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Published on: December 8, 2014
The rectal mucosa-associated microflora in patients with ulcerative colitis
M G Hartley1, M J Hudson, E T Swarbrick
1Pathology Division, PHLS Centre for Applied Microbiology and Research, Porton Down, Salisbury.
The rectal mucosa-associated flora (MAF) in ulcerative colitis patients showed reduced bacterial counts and diversity during active disease. Treatment led to recovery of MAF, suggesting a role in disease activity.
Area of Science:
- Microbiology
- Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- The gut microbiome, particularly rectal mucosa-associated flora (MAF), is implicated in UC pathogenesis.
- Understanding MAF composition changes during UC is crucial.
Purpose of the Study:
- To investigate the composition and density of MAF in patients with ulcerative colitis.
- To compare MAF in newly diagnosed, relapsed, and remission states of UC.
- To assess MAF changes during treatment for active UC.
Main Methods:
- Studied MAF in 25 newly diagnosed UC patients, 20 with relapse, and 44 in remission.
- Collected rectal mucosal samples for microbiological analysis.
- Quantified bacterial counts and assessed flora diversity in different disease states and during treatment.
Main Results:
- MAF was simpler and less dense than fecal microflora.
- Obligate anaerobes predominated in MAF, but with a lower ratio to facultative species than in feces.
- Reduced bacterial counts and carriage rates of total flora, anaerobes, facultative, and micro-aerobic organisms were observed in active UC compared to inactive disease.
- Counts and carriage rates increased during treatment, approaching levels seen in quiescent disease.
- Alterations were most pronounced in first-time UC attacks.
Conclusions:
- Active ulcerative colitis is associated with significant alterations in rectal mucosa-associated flora.
- Treatment of active UC leads to a partial restoration of MAF.
- The precise role of these MAF alterations in UC etiology and pathogenesis requires further investigation.
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