Article (Scientific journals)
Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC.
Machiels, K.; Sabino, J.; Vandermosten, L. et al.
2017In Gut, 66 (1), p. 79-88
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Keywords :
IBD BASIC RESEARCH; ILEOANAL POUCH; INFLAMMATORY BOWEL DISEASE; INTESTINAL BACTERIA; POUCHITIS; Bacteroidetes; Clostridium perfringens; Colitis, Ulcerative; Ruminococcus; Adult; Cluster Analysis; Colonic Pouches; DNA, Bacterial; Fatty Acids, Volatile; Feces; Female; Gastrointestinal Microbiome; Humans; Leukocyte L1 Antigen Complex; Male; Middle Aged; Predictive Value of Tests; Preoperative Period; Proctocolectomy, Restorative; Prospective Studies; Time Factors
Abstract :
[en] OBJECTIVE: Pouchitis is the most common complication after colectomy with ileal pouch-anal anastomosis (IPAA) for UC and the risk is the highest within the 1st year after surgery. The pathogenesis is not completely understood but clinical response to antibiotics suggests a role for gut microbiota. We hypothesised that the risk for pouchitis can be predicted based on the faecal microbial composition before colectomy. DESIGN: Faecal samples from 21 patients with UC undergoing IPAA were prospectively collected before colectomy and at predefined clinical visits at 1 month, 3 months, 6 months and 12 months after IPAA. The predominant microbiota was analysed using community profiling with denaturing gradient gel electrophoresis followed by quantitative real-time PCR validation. RESULTS: Cluster analysis before colectomy distinguished patients with pouchitis from those with normal pouch during the 1st year of follow-up. In patients developing pouchitis, an increase of Ruminococcus gnavus (p<0.001), Bacteroides vulgatus (p=0.043), Clostridium perfringens (p=0.011) and a reduction of two Lachnospiraceae genera (Blautia (p=0.04), Roseburia (p=0.008)) was observed. A score combining these five bacterial risk factors was calculated and presence of at least two risk factors showed a sensitivity and specificity of 100% and 63.6%, respectively. CONCLUSIONS: Presence of R. gnavus, B. vulgatus and C. perfringens and absence of Blautia and Roseburia in faecal samples of patients with UC before surgery is associated with a higher risk of pouchitis after IPAA. Our findings suggest new predictive and therapeutic strategies in patients undergoing colectomy with IPAA.
Disciplines :
Gastroenterology & hepatology
Life sciences: Multidisciplinary, general & others
Author, co-author :
Machiels, K.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
Sabino, J.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
Vandermosten, L.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
Joossens, M.;  Department Microbiology and Immunology, KU Leuven, Leuven, Belgium, Center for the Biology of Disease, VIB, Leuven, Belgium, Faculty of Sciences and Bioengineering Sciences, Microbiology Unit, Vrije Universiteit Brussel, Brussels, Belgium
Arijs, I.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
de Bruyn, M.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
Eeckhaut, V.;  Department of Pathology, Bacteriology and Avian Diseases, Ghent University, Merelbeke, Belgium
Van Assche, G.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
Ferrante, M.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
Verhaegen, J.;  Department of Microbiology and Immunology, University Hospital Leuven, KU Leuven, Leuven, Belgium
Van Steen, Kristel  ;  Université de Liège - ULiège > Dép. d'électric., électron. et informat. (Inst.Montefiore) > Bioinformatique
Van Immerseel, F.;  Department of Pathology, Bacteriology and Avian Diseases, Ghent University, Merelbeke, Belgium
Huys, G.;  Laboratory of Microbiology & BCCM/LMG Bacteria Collection, Faculty of Sciences, Ghent University, Ghent, Belgium
Verbeke, K.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
Wolthuis, A.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
de Buck Van Overstraeten, A.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
D'Hoore, A.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
Rutgeerts, P.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
Vermeire, S.;  Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium
More authors (9 more) Less
Language :
English
Title :
Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC.
Publication date :
2017
Journal title :
Gut
ISSN :
0017-5749
eISSN :
1468-3288
Publisher :
BMJ Group, London, United Kingdom
Volume :
66
Issue :
1
Pages :
79-88
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 13 June 2016

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