Abstract
Since Crohn's disease is a transmural disease, we hypothesized that examination of deep submucosal tissues directly involved in the inflammatory disease process may provide unique insights into bacterial populations transgressing intestinal barriers and bacterial populations more representative of the causes and agents of the disease. We performed deep 16s microbiota sequencing on isolated ilea mucosal and submucosal tissues on 20 patients with Crohn's disease and 15 non-inflammatory bowel disease controls with a depth of coverage averaging 81,500 sequences in each of the 70 DNA samples yielding an overall resolution down to 0.0001% of the bacterial population. Of the 4,802,328 total sequences generated, 98.9% or 4,749,183 sequences aligned with the Kingdom Bacteria that clustered into 8545 unique sequences with <3% divergence or operational taxonomic units enabling the identification of 401 genera and 698 tentative bacterial species. There were significant differences in all taxonomic levels between the submucosal microbiota in Crohn's disease compared to controls, including organisms of the Order Desulfovibrionales that were present within the submucosal tissues of most Crohn's disease patients but absent in the control group. A variety of organisms of the Phylum Firmicutes were increased in the subjacent submucosa as compared to the parallel mucosal tissue including Ruminococcus spp., Oscillospira spp., Pseudobutyrivibrio spp., and Tumebacillus spp. In addition, Propionibacterium spp. and Cloacibacterium spp. were increased as well as large increases in Proteobacteria including Parasutterella spp. and Methylobacterium spp. This is the first study to examine the microbial populations within submucosal tissues of patients with Crohn's disease and to compare microbial communities found deep within the submucosal tissues with those present on mucosal surfaces. Our data demonstrate the existence of a distinct submucosal microbiome and ecosystem that is not well reflected in the mucosa and/or downstream fecal material.
Highlights
IntroductionThe etiology remains unknown, it is generally accepted that the Crohn's disease syndrome results, in part or in whole, from an abnormal or dysregulated immune response to specific and/or commensal bacteria arising from the intestinal lumen [1]
Crohn’s disease remains one of the major challenges in gastroenterology
Of the 4,802,328 total sequences generated, 98.9% or 4,749,183 sequences aligned with the Kingdom Bacteria that clustered into 8545 unique sequences or OTUs with
Summary
The etiology remains unknown, it is generally accepted that the Crohn's disease syndrome results, in part or in whole, from an abnormal or dysregulated immune response to specific and/or commensal bacteria arising from the intestinal lumen [1] Supporting this suggestion is increasing evidence from genome wide association studies (GWAS) that Crohn's disease, disease involving the ileum in Caucasian patients, may be related to an immune deficiency with polymorphisms detected most notably in the NOD2/CARD15 and the autophagy-associated ATG16L1 and IRGM genes [2]. These susceptibility genes are generally associated with the innate immune system’s recognition and ability to kill intracellular bacteria. The role of luminal bacteria as a primary cause or a secondary effect of the disease remains unclear, there is little dispute that luminal bacterial populations have a profound effect on the clinical manifestations of the disease and patient well-being
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