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Galazzo G, Tedjo DI, Wintjens DSJ, Savelkoul PHM, Masclee AAM, Bodelier AGL, Pierik MJ, Jonkers DMAE, Penders J. Faecal Microbiota Dynamics and their Relation to Disease Course in Crohn's Disease. J Crohns Colitis 2019; 13:1273-1282. [PMID: 30810207 PMCID: PMC6764104 DOI: 10.1093/ecco-jcc/jjz049] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Microbial shifts have been associated with disease activity in Crohn's disease [CD], but findings on specific taxa are inconsistent. This may be due to differences in applied methods and cross-sectional study designs. We prospectively examined the faecal microbiota in adult CD patients with changing or stable disease course over time. METHODS Faeces were collected at two time-points from 15 healthy control individuals [HCs], 35 CD patients who were in remission and who maintained remission [RRs], and 22 CD patients during remission and also during subsequent exacerbation [RAs]. The microbial composition was assessed by 16S rRNA [V4] gene sequencing. RESULTS Compared with HCs, patients with CD had a lower microbial richness [p = 0.0002] and diversity [p = 0.005]. Moreover, the microbial community structure of a subset of patients, clustered apart from HCs, was characterized by low microbial diversity and Faecalibacterium abundance. Patients within this cluster did not differ with respect to long-term disease course compared with patients with a 'healthy-appearing' microbiota.Over time, microbial richness and diversity did not change in RR versus RA patients. Although the microbial community structure of both RR and RA patients was less stable over time compared with that of HCs, no differences were observed between the patient groups [p = 0.17]; nor was the stability impacted by Montreal classification, medication use, or surgery. CONCLUSION The altered microbiota composition and stability in CD was neither associated with disease activity nor long-term disease course, questioning its involvement in the development of an exacerbation. The aberrant microbiota composition in a subset of CD patients warrants further exploration of a more microbiota-driven etiology in this group.
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Affiliation(s)
- Gianluca Galazzo
- School of Nutrition and Translational Research in Metabolism [NUTRIM], Department of Medical Microbiology, Maastricht University Medical Center+, Maastricht, The Netherlands,School of Public Health and Primary Care [Caphri], Department of Medical Microbiology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Danyta I Tedjo
- School of Nutrition and Translational Research in Metabolism [NUTRIM], Department of Medical Microbiology, Maastricht University Medical Center+, Maastricht, The Netherlands,School of Nutrition and Translational Research in Metabolism [NUTRIM], Division Gastroenterology–Hepatology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Dion S J Wintjens
- School of Nutrition and Translational Research in Metabolism [NUTRIM], Division Gastroenterology–Hepatology, Maastricht University Medical Center+, Maastricht, The Netherlands,Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Paul H M Savelkoul
- School of Nutrition and Translational Research in Metabolism [NUTRIM], Department of Medical Microbiology, Maastricht University Medical Center+, Maastricht, The Netherlands,School of Public Health and Primary Care [Caphri], Department of Medical Microbiology, Maastricht University Medical Center+, Maastricht, The Netherlands,Department of Medical Microbiology & Infection control, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ad A M Masclee
- School of Nutrition and Translational Research in Metabolism [NUTRIM], Division Gastroenterology–Hepatology, Maastricht University Medical Center+, Maastricht, The Netherlands,Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Marie J Pierik
- School of Nutrition and Translational Research in Metabolism [NUTRIM], Division Gastroenterology–Hepatology, Maastricht University Medical Center+, Maastricht, The Netherlands,Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Daisy M A E Jonkers
- School of Nutrition and Translational Research in Metabolism [NUTRIM], Division Gastroenterology–Hepatology, Maastricht University Medical Center+, Maastricht, The Netherlands,Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - John Penders
- School of Nutrition and Translational Research in Metabolism [NUTRIM], Department of Medical Microbiology, Maastricht University Medical Center+, Maastricht, The Netherlands,School of Public Health and Primary Care [Caphri], Department of Medical Microbiology, Maastricht University Medical Center+, Maastricht, The Netherlands,Corresponding authors: J. Penders, Department of Medical Microbiology, Maastricht University Medical Center+, PO 5800, 6202 AZ, Maastricht, The Netherlands. Tel: +31-(0)433875134; Fax: +31-(0)433676643;
