Abstract Background Pathogenic CD4+ T-cell responses to commensal microbial antigens drive intestinal inflammation in Crohn’s disease (CD). Both hypo- or hyperactive anti-microbial innate immunity could underlie these aberrant T-cell responses. CD patients have increased IgG and T cell responses against commensal Lachnospiraceae-derived flagellins, which associate with disease complications. We investigated whether CD patients with high anti-Lachnospiraceae flagellin responses at diagnosis have underlying innate hypo- or hyperresponsiveness and high IgG responses to other dysbiotic commensals. Methods IgG reactivity to 19 recombinant flagellins from Lachnospiraceae species colonizing mouse and human gut, was measured in plasma of therapy-naïve pediatric CD patients (n=49) and controls (n=29). In addition, we measured plasma IgG responses to 1 recombinant flagellin and 71 microbial lysates of dysbiotic commensal species in therapy-naive pediatric CD patients (n=103) and controls (n=61). IgG responses were related to immunological and clinicopathological parameters. Results CD patients had significantly higher IgG responses to 12/19 Lachnospiraceae-derived flagellins compared to controls. Multi-reactivity to more than 10 flagellins was common in CD (41%) and associated with increased circulating flagellin-specific memory CD4+ T-cell frequencies. Multi-reactivity, and even single-reactivity to recombinant flagellin, correlated with reduced immune cell infiltration and epithelial damage, and fewer calprotectin-positive neutrophils in colonic lesional tissue, based on histological severity scoring and immune histochemistry, respectively. As these data may argue that high anti-flagellin IgG reactivity relates to innate hyporesponsiveness, we next assessed whether patients had a generalized high IgG response to lysates of dysbiotic intestinal bacteria. Hierarchical clustering identified subgroups of CD patients with different patterns of significantly increased anti-commensal IgG responses. Patients with high anti-Lachnospiraceae flagellin IgG also had high IgG responses against lysate of Roseburia inulinivorans, a Lachnospiraceae species. Of these anti-flagellin high responders, two-thirds responded to many commensals while one-third did not, arguing against a generalized high anti-commensal IgG response. Conclusion In conclusion, high IgG responses to Lachnospiraceae-derived flagellins identify a subgroup of pediatric therapy-naive CD patients with features of innate hyporesponsiveness. These patients do not have uniformly high IgG responses to other dysbiotic commensals, arguing that disturbed host-microbiota responses in CD are highly personalized and do not stem from an overall failure in microbiota-host crosstalk.
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