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. 2023 Sep;23(5):1763-1772.
doi: 10.1007/s10238-022-00917-x. Epub 2022 Nov 7.

Impact of gut Microbiome alteration in Ulcerative Colitis patients on disease severity and outcome

Osama Mohammed Basha  1 , Raghda A Hafez  2 , Sara Mohamed Salem  1 , Reham H Anis  2 , Amr Shaaban Hanafy  3
Affiliations

Impact of gut Microbiome alteration in Ulcerative Colitis patients on disease severity and outcome

Osama Mohammed Basha et al. Clin Exp Med. 2023 Sep.

Abstract

Background: Ulcerative colitis is a heterogeneous disease in terms of disease course, location, and therapeutic response. The current study was done to assess the alteration of the gut microbiome in UC patients and its relationship to severity, response to therapy, and outcome.

Patients and methods: The study included 96 participants who were divided into a case group (n = 48, recent onset, treatment naive ulcerative colitis patients who were subdivided into mild, moderate, and severe subgroups based on Truelove-Witts and endoscopic severity) and a healthy control group (n = 48). All were subjected to a thorough history, clinical examination, colonoscopy, routine laboratory tests, and quantitative real-time PCR to quantify Bacteroides, Lactobacilli, Faecalibacterium prausnitzii, Veillonella, and Hemophilus in fecal samples at baseline and 6 months after treatment.

Results: Bacterial 16S rRNA gene sequencing revealed a significant reduction in the phylum Firmicutes in UC patients, with a significant predominance of the phylum Bacteriodetes. F. prausnitzii and lactobacilli were inversely proportional to disease severity, whereas Bacteroides, Hemophilus, and Veillonella were directly proportional to it. Six months after therapy, a statistically significant increase in F. prausnitzii and lactobacilli was observed, with a decrease in the levels of other bacteria. Lower baseline F. praustinizii (< 8.5) increased the risk of relapse; however, lower ESR (< 10), lower post-treatment CRP (< 6), lower Bacteroides (< 10.6) indefinitely protect against relapse.

Conclusion: The gut microbiome of recently diagnosed UC showed lower levels of Lactobacilli, Faecalibacterium, and higher levels of Bacteroides and Veillonella, and the change in their levels can be used to predict response to therapy.

Keywords: Outcome, microbiota; Severity; Ulcerative colitis.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Different microbiota levels in the studied groups. A F. prausnitzii count in case group before and after treatment in comparison with the control group. B Bacteroides level in case group before and after treatment in comparison with the control group. C Lactobacilli in case group before and after treatment in comparison with the control group. D Boxplot showing Veillonella count in case group before and after treatment in comparison with the control group
Fig. 2
Fig. 2
Multiple bar charts showing microbiota levels affected by the site of UC lesions. A F. praustinizii before and after treatment according to site of lesion. B Lactobacilli before and after treatment according to site of lesion. C Bacteroides before and after treatment according to site of lesion. D Veillonella before and after treatment according to site of lesion
See this image and copyright information in PMC

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