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IBD 患者粪便微生物群特征及其与欧洲多中心研究(IBD-Character)中的诊断、疾病表型、炎症、治疗升级和抗 TNF 反应的关系。

Faecal microbiota signatures of IBD and their relation to diagnosis, disease phenotype, inflammation, treatment escalation and anti-TNF response in a European Multicentre Study (IBD-Character).

机构信息

Department of Gastroenterology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

Scand J Gastroenterol. 2020 Oct;55(10):1146-1156. doi: 10.1080/00365521.2020.1803396. Epub 2020 Aug 11.

DOI:10.1080/00365521.2020.1803396
PMID:32780604
Abstract

METHOD

We examined faecal samples, using the GA-map™ Dysbiosis Test, to associate gut microbiota composition with Crohn's disease (CD) and ulcerative colitis (UC) and to identify markers for future biomarker identification. We conducted a prospective case-control study (EU-ref. no. 305676) in an inception cohort of 324 individuals (64 CD, 84 UC, 116 symptomatic non-IBD controls and 44 healthy controls) across five European centres and examined 54 predetermined bacterial markers. We categorized patients according to the Montreal Classification and calculated the dysbiosis index (DI). Non-parametric tests were used to compare groups and the Bonferroni correction to adjust for multiple comparisons.

RESULTS

The fluorescent signals (FSSs) for and were lower in inflammatory bowel disease (IBD) vs. symptomatic controls (<.05). FSS for Firmicutes, and were lower, whereas the signal for was higher in UC vs. symptomatic controls (<.05). FSS was higher for , , Actinobacteria and Firmicutes among patients with ulcerative proctitis, compared to extensive colitis (<.05). In CD, we observed no association with disease location. The DI correlated with faecal-calprotectin in both CD and in UC (<.001). In terms of treatment escalation and anti-TNF response, differences were observed for some bacterial markers, but none of these associations were statistically significant.

CONCLUSION

Our data reveal that the GA-map™ Dysbiosis Test holds the potential to characterize the faecal microbiota composition and to assess the degree of dysbiosis in new-onset IBD. On the other hand, our results cannot demonstrate any proven diagnostic or predictive value of this method to support clinical decision making.

摘要

方法

我们使用 GA-map™ 肠道微生物失调测试(GA-map™ Dysbiosis Test)来检测粪便样本,以关联肠道微生物组成与克罗恩病(CD)和溃疡性结肠炎(UC),并确定未来生物标志物鉴定的标志物。我们在五个欧洲中心的一个初发队列中进行了一项前瞻性病例对照研究(EU-ref. no. 305676),该队列包括 324 名个体(64 名 CD、84 名 UC、116 名有症状非 IBD 对照和 44 名健康对照),并检测了 54 个预定的细菌标志物。我们根据蒙特利尔分类对患者进行分类,并计算了失调指数(DI)。使用非参数检验比较组,并用 Bonferroni 校正调整多重比较。

结果

与有症状对照相比,炎症性肠病(IBD)患者的荧光信号(FSS) 较低(<.05)。与有症状对照相比,UC 患者的Firmicutes、 和 的 FSS 较低,而 的信号较高(<.05)。与广泛结肠炎相比,溃疡性直肠炎患者的FSS 较高 、 、Actinobacteria 和 Firmicutes(<.05)。在 CD 中,我们没有观察到与疾病部位的关联。DI 与 CD 和 UC 中的粪便钙卫蛋白相关(<.001)。在治疗升级和抗 TNF 反应方面,一些细菌标志物存在差异,但这些关联均无统计学意义。

结论

我们的数据表明,GA-map™ 肠道微生物失调测试具有描述新发病例 IBD 粪便微生物组成和评估失调程度的潜力。另一方面,我们的结果不能证明该方法具有任何已证实的诊断或预测价值,无法支持临床决策。

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