Abstract
BACKGROUND & AIMS Intestinal microbiota is considered to play a crucial role in the aetiology of inflammatory bowel disease (IBD). We aimed to describe faecal microbiota composition and dynamics in a large cohort of children with de novo (naïve) IBD, in comparison to healthy paediatric controls (HC).
METHODS In this prospective study, performed at two tertiary centres, faecal samples from newly diagnosed, treatment-naïve paediatric IBD patients were collected prior to bowel cleansing for colonoscopy (t0) and 1, 3 and 6 weeks and 3 months after initiation of therapy. The microbial profiles of Crohn’s disease (CD) and Ulcerative colitis (UC) patients were compared with HC and linked to therapeutic response. Microbiota composition was analysed by IS-pro technology.
RESULTS Microbial profiles of 104 new IBD-patients (63 CD, 41 UC, median age 14.0 years) were compared to 61 HC (median 7.8 years). IBD was mainly characterised by decreased abundance of Alistipes finegoldi and Alistipes putredinis, which characterize a healthy state microbial core. The classifier including these core species as predictors achieved an AUC of the ROC curve of .87. Core bacteria tended to regain abundance during treatment, but did not reach healthy levels.
CONCLUSION Faecal microbiota profiles of children with de novo CD and UC can be discriminated from HC with high accuracy, mainly driven by a decreased abundance of species shaping the microbial core in the healthy state. Paediatric IBD can therefore be characterized by decreased abundance of certain bacterial species reflecting the healthy state rather than by the introduction of pathogens.
Footnotes
Conflict of interest
P.H.M Savelkoul and A.E. Budding have proprietary rights on the IS-pro platform technology and are co-founders of a spin-off company developing this technique into a clinical diagnostic product.
The other authors have no conflict of interest
No specific funding has been received for this study
What is current knowledge
Intestinal microbiota play a role in inflammatory bowel disease etiology
microbiota may be used as diagnostic tool in paediatric IBD
What is new here
IBD is characterized by decreased abundance of core species reflecting healthy state
Increase of core microbes upon achieving clinical remission suggest a causal relationship