Data_Sheet_1_Methadone maintenance treatment is more effective than compulsory detoxification in addressing gut microbiota dysbiosis caused by heroin abuse.PDF

IntroductionHeroin use disorder (HUD) is commonly accompanied by gut dysbiosis, but the roles of gut microbiota in HUD treatment, such as compulsory detoxification and methadone maintenance treatment (MMT), remain poorly understood.
MethodsIn this study, we performed 16 s rDNA and whole metagenome sequencing to analyze the gut microbial profiles of HUD patients undergoing heroin addiction, heroin withdrawal (compulsory detoxification), and MMT.
ResultsOur findings revealed that, compared to healthy controls, microbial diversity was significantly decreased in HUD patients who were in a state of heroin addiction and withdrawal, but not in those receiving MMT. We observed significant alterations in 10 bacterial phyla and 20 bacterial families in HUD patients, while MMT partially restored these changes. Whole metagenome sequencing indicated gut microbiota functions were significantly disrupted in HUD patients experiencing heroin addiction and withdrawal, but MMT was found to almost reverse these dysfunctions. In addition, we identified 24 featured bacteria at the genus level that could be used to effectively distinguish between healthy individuals and those with heroin addiction, heroin withdrawal, or receiving MMT. Furthermore, we found the relative abundance of Actinomyces, Turicibacter and Weissella were positively associated with the Hamilton Depression Scale score in different states of HUD patients.
DiscussionThis study provides evidence from the gut microbiota perspective that MMT is a more effective approach than compulsory detoxification for HUD treatment.

引言
海洛因使用障碍（Heroin use disorder, HUD）常伴随肠道菌群失调，但肠道微生物群在海洛因使用障碍治疗（如强制戒毒与美沙酮维持治疗（methadone maintenance treatment, MMT））中的作用仍尚不明确。

方法
本研究通过16S核糖体DNA（16S rDNA）测序与全宏基因组测序，对处于海洛因成瘾、海洛因戒断（强制戒毒）及美沙酮维持治疗阶段的海洛因使用障碍患者的肠道微生物谱进行分析。

结果
本研究结果显示，与健康对照者相比，处于海洛因成瘾与戒断阶段的海洛因使用障碍患者的微生物多样性显著降低，但接受美沙酮维持治疗的患者未出现该现象。我们观察到，海洛因使用障碍患者的10个细菌门与20个细菌科发生显著改变，而美沙酮维持治疗可部分逆转这些变化。全宏基因组测序结果表明，处于海洛因成瘾与戒断阶段的海洛因使用障碍患者的肠道微生物群功能显著紊乱，而美沙酮维持治疗几乎可逆转此类功能异常。此外，我们在属水平鉴定出24种特征性细菌，可有效区分健康个体与海洛因成瘾、海洛因戒断或接受美沙酮维持治疗的人群。进一步研究发现，在海洛因使用障碍患者的不同病程阶段，放线菌属（Actinomyces）、图里杆菌属（Turicibacter）与魏斯氏菌属（Weissella）的相对丰度与汉密尔顿抑郁量表（Hamilton Depression Scale）得分呈正相关。

讨论
本研究从肠道微生物群的视角提供证据，表明美沙酮维持治疗相较于强制戒毒，在海洛因使用障碍治疗中更为有效。