Early Postoperative Endoscopic Recurrence in Crohn’s Disease Is Characterised by Distinct Microbiota Recolonisation

BACKGROUND AND AIMS: Intestinal microbiota dysbiosis is implicated in Crohn’s disease [CD] and may play an important role in triggering postoperative disease recurrence [POR]. We prospectively studied faecal and mucosal microbial recolonisation following ileocaecal resection to identify the predicti...

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Autores principales: Machiels, Kathleen, Pozuelo del Río, Marta, Martinez-De la Torre, Adrian, Xie, Zixuan, Pascal Andreu, Victòria, Sabino, João, Santiago, Alba, Campos, David, Wolthuis, Albert, D’Hoore, André, De Hertogh, Gert, Ferrante, Marc, Manichanh, Chaysavanh, Vermeire, Séverine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648170/
https://www.ncbi.nlm.nih.gov/pubmed/32333762
http://dx.doi.org/10.1093/ecco-jcc/jjaa081
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author Machiels, Kathleen
Pozuelo del Río, Marta
Martinez-De la Torre, Adrian
Xie, Zixuan
Pascal Andreu, Victòria
Sabino, João
Santiago, Alba
Campos, David
Wolthuis, Albert
D’Hoore, André
De Hertogh, Gert
Ferrante, Marc
Manichanh, Chaysavanh
Vermeire, Séverine
author_facet Machiels, Kathleen
Pozuelo del Río, Marta
Martinez-De la Torre, Adrian
Xie, Zixuan
Pascal Andreu, Victòria
Sabino, João
Santiago, Alba
Campos, David
Wolthuis, Albert
D’Hoore, André
De Hertogh, Gert
Ferrante, Marc
Manichanh, Chaysavanh
Vermeire, Séverine
author_sort Machiels, Kathleen
collection PubMed
description BACKGROUND AND AIMS: Intestinal microbiota dysbiosis is implicated in Crohn’s disease [CD] and may play an important role in triggering postoperative disease recurrence [POR]. We prospectively studied faecal and mucosal microbial recolonisation following ileocaecal resection to identify the predictive value of recurrence-related microbiota. METHODS: Mucosal and/or faecal samples from 121 CD patients undergoing ileocaecal resection were collected at predefined time points before and after surgery. Ileal biopsies were collected from 39 healthy controls. POR was defined by a Rutgeerts score ≥i2b. The microbiota was evaluated by 16S rRNA sequencing. Prediction analysis was performed using C5.0 and Random Forest algorithms. RESULTS: The mucosa-associated microbiota in CD patients was characterised by a depletion of butyrate-producing species (false discovery rate [FDR] <0.01) and enrichment of Proteobacteria [FDR = 0.009] and Akkermansia spp. [FDR = 0.02]. Following resection, a mucosal enrichment of Lachnospiraceae [FDR <0.001] was seen in all patients but in POR patients, also Fusobacteriaceae [FDR <0.001] increased compared with baseline. Patients without POR showed a decrease of Streptococcaceae [FDR = 0.003] and Actinomycineae [FDR = 0.06]. The mucosa-associated microbiota profile had good discriminative power to predict POR, and was superior to clinical risk factors. At Month 6, patients experiencing POR had a higher abundance of taxa belonging to Negativicutes [FDR = 0.04] and Fusobacteria [FDR = 0.04] compared with patients without POR. CONCLUSIONS: Microbiota recolonisation after ileocaecal resection is different between recurrence and non-recurrence patients, with Fusobacteria as the most prominent player driving early POR. These bacteria involved in the early recolonisation and POR represent a promising therapeutic strategy in the prevention of disease recurrence.
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spelling pubmed-76481702020-11-12 Early Postoperative Endoscopic Recurrence in Crohn’s Disease Is Characterised by Distinct Microbiota Recolonisation Machiels, Kathleen Pozuelo del Río, Marta Martinez-De la Torre, Adrian Xie, Zixuan Pascal Andreu, Victòria Sabino, João Santiago, Alba Campos, David Wolthuis, Albert D’Hoore, André De Hertogh, Gert Ferrante, Marc Manichanh, Chaysavanh Vermeire, Séverine J Crohns Colitis Original Articles BACKGROUND AND AIMS: Intestinal microbiota dysbiosis is implicated in Crohn’s disease [CD] and may play an important role in triggering postoperative disease recurrence [POR]. We prospectively studied faecal and mucosal microbial recolonisation following ileocaecal resection to identify the predictive value of recurrence-related microbiota. METHODS: Mucosal and/or faecal samples from 121 CD patients undergoing ileocaecal resection were collected at predefined time points before and after surgery. Ileal biopsies were collected from 39 healthy controls. POR was defined by a Rutgeerts score ≥i2b. The microbiota was evaluated by 16S rRNA sequencing. Prediction analysis was performed using C5.0 and Random Forest algorithms. RESULTS: The mucosa-associated microbiota in CD patients was characterised by a depletion of butyrate-producing species (false discovery rate [FDR] <0.01) and enrichment of Proteobacteria [FDR = 0.009] and Akkermansia spp. [FDR = 0.02]. Following resection, a mucosal enrichment of Lachnospiraceae [FDR <0.001] was seen in all patients but in POR patients, also Fusobacteriaceae [FDR <0.001] increased compared with baseline. Patients without POR showed a decrease of Streptococcaceae [FDR = 0.003] and Actinomycineae [FDR = 0.06]. The mucosa-associated microbiota profile had good discriminative power to predict POR, and was superior to clinical risk factors. At Month 6, patients experiencing POR had a higher abundance of taxa belonging to Negativicutes [FDR = 0.04] and Fusobacteria [FDR = 0.04] compared with patients without POR. CONCLUSIONS: Microbiota recolonisation after ileocaecal resection is different between recurrence and non-recurrence patients, with Fusobacteria as the most prominent player driving early POR. These bacteria involved in the early recolonisation and POR represent a promising therapeutic strategy in the prevention of disease recurrence. Oxford University Press 2020-04-25 /pmc/articles/PMC7648170/ /pubmed/32333762 http://dx.doi.org/10.1093/ecco-jcc/jjaa081 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
Machiels, Kathleen
Pozuelo del Río, Marta
Martinez-De la Torre, Adrian
Xie, Zixuan
Pascal Andreu, Victòria
Sabino, João
Santiago, Alba
Campos, David
Wolthuis, Albert
D’Hoore, André
De Hertogh, Gert
Ferrante, Marc
Manichanh, Chaysavanh
Vermeire, Séverine
Early Postoperative Endoscopic Recurrence in Crohn’s Disease Is Characterised by Distinct Microbiota Recolonisation
title Early Postoperative Endoscopic Recurrence in Crohn’s Disease Is Characterised by Distinct Microbiota Recolonisation
title_full Early Postoperative Endoscopic Recurrence in Crohn’s Disease Is Characterised by Distinct Microbiota Recolonisation
title_fullStr Early Postoperative Endoscopic Recurrence in Crohn’s Disease Is Characterised by Distinct Microbiota Recolonisation
title_full_unstemmed Early Postoperative Endoscopic Recurrence in Crohn’s Disease Is Characterised by Distinct Microbiota Recolonisation
title_short Early Postoperative Endoscopic Recurrence in Crohn’s Disease Is Characterised by Distinct Microbiota Recolonisation
title_sort early postoperative endoscopic recurrence in crohn’s disease is characterised by distinct microbiota recolonisation
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648170/
https://www.ncbi.nlm.nih.gov/pubmed/32333762
http://dx.doi.org/10.1093/ecco-jcc/jjaa081
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