Davidson Sanna, So Yunjeong, Oscarsson Elin, Håkansson Åsa, Sjöberg Klas
Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
Department of Gastroenterology and Nutrition, Skåne University Hospital, Malmö, 214 28, Sweden.
Sci Rep. 2025 Jun 25;15(1):20283. doi: 10.1038/s41598-025-07535-z.
In inflammatory bowel disease (IBD) the pathogenetic process is characterized by dysbiosis, increased permeability, translocation, and immune activation. The aim of the present study was to assess the presence of viable bacteria in the blood of patients with IBD and to correlate the findings with clinical characteristics. The study included 28 patients with Crohn's disease (CD) (median age 38 years, 50% female, biological treatment in 71%) and 19 patients with ulcerative colitis (UC) (median age 45 years, 33% female, biological treatment in 84%). Identification of viable bacteria in the blood was evaluated by optimized cultivation and Sanger sequencing and for quantification real-time PCR was performed. Viable Gram-positive bacteria were detected in 34 IBD patients (72.3%). There were no associations between the presence of bacteria and gender, antibiotic treatment, intake of alcohol, use of PPI, steroids, or biological treatment. The number of bacterial copies was correlated with higher C-reactive protein (CRP) (p = 0.013). In ¾ of the patients, viable bacteria were identified in the blood despite treatment with biologicals, which indicates a vast barrier defect. This observation also indicates that the disease is still active. To obtain a true deep mucosal healing an intact barrier function is required.
在炎症性肠病（IBD）中，发病机制的特征是生态失调、通透性增加、细菌易位和免疫激活。本研究的目的是评估IBD患者血液中活细菌的存在情况，并将研究结果与临床特征相关联。该研究纳入了28例克罗恩病（CD）患者（中位年龄38岁，50%为女性，71%接受生物治疗）和19例溃疡性结肠炎（UC）患者（中位年龄45岁，33%为女性，84%接受生物治疗）。通过优化培养和桑格测序评估血液中活细菌的鉴定，并进行定量实时PCR。在34例IBD患者（72.3%）中检测到活的革兰氏阳性菌。细菌的存在与性别、抗生素治疗、饮酒、使用质子泵抑制剂（PPI）、类固醇或生物治疗之间无关联。细菌拷贝数与较高的C反应蛋白（CRP）相关（p = 0.013）。在四分之三的患者中，尽管接受了生物治疗，但血液中仍鉴定出活细菌，这表明存在巨大的屏障缺陷。这一观察结果也表明疾病仍处于活动期。要实现真正的深度黏膜愈合，需要完整的屏障功能。
