Department of Gastroenterology, St Vincent's Hospital and Department of Medicine, University of Melbourne , Melbourne, Australia.
Department of Gastroenterology, Austin Health , Melbourne, Australia.
Gut Microbes. 2020 Nov 1;11(6):1713-1728. doi: 10.1080/19490976.2020.1778262. Epub 2020 Jun 21.
Microbial factors are likely to be involved in the recurrence of Crohn's disease (CD) after bowel resection. We investigated the luminal microbiota before and longitudinally after surgery, in relation to disease recurrence, using 16S metagenomic techniques.
In the prospective Post-Operative Crohn's Endoscopic Recurrence (POCER) study, fecal samples were obtained before surgery and 6, 12, and 18 months after surgery from 130 CD patients. Endoscopy was undertaken to detect disease recurrence, defined as Rutgeerts score ≥i2, at 6 months in two-thirds of patients and all patients at 18 months after surgery. The V2 region of the 16S rRNA gene was sequenced using Illumina MiSeq. Cluster analysis was performed at family level, assessing microbiome community differences between patients with and without recurrence.
Six microbial cluster groups were identified. The cluster associated with maintenance of remission was enriched for the family [adjusted OR 0.47 (0.27-0.82), = .007]. The OTU diversity of within this cluster was significantly greater than in all other clusters. The cluster enriched for was associated with an increased risk of disease recurrence [adjusted OR 6.35 (1.24-32.44), = .026]. OTU diversity of within this cluster was significantly greater than in other clusters.
Luminal bacterial communities are associated with protection from, and the occurrence of, Crohn's disease recurrence after surgery. Recurrence may relate to a higher abundance of facultatively anaerobic pathobionts from the family. The ecologic change of depleted , a genus of butyrate-producing bacteria, may permit expansion of through luminal environmental perturbation.
微生物因素可能与肠切除术后克罗恩病（CD）的复发有关。我们使用 16S 宏基因组技术研究了手术前后的腔道微生物群，与疾病复发相关。
在前瞻性术后克罗恩病内镜复发（POCER）研究中，从 130 例 CD 患者中获取手术前和手术后 6、12 和 18 个月的粪便样本。在三分之二的患者中，在术后 6 个月进行内镜检查以检测疾病复发，定义为 Rutgeerts 评分≥i2，在术后 18 个月对所有患者进行内镜检查。使用 Illumina MiSeq 对 16S rRNA 基因的 V2 区进行测序。在家族水平上进行聚类分析，评估有无复发患者之间的微生物群落差异。
确定了六个微生物聚类组。与维持缓解相关的聚类富含 科[调整后的 OR 0.47（0.27-0.82）， = .007]。该聚类中 的 OTU 多样性明显大于其他所有聚类。富含 科的聚类与疾病复发的风险增加相关[调整后的 OR 6.35（1.24-32.44）， = .026]。该聚类中 的 OTU 多样性明显大于其他聚类。
腔道细菌群落与术后 CD 复发的保护和发生有关。复发可能与来自 科的兼性厌氧病原体的丰度增加有关。耗竭的生态变化，一种产生丁酸盐的细菌属，可能通过腔道环境扰动允许 的扩张。