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Smolinska A, Bodelier AGL, Dallinga JW, Masclee AAM, Jonkers DM, van Schooten FJ, Pierik MJ. The potential of volatile organic compounds for the detection of active disease in patients with ulcerative colitis. Aliment Pharmacol Ther 2017; 45:1244-1254. [PMID: 28239876 DOI: 10.1111/apt.14004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 07/26/2016] [Accepted: 02/01/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND To optimise treatment of ulcerative colitis (UC), patients need repeated assessment of mucosal inflammation. Current non-invasive biomarkers and clinical activity indices do not accurately reflect disease activity in all patients and cannot discriminate UC from non-UC colitis. Volatile organic compounds (VOCs) in exhaled air could be predictive of active disease or remission in Crohn's disease. AIM To investigate whether VOCs are able to differentiate between active UC, UC in remission and non-UC colitis. METHODS UC patients participated in a 1-year study. Clinical activity index, blood, faecal and breath samples were collected at each out-patient visit. Patients with clear defined active faecal calprotectin >250 μg/g and inactive disease (Simple Clinical Colitis Activity Index <3, C-reactive protein <5 mg/L and faecal calprotectin <100 μg/g) were included for cross-sectional analysis. Non-UC colitis was confirmed by stool culture or radiological evaluation. Breath samples were analysed by gas chromatography time-of-flight mass spectrometry and kernel-based method to identify discriminating VOCs. RESULTS In total, 72 UC (132 breath samples; 62 active; 70 remission) and 22 non-UC-colitis patients (22 samples) were included. Eleven VOCs predicted active vs. inactive UC in an independent internal validation set with 92% sensitivity and 77% specificity (AUC 0.94). Non-UC colitis patients could be clearly separated from active and inactive UC patients with principal component analysis. CONCLUSIONS Volatile organic compounds can accurately distinguish active disease from remission in UC and profiles in UC are clearly different from profiles in non-UC colitis patients. VOCs have demonstrated potential as new non-invasive biomarker to monitor inflammation in UC.
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Affiliation(s)
- A Smolinska
- Department of Pharmacology and Toxicology, NUTRIM School for Nutrition, and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - A G L Bodelier
- Department of Gastroenterology and Hepatology, NUTRIM School for Nutrition, and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Gastroenterology, Amphia Hospital, Breda, The Netherlands
| | - J W Dallinga
- Department of Pharmacology and Toxicology, NUTRIM School for Nutrition, and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - A A M Masclee
- Department of Gastroenterology and Hepatology, NUTRIM School for Nutrition, and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - D M Jonkers
- Department of Gastroenterology and Hepatology, NUTRIM School for Nutrition, and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - F-J van Schooten
- Department of Pharmacology and Toxicology, NUTRIM School for Nutrition, and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - M J Pierik
- Department of Gastroenterology and Hepatology, NUTRIM School for Nutrition, and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
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Hendrikx T, Watzenböck ML, Walenbergh SMA, Amir S, Gruber S, Kozma MO, Grabsch HI, Koek GH, Pierik MJ, Staufer K, Trauner M, Kalhan SC, Jonkers D, Hofker MH, Binder CJ, Shiri-Sverdlov R. Low levels of IgM antibodies recognizing oxidation-specific epitopes are associated with human non-alcoholic fatty liver disease. BMC Med 2016; 14:107. [PMID: 27443391 PMCID: PMC4957359 DOI: 10.1186/s12916-016-0652-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 06/29/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Lipid oxidation of membrane phospholipids is accompanied by the formation of oxidation-specific epitopes (OSE). These epitopes are recognized by specific antibodies and represent danger-associated molecular patterns that are generated during chronic inflammatory processes. In a murine model for hepatic inflammation during non-alcoholic fatty liver disease (NAFLD), increased antibody levels targeting OSE were found to be protective. Here, our aim was to determine an association between OSE-specific antibody titers and NAFLD in humans. METHODS IgM and IgG levels with specificity for various OSE were assessed in the plasma of patients with NAFLD (n = 71) and healthy controls (n = 68). Antibody titers were comprehensively analyzed in patients with NAFLD after classification by histological evaluation of liver biopsies. Statistical analysis was performed to determine significant correlations and odds ratios. To study the specificity for NAFLD, plasma antibody titers were measured in patients with hepatitis C (n = 40) and inflammatory bowel disease (n = 62). RESULTS IgM titers against OSE were lower in patients with NAFLD compared to controls. Further biopsy-based classification of patients with NAFLD did not show any difference in IgM levels. Plasma IgM titers towards the P1 mimotope demonstrated an inverse correlation with markers for obesity, systemic inflammation, and liver damage. In contrast, hepatitis C and increased disease activity during inflammatory bowel disease was not associated with reduced IgM titers. CONCLUSIONS Our data highlight the importance of immune recognition of OSE by IgM antibodies in the pathophysiology of NAFLD.
