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. 2023 Feb 3:3:1046414.
doi: 10.3389/fmmed.2023.1046414. eCollection 2023.

Definition of a microbial signature as a predictor of endoscopic post-surgical recurrence in patients with Crohn's disease

Lia Oliver  1 , Blau Camps  2 , David Julià-Bergkvist  3 , Joan Amoedo  1 , Sara Ramió-Pujol  1 , Marta Malagón  1 , Anna Bahí  4 , Paola Torres  5 , Eugeni Domènech  5 , Jordi Guardiola  2 , Mariona Serra-Pagès  1 , Jesus Garcia-Gil  1   6 , Xavier Aldeguer  1   3   4
Affiliations

Definition of a microbial signature as a predictor of endoscopic post-surgical recurrence in patients with Crohn's disease

Lia Oliver et al. Front Mol Med. .

Abstract

Background and aims: Although there are several effective drugs for the treatment of Crohn's disease (CD), almost 70% of patients will require surgical resection during their lifetime. This procedure is not always curative, as endoscopic recurrence occurs in 65%-90% of patients in the first year after surgery. The aetiology of the recurrence is unknown; however, several studies have shown how the resident microbiota is modified after surgery. The aim of this study was to evaluate samples from patients with Crohn's disease before and after an intestinal resection to determine whether there were differences in the abundance of different microbial markers, which may predict endoscopic recurrence at baseline. Methods: In this observational study, a stool sample was obtained from 25 patients with Crohn's disease before undergoing surgery, recruited at three Catalan hospitals. From each sample, DNA was purified and the relative abundance of nine microbial markers was quantified using qPCR. Results: An algorithm composed of four microbial markers (E. coli, F. prausnitzii phylogroup I, Bacteroidetes, and Eubacteria) showed a sensitivity and specificity of 90.91% and 85.71%, respectively, and a positive and negative predictive value of 83.33% and 92.31%, respectively. Conclusion: A microbial signature to determine patients who will have post-surgical recurrence was identified. This tool might be very useful in daily clinical practice, allowing the scheduling of personalized therapy and enabling preventive treatment only in patients who really require it.

Keywords: Crohn’s disease; endoscopic recurrence; gut microbiota; precision medicine; surgical resection.

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Conflict of interest statement

GoodGut S.L.U shares the patent PCT/EP 2016/069188 method for the quantification of Faecalibacterium prausnitzii phylogroup I and/or phylogroup II and the use thereof as biomarkers, referenced in this study.

Figures

FIGURE 1
FIGURE 1
Plot of the relative abundances (Microbial marker Ct—Eubacteria Ct) of A. muciniphila (AKK), Bacteroidetes (BAC), Ruminococcus spp. (RUM), E. coli (ECO), F. prausnitzii (FAE), F. prausnitzii phylogroup I (PHGI), F. prausnitzii phylogroup II (PHGII), M. smithii (MSM) for remission (green) and recurrence patients (yellow). No significant differences were found (p-value>0.05). Note that results are shown in PCR Ct values, so a higher value indicates lower abundance than a lower value.
FIGURE 2
FIGURE 2
Plot of the relative abundances (Microbial marker Ct—Eubacteria Ct) of A. muciniphila (AKK), Bacteroidetes (BAC), Ruminococcus spp. (RUM), E. coli (ECO), F. prausnitzii (FAE), F. prausnitzii phylogroup I (PHGI), F. prausnitzii phylogroup II (PHGII), M. smithii (MSM) for sample A (before surgery), sample B (3 months after surgery) and sample C (6 months after surgery). Note that results are shown in PCR Ct values, so a higher value indicates lower abundance than a lower value.
FIGURE 3
FIGURE 3
MANOVA plot where the effects of the surgery on the markers are observed. A. muciniphila (AKK), Bacteroidetes (BAC), Ruminococcus spp. (RUM), E. coli (ECO), F. prausnitzii (FAE), F. prausnitzii phylogroup I (PHGI), F. prausnitzii phylogroup II (PHGII), M. smithii (MSM) and for sample A (before surgery), sample B (3 months after surgery) and sample C (6 months after surgery).
See this image and copyright information in PMC

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