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Gacesa R, Vich Vila A, Collij V, Mujagic Z, Kurilshikov A, Voskuil M, Festen E, Wijmenga C, Jonkers D, Dijkstra G, Fu J, Zhernakova A, Imhann F, Weersma R. A combination of fecal calprotectin and human beta-defensin 2 facilitates diagnosis and monitoring of inflammatory bowel disease. Gut Microbes 2021; 13:1943288. [PMID: 34313538 PMCID: PMC8317932 DOI: 10.1080/19490976.2021.1943288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) show a large overlap in clinical presentation, which presents diagnostic challenges. As a consequence, invasive and burdensome endoscopies are often used to distinguish between IBD and IBS. Here, we aimed to develop a noninvasive fecal test that can distinguish between IBD and IBS and reduce the number of endoscopies.We used shotgun metagenomic sequencing to analyze the composition and function of gut microbiota of 169 IBS patients, 447 IBD patients and 1044 population controls and measured fecal Calprotectin (FCal), human beta defensin 2 (HBD2), and chromogranin A (CgA) in these samples. These measurements were used to construct training sets (75% of data) for logistic regression and machine learning models to differentiate IBS from IBD and inactive from active IBD. The results were replicated on test sets (remaining 25% of the data) and microbiome data obtained using 16S sequencing.Fecal HBD2 showed high sensitivity and specificity for differentiating between IBD and IBS (sensitivity = 0.89, specificity = 0.76), while the inclusion of microbiome data with biomarkers (HBD2 and FCal) showed a potential for improvement in predictive power (optimal sensitivity = 0.87, specificity = 0.93). Shotgun sequencing-based models produced comparable results using 16S-sequencing data. HBD2 and FCal were found to have predictive power for IBD disease activity (AUC ≈ 0.7).HBD2 is a novel biomarker for IBD in patients with gastro-intestinal complaints, especially when used in combination with FCal and potentially in combination with gut microbiome data.
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Affiliation(s)
- R. Gacesa
- University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands,University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - A. Vich Vila
- University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands,University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - V. Collij
- University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands,University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Z. Mujagic
- Maastricht University Medical Center, Division of Gastroenterology-Hepatology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - A. Kurilshikov
- University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - M.D. Voskuil
- University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands,University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - E.A.M. Festen
- University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands,University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - C. Wijmenga
- University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - D.M.A.E. Jonkers
- Maastricht University Medical Center, Division of Gastroenterology-Hepatology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - G. Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands
| | - J. Fu
- University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands,University of Groningen and University Medical Center Groningen, Department of Pediatrics, Groningen, The Netherlands
| | - A. Zhernakova
- University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - F. Imhann
- University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands,University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands,CONTACT F. Imhann University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands
| | - R.K. Weersma
- University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands
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Spekhorst LM, Severs M, de Boer NKH, Festen EAM, Fidder HH, Hoentjen F, Imhann F, de Jong DJ, van der Meulen-de Jong AE, Pierik MJ, van der Woude CJ, Dijkstra G, Ponsioen CY, Löwenberg M, Oldenburg B, Weersma RK. The Impact of Ethnicity and Country of Birth on Inflammatory Bowel Disease Phenotype: a Prospective Cohort Study. J Crohns Colitis 2017; 11:1463-1470. [PMID: 28981621 DOI: 10.1093/ecco-jcc/jjx098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 07/20/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS The number of patients with inflammatory bowel disease [IBD], of non-Caucasian descent in Western Europe, is increasing. We aimed to explore the impact of ethnicity and country of birth on IBD phenotype. METHODS IBD patients treated in the eight University Medical Centers in The Netherlands [Dutch IBD Biobank] were divided into two groups according to their ethnicity: 1] Caucasian patients of Western and Central European descent [CEU]; and 2] patients of non-Caucasian descent [non-CEU]. The non-CEU group was subdivided according to country of birth, into: born in The Netherlands or Western Europe [non-CEU European born]; or born outside Western-Europe who migrated to The Netherlands [non-CEU non-European born]. Both comparisons were analysed for phenotype differences [by chi-square test]. RESULTS The Dutch IBD Biobank included 2921 CEU patients and 233 non-CEU patients. Non-CEU Crohn's disease [CD] patients more often had upper gastro-intestinal disease [16% vs 8%, p = 0.001] and anal stenosis [10% vs 4%, p = 0.002] than CEU CD patients. The use of anti-tumour necrosis factor [TNF] agents and immunomodulators was higher in non-CEU IBD patients than in CEU IBD patients [45% vs 38%, p = 0.042] and [77% vs 66%, p = 0.001], respectively. Non-CEU IBD patients born in Europe [n = 116] were diagnosed at a lower age than non-CEU IBD patients born outside Europe [n = 115] [at 22.7 vs 28.9 years old, p < 0.001]. CONCLUSION Non-Caucasians had more severe disease behaviour than Caucasians. Non-CEU patients born in Europe were diagnosed at a lower age with IBD than those born outside Europe who migrated to The Netherlands.
