Multiphasic analysis of the temporal development of the distal gut microbiota in patients following ileal pouch anal anastomosis.
Multiphasic analysis of the temporal development of the distal gut microbiota in patients following ileal pouch anal anastomosis.
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DOI：
10.1186/2049-2618-1-9
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发表时间：
2013-03-04
期刊：
影响因子：
15.5
通讯作者：
Sogin ML
中科院分区：
文献类型：
--
作者：
Young VB;Raffals LH;Huse SM;Vital M;Dai D;Schloss PD;Brulc JM;Antonopoulos DA;Arrieta RL;Kwon JH;Reddy KG;Hubert NA;Grim SL;Vineis JH;Dalal S;Morrison HG;Eren AM;Meyer F;Schmidt TM;Tiedje JM;Chang EB;Sogin ML
原生肠道微生物群被认为在炎症性肠病的异常炎症反应的发展和维持中起着至关重要的作用。肠道微生物群在这些疾病中的作用的直接测试通常受到限制，因为微生物群的采样通常是在疾病变得明显时进行的。通过研究接受全直结肠切除术并回肠袋肛管吻合术（IPAA）作为溃疡性结肠炎最终治疗的患者，可以潜在地规避这一局限性。一部分接受IPAA治疗的患者会出现一种被称为袋炎的炎症，这被认为是溃疡性结肠炎的发病机制。跟踪袋子微生物组的发展将允许表征在显性疾病发展之前的微生物群落。我们监测了4例接受IPAA的患者眼袋微生物群的发育情况。在取下转移回肠造口之前获得粘膜和管腔样本，并与恢复肠连续性后2、4和8周获得的样本进行比较。通过16S rrna编码基因扩增子、16S靶向扩增和微生物培养的联合分析，我们观察到回肠造口术后袋内微生物群结构和功能的重大变化。具有复杂碳水化合物发酵能力的厌氧微生物相对增加，这与回肠袋内肠道内容物的物理停滞相对应。与健康个体结肠粘膜中的微生物组结构相比，四个人中有三人的育袋微生物群落非常不同。在第4例患者中，建立了一个与健康结肠相似的社区，并且该患者的临床病程也是4例患者中最良性的，在IPAA后2年没有出现囊炎。溃疡性结肠炎患者接受IPAA治疗后，其回肠肛管内的微生物群表现出与粪便流恢复相关的显著结构和功能变化。我们的初步结果表明，一旦眼袋承担了先前由完整结肠发挥的生理作用，相对于正常的结肠微生物群，眼袋微生物群的精确结构和功能将决定是否建立稳定、健康的粘膜环境或重新启动导致肠道炎症的致病级联反应。
The indigenous gut microbiota are thought to play a crucial role in the development and maintenance of the abnormal inflammatory responses that are the hallmark of inflammatory bowel disease. Direct tests of the role of the gut microbiome in these disorders are typically limited by the fact that sampling of the microbiota generally occurs once disease has become manifest. This limitation could potentially be circumvented by studying patients who undergo total proctocolectomy with ileal pouch anal anastomosis (IPAA) for the definitive treatment of ulcerative colitis. A subset of patients who undergo IPAA develops an inflammatory condition known as pouchitis, which is thought to mirror the pathogenesis of ulcerative colitis. Following the development of the microbiome of the pouch would allow characterization of the microbial community that predates the development of overt disease. We monitored the development of the pouch microbiota in four patients who underwent IPAA. Mucosal and luminal samples were obtained prior to takedown of the diverting ileostomy and compared to samples obtained 2, 4 and 8 weeks after intestinal continuity had been restored. Through the combined analysis of 16S rRNA-encoding gene amplicons, targeted 16S amplification and microbial cultivation, we observed major changes in structure and function of the pouch microbiota following ileostomy. There is a relative increase in anaerobic microorganisms with the capacity for fermentation of complex carbohydrates, which corresponds to the physical stasis of intestinal contents in the ileal pouch. Compared to the microbiome structure encountered in the colonic mucosa of healthy individuals, the pouch microbial community in three of the four individuals was quite distinct. In the fourth patient, a community that was much like that seen in a healthy colon was established, and this patient also had the most benign clinical course of the four patients, without the development of pouchitis 2 years after IPAA. The microbiota that inhabit the ileal-anal pouch of patients who undergo IPAA for treatment of ulcerative colitis demonstrate significant structural and functional changes related to the restoration of fecal flow. Our preliminary results suggest once the pouch has assumed the physiologic role previously played by the intact colon, the precise structure and function of the pouch microbiome, relative to a normal colonic microbiota, will determine if there is establishment of a stable, healthy mucosal environment or the reinitiation of the pathogenic cascade that results in intestinal inflammation.
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影响因子：
12.2
作者：
Reeves, Angela E.;Theriot, Casey M.;Young, Vincent B.
通讯作者：
Young, Vincent B.
影响因子：
12.3
作者：
Huse SM;Huber JA;Morrison HG;Sogin ML;Welch DM
通讯作者：
Welch DM
影响因子：
3.1
作者：
Sekirov, Inna;Tam, Nicola M.;Finlay, B. Brett
通讯作者：
Finlay, B. Brett
影响因子：
14.9
作者：
Pruesse E;Quast C;Knittel K;Fuchs BM;Ludwig W;Peplies J;Glöckner FO
通讯作者：
Glöckner FO
影响因子：
8.9
作者：
SANDBORN, WJ;TREMAINE, WJ;PHILLIPS, SF
通讯作者：
PHILLIPS, SF