在患有炎症性肠病的患者中解读微生物组成:对对生物代理物的治疗反应的影响
Orazio Palmieri1, Fabrizio Bossa1, Stefano Castellana2
1Division of Gastroenterology and Endoscopy, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
肠道微生物组的改变会影响炎症性肠道疾病 (IBD). 肠道炎症患者的失生症与对生物疗法的反应不佳相关,这表明微生物特征可以预测治疗结果.
科学领域:
- 微生物组研究 微生物组研究
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 肠道微生物组的变化越来越多地与炎症性肠道疾病 (IBD) 的发展有关,包括克罗恩病 (CD) 和性结肠炎 (UC).
- 目前的IBD治疗方法,如免疫抑制剂和生物药物,旨在临床缓解和粘膜愈合,但一小部分患者表现出有限的益处,需要更好的预后生物标志物.
- 了解肠道微生物组在治疗反应中的作用对于IBD管理中的个性化治疗策略至关重要.
研究的目的:
- 为了研究接受生物治疗的IBD患者的肠道微生物组合.
- 识别与治疗反应和对生物药物的不反应相关的特定微生物特征.
- 探索基线肠道失调与CD和UC患者生物疗法的疗效之间的关系.
主要方法:
- 来自39名IBD患者的66个便样本 (20个CD,19个UC) 开始生物疗法和29个健康对照 (HCs) 的前性分析.
- 用下一代测序 (NGS) 和元基因组分析工具来描述微生物群落.
- 微生物多样性 (α和β指标) 和患者组和对照组之间的微生物多样性和差异性丰度分析的比较,以及响应者与非响应者.
主要成果:
- 在CD,UC和HC群体中观察到肠道微生物组合 (α和β多样性) 的显著差异,CD患者的失生症更明显.
- 具有基线抗生素失调的IBD患者对生物药物的反应有限. 响应者中有大量的特定属,如 * Odoribacter * 和 * Ruminococcus * ,而 * Collinsella * 在不响应者中普遍存在.
- 短链脂肪酸 (SCFA) 生产细菌的枯竭和大量的病原生物在IBD患者中被发现,特别是非响应者. 生产SCFA的细菌被丰富了对生物药物和Vedolizumab的反应者.
结论:
- 肠道微生物组失调,特别是减少的SCFA产生细菌和增加的病原生物,与IBD患者对生物疗法的反应不佳有关.
- 基线时的特定微生物特征可能作为克罗恩病和性结肠炎治疗反应的预测生物标志物.
- 针对肠道微生物群,可能通过恢复SCFA产生细菌,可能代表IBD患者对当前生物药物不反应的未来治疗途径.
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