CGMP

Brief introduction about the CGMP

Constipation is a prevalent gastrointestinal disorder affecting approximately 10% of the global population, significantly impacting patients’ physical and psychological health. Recent research underscores the close relationship between gut microbiota and constipation occurrence. However, consensus on the characteristic microbiota and metabolites associated with constipation remains elusive. To address this, we have initiated the CGMP (Chinese Gut Motility Project), a prospective cohort study focusing on Chinese patients with constipation, in collaboration with multiple hospitals in Shanghai and Jiangsu. This project aims to enroll at least 2000 patients with constipation and 500 healthy controls from several centers. Comprehensive data collection will include demographics, diet, lifestyle, medical history, mental health, and biological samples such as blood, stool, saliva, and biopsy tissue. Multi-omics analyses (metagenomics, metabolomics, and transcriptomics) will be performed to integrate various data types for an exhaustive analysis of constipation.
The CGMP aims to establish a microbiota-based diagnostic system and predictive model for constipation, facilitating differentiation between constipated patients and non-constipated controls. This approach promises a novel, non-invasive method for clinical diagnosis of constipation. Additionally, personalized clinical and microbiota-targeted dietary intervention strategies will be developed based on gut microbiota characteristics for different types of constipation. Ultimately, a comprehensive microbiological diagnostic platform for constipation will be established offering new opportunities for precision medicine in the treatment and management of constipation. Show All

Figure1.CGMP Cohort Flowchart.
a. Patient recruitment; b. Questionnaire information survey and sample collection; c. Histological determination and analysis; d. Exploration of constipated population flora characteristics and construction of diagnostic model; e. Development of constipated microbiota-targeted food therapy.

Revealing Biomarkers of Constipation through Multi-omics

The CGMP will initially screen patients with constipation according to the Rome IV criteria. In accordance with relevant standards, patients who do not meet the requirements, such as those who have recently taken laxatives, will be excluded. Further clinical indicator tests will be carried out, and relevant questionnaire information will be collected. After obtaining informed consent, the collection of data and biological samples will be conducted. The relevant blood, feces, saliva, and intestinal mucosa samples will be collected within one week after the completion of recruitment to complete the collection of baseline sample information.In addition, apart from the collection of relevant samples and information at the baseline, the healthy and constipated patients included in the study will be followed up for up to one year to monitor their constipation status. Fecal and saliva samples will be collected once a month, with a total of 12 collections of fecal and saliva samples. For individual patients with active diseases, additional blood and intestinal mucosa samples will be collected simultaneously when collecting fecal samples. And the collection of these samples, like that of the baseline samples, will be carried out in local medical centers.Later, multi-omics assays of the samples will be performed through the microbiome, metabolome, transcriptome, and proteome to explore the characteristic flora and metabolic features of patients with constipation and construct a constipation diagnosis test system and prediction model based on the microbiota. Show All

Figure2.The Flowchart of Population Recruitment, Sample Collection and Analysis for CGMP cohort.
a. Patient recruitment process; b. Questionnaire information, sample collection, and data analysis process.

Intervention with Microbiota-Targeted Food Formulations

Conventional microbiological treatments for constipation often fail to address the needs of all patients due to inter-individual differences in gut microbiota composition and function. Microbiota-directed foods (MDF), designed to regulate the consumer's intestinal community characteristics, have garnered attention for their potential to precisely shape or re-establish a healthy gut microbiota, thereby preventing or alleviating related diseases. The CGMP aims to develop MDF formulas tailored to the microbiota profiles of constipated patients. This approach seeks to create a novel therapeutic modality that improves constipation symptoms by targeting and modulating the specific microbiota of affected individuals. Dietary ingredients will be screened based on microbiota characteristics, including metabolic function and substrate utilization, and validated through initial formulation tests. These formulations will then undergo further validation in clinical trials . Enrolled patients willing to receive the dietary formulations will consume them daily for one month. They will undergo an on-site assessment at the hospital after one month, with follow-up visits at one month and six months post-intervention to evaluate constipation status and microbiota improvement. Show All

Figure3.Development and Intervention of Targeted Foods.
a. Typing of constipation patients based on intestinal flora; b. Identification of potential regulatory factors based on microbiota characteristics and further compounding for validation; c. The clinical intervention process of microbiota-targeted foods.