Evaluation of bacterial biomarkers to aid in challenging inflammatory bowel diseases diagnostics and subtype classification

• 作者: Harry J Flint L Jesús Garcia-Gil Margarita Martinez-Medina Mariona Serra-Pagès Mireia Lopez-Siles Miriam Sabat-Mir Sylvia H Duncan Xavier Aldeguer
• 来源期刊: 世界胃肠病理生理学杂志:英文版(电子版)
• 学科: 医学
• 关键词: Crohn’s DISEASE ULCERATIVE colitis Inflammatory BOWEL DISEASE Diagnostic tests Faecalibacterium prausnitzii ESCHERICHIA COLI IRRITABLE BOWEL syndrome Colorectal cancer
• 年，卷（期）: 2020,（3）
• 页码范围: 64-77
• 页数: 14页
• 分类号: R57

摘要

BACKGROUND The challenges for inflammatory bowel disease(IBD)diagnostics are to discriminate it from gut conditions with similar symptoms such as irritable bowel syndrome(IBS),to distinguish IBD subtypes,to predict disease progression,and to establish the risk to develop colorectal cancer(CRC).Alterations in gut microbiota have been proposed as a source of information to assist in IBD diagnostics.Faecalibacterium prausnitzii(F.prausnitzii),its phylogroups,and Escherichia coli(E.coli)have been reported as potential biomarkers,but their performance in challenging IBD diagnostic situations remains elusive.We hypothesize that bacterial biomarkers based in these species may help to discriminate these conditions of complex diagnostics.AIM To evaluate the usefulness of indices calculated from the quantification of these species as biomarkers to aid in IBD diagnostics.METHODS A retrospective study of 131 subjects(31 controls(H);45 Crohn’s disease(CD),25 ulcerative colitis(UC),10 IBS,and 20 CRC patients)was performed to assess the usefulness of bacterial biomarkers in biopsies.Further,the performance of biomarkers in faeces was studied in 29 stool samples(19 CD,10 UC).Relative abundances of total F.prausnitzii(FP),its phylogroups(PHGI and PHGII),and E.coli(E)quantification were determined by qPCR.Loads were combined to calculate the FP-E index,the PHGI–E index and the PHGII-E index.Biomarkers accuracy to discriminate among conditions was measured by the area under the receiver operating characteristic curve(AUC).RESULTS In biopsies,FP-E index was good for discriminating IBS from CD(AUC=0.752)while PHGII-E index was suitable for discriminating IBS from UC(AUC=0.632).The FP-E index would be the choice to discriminate IBD from CRC,especially from all UC subtypes(AUC≥0.875),regardless of the activity status of the patient.Discrimination between UC patients that had the longest disease duration and those with CRC featured slightly lower AUC values.Concerning differentiation in IBD with shared location,PHGI-E index can es