Submitted:
11 June 2025
Posted:
12 June 2025
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Abstract
Keywords:
1. Introduction
2. Materials and Methods
2.1. Materials
2.2. Human Safety Assessment
2.3. Study Design
2.4. Sample Size
2.5. Study Population
- Group A: 125 mg SLE-F, twice daily (n = 29; 32.2%)
- Group B: 500 mg SLE-F, twice daily (n = 30; 33.3%)
- Group C: Placebo, twice daily (n = 31; 34.4%)
2.6. Sample Collection
- Forward (IlluminaF): CCTACGGGNGGCWGCAG
- Reverse (IlluminaR): GACTACHVGGGTATCTAATCC
2.8. Bioinformatic Processing and Quality Control
2.9. Alpha Diversity Analysis
2.10. Random Forest Classifier Analysis
2.11. Recovery Score
2.12. Abundance and Biomarker Analysis
2.13. Statistical Analysis: LEfSe and Kruskal-Wallis Tests
2.13.1. LEfSe Analysis
2.13.2. Kruskal-Wallis H Test (Independent Analysis)
2.14. Statistical Analysis
3. Results
3.1. Epidemiological Context and Participant Infection Status
3.2. Baseline Comparison of Intestinal Inflammation
3.3. Functional Gene Signatures: Random Forest
3.4. Taxonomic Shifts in the Gut Microbiome Following Viral Infection
3.5. Alpha Diversity Trends
3.6. Impact of Fucoidan Treatment on LE Ratios and Functional Gene Profiles
4. Discussion
4.1. Baseline Comparison of Intestinal Inflammation
4.2. The Random Forest Model
4.3. Functional Gene Signatures Differentiate Fucoidan and Placebo Cohorts
4.4. Kruskal-Wallis Analysis: Suppression of Dysbiosis-Associated Functions in Fucoidan-Treated Participants
4.5. LEfSe Analysis: Promotion of Functional Resilience in the Fucoidan Group
4.5.1. Expanded Pathway-Level Insights from High-Dose Fucoidan EOS Samples
4.6. Functional Interpretation of Gene-Level Shifts in the Context of Taxonomy and Function
4.7. Integrative Insight and Therapeutic Implications
4.8. Diversity
4.9. Recovery Explanation
4.9.1. Microbial Activation Pathway
4.10. Limitations
- Subset Analysis: The observation regarding microbiome recovery post-viral infection was derived from a subset of participants who became infected during the trial. This subset was not pre-stratified or powered specifically to assess the effects of viral infection on microbiome dynamics, limiting the generalizability of the findings.
- Sample Size and Statistical Power: The number of participants infected with Dengue or Oropouche viruses within each treatment group was relatively small. This limited the statistical power for subgroup comparisons and may have contributed to the lack of significance in some outcomes, particularly in diversity measures and certain taxa-level analyses.
- Timing and Heterogeneity of Infection: Participants contracted viral infections at different time points during the study, which introduces heterogeneity in terms of exposure duration and immune response. Additionally, infections were not experimentally induced or uniformly documented via molecular diagnostics, which could influence the precision of infection status classification.
- Confounding by Other Variables: Although dietary and medication use exclusions were applied, other unmeasured factors—such as variations in baseline diet, host genetics, or environmental exposures—may have influenced microbiome composition and recovery trajectories.
- Short-Term Follow-Up: The study duration of 90 days may not have been sufficient to capture long-term microbiome stabilization or delayed effects of viral infection or SLE-F treatment. Longer follow-up would help clarify whether observed improvements persist over time.
- Taxonomic Resolution: While 16S rRNA sequencing offers valuable insights into bacterial composition, it lacks the resolution of metagenomic or metatranscriptomic approaches, limiting functional inference and the ability to capture strain-level variation.
- Lack of Virome and Mycobiome Profiling: The study focused exclusively on bacterial communities and did not assess viral or fungal components of the microbiome, which may also play critical roles in gut health and immune regulation during infection.
