This presentation was a preliminary study to establish whether dysbiosis was present and likely to play a role in the pathogenesis of BD. Methods: Fecal samples from 11 BD patients, 7 patients with a family history of BD, and 20 healthy controls were collected at ProgenaBiome laboratories. Data were processed through the OneCodex bioinformatics pipeline for microbiota composition and relative abundances of top genera and phyla, as well as Alpha diversity via Shannon Index. A two-sample t-test was used to evaluate statistical significance. Results: When compared to healthy controls, the gut microbiome of BD patients had a lower relative abundance of Bifidobacterium (p=0.025), and a higher relative abundance of Bacteroides which was clinically significant. Bifidobacterium levels were also slightly lower in subjects with a family history of BD when compared to healthy controls; however, this association was not statistically significant (p=0.152). Genus Bacteroides was elevated in subjects with BD (p< 0.001), and in those with a family history of bipolar disorder (P< 0.05), compared to healthy subjects. While a trend towards lower diversity was observed in subjects with BD and in those with a history of BD, compared to healthy subjects, this association was not statistically significant (all p >0.103). Discussion: This small pilot successfully identified a Bacteroides-Bifidobacteria ( B-B Gap) gap of value in assessing dysbiosis in BD, and deficit Bifidobacteria species as a potential target for intervention therapy. Prospective controlled studies are in place to correlate more significantly the diagnostic and monitoring value of the B-B gap, and the therapeutic value of Bifida-enrichment strategies in flattening variable mood fluctuation.
Disclosures: Sabine Hazan: Progenabiome – Owner/Ownership Interest. Jordan Daniels indicated no relevant financial relationships. Adriana Vidal indicated no relevant financial relationships. Robert Clancy indicated no relevant financial relationships.
Sabine Hazan, MD1, Jordan Daniels, MS1, Adriana Vidal, PhD1, Robert Clancy, MD2. P5582 - Bipolar Disorder: A Model to Explore Pathogenesis and Treatment Options Based on Control of Gut Dysbiosis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
