Fecal microbiota related to postoperative endoscopic recurrence in patients with Crohn's disease

Haichao Wang; Guorong Yan; Yaling Wu; Deji Zhuoma; Zhanju Liu; Xuefeng Gao; Xiaolei Wang

doi:10.1093/gastro/goae017

Fecal microbiota related to postoperative endoscopic recurrence in patients with Crohn's disease

Gastroenterol Rep (Oxf). 2024 Mar 23:12:goae017. doi: 10.1093/gastro/goae017. eCollection 2024.

Authors

Haichao Wang¹, Guorong Yan², Yaling Wu³, Deji Zhuoma⁴, Zhanju Liu⁴, Xuefeng Gao⁵, Xiaolei Wang⁴

Affiliations

¹ Department of Nephrology and Rheumatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, P. R. China.
² Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, P. R. China.
³ Department of Geriatrics, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, P. R. China.
⁴ Department of Gastroenterology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, P. R. China.
⁵ Integrative Microecology Center, Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, P. R. China.

Abstract

Background: Postoperative recurrence (POR) remains a major challenge for patients with Crohn's disease (CD). Gut microbial dysbiosis has been reported to be involved in the pathogenesis of POR. This study aims to investigate the relationship between fecal microbiome and endoscopic recurrence in patients with CD after ileocolonic resection.

Methods: This is a cross-sectional study. Fecal samples were collected from 52 patients with CD after surgical intervention from 6 to 12 months before endoscopic examination. Endoscopic recurrence was defined as Rutgeerts score ≥ i2. The microbiome was analyzed by sequencing the V3-V4 hypervariable regions of the 16S rRNA gene.

Results: A total of 52 patients were included and classified into POR (n = 27) and non-POR (n = 25) groups. Compared with the non-POR group, the POR group had a significantly lower community richness (Chao1 index: 106.5 vs 124, P = 0.013) and separated microbial community (P = 0.007 for Adonis, P = 0.032 for Anosim), combined with different distribution of 16 gut microbiotas and decrease of 11 predicted metabolic pathways (P < 0.05). Lactobacillus and Streptococcus were identified to closely correlate to non-POR (P < 0.05) after controlling for confounding factors. Kaplan-Meier analysis indicated that the patients with higher abundance of Streptococcus experienced longer remission periods (P < 0.01), but this was not for Lactobacillus. The predicted ethylmalonyl-coA pathway related to increased amount of succinate was positively correlated with Streptococcus (r > 0.5, P < 0.05).

Conclusions: The characteristic alterations of fecal microbiota are associated with postoperative endoscopic recurrence in patients with CD; particularly, high abundance of Streptococcus may be closely related to endoscopic remission.

Keywords: 16S rRNA gene sequencing; Crohn’s disease; fecal microbiota; postoperative endoscopic recurrence.