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Variability of core microbiota in newly diagnosed treatment-naïve paediatric inflammatory bowel disease patients
T G J de Meij1, E F J de Groot2, C F W Peeters3
1Department of Paediatric Gastroenterology, VU University Medical Centre, Amsterdam, The Netherlands.
Insights
Children with new inflammatory bowel disease (IBD) show distinct gut microbial profiles compared to healthy children. This difference is primarily due to lower levels of key beneficial bacteria, not the presence of pathogens.
Area of Science:
- Gastroenterology
- Microbiology
- Pediatrics
Background:
- Intestinal microbiota is implicated in the development of inflammatory bowel disease (IBD).
- Understanding IBD's microbial basis in children is crucial for early diagnosis and treatment.
Purpose of the Study:
- To characterize fecal microbiota composition and dynamics in treatment-naïve pediatric IBD patients.
- To compare these profiles with healthy children and assess their relationship to treatment response.
Main Methods:
- Prospective study of 104 newly diagnosed pediatric IBD patients (Crohn's disease and Ulcerative Colitis) and 61 healthy controls.
- Faecal samples collected pre-treatment and at multiple time points post-therapy initiation.
- Microbiota analysis using IS-pro technology.
Main Results:
- IBD patients exhibited significantly lower abundance of Alistipes finegoldii and Alistipes putredinis compared to healthy controls.
- A classifier using these core species accurately distinguished IBD patients (AUC of 0.87).
- Beneficial core bacteria showed a tendency to recover during treatment but did not reach healthy levels.
Conclusions:
- Fecal microbiota profiles in pediatric de novo IBD (Crohn's disease and Ulcerative Colitis) are distinct from healthy controls.
- The key difference lies in the reduced abundance of healthy gut microbial core species.
- Pediatric IBD is characterized by a depletion of beneficial bacteria rather than an increase in pathogens.
Background & Aims:
Intestinal microbiota is considered to play a crucial role in the aetiology of inflammatory bowel disease (IBD). We aimed to describe faecal microbiota composition and dynamics in a large cohort of children with de novo (naïve) IBD, in comparison to healthy paediatric controls (HC).
Methods:
In this prospective study, performed at two tertiary centres, faecal samples from newly diagnosed, treatment-naïve paediatric IBD patients were collected prior to bowel cleansing for colonoscopy (t0) and 1, 3 and 6 weeks and 3 months after initiation of therapy. The microbial profiles of Crohn's disease (CD) and Ulcerative colitis (UC) patients were compared with HC and linked to therapeutic response. Microbiota composition was analysed by IS-pro technology.
Results:
Microbial profiles of 104 new IBD-patients (63 CD, 41 UC, median age 14.0 years) were compared to 61 HC (median 7.8 years). IBD was mainly characterised by decreased abundance of Alistipes finegoldii and Alistipes putredinis, which characterize a healthy state microbial core. The classifier including these core species as predictors achieved an AUC of the ROC curve of .87. Core bacteria tended to regain abundance during treatment, but did not reach healthy levels.
Conclusion:
Faecal microbiota profiles of children with de novo CD and UC can be discriminated from HC with high accuracy, mainly driven by a decreased abundance of species shaping the microbial core in the healthy state. Paediatric IBD can therefore be characterized by decreased abundance of certain bacterial species reflecting the healthy state rather than by the introduction of pathogens.
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