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Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC

(2017) GUT. 66(1). p.79-88
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Abstract
Objective: Pouchitis is the most common complication after colectomy with ileal pouch-anal anastomosis (IPAA) for UC and the risk is the highest within the 1st year after surgery. The pathogenesis is not completely understood but clinical response to antibiotics suggests a role for gut microbiota. We hypothesised that the risk for pouchitis can be predicted based on the faecal microbial composition before colectomy. Design: Faecal samples from 21 patients with UC undergoing IPAA were prospectively collected before colectomy and at predefined clinical visits at 1 month, 3 months, 6 months and 12 months after IPAA. The predominant microbiota was analysed using community profiling with denaturing gradient gel electrophoresis followed by quantitative real-time PCR validation. Results: Cluster analysis before colectomy distinguished patients with pouchitis from those with normal pouch during the 1st year of follow-up. In patients developing pouchitis, an increase of Ruminococcus gnavus (p<0.001), Bacteroides vulgatus (p=0.043), Clostridium perfringens (p=0.011) and a reduction of two Lachnospiraceae genera (Blautia (p=0.04), Roseburia (p=0.008)) was observed. A score combining these five bacterial risk factors was calculated and presence of at least two risk factors showed a sensitivity and specificity of 100% and 63.6%, respectively. Conclusions: Presence of R. gnavus, B. vulgatus and C. perfringens and absence of Blautia and Roseburia in faecal samples of patients with UC before surgery is associated with a higher risk of pouchitis after IPAA. Our findings suggest new predictive and therapeutic strategies in patients undergoing colectomy with IPAA.
Keywords
INFLAMMATORY-BOWEL-DISEASE, ULCERATIVE-COLITIS PATIENTS, BUTYRATE-PRODUCING BACTERIA, PLACEBO-CONTROLLED TRIAL, BACTEROIDES-VULGATUS, HUMAN FECES, RESTORATIVE PROCTOCOLECTOMY, RUMINOCOCCUS-GNAVUS, PROBIOTIC THERAPY, ANAL ANASTOMOSIS

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Chicago
Machiels, Kathleen, João Sabino, Leen Vandermosten, Marie Joossens, Ingrid Arijs, Magali de Bruyn, Venessa Eeckhaut, et al. 2017. “Specific Members of the Predominant Gut Microbiota Predict Pouchitis Following Colectomy and IPAA in UC.” GUT 66 (1): 79–88.
APA
Machiels, Kathleen, Sabino, J., Vandermosten, L., Joossens, M., Arijs, I., de Bruyn, M., Eeckhaut, V., et al. (2017). Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC. GUT, 66(1), 79–88.
Vancouver
1.
Machiels K, Sabino J, Vandermosten L, Joossens M, Arijs I, de Bruyn M, et al. Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC. GUT. 2017;66(1):79–88.
MLA
Machiels, Kathleen, João Sabino, Leen Vandermosten, et al. “Specific Members of the Predominant Gut Microbiota Predict Pouchitis Following Colectomy and IPAA in UC.” GUT 66.1 (2017): 79–88. Print.
@article{8515158,
  abstract     = {Objective: Pouchitis is the most common complication after colectomy with ileal pouch-anal anastomosis (IPAA) for UC and the risk is the highest within the 1st year after surgery. The pathogenesis is not completely understood but clinical response to antibiotics suggests a role for gut microbiota. We hypothesised that the risk for pouchitis can be predicted based on the faecal microbial composition before colectomy. 
Design: Faecal samples from 21 patients with UC undergoing IPAA were prospectively collected before colectomy and at predefined clinical visits at 1 month, 3 months, 6 months and 12 months after IPAA. The predominant microbiota was analysed using community profiling with denaturing gradient gel electrophoresis followed by quantitative real-time PCR validation. 
Results: Cluster analysis before colectomy distinguished patients with pouchitis from those with normal pouch during the 1st year of follow-up. In patients developing pouchitis, an increase of Ruminococcus gnavus (p{\textlangle}0.001), Bacteroides vulgatus (p=0.043), Clostridium perfringens (p=0.011) and a reduction of two Lachnospiraceae genera (Blautia (p=0.04), Roseburia (p=0.008)) was observed. A score combining these five bacterial risk factors was calculated and presence of at least two risk factors showed a sensitivity and specificity of 100\% and 63.6\%, respectively. 
Conclusions: Presence of R. gnavus, B. vulgatus and C. perfringens and absence of Blautia and Roseburia in faecal samples of patients with UC before surgery is associated with a higher risk of pouchitis after IPAA. Our findings suggest new predictive and therapeutic strategies in patients undergoing colectomy with IPAA.},
  author       = {Machiels, Kathleen and Sabino, Jo{\~a}o and Vandermosten, Leen and Joossens, Marie and Arijs, Ingrid and de Bruyn, Magali and Eeckhaut, Venessa and Van Assche, Gert and Ferrante, Marc and Verhaegen, Jan and Van Steen, Kristel and Van Immerseel, Filip and Huys, Geert and Verbeke, Kristin and Wolthuis, Albert and de Buck Van Overstraeten, Anthony and D'Hoore, Andre and Rutgeerts, Paul and Vermeire, S{\'e}verine},
  issn         = {0017-5749},
  journal      = {GUT},
  keyword      = {INFLAMMATORY-BOWEL-DISEASE,ULCERATIVE-COLITIS PATIENTS,BUTYRATE-PRODUCING BACTERIA,PLACEBO-CONTROLLED TRIAL,BACTEROIDES-VULGATUS,HUMAN FECES,RESTORATIVE PROCTOCOLECTOMY,RUMINOCOCCUS-GNAVUS,PROBIOTIC THERAPY,ANAL ANASTOMOSIS},
  language     = {eng},
  number       = {1},
  pages        = {79--88},
  title        = {Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC},
  url          = {http://dx.doi.org/10.1136/gutjnl-2015-309398},
  volume       = {66},
  year         = {2017},
}

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