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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| Treatment | p-value | ||||
|---|---|---|---|---|---|
| A | B | C | (χ2) | ||
| 29 | 30 | 31 | |||
| Viral infection during the study | No | 15 (51.7%) | 14 (46.7%) | 14 (45.2%) | 0.869 |
| yes | 14 (48.3%) | 16 (53.3%) | 17 (52.2%) | ||
| ↓ | ↓ | ↓ | ↓ | ||
| Before/Beginning | 4 (28.6%) | 6 (37.5%) | 10 (58.8%) | 0.207 | |
| During | 10 (71.4%) | 10 (62.5%) | 7 (41.2%) | ||
| Ortholog | Definition | Importance Score | SLE-F EOS | Placebo EOS | Enriched Group |
|---|---|---|---|---|---|
| K01186 | Sialidase | 0.0588 | 0.0560 | 0.0615 | Placebo |
| K10118 | raffinose/stachyose/melibiose transport system permease protein | 0.0588 | 0.0516 | 0.0455 | SLE-F |
| K08191 | MFS transporter, ACS family, hexuronate | 0.0588 | 0.0392 | 0.0156 | SLE-F |
| K06921 | uncharacterized protein | 0.0588 | 0.1570 | 0.0734 | SLE-F |
| K16785 | energy-coupling factor transport system permease protein | 0.0471 | 0.0535 | 0.0696 | Placebo |
| K19353 | heptose-I-phosphate ethanolaminephosphotransferase | 0.0431 | 0.0208 | 0.0076 | SLE-F |
| K21903 | ArsR family transcriptional regulator, lead/cadmium/zinc/bismuth-responsive transcriptional repressor | 0.0353 | 0.0279 | 0.0414 | Placebo |
| K12988 | alpha-1,3-rhamnosyltransferase | 0.0353 | 0.0378 | 0.0177 | SLE-F |
| K01462 | peptide deformylase | 0.0353 | 0.0756 | 0.0732 | SLE-F |
| K01607 | carboxymuconolactone | 0.0353 | 0.0452 | 0.0687 | Placebo |
| A. Kruskal-Wallis | |||||
|---|---|---|---|---|---|
| Ortholog | Definition | Fold Change SLE-F | Fold Change Placebo |
FDR adjusted p-value |
Cohort Enriched |
| K09885 | Aquaporin rerated protein, other eukaryotes | 0.0180 | 1.0000 | 0.0002 | Placebo |
| K03124 | Transcription initiation factor TFIIB | 0.0088 | 1.0000 | 0.0002 | Placebo |
| K15965 | glycosyltransferase | 0.0093 | 1.0000 | 0.0002 | Placebo |
| K05083 | Receptor tyrosine-protein kinase erbB-2 | 0.0180 | 0.1250 | 0.0028 | Placebo |
| K03334 | L-amino-acid oxidase | 0.0076 | 0.1272 | 0.0028 | Placebo |
| K21148 | [CysO sulfur-carrier protein]-thiocarboxylate-dependent cysteine synthase | 0.0053 | 0.1272 | 0.0028 | Placebo |
| K15761 | Toluene monooxygenase system protein B | 0.0138 | 0.1250 | 0.0028 | Placebo |
| K03773 | Protein-folding Isomerase | 0.0048 | 0.1272 | 0.0028 | Placebo |
| K02429 | L-fucose permease | 0.0066 | 0.1272 | 0.0028 | Placebo |
| K07190 | Phosphorylase kinase alpha/beta subunit | 0.0059 | 0.0673 | 0.0031 | Placebo |
| B. LEfSe (Linear Discriminant Analysis Effect Size) | |||||
| Ortholog | Definition | Fold Change SLE-F | Fold Change Placebo | LDA Effect Size | Cohort Enriched |
| K07284 | Sortase A | 1.2755 | 0.6212 | 2.6276 | SLE-F |
| K02315 | DNA replication protein DnaC | 1.5720 | 1.6683 | 2.4694 | Placebo |
| K03773 | FKBP-type peptidyl-prolyl cis-trans isomerase FklB | 1.0909 | 0.5163 | 2.4286 | SLE-F |
| K02003, K02004, K06147 | ABC transport system ATP-binding protein | 1.3726 | 1.1534 | 2.4191 | SLE-F |
| K02429 | MFS transporter, FHS family, L-fucose permease | 1.0626 | 0.5566 | 2.3667 | SLE-F |
| K02030 | Polar amino acid transport system substrate-binding protein | 1.2128 | 1.3541 | 2.2981 | Placebo |
| K03286 | OmpA-OmpF porin, OOP family | 1.0185 | 0.5629 | 2.2478 | SLE-F |
| K10117,K10118, K10119 | Raffinose/stachyose/melibiose transport system substrate-binding protein | 1.6093 | 1.4149 | 2.2456 | SLE-F |
| K03657 | Stress response/DNA helicase I /ATP-dependent DNA helicase PcrA | 1.2597 | 1.3317 | 2.1916 | SLE-F |
| K16785 | Energy-coupling factor transport system permease protein | 1.3868 | 1.8712 | 2.1724 | Placebo |
| KO1214 | Isoamylase | 1.7511 | 1.1182 | 2.6544 | SLE-F |
| KO0688 | Glycogen phosphorylase | 1.3336 | 1.1124 | 2.4281 | SLE-F |
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