眼袋炎
结肠切除术
胃肠病学
内科学
蔷薇花
产气荚膜梭菌
小袋
医学
生物
溃疡性结肠炎
拟杆菌
外科
疾病
细菌
遗传学
作者
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,André D’Hoore,Paul Rutgeerts,Séverine Vermeire
出处
期刊:Gut
[BMJ]
日期:2015-09-30
卷期号:66 (1): 79-88
被引量:102
标识
DOI:10.1136/gutjnl-2015-309398
摘要
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.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.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.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.
科研通智能强力驱动
Strongly Powered by AbleSci AI