Title

Compositional and Temporal Changes in the Gut Microbiome of Pediatric Ulcerative Colitis Patients Are Linked to Disease Course

Publication Date

2018

Journal Title

Cell Host Microbe

Abstract

© 2018 Elsevier Inc. Evaluating progression risk and determining optimal therapy for ulcerative colitis (UC) is challenging as many patients exhibit incomplete responses to treatment. As part of the PROTECT (Predicting Response to Standardized Colitis Therapy) Study, we evaluated the role of the gut microbiome in disease course for 405 pediatric, new-onset, treatment-naive UC patients. Patients were monitored for 1 year upon treatment initiation, and microbial taxonomic composition was analyzed from fecal samples and rectal biopsies. Depletion of core gut microbes and expansion of bacteria typical of the oral cavity were associated with baseline disease severity. Remission and refractory disease were linked to species-specific temporal changes that may be implicative of therapy efficacy, and a pronounced increase in microbiome variability was observed prior to colectomy. Finally, microbial associations with disease-associated serological markers suggest host-microbial interactions in UC. These insights will help improve existing treatments and develop therapeutic approaches guiding optimal medical care. Many patients exhibit incomplete responses to ulcerative colitis (UC) therapy. Schirmer et al. investigate the gut microbiome's role in pediatric UC treated with two conventional therapies. Baseline and longitudinal microbial trends are implicated in disease severity and progression, including remission and colectomy requirement. These insights may motivate new therapeutic approaches.

Volume Number

24

Issue Number

4

Pages

600 - 610.e4

Document Type

Article

Status

Faculty

Facility

School of Medicine

Primary Department

General Pediatrics

PMID

30308161

DOI

10.1016/j.chom.2018.09.009

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