淀粉摄入可能改变回肠贮袋术后患者的抗糖蛋白抗体和粪便真菌组成。

Starch Consumption May Modify Antiglycan Antibodies and Fecal Fungal Composition in Patients With Ileo-Anal Pouch.

机构信息

Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Inflamm Bowel Dis. 2019 Mar 14;25(4):742-749. doi: 10.1093/ibd/izy370.

DOI:10.1093/ibd/izy370

PMID:30535148

Abstract

BACKGROUND

Inflammatory bowel diseases (IBDs) are characterized by serologic responses to glycans. Patients with ulcerative colitis (UC) after proctocolectomy with ileo-anal anastomosis (pouch surgery) may develop inflammation (pouchitis) that resembles Crohn's disease (CD). We hypothesized that patients' serologic responses were affected by their consumption of dietary sugars. This study analyzed the correlations between antiglycan antibody expression and dietary sugar consumption in patients with UC pouch and the evolution in antibody levels over time.

METHODS

Patients were followed prospectively for 2 consecutive visits. The following antiglycan carbohydrate antibodies were detected by enzyme-linked immunosorbent assay: antichitobioside (ACCA), antilaminaribioside (ALCA), antimannobioside (AMCA), and anti-Saccharomyces cerevisiae (ASCA) antibodies. Patients completed a food frequency questionnaire. The fungal community in patients' fecal samples was analyzed by sequencing the internal transcribed spacer 2 (ITS2) region of nuclear ribosomal DNA.

RESULTS

We included 75 UC pouch patients aged 45.2 ± 14 years who underwent pouch surgery 9.8 ± 6.7 years previously. Of these patients, 34.7% (n = 26) showed seropositivity for antiglycan antibodies. Starch consumption was significantly higher in patients with positive serologic responses (P = 0.05). Higher starch consumption was associated with higher AMCA and ACCA titers, which increased by 4.08% (0.8%-7.4%; P = 0.014) and 4.8% (0.7%-9.1%; P = 0.007), respectively, for each 10-g increase of dietary starch. The per-patient change in the relative abundance of Candida albicans in fecal samples correlated positively with changes in starch consumption (Spearman's r = 0.72; P = 0.012).

CONCLUSIONS

Starch consumption correlated with positive antiglycan serology (ACCA and AMCA), suggesting that increased dietary starch intake may promote a specific immune response in patients with IBD.

摘要

背景

炎症性肠病（IBD）的特征是针对聚糖的血清反应。接受直肠结肠切除+回肠肛管吻合术（pouch surgery）的溃疡性结肠炎（UC）患者可能会发生类似克罗恩病（CD）的炎症（pouchitis）。我们假设患者的血清反应受到其饮食中糖的消耗的影响。本研究分析了 UC pouch 患者的抗糖抗体表达与饮食糖消耗之间的相关性，以及抗体水平随时间的演变。

方法

前瞻性随访患者连续 2 次就诊。通过酶联免疫吸附试验检测以下抗糖碳水化合物抗体：抗 chitobioside（ACCA）、抗 laminaribioside（ALCA）、抗 mannobioside（AMCA）和抗 Saccharomyces cerevisiae（ASCA）抗体。患者完成了食物频率问卷。通过对核核糖体 DNA 的内部转录间隔区 2（ITS2）区域进行测序分析患者粪便样本中的真菌群落。

结果

我们纳入了 75 名年龄为 45.2 ± 14 岁的 UC pouch 患者，他们在 9.8 ± 6.7 年前接受了 pouch 手术。其中，34.7%（n = 26）的患者对糖抗原抗体呈血清阳性。阳性血清反应患者的淀粉消耗明显较高（P = 0.05）。较高的淀粉消耗与更高的 AMCA 和 ACCA 滴度相关，分别增加了 4.08%（0.8%-7.4%；P = 0.014）和 4.8%（0.7%-9.1%；P = 0.007），每增加 10 克饮食淀粉。粪便样本中白色念珠菌的相对丰度的个体变化与淀粉消耗的变化呈正相关（Spearman r = 0.72；P = 0.012）。