Article (Scientific journals)
Alterations in the intestinal microbiome (dysbiosis) as a predictor of relapse after infliximab withdrawal in Crohn's disease.
Rajca, Sylvie; Grondin, Virginie; Louis, Edouard et al.
2014In Inflammatory Bowel Diseases, 20 (6), p. 978-86
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Keywords :
Adult; Antibodies, Monoclonal/administration & dosage/adverse effects; Crohn Disease/diagnosis/drug therapy/microbiology; Dysbiosis/diagnosis/microbiology; Feces/microbiology; Female; Follow-Up Studies; Gastrointestinal Agents/administration & dosage/adverse effects; Humans; Intestines/drug effects/microbiology; Male; Microbiota; Predictive Value of Tests; Prospective Studies; Recurrence; Substance Withdrawal Syndrome/microbiology
Abstract :
[en] BACKGROUND: Crohn's disease (CD)-associated dysbiosis could predispose patients to relapse. Gut microbiota composition of patients from the prospective cohort study designed to identify predictive factors of clinical relapse after infliximab discontinuation (STORI Study) was investigated to determine the impact of dysbiosis in CD relapse. METHODS: Fecal samples from 33 patients with CD in this cohort were collected at baseline, 2 months, 6 months, and at the end of the follow-up period (19 relapsers and 14 nonrelapsers). Healthy volunteers subjects (n = 29) were used as a control group. The fecal microbiota composition was assessed using quantitative PCR, and comparisons between the patient groups were made at different time points using the Wilcoxon test. The analysis of the time-to-relapse was performed according to the baseline median level of each bacterial signal. RESULTS: Dysbiosis was observed in patients with CD compared with healthy subjects, and it was characterized by low mean counts of Firmicutes (Clostridium coccoides [P = 0.0003], C. leptum [P < 0.0001], and Faecalibacterium prausnitzii [P = 0.003]). Lower rates of Firmicutes were seen in relapsers compared with nonrelapsers. Moreover, a low rate of F. prausnitzii (P = 0.014) and a low rate of Bacteroides (P = 0.030) predicted relapse independently from high C reactive protein level (P = 0.0001). CONCLUSIONS: In this work, we report that CD-associated dysbiosis, characterized by a decrease in Firmicutes, correlates with the time-to-relapse after infliximab withdrawal. A deficit in some bacterial groups or species, such as F. prausnitzii, may represent a predictive factor for relapse. Restoring normobiosis in CD could be a new goal for optimal CD management.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Rajca, Sylvie
Grondin, Virginie
Louis, Edouard  ;  Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Vernier-Massouille, Gwenola
Grimaud, Jean-Charle
Bouhnik, Yoram
Laharie, David
Dupas, Jean-Louis
Pillant, Helene
Picon, Laurence
Veyrac, Michel
Flamant, Mathurin
Savoye, Guillaume
Jian, Raymond
Devos, Martine
Paintaud, Gilles
Piver, Eric
Allez, Matthieu
Mary, Jean Yves
Sokol, Harry
Colombel, Jean-Frederic
Seksik, Philippe
More authors (12 more) Less
Language :
English
Title :
Alterations in the intestinal microbiome (dysbiosis) as a predictor of relapse after infliximab withdrawal in Crohn's disease.
Publication date :
2014
Journal title :
Inflammatory Bowel Diseases
ISSN :
1078-0998
eISSN :
1536-4844
Publisher :
Lippincott Williams & Wilkins, United States - Maryland
Volume :
20
Issue :
6
Pages :
978-86
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 25 January 2015

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