Collinsella aerofaciens

Collinsella aerofaciens is a gram-positive, non-motile, obligately anaerobic bacterium belonging to the phylum Actinobacteria, class Coriobacteriia, family Coriobacteriaceae. It is one of the most abundant members of the human gut microbiota, particularly in the colon, where it plays various roles in host metabolism and health.

Key Characteristics

C. aerofaciens is characterized by its rod-shaped morphology, often appearing as short, sometimes curved rods that can form chains. It is non-spore-forming and lacks flagella for motility. As an obligate anaerobe, it requires an oxygen-free environment for growth and survival. The bacterium ferments carbohydrates to produce various short-chain fatty acids, including acetate, formate, and lactate, which serve as energy sources for colonocytes and influence gut health.

The genome of C. aerofaciens contains numerous genes involved in carbohydrate metabolism, particularly those enabling the breakdown of complex dietary fibers and resistant starches that escape digestion in the upper gastrointestinal tract. This metabolic capability allows C. aerofaciens to thrive in the distal gut environment where these substrates are abundant.

Role in the Human Microbiome

C. aerofaciens is among the most prevalent and abundant bacteria in the human gut microbiome, with studies suggesting it is present in over 90% of adults. Its abundance is influenced by various factors, including:

1. Diet: Higher abundance is associated with low-fiber, high-fat diets, while dietary fiber intake is inversely correlated with Collinsella abundance
2. Age: Typically increases with age, becoming established early in life
3. Geography: Varies across different populations, potentially reflecting dietary and lifestyle differences
4. Host genetics: Some evidence suggests host genetic factors may influence Collinsella colonization

Within the gut ecosystem, C. aerofaciens interacts with other microbes through cross-feeding relationships, competition for nutrients, and potentially through the production of metabolites that influence the growth of other species. It is particularly adept at fermenting complex carbohydrates that other gut bacteria cannot utilize, occupying a specialized niche in the gut microbial community.

Health Implications

The relationship between C. aerofaciens and human health is complex and context-dependent, with evidence suggesting both beneficial and potentially detrimental effects:^[1][1]

Context-Dependent Dual Role

Recent research (2020-2025) has revealed that C. aerofaciens can be either beneficial or harmful depending on dietary context, strain, and microbiome composition. This paradigm challenges simple "good" or "bad" classifications of gut bacteria.

Pathobiont Contexts (Disease-Promoting)

1. Type 2 Diabetes: C. aerofaciens is overabundant in T2D patients; remained dominant after 12 weeks metformin treatment despite HbA1c improvement^[2][2]
2. Cardiovascular Disease: Significant positive correlation with CVCs; average abundance 0.10% without CVCs vs 0.23% with CVCs; produces TMA (converted to atherogenic TMAO)^[3][3]
3. NAFLD/NASH: Higher abundance in obese and NASH patients; increases systemic ethanol via malfunctioning acetaldehyde-CoA/alcohol dehydrogenase; elevates hepatic hydroxyproline, triglycerides, and inflammation (NF-κB, TNF-α, IL-6)^[4][4]
4. Rheumatoid Arthritis: Induces IL-17 network cytokines; reduces tight junction proteins; stimulates gut leakage

Beneficial Contexts (Health-Promoting)

1. Cancer Immunotherapy Response: Increased in melanoma responders to anti-PD-L1 therapy; FMT from responders improved outcomes in mice; MET4 trial showed C. aerofaciens engrafters had increased IgG Response Index (coefficient=1.97)^[5][5]
2. FMT for Immune Colitis: 92% remission in refractory immune-mediated colitis; C. aerofaciens enrichment associated with resolution of immunotherapy toxicity
3. Endometrial Carcinoma: Exhibits antitumor activity via p53 signaling; supernatant inhibits EC cell proliferation, migration, and invasion^[6][6]
4. Lactose Intolerance: Long-term GOS supplementation increased C. aerofaciens; improved quality of life and dairy tolerance

Disease Associations

1. Irritable Bowel Syndrome (IBS): Predictive marker of response to probiotic treatment in non-constipated IBS
2. NAFLD: Contributes to increased systemic ethanol and hepatic inflammation
3. Obesity/Metabolic Syndrome: Positively correlated with total cholesterol, LDL, triglycerides; negatively with HDL
4. Autoimmune Conditions: Associated with RA, psoriatic arthritis, psoriasis

