Abstract
Besides genetic polymorphisms and environmental factors, the intestinal microbiota is an important factor in the etiology of Crohn’s disease (CD). Among microbiota alterations, a particular pathotype of Escherichia coli involved in the pathogenesis of CD abnormally colonizes the intestinal mucosa of patients: the adherent-invasive Escherichia coli (AIEC) pathobiont bacteria, which have the abilities to adhere to and to invade intestinal epithelial cells (IECs), as well as to survive and replicate within macrophages. AIEC have been the subject of many studies in recent years to unveil some genes linked to AIEC virulence and to understand the impact of AIEC infection on the gut and consequently their involvement in CD. In this review, we describe the lifestyle of AIEC bacteria within the intestine, from the interaction with intestinal epithelial and immune cells with an emphasis on environmental and genetic factors favoring their implantation, to their lifestyle in the intestinal lumen. Finally, we discuss AIEC-targeting strategies such as the use of FimH antagonists, bacteriophages, or antibiotics, which could constitute therapeutic options to prevent and limit AIEC colonization in CD patients.
Highlights
Crohn’s disease (CD) and ulcerative colitis (UC) are inflammatory bowel disease (IBD) characterized by chronic inflammatory disorders of the gastrointestinal (GI) tract
Enterobacteria, members of the Proteobacteria phylum, can represent up to 100% of the aeroanaerobic microbiota associated to the ileal mucosa in CD, and particular adherent strains of Escherichia coli have been identified in the inflamed ileal and colonic mucosa of CD patients [21,22,23,24,25,26,27]
Many research groups focus their work to better understand how adherent-invasive E. coli (AIEC) bacteria evolved from commensal E. coli strain, how AIEC bacteria interact with the complex microenvironment of the digestive tract, how they take advantage of specific environmental conditions, how they interact with intestinal epithelial cells (IECs), and how they subvert host defense to colonize intestinal mucosa of CD patients
Summary
Crohn’s disease (CD) and ulcerative colitis (UC) are inflammatory bowel disease (IBD) characterized by chronic inflammatory disorders of the gastrointestinal (GI) tract. Enterobacteria, members of the Proteobacteria phylum, can represent up to 100% of the aeroanaerobic microbiota associated to the ileal mucosa in CD, and particular adherent strains of Escherichia coli have been identified in the inflamed ileal and colonic mucosa of CD patients [21,22,23,24,25,26,27] Both abilities of these strains to adhere to and to invade intestinal epithelial cells (IECs) as to survive and to replicate within macrophages led to the definition of a new pathogenic group: the adherent-invasive E. coli (AIEC) [21,22,28]. Based on the recent literature, this review will discuss the new therapeutic strategies which could be developed to limit AIEC overgrowth in CD patients and ongoing clinical trials targeting AIEC bacteria
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