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Articles
https://doi.org/10.1038/s41564-019-0655-7
1Broad Institute of MIT and Harvard, Cambridge, MA, USA. 2Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
3Chemical Biology and Therapeutics, Novartis Institutes for Biomedical Research Inc., Cambridge, MA, USA. 4Departments of Medicine, Microbiology
and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 5Center for Microbiome Informatics and Therapeutics, Massachusetts
Institute of Technology, Cambridge, MA, USA. 6Department of Molecular Biology, Massachusetts General Hospital and Harvard Medical School, Boston,
MA, USA. 7Center for Computational and Integrative Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
8These authors contributed equally: Eric A. Franzosa, Jason Bishai. *e-mail: hera@broadinstitute.org; xavier@molbio.mgh.harvard.edu
Inflammatory bowel diseases (IBD), including ulcerative colitis
(UC) and Crohn’s disease (CD), are conditions of chronic gas-
trointestinal inflammation resulting from genetic predisposition
and perturbed interactions between gut microorganisms and host
immunity1,2. Many studies focus on microbial taxonomic and func-
tional changes during IBD3–5; however, the gut metabolome (com-
prising diet-, host- and microorganism-derived metabolites) is an
equally important contributor to intestinal health6–8.
Certain gut bacteria metabolize dietary fibre into short-chain
fatty acids such as butyrate that nourish colonocytes, promote
regulatory T-cell expansion and have immunosuppressive func-
tions9,10. Butyrate concentration and butyrate-producing bacte-
ria are depleted in the IBD gut11,12. Other bacteria (for example,
Lactobacillus spp., Bacteroides spp. and Clostridium sporogenes) con-
vert tryptophan into indole derivatives that promote healthy intes-
tinal barrier function and immune tolerance13. Indole producers are
also depleted in IBD8,12. Urease activity, predominantly contributed
by Proteobacteria, shifts the microbiome towards the imbalanced
state seen in IBD and worsens disease in a murine colitis model14.
Host-derived metabolites likewise affect microbiota composition:
bile acids, enriched in the IBD gut8, promote growth of bile acid-
metabolizing bacteria and inhibit growth of bile-sensitive bacteria15.
Inferring covariations between metabolites and bacteria that
are differentially abundant in IBD can functionally implicate gut
metabolites and microorganisms in intestinal health7,16. Two recent
studies combined microbial metagenomics and untargeted mass
spectrometry of metabolites to identify associations between stool
bacterial species and metabolites8,12. The first was a cross-sectional
study of UC, CD and non-IBD subjects within the Prospective
Registry in IBD Study at MGH (PRISM) cohort, and the sec-
ond was the longitudinal integrative Human Microbiome Project
(iHMP). Both concluded that microbial taxonomic changes associ-
ated with IBD, such as blooms of facultative anaerobes including
Proteobacteria4,5, are accompanied by significant shifts in metabo-
lite composition.
Here, we investigated the effects of intestinal metabolites that are
differentially abundant in IBD on the growth of gut bacteria that are
also differentially abundant in IBD, finding that metabolites includ-
ing amines and fatty acids strongly affect bacterial growth. Linoleoyl
ethanolamide (LEA), an NAE, impacted growth in ways that reflect
altered bacterial abundances in the IBD microbiome. We show that
LEA and three structurally related NAEs—palmitoylethanolamide
(PEA), oleoyl ethanolamide (OEA) and arachidonoyl ethanolamide
(AEA)—are enriched in stool from IBD patients and a T-cell trans-
fer model of colitis. These NAEs share common receptors and are
part of the endocannabinoid system, although only AEA is con-
sidered a true endocannabinoid as it binds the cannabinoid recep-
tors CB1 and CB217. We treated monocultures of bacteria that shift
Growth effects of N-acylethanolamines on gut
bacteria reflect altered bacterial abundances in
inflammatory bowel disease
Nadine Fornelos1, Eric A. Franzosa 1,2,8, Jason Bishai 1,8, John W. Annand3, Akihiko Oka 4,
Jason Lloyd-Price 1,2, Timothy D. Arthur1, Ashley Garner1, Julian Avila-Pacheco1, Henry J. Haiser3,
Andrew C. Tolonen1, Jeffrey A. Porter3, Clary B. Clish 1, R. Balfour Sartor4, Curtis Huttenhower 1,2,
Hera Vlamakis 1* and Ramnik J. Xavier 1,5,6,7*
Inflammatory bowel diseases (IBD) are associated with alterations in gut microbial abundances and lumenal metabolite
concentrations, but the effects of specific metabolites on the gut microbiota in health and disease remain largely unknown.
Here, we analysed the influences of metabolites that are differentially abundant in IBD on the growth and physiology of gut
bacteria that are also differentially abundant in IBD. We found that N-acylethanolamines (NAEs), a class of endogenously
produced signalling lipids elevated in the stool of IBD patients and a T-cell transfer model of colitis, stimulated growth of
species over-represented in IBD and inhibited that of species depleted in IBD invitro. Using metagenomic sequencing, we
recapitulated the effects of NAEs in complex microbial communities ex vivo, with Proteobacteria blooming and Bacteroidetes
declining in the presence of NAEs. Metatranscriptomic analysis of the same communities identified components of the respira-
tory chain as important for the metabolism of NAEs, and this was verified using a mutant deficient for respiratory complex I.
In this study, we identified NAEs as a class of metabolites that are elevated in IBD and have the potential to shift gut microbiota
towards an IBD-like composition.
NATURE MICROBIOLOGY | VOL 5 | MARCH 2020 | 486–497 | www.nature.com/naturemicrobiology
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