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Mucosal flora in inflammatory bowel disease.

Alexander Swidsinski¹, Axel Ladhoff, Annelie Pernthaler

¹Innere Klinik, Gastroenterologie, Charité Humboldt Universität, Berlin, Germany. alexander.swindinski@charite.de

Gastroenterology

|January 10, 2002

Summary

Changes in gut bacteria near the intestinal lining are linked to inflammatory bowel disease (IBD). A healthy gut lining prevents excessive bacteria, a function impaired in IBD patients.

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Area of Science:

Gastroenterology
Microbiology
Immunology

Background:

Microorganisms directly interacting with the intestinal mucosa are difficult to study due to overlying fecal flora.
Characterizing the mucosal microbiome is crucial for understanding gut health and disease.

Purpose of the Study:

To investigate the composition and concentration of bacteria at the mucosal surface in patients with inflammatory bowel disease (IBD) compared to controls.
To determine if observed mucosal microbial changes are a cause or consequence of intestinal inflammation.

Main Methods:

Analysis of washed colonoscopic biopsies from 305 patients with bowel inflammation and 40 controls.
Microbial cultures validated using quantitative polymerase chain reaction (qPCR), cloning, sequencing, fluorescence in-situ hybridization (FISH), and electron microscopy.

Main Results:

Significantly higher concentrations of mucosal bacteria were found in patients with bowel inflammation compared to controls.
Mucosal bacterial concentrations correlated with disease severity in both inflamed and non-inflamed colon segments.
In patients with severe inflammation (IBD), bacteria were observed within enterocytes, detached from the fecal stream, suggesting a host-specific interaction.

Conclusions:

Alterations in mucosal flora in IBD are likely a primary host response, not merely secondary to inflammation.
A healthy intestinal mucosa actively restricts bacterial adherence, a function demonstrably impaired in IBD.
These findings suggest a potential role for mucosal barrier dysfunction in the pathogenesis of IBD.