Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC

Kathleen Machiels; João Sabino; Leen Vandermosten; Marie Joossens; Ingrid Arijs; Magali de Bruyn; Venessa Eeckhaut; Gert Van Assche; Marc Ferrante; Jan Verhaegen; Kristel Van Steen; Filip Van Immerseel; Geert Huys; Kristin Verbeke; Albert Wolthuis; Anthony de Buck Van Overstraeten; Andre D'Hoore; Paul Rutgeerts; Séverine Vermeire

doi:10.1136/gutjnl-2015-309398

Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC

Kathleen Machiels, João Sabino, Leen Vandermosten, Marie Joossens, Ingrid Arijs, Magali de Bruyn, Venessa Eeckhaut, Gert Van Assche, Marc Ferrante, Jan Verhaegen, Kristel Van Steen, Filip Van Immerseel, Geert Huys, Kristin Verbeke, Albert Wolthuis, Anthony de Buck Van Overstraeten, Andre D'Hoore, Paul Rutgeerts, Séverine Vermeire

Research output: Contribution to journal › Article › peer-review

107 Citations (Scopus)

Abstract

OBJECTIVE: Pouchitis is the most common complication after colectomy with ileal pouch-anal anastomosis (IPAA) for UC and the risk is the highest within the 1st year after surgery. The pathogenesis is not completely understood but clinical response to antibiotics suggests a role for gut microbiota. We hypothesised that the risk for pouchitis can be predicted based on the faecal microbial composition before colectomy.

DESIGN: Faecal samples from 21 patients with UC undergoing IPAA were prospectively collected before colectomy and at predefined clinical visits at 1 month, 3 months, 6 months and 12 months after IPAA. The predominant microbiota was analysed using community profiling with denaturing gradient gel electrophoresis followed by quantitative real-time PCR validation.

RESULTS: Cluster analysis before colectomy distinguished patients with pouchitis from those with normal pouch during the 1st year of follow-up. In patients developing pouchitis, an increase of Ruminococcus gnavus (p<0.001), Bacteroides vulgatus (p=0.043), Clostridium perfringens (p=0.011) and a reduction of two Lachnospiraceae genera (Blautia (p=0.04), Roseburia (p=0.008)) was observed. A score combining these five bacterial risk factors was calculated and presence of at least two risk factors showed a sensitivity and specificity of 100% and 63.6%, respectively.

CONCLUSIONS: Presence of R. gnavus, B. vulgatus and C. perfringens and absence of Blautia and Roseburia in faecal samples of patients with UC before surgery is associated with a higher risk of pouchitis after IPAA. Our findings suggest new predictive and therapeutic strategies in patients undergoing colectomy with IPAA.

Original language	English
Journal	Gut
DOIs	https://doi.org/10.1136/gutjnl-2015-309398
Publication status	Published - 30 Sep 2015

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Machiels, K., Sabino, J., Vandermosten, L., Joossens, M., Arijs, I., de Bruyn, M., Eeckhaut, V., Van Assche, G., Ferrante, M., Verhaegen, J., Van Steen, K., Van Immerseel, F., Huys, G., Verbeke, K., Wolthuis, A., de Buck Van Overstraeten, A., D'Hoore, A., Rutgeerts, P., & Vermeire, S. (2015). Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC. Gut. https://doi.org/10.1136/gutjnl-2015-309398

Machiels, Kathleen ; Sabino, João ; Vandermosten, Leen ; Joossens, Marie ; Arijs, Ingrid ; de Bruyn, Magali ; Eeckhaut, Venessa ; Van Assche, Gert ; Ferrante, Marc ; Verhaegen, Jan ; Van Steen, Kristel ; Van Immerseel, Filip ; Huys, Geert ; Verbeke, Kristin ; Wolthuis, Albert ; de Buck Van Overstraeten, Anthony ; D'Hoore, Andre ; Rutgeerts, Paul ; Vermeire, Séverine. / Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC. In: Gut. 2015.

@article{6aba7664a02b43e4ab781bc3f72e1a02,

title = "Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC",

abstract = "OBJECTIVE: Pouchitis is the most common complication after colectomy with ileal pouch-anal anastomosis (IPAA) for UC and the risk is the highest within the 1st year after surgery. The pathogenesis is not completely understood but clinical response to antibiotics suggests a role for gut microbiota. We hypothesised that the risk for pouchitis can be predicted based on the faecal microbial composition before colectomy.DESIGN: Faecal samples from 21 patients with UC undergoing IPAA were prospectively collected before colectomy and at predefined clinical visits at 1 month, 3 months, 6 months and 12 months after IPAA. The predominant microbiota was analysed using community profiling with denaturing gradient gel electrophoresis followed by quantitative real-time PCR validation.RESULTS: Cluster analysis before colectomy distinguished patients with pouchitis from those with normal pouch during the 1st year of follow-up. In patients developing pouchitis, an increase of Ruminococcus gnavus (p<0.001), Bacteroides vulgatus (p=0.043), Clostridium perfringens (p=0.011) and a reduction of two Lachnospiraceae genera (Blautia (p=0.04), Roseburia (p=0.008)) was observed. A score combining these five bacterial risk factors was calculated and presence of at least two risk factors showed a sensitivity and specificity of 100% and 63.6%, respectively.CONCLUSIONS: Presence of R. gnavus, B. vulgatus and C. perfringens and absence of Blautia and Roseburia in faecal samples of patients with UC before surgery is associated with a higher risk of pouchitis after IPAA. Our findings suggest new predictive and therapeutic strategies in patients undergoing colectomy with IPAA.",

