Fecal Microbiota in Pediatric Inflammatory Bowel Disease and Its Relation to Inflammation
Fecal Microbiota in Pediatric Inflammatory Bowel Disease and Its Relation to Inflammation
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DOI：
10.1038/ajg.2015.149
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发表时间：
2015-06-01
影响因子：
9.8
通讯作者：
de Vos, Willem M.
中科院分区：
文献类型：
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作者：
Kolho, Kaija-Leena;Korpela, Katri;de Vos, Willem M.
炎症性肠病（IBD）被认为是由宿主和肠道微生物群之间的相互作用引起的。虽然成人IBD已被证明与肠道微生物群的显著变化有关，但只有少数儿童研究，特别是缺乏关注治疗反应的研究。因此，这项前瞻性研究解决了肠道菌群在小儿IBD，特别是有关的inflammation.METHODS的水平：在总数，68例小儿IBD和26个控制提供粪便和血液样本在三级医院和32个接受抗肿瘤坏死因子-α（抗TNF-α）。测定血液炎症标志物和粪便钙卫蛋白水平。结果：肠道微生物群沿着增加的肠道炎症（由钙卫蛋白水平指示）梯度变化，这与微生物丰富度降低、丁酸生产者丰富度和革兰氏阳性菌（尤其是梭菌簇IV和XIVa）相对丰富度相关。通过一组预测钙卫蛋白水平的细菌组（曲线下面积（AUC）为0.85）表明微生物群组成与炎症之间的显著关联。在抗TNF-α诱导期间，到第6周，应答组的微生物多样性和与对照组微生物群的相似性增加，但无应答组没有增加（P
OBJECTIVES: Inflammatory bowel disease (IBD) is considered to result from interplay between host and intestinal microbiota. While IBD in adults has shown to be associated with marked changes in the intestinal microbiota, there are only a few studies in children, and particularly studies focusing on therapeutic responses are lacking. Hence, this prospective study addressed the intestinal microbiota in pediatric IBD especially related to the level of inflammation.METHODS: In total, 68 pediatric patients with IBD and 26 controls provided stool and blood samples in a tertiary care hospital and 32 received anti-tumor necrosis factor-alpha (anti-TNF-alpha). Blood inflammatory markers and fecal calprotectin levels were determined. The intestinal microbiota was characterized by phylogenetic microarray and qPCR analysis.RESULTS: The microbiota varied along a gradient of increasing intestinal inflammation (indicated by calprotectin levels), which was associated with reduced microbial richness, abundance of butyrate producers, and relative abundance of Gram-positive bacteria (especially Clostridium clusters IV and XIVa). A significant association between microbiota composition and inflammation was indicated by a set of bacterial groups predicting the calprotectin levels (area under curve (AUC) of 0.85). During the induction of anti-TNF-alpha, the microbial diversity and similarity to the microbiota of controls increased in the responder group by week 6, but not in the non-responders (P