Hu Yibing, Wu Zhenping, Yang Xiaoyun, Ding Jin, Wang Qunying, Fang Hao, Zhu Lujian, Hu Minli
Department of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No.365 Renming East Road, Jinhua, Zhejiang, P. R. China.
Department of Traumatology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, P. R. China.
BMC Microbiol. 2024 Dec 27;24(1):543. doi: 10.1186/s12866-024-03705-7.
The gut microbiota plays a pivotal role in ulcerative colitis (UC) development. This study explores the impact of latent tuberculosis infection (LTBI) on the gut microbiota in UC and assesses changes during vedolizumab treatment, investigating prophylactic anti-tuberculosis therapy.
This cohort study included adult patients with UC receiving vedolizumab treatment at Jinhua Hospital, Zhejiang University from April 2021 to December 2022. Patients were divided into LTBI (n = 24) and non-LTBI (n = 21) groups. Patients in the LTBI group were further subdivided into prophylactic (n = 13) and non-prophylactic (n = 11) groups. Clinical and fecal samples were collected pre- and post-vedolizumab treatment for the LTBI groups and pre-treatment for the non-LTBI group. The gut microbiota was analyzed using 16 S rRNA sequencing. Patients in the non-LTBI group exhibited higher diversity indices. Vedolizumab demonstrated efficacy in the LTBI group, with clinical response and remission rates of 83.3% and 75.0%, respectively. The gut microbiota diversity in the LTBI group increased post-vedolizumab treatment, and receiving prophylactic isoniazid showed no significant difference in vedolizumab treatment response compared to not receiving prophylactic isoniazid. Microbiota changes were similar between groups, with an increase in [Ruminococcus] expression after vedolizumab treatment.
This cohort study, conducted at a single center, highlights that LTBI can reduce gut microbiota diversity among adult patient with UC. The observed efficacy of vedolizumab treatment in the LTBI group indicates a potential association with microbiota changes. However, mono-isoniazid exhibited limited impact, underscoring the potential of vedolizumab as a promising candidate for prophylactic anti-tuberculosis treatment in the context of UC.
肠道微生物群在溃疡性结肠炎（UC）的发展中起关键作用。本研究探讨潜伏性结核感染（LTBI）对UC患者肠道微生物群的影响，并评估维多珠单抗治疗期间的变化，同时研究预防性抗结核治疗。
本队列研究纳入了2021年4月至2022年12月在浙江大学金华医院接受维多珠单抗治疗的成年UC患者。患者分为LTBI组（n = 24）和非LTBI组（n = 21）。LTBI组患者进一步细分为预防性治疗组（n = 13）和非预防性治疗组（n = 11）。在LTBI组维多珠单抗治疗前后以及非LTBI组治疗前收集临床和粪便样本。使用16S rRNA测序分析肠道微生物群。非LTBI组患者表现出更高的多样性指数。维多珠单抗在LTBI组显示出疗效，临床缓解率和缓解率分别为83.3%和75.0%。LTBI组维多珠单抗治疗后肠道微生物群多样性增加，与未接受预防性异烟肼治疗相比，接受预防性异烟肼治疗的患者在维多珠单抗治疗反应上无显著差异。各组之间微生物群变化相似，维多珠单抗治疗后[瘤胃球菌]表达增加。
这项在单一中心进行的队列研究强调，LTBI可降低成年UC患者的肠道微生物群多样性。在LTBI组中观察到的维多珠单抗治疗效果表明其与微生物群变化存在潜在关联。然而，单一异烟肼的影响有限，这凸显了维多珠单抗在UC背景下作为预防性抗结核治疗的有前景候选药物的潜力。
