Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Electroacupuncture alleviates symptoms and identifies a potential microbial biomarker in patients with constipation-predominant irritable bowel syndrome
Kiangyada Yaklai, Chanon Kunasol, Kanokphong Suparan, Nattayaporn Apaijai, Taned Chitapanarux, Sintip Pattanakuhar, Nipon Chattipakorn, Siriporn C Chattipakorn
Kiangyada Yaklai, Sriphat Medical Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Chanon Kunasol, Nattayaporn Apaijai, Nipon Chattipakorn, Siriporn C Chattipakorn, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Muang 50200, Chiang Mai, Thailand
Chanon Kunasol, Nattayaporn Apaijai, Nipon Chattipakorn, Siriporn C Chattipakorn, Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand
Kanokphong Suparan, Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Taned Chitapanarux, Department of Internal Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Sintip Pattanakuhar, Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Co-first authors: Kiangyada Yaklai and Chanon Kunasol.
Author contributions: Yaklai K performed the experiments, analyzed the data, and wrote the manuscript; Kunasol C, Suparan K, and Apaijai N performed the experiments and analyzed the data; Chitapanarux T, and Pattanakuhar S designed the study and edited the manuscript; Chattipakorn N designed the study, contributed to the discussion, and edited the manuscript; Chattipakorn SC designed the study, analyzed the data, contributed to the discussion, and edited and finalized the manuscript; All authors approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Research Ethics Committee of the Faculty of Medicine, Chiang Mai University, Thailand (Study Code: No. FAM-256307774, Research No. 07774).
Informed consent statement: All study participants, or their legal guardians, provided written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Data sharing statement: The 16S rRNA gene sequencing data generated in this study have been deposited in the National Center for Biotechnology Information (NCBI) Sequence Read Archive (SRA) under the accession number PRJNA1264069. All microbiome analyses were conducted using QIIME 2 (version 2024.10), following standard workflows available at:
https://docs.qiime2.org/2024.10/tutorials/. Analysis scripts and clinical metadata are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Siriporn C Chattipakorn, DDS, PhD, Professor, Cardiac Electrophysio
logy Research and Training Center, Faculty of Medicine, Muang 50200, Chiang Mai, Thailand.
scchattipakorn@gmail.com
Received: April 29, 2025
Revised: May 23, 2025
Accepted: July 2, 2025
Published online: September 5, 2025
Processing time: 129 Days and 0.3 Hours
BACKGROUND
Irritable bowel syndrome with predominant constipation (IBS-C) is a chronic gastrointestinal disorder that significantly impacts the quality of life of patients and currently lacks a definitive treatment. The use of electroacupuncture (EA) has demonstrated clinical efficacy in treating IBS-C and the gut-brain axis modulation, though its mechanisms remain unclear.
AIM
To investigate gut-brain-microbiota axis alteration and EA-associated microbial changes in IBS-C patients and treatment responders.
METHODS
This study consisted of two phases. The first phase was a cross-sectional study recruiting sixteen IBS-C patients and 16 healthy controls. Baseline fecal samples were collected to assess gut microbiota profiles between the two groups. The second phase was an observational longitudinal study in which the 16 IBS-C patients underwent nine EA sessions over one month. Gut microbiota profiles and clinical outcomes were assessed post-treatment course and at a one-month follow-up.
RESULTS
IBS-C patients exhibited significant gut dysbiosis, as indicated by altered beta diversity compared to healthy controls. EA significantly improved clinical outcomes and gut dysbiosis, with sustained therapeutic effects and normalization of neurotransmitter-related metabolic pathways observed at one-month follow-up. Notably, the gut bacterium Senegalimassilia was positively associated with symptom improvement, suggesting its potential as a predictive biomarker of EA responsiveness.
CONCLUSION
These findings support the integration of EA into IBS-C management and highlight Senegalimassilia as a candidate microbial biomarker for treatment response.
Core Tip: Given the complex pathophysiology of irritable bowel syndrome (IBS), inconsistency of gut microbiota profiles, and the scarce evidence regarding constipation subtype, current treatments often focus on symptom management. Electroacupuncture (EA), as an alternative or complementary approach, has shown clinical efficacy. Our study demonstrated that EA not only alleviated constipation-predominant type (IBS-C) symptoms but also modulated gut dysbiosis and normalized neurotransmitter-related metabolic pathways. Notably, Senegalimassilia was positively linked with clinical improvement, suggesting its potential as a predictive biomarker of EA responsiveness. Additionally, EA offered sustained beneficial therapeutic effects in IBS-C through gut microbiota modulation, supporting its role in clinical practice.
