Looking into Enteric Virome in Patients with IBD

Lopes, Susana; Andrade, Patrícia; Conde, Silvia; Liberal, Rodrigo; Dias, Cláudia Camila; Fernandes, Salomão; Pinheiro, Jorge; Simões, Joana; Carneiro, Fátima; Magro, Fernando; Macedo, Guilherme

doi:10.1097/mib.0000000000001167

Cited by 38 publications

(20 citation statements)

References 26 publications

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“…Herpesviruses have been reported in human feces and proposed to have a role in the pathogenesis of UC. [29][30][31] We detected a higher number of herpesvirus-positive samples in UC baseline subjects (n = 5) than follow-up UC subjects (n = 1) or IBS control subjects (n = 2). Between group differences were not statistically significant.…”

Section: Virome Classificationmentioning

confidence: 82%

Characterization of Stool Virome in Children Newly Diagnosed With Moderate to Severe Ulcerative Colitis

Tokarz

Hyams

Mack

et al. 2019

Inflammatory Bowel Diseases

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Background: Viral infections have been suggested as possible triggers for the onset of ulcerative colitis (UC). Methods: We employed VirCapSeq-Vert, a high-throughput sequencing virus capture platform, to examine the stool virome of children with newly diagnosed moderate to severe UC. We surveyed fecal samples collected at presentation, after symptom remission, and from a control group diagnosed with irritable bowel syndrome.Results: Seventy subjects with UC (mean age 13 years, 45 had moderate symptoms, 25 had severe, 69 of 70 had a Mayo endoscopy subscore 2/3) were studied. We detected a wide range of animal viruses that were taxonomically classified into 12 viral families. A virus was present in 50% of fecal samples collected at presentation, 41% of samples collected after remission, and 40% of samples in our control group. The most frequently identified viruses were diet-based gyroviruses. The UC cohort had a significantly higher prevalence of anelloviruses compared with the control cohort. However, we did not identify a single virus that can be implicated in the onset of UC and did not find an association between UC disease severity and viral presence.Conclusion: Presence of virus in stool was not associated with the onset of pediatric UC.

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Section: Virome Classificationmentioning

confidence: 82%

Characterization of Stool Virome in Children Newly Diagnosed With Moderate to Severe Ulcerative Colitis

Tokarz

Hyams

Mack

et al. 2019

Inflammatory Bowel Diseases

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“…5 Besides bacteriophages, the gut virome hosts also DNA-and RNA-based eukaryotic-targeting viruses able to directly transfer their genetic information to host cells, and demonstrated to be associated with the pathogenesis of both UC and CD. 6 Furthermore, eukaryotic viruses have been shown to contribute to intestinal dysbiosis in mice carrying mutations in the IBD-associated Il10 or Atg16L1 genes 7,8 , suggesting that the gut virome might cooperate with genetic factors, ultimately leading to chronic intestinal inflammation.…”

Section: Introductionmentioning

confidence: 99%

Metagenomic analysis of intestinal mucosa revealed a specific eukaryotic gut virome signature in early-diagnosed inflammatory bowel disease

et al. 2018

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“…Several studies have reported on the presence of EBV in the intestinal mucosa of IBD patients with active inflammation and observed prevalences are as high as 64% using PCR assays of the EBV genome in inflamed colonic mucosa. [1,4] However, it remains unclear whether the virus is involved in the pathogenesis or is an innocent bystander. The first case of this series is in line with previous observations that presence of EBV in inflamed colonic mucosa and increased proliferation are associated with severe mucosal inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…Epstein-Barr virus (EBV) has been proposed as a trigger in the complex multifactorial etiopathogenesis of inflammatory bowel disease (IBD) [1], as well as an aggravating agent during flares and for perpetuation of the inflammatory process. [2] In addition, EBV-associated lymphoproliferative disease in IBD is a feared complication, mostly attributed to immunosuppressive agents.…”

Section: Introductionmentioning

confidence: 99%

Clinical and endoscopic complications of Epstein-Barr virus in inflammatory bowel disease: an illustrative case series

Goetgebuer

Woude

Ridder

et al. 2019

Int J Colorectal Dis

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Background and aim Epstein-Barr virus (EBV) is a proposed trigger in the etiopathogenesis of inflammatory bowel disease (IBD) and is associated with lymphoproliferative diseases. Nevertheless, testing for EBV DNA in the intestinal mucosa and screening for EBV infection before initiation of a drug therapy are not routinely performed. The aim of this article is to increase awareness of the relevance of EBV infection in specific clinical situations. Methods In this short communication, we describe the disease course of three IBD patients with EBV infection, varying from EBV reactivation during disease flare up to a trigger of EBV-related mucocutaneous ulcer (EBV-MCU) and haemophagocytic lymphohistiocytosis (HLH). Results Our first patient was diagnosed with EBV reactivation-associated severe colitis and showed a rapid clinical improvement after induction therapy with infliximab and azathioprine. Without antiviral treatment, the patient remained in complete remission and no complications of EBV were seen. After diagnosing EBV-MCU in the second patient, immunosuppressive medication was discontinued and four infusions of rituximab resulted in a rapid clinical recovery and eventually complete response. After discontinuation of the immunosuppression in our last patient with haemophagocytic lymphohistiocytosis, treatment with a combination of corticosteroid and antiviral therapy resulted in a complete recovery over a time span of several weeks. Conclusion EBV infection has a wide variety of potentially life-threatening clinical manifestations in IBD patients. Testing for EBV in case of a flare up and screening for EBV before the start of immunosuppressive therapy will create awareness for EBVrelated symptoms or complications during follow-up.

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Looking into Enteric Virome in Patients with IBD

Cited by 38 publications

References 26 publications

Characterization of Stool Virome in Children Newly Diagnosed With Moderate to Severe Ulcerative Colitis

Characterization of Stool Virome in Children Newly Diagnosed With Moderate to Severe Ulcerative Colitis

Metagenomic analysis of intestinal mucosa revealed a specific eukaryotic gut virome signature in early-diagnosed inflammatory bowel disease

Clinical and endoscopic complications of Epstein-Barr virus in inflammatory bowel disease: an illustrative case series

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