Abstract
Intestinal dysbiosis in inflammatory bowel disease (IBD) patients depend on disease activity. We aimed to characterize the microbiota after 7 years of follow-up in an unselected cohort of IBD patients according to disease activity and disease severity. Fifty eight Crohn’s disease (CD) and 82 ulcerative colitis (UC) patients were included. Disease activity was assessed by the Harvey-Bradshaw Index for CD and Simple Clinical Colitis Activity Index for UC. Microbiota diversity was assessed by 16S rDNA MiSeq sequencing. In UC patients with active disease and in CD patients with aggressive disease the richness (number of OTUs, p = 0.018 and p = 0.013, respectively) and diversity (Shannons index, p = 0.017 and p = 0.023, respectively) were significantly decreased. In the active UC group there was a significant decrease in abundance of the phylum Firmicutes (p = 0.018). The same was found in CD patients with aggressive disease (p = 0.05) while the abundance of Proteobacteria phylum showed a significant increase (p = 0.03) in CD patients. We found a change in the microbial abundance in UC patients with active disease and in CD patients with aggressive disease. These results suggest that dysbiosis of the gut in IBD patients is not only related to current activity but also to the course of the disease.
Highlights
The potential role of the gut microbiota as a driver of the inflammatory process in inflammatory bowel diseases (IBD) has gained increasing attention in the past decades and the body of research in this field has expanded vastly
We have previously shown that E. coli play an important role in IBD pathogenesis in ulcerative colitis (UC) patients[23,24,25]
Fecal microbiota from 58 UC patients and 82 Crohn’s disease (CD) patients and 30 healthy controls was successfully determined by 16S rDNA sequencing
Summary
The potential role of the gut microbiota as a driver of the inflammatory process in inflammatory bowel diseases (IBD) has gained increasing attention in the past decades and the body of research in this field has expanded vastly. Fecal microbiota transplantation (FMT) appears to be effective for induction of remission in UC as described in a recent meta-analysis of four placebo controlled trials[26]. These findings do support that intestinal dysbiosis play an important role as trigger of inflammation in UC. The course of disease comprising periods of quiescent disease with alternating periods of active disease and thereby repeating or changing medication regimens may influence gut microbiota[33,34,35] it is possible that different IBD phenotypes as well as disease course are associated to different specific microbial characteristics. We wished to characterize the microbiota according to disease activity state, disease severity and disease localization in the included population after 7 years of disease duration
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