Fecal microbiota in pouchitis and ulcerative colitis

Abstract

AIMTo investigate the changes in microbiota in feces of patients with ulcerative colitis (UC) and pouchitis using genomic technology.METHODSFecal samples were obtained from UC patients with or without an ileal pouch-anal anastomosis (IPAA) procedure, as well as healthy controls. The touchdown polymerase chain reaction technique was used to amplify the whole V3 region of the 16S rRNA gene, which was transcribed from DNA extracted from fecal samples. Denaturing gradient gel electrophoresis was used to separate the amplicons. The band profiles and similarity indices were analyzed digitally. The predominant microbiota in different groups was confirmed by sequencing the 16S rRNA gene.RESULTSMicrobial biodiversity in the healthy controls was significantly higher compared with the UC groups (P < 0.001) and IPAA groups (P < 0.001). Compared with healthy controls, the UC patients in remission and those in the mildly active stage, the predominant species in patients with moderately and severely active UC changed obviously. In addition, the proportion of the dominant microbiota, which was negatively correlated with the disease activity of UC (r = -6.591, P < 0.01), was decreased in pouchitis patients. The numbers of two types of bacteria, Faecalibacterium prausnitzii and Eubacterium rectale, were reduced in UC. Patients with pouchitis had an altered microbiota composition compared with UC patients. The microbiota from pouchitis patients was less diverse than that from severely active UC patients. Sequencing results showed that similar microbiota, such as Clostridium perfringens, were shared in both UC and pouchitis.CONCLUSIONLess diverse fecal microbiota was present in patients with UC and pouchitis. Increased C. perfringens in feces suggest its role in the exacerbation of UC and pouchitis.

Systematic review: ileoanal pouch microbiota in health and disease

“…Similar to IBD, bacterial diversity has been shown to be reduced in patients with pouchitis with changes in both anaerobic and aerobic bacteria noted . Analysis of faecal samples has shown higher levels of aerobes and lower levels of anaerobes in patients with pouchitis when compared with controls without pouchitis (Table ) (both UC and FAP) …”

“…Both ciprofloxacin and metronidazole are the first line treatments for pouchitis and result in clinical remission in about 60% of patients . As both C. perfringens and E. coli have been associated with pouchitis, this gives further credence to the concept that manipulating the gut microbiota to alter specific bacteria may help prevent this disease.…”

VSL#3 probiotic differently influences IEC‐6 intestinal epithelial cell status and function

“…The colonic epithelium is a single layer of cells undergoing continuous renewal which is able to respond to a wide range of stimuli, to absorb and to secrete. The etiology of pouchitis and IBD is still debated, but many evidences point to a disturbance between gut wall and commensal bacteria in certain individuals that are genetically susceptible (Li et al, ; Wu & Shen, ). Since VSL#3 is recommended by (American Gastroenterological Association) and ECCO (European Crohńs and Colitis Organization) guidelines for the prevention and remission induction or maintenance of pouchitis (Mowat et al, ), it would have been of some interest to look at the relationships between the bacteria present in the probiotic mix and the epithelial cells.…”

“…Other factors like nutrients, polyamines, short chain fatty acids, lipids, and trace elements present in the gut may affect positively or negatively the intestinal wound healing. Indeed, for example, progression and flares of Inflammatory Bowel Diseases (IBD) may result also from the presence of microbes and microbe‐derived substances in the gut, even after the inciting agents responsible for the initiation of inflammation are controlled (Li et al, ; Wu & Shen, ). Recently, it has been reported that the secretion of alpha‐hemolysin by Escherichia coli disrupts tight junctions in ulcerative colitis patients (Mirsepasi‐Lauridsen et al, ).…”

Review article: the gut microbiome in inflammatory bowel disease—avenues for microbial management

“…Abnormalities in the intestinal microbiota have also been reported in ulcerative colitis, although to a lesser degree compared to CD. Less diverse microbiota profiles have been demonstrated in ulcerative colitis patient samples, and in particular, the finding of increased Clostridium perfringens in faeces suggests a role in disease exacerbation . A decrease in Fusicatenibacter saccharivorans in patients with active ulcerative colitis has also been reported, in contrast to the increase observed in patients with quiescent disease …”