Luminal microbiota related to Crohn’s disease recurrence after surgery

毛螺菌科 生物 克罗恩病 内科学 微生物群 优势比 疾病 胃肠病学 炎症性肠病 丁酸盐 16S核糖体RNA 细菌 医学 遗传学 发酵 食品科学 厚壁菌
作者
Amy L. Hamilton,Michael A. Kamm,Peter De Cruz,Emily K. Wright,Hai Feng,Josef Wagner,Joseph J.�Y. Sung,Carl D. Kirkwood,Michael Inouye,Shu Mei Teo
出处
期刊:Gut microbes [Informa]
卷期号:11 (6): 1713-1728 被引量:31
标识
DOI:10.1080/19490976.2020.1778262
摘要

Microbial factors are likely to be involved in the recurrence of Crohn's disease (CD) after bowel resection. We investigated the luminal microbiota before and longitudinally after surgery, in relation to disease recurrence, using 16S metagenomic techniques.In the prospective Post-Operative Crohn's Endoscopic Recurrence (POCER) study, fecal samples were obtained before surgery and 6, 12, and 18 months after surgery from 130 CD patients. Endoscopy was undertaken to detect disease recurrence, defined as Rutgeerts score ≥i2, at 6 months in two-thirds of patients and all patients at 18 months after surgery. The V2 region of the 16S rRNA gene was sequenced using Illumina MiSeq. Cluster analysis was performed at family level, assessing microbiome community differences between patients with and without recurrence.Six microbial cluster groups were identified. The cluster associated with maintenance of remission was enriched for the Lachnospiraceae family [adjusted OR 0.47 (0.27-0.82), P = .007]. The OTU diversity of Lachnospiraceae within this cluster was significantly greater than in all other clusters. The cluster enriched for Enterobacteriaceae was associated with an increased risk of disease recurrence [adjusted OR 6.35 (1.24-32.44), P = .026]. OTU diversity of Enterobacteriaceae within this cluster was significantly greater than in other clusters.Luminal bacterial communities are associated with protection from, and the occurrence of, Crohn's disease recurrence after surgery. Recurrence may relate to a higher abundance of facultatively anaerobic pathobionts from the Enterobacteriaceae family. The ecologic change of depleted Lachnospiraceae, a genus of butyrate-producing bacteria, may permit expansion of Enterobacteriaceae through luminal environmental perturbation.

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