author = "Kathleen Machiels and Jo{\~a}o Sabino and Leen Vandermosten and Marie Joossens and Ingrid Arijs and {de Bruyn}, Magali and Venessa Eeckhaut and {Van Assche}, Gert and Marc Ferrante and Jan Verhaegen and {Van Steen}, Kristel and {Van Immerseel}, Filip and Geert Huys and Kristin Verbeke and Albert Wolthuis and {de Buck Van Overstraeten}, Anthony and Andre D'Hoore and Paul Rutgeerts and S{\'e}verine Vermeire",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.",

year = "2015",

month = sep,

day = "30",

doi = "10.1136/gutjnl-2015-309398",

language = "English",

journal = "Gut",

issn = "0017-5749",

publisher = "BMJ Publishing Group",

}

Machiels, K, Sabino, J, Vandermosten, L, Joossens, M, Arijs, I, de Bruyn, M, Eeckhaut, V, Van Assche, G, Ferrante, M, Verhaegen, J, Van Steen, K, Van Immerseel, F, Huys, G, Verbeke, K, Wolthuis, A, de Buck Van Overstraeten, A, D'Hoore, A, Rutgeerts, P & Vermeire, S 2015, 'Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC', Gut. https://doi.org/10.1136/gutjnl-2015-309398

Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC. / Machiels, Kathleen; Sabino, João; Vandermosten, Leen; Joossens, Marie; Arijs, Ingrid; de Bruyn, Magali; Eeckhaut, Venessa; Van Assche, Gert; Ferrante, Marc; Verhaegen, Jan; Van Steen, Kristel; Van Immerseel, Filip; Huys, Geert; Verbeke, Kristin; Wolthuis, Albert; de Buck Van Overstraeten, Anthony; D'Hoore, Andre; Rutgeerts, Paul; Vermeire, Séverine.

In: Gut, 30.09.2015.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC

AU - Machiels, Kathleen

AU - Sabino, João

AU - Vandermosten, Leen

AU - Joossens, Marie

AU - Arijs, Ingrid

AU - de Bruyn, Magali

AU - Eeckhaut, Venessa

AU - Van Assche, Gert

AU - Ferrante, Marc

AU - Verhaegen, Jan

AU - Van Steen, Kristel

AU - Van Immerseel, Filip

AU - Huys, Geert

AU - Verbeke, Kristin

AU - Wolthuis, Albert

AU - de Buck Van Overstraeten, Anthony

AU - D'Hoore, Andre

AU - Rutgeerts, Paul

AU - Vermeire, Séverine

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2015/9/30

Y1 - 2015/9/30

N2 - OBJECTIVE: Pouchitis is the most common complication after colectomy with ileal pouch-anal anastomosis (IPAA) for UC and the risk is the highest within the 1st year after surgery. The pathogenesis is not completely understood but clinical response to antibiotics suggests a role for gut microbiota. We hypothesised that the risk for pouchitis can be predicted based on the faecal microbial composition before colectomy.DESIGN: Faecal samples from 21 patients with UC undergoing IPAA were prospectively collected before colectomy and at predefined clinical visits at 1 month, 3 months, 6 months and 12 months after IPAA. The predominant microbiota was analysed using community profiling with denaturing gradient gel electrophoresis followed by quantitative real-time PCR validation.RESULTS: Cluster analysis before colectomy distinguished patients with pouchitis from those with normal pouch during the 1st year of follow-up. In patients developing pouchitis, an increase of Ruminococcus gnavus (p<0.001), Bacteroides vulgatus (p=0.043), Clostridium perfringens (p=0.011) and a reduction of two Lachnospiraceae genera (Blautia (p=0.04), Roseburia (p=0.008)) was observed. A score combining these five bacterial risk factors was calculated and presence of at least two risk factors showed a sensitivity and specificity of 100% and 63.6%, respectively.CONCLUSIONS: Presence of R. gnavus, B. vulgatus and C. perfringens and absence of Blautia and Roseburia in faecal samples of patients with UC before surgery is associated with a higher risk of pouchitis after IPAA. Our findings suggest new predictive and therapeutic strategies in patients undergoing colectomy with IPAA.

AB - OBJECTIVE: Pouchitis is the most common complication after colectomy with ileal pouch-anal anastomosis (IPAA) for UC and the risk is the highest within the 1st year after surgery. The pathogenesis is not completely understood but clinical response to antibiotics suggests a role for gut microbiota. We hypothesised that the risk for pouchitis can be predicted based on the faecal microbial composition before colectomy.DESIGN: Faecal samples from 21 patients with UC undergoing IPAA were prospectively collected before colectomy and at predefined clinical visits at 1 month, 3 months, 6 months and 12 months after IPAA. The predominant microbiota was analysed using community profiling with denaturing gradient gel electrophoresis followed by quantitative real-time PCR validation.RESULTS: Cluster analysis before colectomy distinguished patients with pouchitis from those with normal pouch during the 1st year of follow-up. In patients developing pouchitis, an increase of Ruminococcus gnavus (p<0.001), Bacteroides vulgatus (p=0.043), Clostridium perfringens (p=0.011) and a reduction of two Lachnospiraceae genera (Blautia (p=0.04), Roseburia (p=0.008)) was observed. A score combining these five bacterial risk factors was calculated and presence of at least two risk factors showed a sensitivity and specificity of 100% and 63.6%, respectively.CONCLUSIONS: Presence of R. gnavus, B. vulgatus and C. perfringens and absence of Blautia and Roseburia in faecal samples of patients with UC before surgery is associated with a higher risk of pouchitis after IPAA. Our findings suggest new predictive and therapeutic strategies in patients undergoing colectomy with IPAA.

U2 - 10.1136/gutjnl-2015-309398

DO - 10.1136/gutjnl-2015-309398

M3 - Article

C2 - 26423113

JO - Gut

JF - Gut

SN - 0017-5749

ER -

Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC

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