A characterization of anaerobic colonization and associated mucosal adaptations in the undiseased ileal pouch.
Smith, F M Coffey, J C Kell, M R O'Sullivan, M Redmond, H P Kirwan, W O
Smith, F M
Coffey, J C
Kell, M R
O'Sullivan, M
Redmond, H P
Kirwan, W O
Advisors
Editors
Other Contributors
Date
2012-02-03T15:06:27Z
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adenomatous Polyposis Coli/surgery
Bacteroides/*isolation & purification
Bifidobacterium/*isolation & purification
Clostridium perfringens/*isolation & purification
Colitis, Ulcerative/surgery
Female
Humans
Intestinal Mucosa/*pathology
Male
Pouchitis/*microbiology/*pathology
Bacteroides/*isolation & purification
Bifidobacterium/*isolation & purification
Clostridium perfringens/*isolation & purification
Colitis, Ulcerative/surgery
Female
Humans
Intestinal Mucosa/*pathology
Male
Pouchitis/*microbiology/*pathology
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
INTRODUCTION: The resolution of pouchitis with metronidazole points to an anaerobic aetiology. Pouchitis is mainly seen in patients with ulcerative colitis pouches (UCP). We have recently found that sulphate reducing bacteria (SRB), a species of strict anaerobe, colonize UCP exclusively. Herein, we aimed to correlate levels of different bacterial species (including SRB) with mucosal inflammation and morphology. METHODS: Following ethical approval, fresh faecal samples and mucosal biopsies were taken from 9 patients with UCP and 5 patients with familial adenomatous polyposis pouches (FAPP). For the purposes of comparison, faecal samples and mucosal biopsies were also taken from the stomas of 7 of the 9 patients with UC (UCS). Colonization by four types of strict anaerobes (SRB, Clostridium perfringens, Bifidobacteria and Bacteroides) as well as by three types of facultative anaerobes (Enterococci, Coliforms and Lactobacilli) was evaluated. Inflammatory scores and mucosal morphology were assessed histologically in a blinded fashion by a pathologist. RESULTS: In general, strict anaerobes predominated over facultative in the UCP (P = 0.041). SRB were present in UCP exclusively. Even after exclusion of SRB from total bacterial counts, strict anaerobes still predominated. In the UCS, facultative anaerobes predominated. Strict and facultative anaerobes were present at similar levels in the FAPP. Enterococci were present at significantly reduced levels in the UCP when compared with the UCS (P = 0.031). When levels of SRB and other anaerobic species were individually correlated with mucosal inflammation and morphology, no trends were observed. CONCLUSION: We have previously identified that SRB exclusively colonize UCP. In addition we have now identified a novel increase in the strict/facultative anaerobic ratio within the UCP compared to UCS. These stark differences in bacterial colonization, however, appear to have limited impact on mucosal inflammation or morphology.
Language
eng
ISSN
1462-8910 (Print)
1462-8910 (Linking)
1462-8910 (Linking)
eISSN
ISBN
DOI
10.1111/j.1463-1318.2005.00833.x
PMID
16232236