Faecal Microbiota Dynamics and their Relation to Disease Course in Crohn’s Disease

Abstract

Background Microbial shifts have been associated with disease activity in Crohn’s disease [CD], but findings on specific taxa are inconsistent. This may be due to differences in applied methods and cross-sectional study designs. We prospectively examined the faecal microbiota in adult CD patients with changing or stable disease course over time. Methods Faeces were collected at two time-points from 15 healthy control individuals [HCs], 35 CD patients who were in remission and who maintained remission [RRs], and 22 CD patients during remission and also during subsequent exacerbation [RAs]. The microbial composition was assessed by 16S rRNA [V4] gene sequencing. Results Compared with HCs, patients with CD had a lower microbial richness [p = 0.0002] and diversity [p = 0.005]. Moreover, the microbial community structure of a subset of patients, clustered apart from HCs, was characterized by low microbial diversity and Faecalibacterium abundance. Patients within this cluster did not differ with respect to long-term disease course compared with patients with a ‘healthy-appearing’ microbiota. Over time, microbial richness and diversity did not change in RR versus RA patients. Although the microbial community structure of both RR and RA patients was less stable over time compared with that of HCs, no differences were observed between the patient groups [p = 0.17]; nor was the stability impacted by Montreal classification, medication use, or surgery. Conclusion The altered microbiota composition and stability in CD was neither associated with disease activity nor long-term disease course, questioning its involvement in the development of an exacerbation. The aberrant microbiota composition in a subset of CD patients warrants further exploration of a more microbiota-driven etiology in this group.

Randomized clinical trial: Effects of Aloe barbadensis Mill. extract on symptoms, fecal microbiota and fecal metabolite profiles in patients with irritable bowel syndrome

“…The temporal stability of the microbiota composition within an individual is relatively stable over time, even during severe intestinal inflammation 34 . Thus, as expected neither Aloe nor inulin induced any major change on gut microbiota and metabolite profiles in the two treatment groups.…”

Fecal microbiota composition is linked to the postoperative disease course in patients with Crohn’s disease

“…Thus, paired fecal samples from the same individual at early and 1-year follow up had similar microbiota composition, regardless of disease activity. Although fecal microbiota composition of IBD patients has been reported to fluctuate more than that of healthy subjects [7,10], studies using GA-Map technology demonstrated low fecal microbiota variation over time in IBD patients undergoing anti-TNF therapy regardless of therapy outcome [33] as well as in healthy subjects [25]. The microbial temporal stability within patients together with the relatively strong association between fecal microbiota composition and postsurgical outcome indicates that fecal microbiota profiles may be used to predict disease course even shortly after surgery.…”

“…Numerous studies have documented differences in gut microbial profiles between patients with CD and healthy individuals, with a reduced microbial diversity and a lower relative abundance of specific bacteria in CD patients [6][7][8][9][10][11]. The relationship between gut microbiota profile and CD has further been accentuated by recent studies suggesting that fecal microbiota transplantation from healthy donors may be beneficial for CD patients [12][13][14].…”

Gut Dysbiosis Is Related With Activity And Remission Phases Of Ulcerative Colitis And Healthy Condition

“…Furthermore, studies characterizing gut microbiota composition and its modi cation during UC are relevant, since: a) UC provides a higher risk for colorectal cancer, whereas gut dysbiosis is thought to facilitate colorectal cancer development; b) the study of gut microbial communities during clinical phases of UC contributes to a better understanding of potential interactions with host immune response; c) characterization of speci c genus of gut microbial communities may own potential clinical application derived from their association with active or remission phases of UC; and d) speci c microbial manipulation, concomitant to antibiotic use, is currently used as a therapeutic approach for UC [49,60,61].…”