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Affiliation(s)
- Tim Hendrikx
- Departments of Molecular Genetics, Pathology, and Internal Medicine, Division of Gastroenterology and Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM) and School of Oncology and Developmental Biology (GROW), Maastricht University and Maastricht University Medical Center (MUMC), PO Box 616, 6200 MD, Maastricht, The Netherlands.,Departments of Laboratory Medicine, Surgery, and Internal Medicine III, Division of Gastroenterology And Hepatology, Medical University of Vienna, Vienna, Austria.,Center for Molecular Medicine (CeMM) of the Austrian Academy of Sciences, Vienna, Austria
| | - Martin L Watzenböck
- Departments of Laboratory Medicine, Surgery, and Internal Medicine III, Division of Gastroenterology And Hepatology, Medical University of Vienna, Vienna, Austria.,Center for Molecular Medicine (CeMM) of the Austrian Academy of Sciences, Vienna, Austria
| | - Sofie M A Walenbergh
- Departments of Molecular Genetics, Pathology, and Internal Medicine, Division of Gastroenterology and Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM) and School of Oncology and Developmental Biology (GROW), Maastricht University and Maastricht University Medical Center (MUMC), PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Shahzada Amir
- Departments of Laboratory Medicine, Surgery, and Internal Medicine III, Division of Gastroenterology And Hepatology, Medical University of Vienna, Vienna, Austria.,Center for Molecular Medicine (CeMM) of the Austrian Academy of Sciences, Vienna, Austria
| | - Sabrina Gruber
- Departments of Laboratory Medicine, Surgery, and Internal Medicine III, Division of Gastroenterology And Hepatology, Medical University of Vienna, Vienna, Austria.,Center for Molecular Medicine (CeMM) of the Austrian Academy of Sciences, Vienna, Austria
| | - Maria Ozsvar Kozma
- Departments of Laboratory Medicine, Surgery, and Internal Medicine III, Division of Gastroenterology And Hepatology, Medical University of Vienna, Vienna, Austria.,Center for Molecular Medicine (CeMM) of the Austrian Academy of Sciences, Vienna, Austria
| | - Heike I Grabsch
- Departments of Molecular Genetics, Pathology, and Internal Medicine, Division of Gastroenterology and Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM) and School of Oncology and Developmental Biology (GROW), Maastricht University and Maastricht University Medical Center (MUMC), PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Ger H Koek
- Departments of Molecular Genetics, Pathology, and Internal Medicine, Division of Gastroenterology and Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM) and School of Oncology and Developmental Biology (GROW), Maastricht University and Maastricht University Medical Center (MUMC), PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Marieke J Pierik
- Departments of Molecular Genetics, Pathology, and Internal Medicine, Division of Gastroenterology and Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM) and School of Oncology and Developmental Biology (GROW), Maastricht University and Maastricht University Medical Center (MUMC), PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Katharina Staufer
- Departments of Laboratory Medicine, Surgery, and Internal Medicine III, Division of Gastroenterology And Hepatology, Medical University of Vienna, Vienna, Austria
| | - Michael Trauner
- Departments of Laboratory Medicine, Surgery, and Internal Medicine III, Division of Gastroenterology And Hepatology, Medical University of Vienna, Vienna, Austria
| | - Satish C Kalhan
- Department of Pathobiology, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Daisy Jonkers
- Departments of Molecular Genetics, Pathology, and Internal Medicine, Division of Gastroenterology and Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM) and School of Oncology and Developmental Biology (GROW), Maastricht University and Maastricht University Medical Center (MUMC), PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Marten H Hofker
- Department of Pathology & Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Christoph J Binder
- Departments of Laboratory Medicine, Surgery, and Internal Medicine III, Division of Gastroenterology And Hepatology, Medical University of Vienna, Vienna, Austria.,Center for Molecular Medicine (CeMM) of the Austrian Academy of Sciences, Vienna, Austria
| | - Ronit Shiri-Sverdlov
- Departments of Molecular Genetics, Pathology, and Internal Medicine, Division of Gastroenterology and Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM) and School of Oncology and Developmental Biology (GROW), Maastricht University and Maastricht University Medical Center (MUMC), PO Box 616, 6200 MD, Maastricht, The Netherlands.
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