Abstract
This study employs spectroscopy-based metabolic profiling of fecal extracts from healthy subjects and patients with active or inactive ulcerative colitis (UC) and Crohn’s disease (CD) to substantiate the potential use of spectroscopy as a non-invasive diagnostic tool and to characterize the fecal metabolome in inflammatory bowel disease (IBD). Stool samples from 113 individuals (UC 48, CD 44, controls 21) were analyzed by 1H nuclear magnetic resonance (NMR) spectroscopy (Bruker 600 MHz, Bruker BioSpin, Rheinstetten, Germany). Data were analyzed with principal component analysis and orthogonal-projection to latent structure-discriminant analysis using SIMCA-P + 12 and MATLAB. Significant differences were found in the metabolic profiles making it possible to differentiate between active IBD and controls and between UC and CD. The metabolites holding differential power primarily belonged to a range of amino acids, microbiota-related short chain fatty acids, and lactate suggestive of an inflammation-driven malabsorption and dysbiosis of the normal bacterial ecology. However, removal of patients with intestinal surgery and anti-TNF-α antibody treatment eliminated the discriminative power regarding UC versus CD. This study consequently demonstrates that 1H NMR spectroscopy of fecal extracts is a potential non-invasive diagnostic tool and able to characterize the inflammation-driven changes in the metabolic profiles related to malabsorption and dysbiosis. Intestinal surgery and medication are to be accounted for in future studies, as it seems to be factors of importance in the discriminative process.Electronic supplementary materialThe online version of this article (doi:10.1007/s11306-014-0677-3) contains supplementary material, which is available to authorized users.
Highlights
Ulcerative colitis (UC) and Crohn’s disease (CD) are the two main entities under the umbrella diagnosis of chronic inflammatory bowel disease (IBD)
This study demonstrates that 1H nuclear magnetic resonance (NMR) spectroscopy of fecal extracts is a potential non-invasive diagnostic tool and able to characterize the inflammationdriven changes in the metabolic profiles related to malabsorption and dysbiosis
Typical 1H NMR spectra of fecal extracts obtained from controls and active and inactive CD and ulcerative colitis (UC) patients are shown in supplementary material 1
Summary
Ulcerative colitis (UC) and Crohn’s disease (CD) are the two main entities under the umbrella diagnosis of chronic inflammatory bowel disease (IBD). These two similar, yet distinct diseases are believed to be the consequence of an unbalanced immunological response towards intestinal microbes or components hereof in genetically predisposed individuals (Baumgart and Sandborn 2012; Ordas et al 2012). Non-invasive tests are badly needed for the diagnostics and the surveillance of the disease activity
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