Spatial organization and composition of the mucosal flora in patients with inflammatory bowel disease
Spatial organization and composition of the mucosal flora in patients with inflammatory bowel disease
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DOI：
10.1128/jcm.43.7.3380-3389.2005
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发表时间：
2005-07-01
影响因子：
9.4
通讯作者：
Lochs, H
中科院分区：
文献类型：
--
作者：
Swidsinski, A;Weber, J;Lochs, H
通过使用广泛的荧光细菌群特异性rRNA靶向寡核苷酸探针，研究了炎症性肠病（IBD;克罗恩病或溃疡性结肠炎）、自限性结肠炎、肠易激综合征（IBS）和健康对照患者活检标本中粘膜植物群的组成和空间组织。每组包括20名受试者。还研究了10名患有IBD并正在接受抗生素治疗的患者。使用非水Carnoy固定剂保存粘液层对于检测粘附于粘膜表面的细菌（粘膜细菌）至关重要。在福尔马林固定的活检标本中未检测到生物膜。在90%至95%的IBD患者、95%的自限性结肠炎患者、65%的IBS患者和35%的健康对照中发现了浓度大于10（9）/ml的粘液菌。IBD患者粘膜生物膜的平均密度比IBS患者或对照组高2倍，细菌大多粘附。脆弱拟杆菌负责IBD患者中> 60%的生物膜质量，但仅负责自限性结肠炎患者中30%的生物膜质量和IBS患者中< 15%的生物膜质量。相比之下，与直肠真杆菌-球状梭菌特异性探针阳性杂交的细菌在IBS患者中占生物膜的> 40%，但在IBD患者中占生物膜的< 15%。在用（5-阿萨）或抗生素治疗的患者中，生物膜可以用4，6-diamidino-2-phenylindole检测到，但不能与荧光原位杂交探针杂交。脆弱拟杆菌生物膜是IBD的主要特征。由于缺乏适当的组织固定，这一点之前未被认识到。5-阿萨和抗生素都抑制但不能消除粘附的生物膜。
The composition and spatial organization of the mucosal flora in biopsy specimens from patients with inflammatory bowel disease (IBD; either Crohn's disease or ulcerative colitis), self-limiting colitis, irritable-bowel syndrome (IBS), and healthy controls were investigated by using a broad range of fluorescent bacterial group-specific rRNA-targeted oligonucleotide probes. Each group included 20 subjects. Ten patients who had IBD and who were being treated with antibiotics were also studied. Use of nonaqueous Carnoy fixative to preserve the mucus layer was crucial for detection of bacteria adherent to the mucosal surface (mucosal bacteria). No biofilm was detectable in formalin-fixed biopsy specimens. Mucosal bacteria were found at concentrations greater than 10(9)/ml in 90 to 95% of IBD patients, 95% of patients with self-limiting colitis, 65% of IBS patients, and 35% of healthy controls. The mean density of the mucosal biofilm was 2 powers higher in IBD patients than in patients with IBS or controls, and bacteria were mostly adherent. Bacteroides fragilis was responsible for > 60% of the biofilm mass in patients with IBD but for only 30% of the biofilm mass in patients with self-limiting colitis and < 15% of the biofilm mass in patients with IBS. In contrast, bacteria which positively hybridized with the probe specific for Eubacterium rectale-Clostridium coccoides accounted for > 40% of the biofilm in IBS patients but for < 15% of the biofilm in IBD patients. In patients treated with (5-ASA) or antibiotics, the biofilm could be detected with 4,6-diamidino-2-phenylindole but did not hybridize with fluorescence in situ hybridization probes. A Bacteroides fragilis biofilm is the main feature of IBD. This was not previously recognized due to a lack of appropriate tissue fixation. Both 5-ASA and antibiotics suppress but do not eliminate the adherent biofilm.