Microbial network disturbances in relapsing refractory Crohn's disease

Nat Med. 2019 Feb;25(2):323-336. doi: 10.1038/s41591-018-0308-z. Epub 2019 Jan 21.

Abstract

Inflammatory bowel diseases (IBD) can be broadly divided into Crohn's disease (CD) and ulcerative colitis (UC) from their clinical phenotypes. Over 150 host susceptibility genes have been described, although most overlap between CD, UC and their subtypes, and they do not adequately account for the overall incidence or the highly variable severity of disease. Replicating key findings between two long-term IBD cohorts, we have defined distinct networks of taxa associations within intestinal biopsies of CD and UC patients. Disturbances in an association network containing taxa of the Lachnospiraceae and Ruminococcaceae families, typically producing short chain fatty acids, characterize frequently relapsing disease and poor responses to treatment with anti-TNF-α therapeutic antibodies. Alterations of taxa within this network also characterize risk of later disease recurrence of patients in remission after the active inflamed segment of CD has been surgically removed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Case-Control Studies
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / microbiology
  • Colitis, Ulcerative / surgery
  • Crohn Disease / diagnosis
  • Crohn Disease / drug therapy
  • Crohn Disease / microbiology*
  • Crohn Disease / surgery
  • Gastrointestinal Microbiome*
  • Humans
  • Recurrence
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Adrenal Cortex Hormones
  • Tumor Necrosis Factor-alpha