Baseline Fecal Microbiota in Pediatric Patients With Celiac Disease Is Similar to Controls But Dissimilar After 1 Year on the Gluten-Free Diet

Dory Sample; Janelle Fouhse; Seema King; Hien Q Huynh; Levinus A Dieleman; Benjamin P Willing; Justine Turner

doi:10.1097/PG9.0000000000000127

Baseline Fecal Microbiota in Pediatric Patients With Celiac Disease Is Similar to Controls But Dissimilar After 1 Year on the Gluten-Free Diet

JPGN Rep. 2021 Oct 13;2(4):e127. doi: 10.1097/PG9.0000000000000127. eCollection 2021 Nov.

Authors

Dory Sample¹, Janelle Fouhse², Seema King³, Hien Q Huynh¹, Levinus A Dieleman⁴, Benjamin P Willing², Justine Turner¹

Affiliations

¹ From the Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
² Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada.
³ Department of Medicine, Community Health Sciences, University of Calgary, Calgary, AB, Canada.
⁴ Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.

Abstract

The objectives of this pilot study were to examine fecal microbiota composition of pediatric patients with celiac disease (CD) before and after a 1-year gluten-free diet (GFD) and to determine the association with symptoms and anti-tissue transglutaminase (aTTG) antibody.

Methods: Stool samples were obtained from pediatric patients with CD and from healthy controls. Patients were classified by the presence (diarrhea, abdominal pain, weight loss) or absence (asymptomatic, headache, fatigue, etc.) of typical CD gastrointestinal symptoms and by aTTG normalization post-GFD intervention (< 7 U/mL). Fecal microbial composition was measured using 16S ribosomal RNA gene amplicon sequencing of the V3-V4 region.

Results: At diagnosis, 13 of 22 patients with CD had typical gastrointestinal symptoms, the remaining patients having atypical or asymptomatic presentations. After a 1-year GFD, all symptomatic patients improved and 9 of 19 had normalized aTTG. Prior to GFD, no distinct microbial signature was observed between patients and controls (P = 0.39). Post-GFD, patients with CD had a unique microbial signature with reductions in known fiber-degrading bacteria, including Blautia, Dorea, Lactobacillus, and Prevotella compared with controls. Within the patients with CD, microbial composition was not associated with reported symptom presentation or aTTG normalization.

Conclusions: Pediatric patients with CD only had a unique microbial signature compared with healthy controls when placed on the GFD. These results suggest that pediatric patients with CD may not have a unique fecal microbial signature indicative of inherent dysbiosis, in contrast to that suggested for older patients. In children with CD, diet may play a role in shaping microbial composition more so than disease status.

Keywords: celiac disease; gluten-free diet; microbiota.

Copyright © 2021 The Author(s). Published by Wolters Kluwer on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.