Metabolic Activities

C. aerofaciens is a versatile saccharolytic bacterium with 118 glycoside hydrolases identified in its genome:^[7][7]

Primary Metabolic Products

• Lactate: Major fermentation product (38.67 mmol/L at 72h)
• Acetate: 19.88 mmol/L at 72h
• Formate: Secondary product
• Hydrogen (H2): Supports methanogens and sulfate reducers
• Butyrate: Strain-specific (subsp. shenzhenensis TF06-26 produces 4.37 mmol/L via unique butyric acid kinase pathway)

Bile Acid Metabolism^[8][8]

• Bile Salt Hydrolase (BSH): Deconjugates bile acids; crucial step in secondary BA metabolism
• Hydroxysteroid Dehydrogenases: Expresses 7α-HSDH, 7β-HSDH (NADPH-dependent), and 12α-HSDH
• UDCA Production: Epimerizes CDCA to ursodeoxycholic acid (potential therapeutic benefits)
• Cholesterol Impact: Modifies BA composition affecting intestinal cholesterol absorption

Immunogenic Compound Production^[9][9]

• CaLGL-1: pH-responsive lipid immunogen
• Precursor: Plasmalogen (CaPlsM)
• Activation: Low-pH environment triggers intramolecular acid-catalyzed conversion
• Immune Response: TLR2-dependent signaling; robust TNF-α production in dendritic cells

Cross-Feeding and Ecological Role^[10][10]

• Lactate Cross-Feeding: Co-culture with Anaerostipes caccae converts 100% of lactate to butyrate (~11.5 mM)
• Network Partners: Bifidobacterium spp., Bacteroides vulgatus, Dialister spp.
• Ecological Function: Central metabolite provider in gut microbial food web

Ethanol Production (Pathological)

• Mechanism: Malfunctioning bifunctional acetaldehyde-CoA/alcohol dehydrogenase
• Clinical Impact: Associated with increased systemic ethanol in NASH patients; contributes to liver inflammation

Clinical Relevance

The clinical significance of C. aerofaciens is emerging as research advances:

1. Biomarker Potential: Recent studies suggest C. aerofaciens abundance could serve as a biomarker for predicting response to probiotic treatment in IBS patients, potentially enabling more personalized therapeutic approaches
2. Therapeutic Target: Given its associations with metabolic disorders like NAFLD, C. aerofaciens might represent a potential therapeutic target for microbiome-based interventions
3. Diagnostic Indicator: Altered abundance may contribute to microbial signatures associated with various gastrointestinal and metabolic conditions

Modulation Strategies

Several approaches may influence C. aerofaciens abundance and activity:

1. Dietary Interventions: Increasing dietary fiber intake has been shown to reduce Collinsella abundance in some studies
2. Prebiotics: Specific prebiotic compounds may selectively influence C. aerofaciens growth
3. Probiotics: Certain probiotic strains, such as Lacticaseibacillus paracasei DG, have been shown to reduce C. aerofaciens abundance in responsive IBS patients
4. Antibiotics: While not a targeted approach, antibiotic treatment can significantly alter C. aerofaciens populations

Research Directions

Current and future research on C. aerofaciens focuses on several key areas:

1. Mechanistic Studies: Investigating the molecular mechanisms by which C. aerofaciens influences host metabolism and immune function
2. Strain Diversity: Characterizing the functional differences between various C. aerofaciens strains and their health implications
3. Therapeutic Applications: Exploring the potential of C. aerofaciens as a biomarker for personalized medicine approaches in gastrointestinal disorders
4. Metabolic Interactions: Further elucidating the role of C. aerofaciens in the gut-liver axis and its contributions to metabolic health and disease
5. Intervention Studies: Developing and testing targeted interventions to modulate C. aerofaciens abundance and activity for therapeutic purposes

As research continues to unravel the complex relationships between C. aerofaciens and human health, this common gut bacterium may emerge as an important target for microbiome-based diagnostic and therapeutic strategies in various health conditions.