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Affiliation(s)
- L M Spekhorst
- University of Groningen and University Medical Center Groningen, Department of Gastroenterology and Hepatology, The Netherlands.,University of Groningen and University Medical Center Groningen, Department of Genetics, The Netherlands
| | - M Severs
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, The Netherlands
| | - N K H de Boer
- Department of Gastroenterology and Hepatology, VU University Medical Centre, The Netherlands
| | - E A M Festen
- University of Groningen and University Medical Center Groningen, Department of Gastroenterology and Hepatology, The Netherlands.,University of Groningen and University Medical Center Groningen, Department of Genetics, The Netherlands
| | - H H Fidder
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, The Netherlands
| | - F Hoentjen
- Department of Gastroenterology and Hepatology, University Medical Centre St. Radboud, The Netherlands
| | - F Imhann
- University of Groningen and University Medical Center Groningen, Department of Gastroenterology and Hepatology, The Netherlands.,University of Groningen and University Medical Center Groningen, Department of Genetics, The Netherlands
| | - D J de Jong
- Department of Gastroenterology and Hepatology, University Medical Centre St. Radboud, The Netherlands
| | | | - M J Pierik
- Department of Gastroenterology and Hepatology, University Medical Centre Maastricht, The Netherlands
| | - C J van der Woude
- Department of Gastroenterology and Hepatology, Erasmus Medical Centre, The Netherlands
| | - G Dijkstra
- University of Groningen and University Medical Center Groningen, Department of Gastroenterology and Hepatology, The Netherlands
| | - C Y Ponsioen
- Department of Gastroenterology and Hepatology, Amsterdam Medical Centre, The Netherlands
| | - M Löwenberg
- Department of Gastroenterology and Hepatology, Amsterdam Medical Centre, The Netherlands
| | - B Oldenburg
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, The Netherlands
| | - R K Weersma
- University of Groningen and University Medical Center Groningen, Department of Gastroenterology and Hepatology, The Netherlands
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Neelis EG, Roskott AM, Dijkstra G, Wanten GJ, Serlie MJ, Tabbers MM, Damen G, Olthof ED, Jonkers CF, Kloeze JH, Ploeg RJ, Imhann F, Nieuwenhuijs VB, Rings EHHM. Presentation of a nationwide multicenter registry of intestinal failure and intestinal transplantation. Clin Nutr 2015; 35:225-229. [PMID: 25660415 DOI: 10.1016/j.clnu.2015.01.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 01/14/2015] [Accepted: 01/15/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS Exact data on Dutch patients with chronic intestinal failure (CIF) and after intestinal transplantation (ITx) have been lacking. To improve standard care of these patients, a nationwide collaboration has been established. Objectives of this study were obtaining an up-to-date prevalence of CIF and characterizing these patients using the specially developed multicenter web-based Dutch Registry of Intestinal Failure and Intestinal Transplantation (DRIFT). METHODS Cross-sectional study. CIF was defined as type 3 intestinal failure in which >75% of nutritional requirements were given as home parenteral nutrition (HPN) for ≥ 4 weeks in children and >50% for ≥3 months in adults. All patients with CIF receiving HPN care by the three Dutch specialized centers on January 1, 2013 and all ITx patients were registered in DRIFT (https://drift.darmfalen.nl). RESULTS In total, 195 patients with CIF (158 adults, 37 children) were identified, of whom 184 were registered in DRIFT. The Dutch point prevalence of CIF was 11.62 per million (12.24 for adults, 9.56 for children) on January 1, 2013. Fifty-seven patients (31%) had one or more indications for ITx, while 12 patients actually underwent ITx since its Dutch introduction. Four patients required transplantectomy of their intestinal graft and 3 intestinal transplant patients died. CONCLUSION The multicenter registry DRIFT revealed an up-to-date prevalence of CIF and provided nationwide insight into the patients with CIF during HPN and after ITx in the Netherlands. DRIFT will facilitate the multicenter monitoring of individual patients, thereby supporting multidisciplinary care and decision-making.
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Affiliation(s)
- E G Neelis
- Department of Pediatric Gastroenterology, University Medical Center Groningen, Beatrix Children's Hospital, Post Office Box 30.001, 9700 RB, Groningen, The Netherlands; Department of Pediatric Gastroenterology, Erasmus Medical Center-Sophia Children's Hospital, Post Office Box 2060, 3000 CB, Rotterdam, The Netherlands.
| | - A M Roskott
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Post Office Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - G Dijkstra
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Post Office Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - G J Wanten
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Post Office Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - M J Serlie
- Department of Endocrinology and Metabolism, Academic Medical Center, Post Office Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - M M Tabbers
- Department of Pediatric Gastroenterology, Academic Medical Center, Emma Children's Hospital, Post Office Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - G Damen
- Department of Pediatric Gastroenterology, Radboud University Medical Center, Post Office Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - E D Olthof
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Post Office Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - C F Jonkers
- Nutrition Support Team, Academic Medical Center, Post Office Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - J H Kloeze
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Post Office Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - R J Ploeg
- Nuffield Department of Surgical Sciences, University of Oxford, OX37DQ, Oxford, United Kingdom.
| | - F Imhann
- Healthcare IT Developer, Aceso BV, De Deimten 11, 9747 AV, Groningen, The Netherlands.
| | - V B Nieuwenhuijs
- Department of Surgery, Isala Clinics, Post Office Box 10400, 8000 GK, Zwolle, The Netherlands.
| | - E H H M Rings
- Department of Pediatric Gastroenterology, Erasmus Medical Center-Sophia Children's Hospital, Post Office Box 2060, 3000 CB, Rotterdam, The Netherlands; Department of Pediatrics, Leiden University Medical Center, Willem Alexander Children's Hospital, Post Office Box 9600, 2300 RC, Leiden, The Netherlands.
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