Distinct changes in the colonic microbiome associated with acute diverticulitis

Abstract

Aim The pathogenesis of acute diverticulitis (AD) remains incompletely understood, despite it being one of the most common gastrointestinal conditions worldwide. The aim of this study was to investigate the role of the colonic microbiome in the pathogenesis of AD. Method A prospective case–control study was performed, comparing the microbiome of AD patients with that of controls, using 16S rRNA sequencing of rectal swab samples. Results The microbiome of individuals with AD showed lower diversity than that of controls. There were significant compositional differences observed, with a lower abundance of commensal bacterial families and genera such as Lachnospiraceae, Ruminococcus and Faecalibacterium in AD patients compared with controls, and there was an increase in several genera with known pathogenic roles including Fusobacteria, Prevotella and Paraprevotella. Conclusion This is the largest study to date to examine the microbiota of AD patients, and adds evidence to the proposed hypothesis that alterations in the colonic microbiome play a role in the pathogenesis of AD.

Does the microbiome play a role in the pathogenesis of colonic diverticular disease? A systematic review

“…Overall, alpha and beta diversity were not significantly different from control samples in nine studies on diverticulosis, SUDD, and diverticulitis 8,15,17,18,24–27 (Table 5). O'Grady et al 29 . (rectal swab) and Lopetso et al 16 .…”

“…Table 5 outlines eight studies with diverticulitis microbiota outcomes 16,17,23,25–29 . The diverticulitis cases ranged from 8 to 104 participants (total n = 270), with a median age of 60.9 (range of 53–70) years, composed of 125 female participants and 145 male participants.…”

“…Based on the AHRQ scoring rubric (Table S2), six studies scored the highest standard of "good," 8,15,23-26 one scored "fair," 17 and five scored "poor." 16,18,[27][28][29] Study characteristics. Sampling sites varied, with only one study analyzing the microbiota from full-width resection samples.…”

“…as significantly decreased in diverticular disease compared to controls. O'Grady et al 29 . found that the Fecalibacterium species was significantly increased in complicated compare with uncomplicated diverticulitis.…”

“…Overall, alpha and beta diversity were not significantly different from control samples in nine studies on diverticulosis, SUDD, and diverticulitis 8,15,17,18,[24][25][26][27] (Table 5). O'Grady et al 29 (rectal swab) and Lopetso et al 16 (stool sample) reported decreased microbial richness and alpha diversity in diverticulitis. Daniels et al 23 (rectal swab) reported the Shannon diversity increased in diverticulitis.…”