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Title: Luminal microbiota related to Crohn's disease recurrence after surgery.
Austin Authors: Hamilton, Amy L;Kamm, Michael A;De Cruz, Peter P ;Wright, Emily K;Feng, Hai;Wagner, Josef;Sung, Joseph J Y;Kirkwood, Carl D;Inouye, Michael;Teo, Shu-Mei
Affiliation: Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital, Melbourne, Australia
Cambridge Baker Systems Genomics Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Australia
Enteric Virus Group, Murdoch Children's Research Institute, Melbourne, Australia
School of Pharmacy, Harbin Medical University, Harbin, China
Department of Gastroenterology, St Vincent's Hospital and Department of Medicine, University of Melbourne, Melbourne, Australia
Gastroenterology and Hepatology
Enteric and Diarrheal Diseases Global Health, Bill and Melinda Gates Foundation, Seattle, WA, USA
The Chinese University of Hong Kong, Hong Kong, China
Issue Date: 1-Nov-2020
Date: 2020-06-21
Publication information: Gut Microbes 2020; 11(6): 1713-1728
Abstract: 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.
DOI: 10.1080/19490976.2020.1778262
ORCID: 0000-0002-3399-7236
Journal: Gut Microbes
PubMed URL: 32564657
Type: Journal Article
Subjects: Crohn’s disease
Appears in Collections:Journal articles

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