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Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport
Published on: November 27, 2016
Decreased secondary faecal bile acids in children with ulcerative colitis and Clostridioides difficile infection
Sarah Rotondo-Trivette1, Beibei Wang2,3, Christopher Gayer1,4
1Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Insights
Children with ulcerative colitis (UC) and prior Clostridioides difficile infection (CDI) show lower secondary bile acids and altered gut microbial genes. These findings may help identify UC patients at risk for CDI.
Area of Science:
- Gastroenterology
- Microbiome Research
- Pediatric Inflammatory Bowel Disease
Background:
- Patients with ulcerative colitis (UC) face an elevated risk of Clostridioides difficile infection (CDI).
- A significant association exists between bile acid metabolism and CDI pathogenesis.
Purpose of the Study:
- To investigate fecal bile acid profiles.
- To examine gut microbial alterations in children with UC and a history of CDI.
Main Methods:
- Fecal bile acids and microbial genes involved in bile acid metabolism were analyzed.
- Study included healthy children, children with UC without CDI, children with UC and prior CDI, and children with CDI without UC.
Main Results:
- Children with UC and prior CDI exhibited significantly lower levels of secondary bile acids, including lithocholic acid and ursodeoxycholic acid.
- Reduced expression of microbial genes for bile salt hydrolase and dehydroxylation was observed in children with UC and prior CDI.
- Fecal bile acid profiles accurately predicted disease status (UC with vs. without prior CDI) with 84.6% accuracy.
Conclusions:
- Bile acid profiles can differentiate children with UC based on their history of CDI.
- Alterations in bile acid profiles correlate with changes in specific gut microbial genes.
- Bile acid profiles show potential as biomarkers for identifying UC patients with prior CDI and as therapeutic targets.
Background:
Patients with ulcerative colitis (UC) have an increased risk of Clostridioides difficile infection (CDI). There is a well-documented relationship between bile acids and CDI.
Aims:
To evaluate faecal bile acid profiles and gut microbial changes associated with CDI in children with UC.
Methods:
This study was conducted at Children's Hospital Los Angeles. Faecal bile acids and gut microbial genes related to bile acid metabolism were measured in 29 healthy children, 23 children with mild to moderate UC without prior CDI (UC group), 16 children with mild to moderate UC with prior CDI (UC+CDI group) and 10 children without UC with prior CDI (CDI group).
Results:
Secondary faecal bile acids, especially lithocholic acid (3.296 vs 10.793, P ≤ 0.001) and ursodeoxycholic acid (7.414 vs 10.617, P ≤ 0.0001), were significantly lower in children with UC+CDI when compared to UC alone. Secondary faecal bile acids can predict disease status between these groups with 84.6% accuracy. Additionally, gut microbial genes coding for bile salt hydrolase, 7α-hydroxysteroid dehydrogenase and 7α/β-dehydroxylation were all diminished in children with UC+CDI compared to children with UC alone.
Conclusions:
Bile acids can distinguish between children with UC based on their prior CDI status. Bile acid profile changes can be explained by gut microbial genes encoding for bile salt hydrolase, 7α-hydroxysteroid dehydrogenase and 7α/β-dehydroxylation. Bile acid profiles may be helpful as biomarkers to identify UC children who have had CDI and may serve as future therapeutic targets.
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