Dependence of Colonization of the Large Intestine by Candida on the Treatment of Crohn’s Disease

Abstract

The aim of this study was to determine if there are quantitative differences in Candida fungi between pediatric patients with Crohn's disease (before and after exclusive enteral nutrition (EEN), and the biologic therapy with anti-tumor necrosis factor alpha-(IFX)), and healthy controls. DNA was isolated from fecal samples and PCR was used to determine the number of fungal cells. Both therapeutic interventions resulted in a statistically significant decrease in Pediatric Crohn's Disease Activity Index. The numbers of Candida decreased during both therapeutic intervention but the difference was statistically significant for the IFX intervention only (p = 0.045). Moreover, fungi population in both study groups declined during intervention when compared to the control group but the difference was significant before treatment only in the IFX group (p = 0.013). The total distribution of Candida with both IFX and EEN as well as in the control group differed significantly (p = 0.01) before treatment only. No correlation between the numbers of Candida and disease activity as well as the following biochemical parameters: serum iron concentration, protein or glucose level were found. It cannot be ruled out that, in combination with genetic and immunological disorders, fungi can contribute to the initiation of the disease process and perpetuation of active inflammation. K e y w o r d s: Crohn's disease; children; gut microbiota; biological treatment Kowalska-Duplaga K. et al.

Differences in the intestinal microbiome of healthy children and patients with newly diagnosed Crohn’s disease

“…A detailed DNA isolation protocol was presented in our team’s previous studies 16 . The frozen samples were thawed, precisely weighed (about 0.1 g of stool sample was used) and homogenized in 0.1 ml of saline.…”

Analysis of the Gut Mycobiome in Adult Patients with Type 1 and Type 2 Diabetes Using Next-Generation Sequencing (NGS) with Increased Sensitivity—Pilot Study

“…At the Department of Microbiology JUMC, Kraków, Poland, fungal DNA was isolated from 76 stool samples using the Genomic Mini AX Stool Spin kit (A&A Biotechnology, Gdańsk, Poland) with the application of a preliminary procedure, as described by us earlier [ 15 , 21 ].…”

“…The gut mycobiota composition seems to be influenced by diet, including consumption of carbohydrates, which correlate positively with fungi of the genus Candida [ 14 ]. Additionally, an effective biological treatment applied to children with Crohn’s disease (CD) resulted in reducing the number of fungi of the genus Candida in the colon of these patients, which may suggest their significance in the development and course of CD [ 15 ]. Analysis of the gut microbiome in patients with diabetes, also taking fungi into consideration, was also conducted, showing that fungi of the genera Aspergillus and Candida (opportunistic fungal pathogens) were overrepresented in newly diagnosed type 2 diabetic subjects [ 16 ].…”

Gut mycobiome: The probable determinative role of fungi in IBD patients

“…In this line, Liguori et al, 57 and Sokol et al, 33 reported an increased abundance of C glabrata and C albicans in CD patients, respectively. Recently, Kowalska‐Duplaga et al, 107 presented the abundance of Candida in CD patients that decreased during the therapeutic intervention, particularly in patients who received anti‐TNF‐α treatment (infliximab).…”