School of Nutrition and Translational Research in Metabolism [NUTRIM], Department of Medical Microbiology, Maastricht University Medical Center+, Maastricht, The Netherlands.
School of Public Health and Primary Care [Caphri], Department of Medical Microbiology, Maastricht University Medical Center+, Maastricht, The Netherlands.
J Crohns Colitis. 2019 Sep 27;13(10):1273-1282. doi: 10.1093/ecco-jcc/jjz049.
Microbial shifts have been associated with disease activity in Crohn's disease [CD], but findings on specific taxa are inconsistent. This may be due to differences in applied methods and cross-sectional study designs. We prospectively examined the faecal microbiota in adult CD patients with changing or stable disease course over time.
Faeces were collected at two time-points from 15 healthy control individuals [HCs], 35 CD patients who were in remission and who maintained remission [RRs], and 22 CD patients during remission and also during subsequent exacerbation [RAs]. The microbial composition was assessed by 16S rRNA [V4] gene sequencing.
Compared with HCs, patients with CD had a lower microbial richness [p = 0.0002] and diversity [p = 0.005]. Moreover, the microbial community structure of a subset of patients, clustered apart from HCs, was characterized by low microbial diversity and Faecalibacterium abundance. Patients within this cluster did not differ with respect to long-term disease course compared with patients with a 'healthy-appearing' microbiota.Over time, microbial richness and diversity did not change in RR versus RA patients. Although the microbial community structure of both RR and RA patients was less stable over time compared with that of HCs, no differences were observed between the patient groups [p = 0.17]; nor was the stability impacted by Montreal classification, medication use, or surgery.
The altered microbiota composition and stability in CD was neither associated with disease activity nor long-term disease course, questioning its involvement in the development of an exacerbation. The aberrant microbiota composition in a subset of CD patients warrants further exploration of a more microbiota-driven etiology in this group.
微生物群的变化与克罗恩病[CD]的疾病活动有关，但特定分类群的发现结果不一致。这可能是由于应用方法和横断面研究设计的差异所致。我们前瞻性地研究了随着时间的推移病情变化或稳定的成年 CD 患者的粪便微生物群。
从 15 名健康对照[HCs]、35 名处于缓解期且保持缓解[RRs]的 CD 患者和 22 名缓解期但随后出现恶化[RAs]的 CD 患者中收集粪便。采用 16S rRNA[V4]基因测序评估微生物组成。
与 HCs 相比，CD 患者的微生物丰富度[P = 0.0002]和多样性[P = 0.005]较低。此外，一部分患者的微生物群落结构与 HCs 分离，其特征是微生物多样性和粪杆菌丰度低。与具有“健康样”微生物群的患者相比，该亚群患者的长期疾病病程没有差异。RR 与 RA 患者的微生物丰富度和多样性随时间变化而无变化。尽管 RR 和 RA 患者的微生物群落结构随时间的推移不如 HCs 稳定，但两组患者之间没有差异[P = 0.17]；也没有观察到疾病分类、药物使用或手术对稳定性的影响。
CD 中改变的微生物群组成和稳定性与疾病活动或长期疾病病程无关，这质疑了其在恶化中的参与。CD 患者亚群中异常的微生物群组成需要进一步探索该组中更基于微生物群的病因。
