High Abundance of Proteobacteria in Ileo-Anal Pouch Anastomosis and Increased Abundance of Fusobacteria Associated with Increased Pouch Inflammation

Abstract

Low diversity intestinal dysbiosis has been associated with inflammatory bowel disease, including patients with ulcerative colitis with an ileo-anal pouch anastomosis. Furthermore, specific Escherichia coli phylogroups have been linked to inflammatory bowel disease. Our aim was to characterize the differences among microbiota and E. coli phylogroups in active and inactive pouchitis. Disease activity was assessed using the modified pouch disease activity index and by fecal calprotectin. Microbiota diversity was assessed by 16S rDNA MiSeq sequencing. E. coli phylogroup was determined after triplex PCR. Twenty patients with ulcerative colitis with an ileo-anal pouch anastomosis were included, 10 of whom had active pouchitis. Ileo-anal pouch anastomosis patients had an increased abundance of Proteobacteria colonization compared to patients with ulcerative colitis or Crohn’s disease and healthy controls, p = 1.4·10−5. No differences in E. coli phylogroup colonization could be determined between cases of active and inactive disease. No significant link was found between α-diversity and pouch inflammation. However, higher levels of Fusobacteria colonization were found in patients with a pouch with a fecal calprotectin level above 500, p = 0.02. In conclusion, patients with a pouch had an increased Proteobacteria abundance, but only Fusobacteria abundance was linked to inflammation.

The Microbiota Profile in Inflamed and Non-Inflamed Ileal Pouch–Anal Anastomosis

“…The abundance of the phylum Proteobacteria was increased in both patients with a normal functioning pouch and healthy individuals compared to chronic pouchitis patients. Two out of the three chronic pouchitis patients receiving continued long-term treatment with ciprofloxacin and metronidazole had no detection of members of the Bacteroides genera among the most abundant genera, which possibly could be explained by the previous use of antibiotics, as also suggested by Petersen et al [ 31 ].…”

“…A recent study by Petersen et al [ 31 ] found that ileo-anal pouch anastomosis patients had an increased abundance of the phylum Proteobacteria compared to patients with UC or Crohn’s disease and healthy individuals. Furthermore, a higher abundance of the phylum Fusobacteria was found in pouch patients with a faecal calprotectin level above 500 µg/mg as a measure for an inflamed pouch [ 31 ].…”

“…A recent study by Petersen et al [ 31 ] found that ileo-anal pouch anastomosis patients had an increased abundance of the phylum Proteobacteria compared to patients with UC or Crohn’s disease and healthy individuals. Furthermore, a higher abundance of the phylum Fusobacteria was found in pouch patients with a faecal calprotectin level above 500 µg/mg as a measure for an inflamed pouch [ 31 ]. In our study, the difference of the microbiota of chronic pouchitis patients compared to healthy individuals and patients with a non-inflamed pouch could mainly be explained by several taxa from the genus Bacteroides , which were most abundant in healthy individuals and patients with a normal pouch function, while taxa from the family Enterobacteriaceae including genus Escherichia primarily were most abundant in patients with chronic pouchitis.…”

“…Faecal samples from patients with UC or Crohn’s diseases were not included in our study, as it was outside the scope of our aim. However, it would have been relevant to include UC patients with an intact colon, to compare inflamed pouch microbiota with inflamed colon microbiota, as described by Petersen et al [ 31 ]. All patients with chronic pouchitis had received one or several antibiotic treatments before inclusion in the study, as antibiotics are the primary treatment of pouchitis.…”

Special Issue: Pathogenic Escherichia coli: Infections and Therapies

“…This Special Issue “Pathogenic Escherichia coli : Infections and Therapies” consists of 12 articles, including original research on intestinal pathologies and extraintestinal infections of human and animal origins caused by E. coli [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ] and a review on FimH antiadhesive molecules that can be used to treat urinary tract infections caused by uropathogenic E. coli (UPEC) [ 8 ]. Apart from this review, other original articles propose novel approaches to treat and/or prevent E. coli infections.…”