Bacsur Péter, Rutka Mariann, Asbóth András, Resál Tamás, Szántó Kata, Jójárt Boldizsár, Bálint Anita, Ari Eszter, Ajibola Walliyulahi, Kintses Bálint, Fehér Tamás, Pigniczki Daniella, Bor Renáta, Fábián Anna, Maléth József, Szepes Zoltán, Farkas Klaudia, Molnár Tamás
Department of Medicine, Szent-Györgyi Albert Medical School, University of Szeged, Szeged, Hungary.
Synthetic and System Biology Unit, Institute of Biochemistry, Biological Research Centre, Eötvös Loránd Research Network (ELKH), Szeged, Hungary.
Therap Adv Gastroenterol. 2023 Jun 6;16:17562848231174298. doi: 10.1177/17562848231174298. eCollection 2023.
In patients with inflammatory bowel disease (IBD), Crohn's disease (CD), and ulcerative colitis (UC), numerous cases of exacerbations could be observed after colonoscopy, raising the possible pathogenetic effect of colonic microbiota alterations in IBD flare.
We aimed to investigate the changes in the fecal microbiota composition in IBD patients influenced by the bowel preparation with sodium picosulfate.
We enrolled patients with IBD undergoing bowel preparation for colonoscopy in the prospective cohort study. The control group (Con) comprised non-IBD patients who underwent colonoscopy. Clinical data, blood, and stool samples were collected before colonoscopy (timepoint A), 3 days later (timepoint B), and 4 weeks later (timepoint C).
Disease activity and gut microbiota changes were assessed at each timepoint. Fecal microbiota structure - at family level - was determined by sequencing the V4 region of the 16S rRNA gene. Statistical analysis included differential abundance analysis and Mann-Whitney tests.
Forty-one patients (9 CD, 13 UC, and 19 Con) were included. After bowel preparation, alpha diversity was lower in the CD group than in the UC ( = 0.01) and Con ( = 0.02) groups at timepoint B. Alpha diversity was significantly higher in the UC group than in the CD and Con ( = 0.03) groups at timepoint C. Beta diversity difference differed between the IBD and Con ( = 0.001) groups. Based on the differential abundance analysis, the Clostridiales family was increased, whereas the family was decreased in CD patients compared to the Con at timepoint B.
Bowel preparation may change the fecal microbial composition in IBD patients, which may have a potential role in disease exacerbation after bowel cleansing.
在炎症性肠病（IBD）、克罗恩病（CD）和溃疡性结肠炎（UC）患者中，结肠镜检查后可观察到大量病情加重的病例，这提示结肠微生物群改变在IBD发作中可能具有致病作用。
我们旨在研究服用比沙可啶进行肠道准备对IBD患者粪便微生物群组成的影响。
我们在一项前瞻性队列研究中纳入了因结肠镜检查而进行肠道准备的IBD患者。对照组（Con）由接受结肠镜检查的非IBD患者组成。在结肠镜检查前（时间点A）、3天后（时间点B）和4周后（时间点C）收集临床数据、血液和粪便样本。
在每个时间点评估疾病活动度和肠道微生物群变化。通过对16S rRNA基因的V4区域进行测序来确定粪便微生物群结构（家族水平）。统计分析包括差异丰度分析和曼-惠特尼检验。
共纳入41例患者（9例CD、13例UC和19例Con）。肠道准备后，在时间点B，CD组的α多样性低于UC组（P = 0.01）和Con组（P = 0.02）。在时间点C，UC组的α多样性显著高于CD组和Con组（P = 0.03）。IBD组和Con组之间的β多样性存在差异（P = 0.001）。基于差异丰度分析，与Con组相比，在时间点B，CD患者的梭菌目家族增加，而 家族减少。
肠道准备可能会改变IBD患者的粪便微生物组成，这可能在肠道清洁后疾病加重中具有潜在作用。
