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Changes in dominant gut microbial species and metabolites in children with Crohn's disease during exclusive enteral nutrition

Published online by Cambridge University Press:  20 May 2014

K. Gerasimidis
Affiliation:
Human Nutrition, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, G3 8SJ Department of Pediatric Gastroenterology, Hepatology and Nutrition, Royal Hospital for Sick Children, Glasgow, G3 8SJ
M. Bertz
Affiliation:
Human Nutrition, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, G3 8SJ Department of Gastrointestinal Microbiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
L. Hanske
Affiliation:
Department of Gastrointestinal Microbiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
J. Junick
Affiliation:
Department of Gastrointestinal Microbiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
O. Biskou
Affiliation:
Human Nutrition, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, G3 8SJ
M. Aguilera
Affiliation:
Department of Microbiology, Faculty of Pharmacy, University of Granada, Granada, Spain
V. Garrick
Affiliation:
Department of Pediatric Gastroenterology, Hepatology and Nutrition, Royal Hospital for Sick Children, Glasgow, G3 8SJ
R. K. Russell
Affiliation:
Human Nutrition, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, G3 8SJ Department of Pediatric Gastroenterology, Hepatology and Nutrition, Royal Hospital for Sick Children, Glasgow, G3 8SJ
M. Blaut
Affiliation:
Department of Gastrointestinal Microbiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
P. McGrogan
Affiliation:
Human Nutrition, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, G3 8SJ Department of Pediatric Gastroenterology, Hepatology and Nutrition, Royal Hospital for Sick Children, Glasgow, G3 8SJ
C. A. Edwards
Affiliation:
Human Nutrition, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, G3 8SJ
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Abstract

Type
Abstract
Copyright
Copyright © The Authors 2014 

The gut microbiota is implicated in the pathogenesis of Crohn's Disease (CD)( Reference Sartor 1 ). Exclusive enteral nutrition (EEN) is a successful treatment but its mode of action remains unknown( Reference Gerasimidis 2 ). We assessed changes in the fecal microbiota milieu during EEN.

Five faecal samples were collected from CD children; 4 during EEN (start, 15, 30, end EEN∼60 days) and a fifth on free habitual diet. Two samples were collected from healthy controls. Faecal pH, bacterial metabolites (Figure) and quantitative changes (q-PCR) of total and 7 major bacterial groups implicated in CD were measured.

68 samples were from 15 CD children and 40 from 21 controls. Faecal pH and total sulphide increased and butyric acid decreased during EEN (Figure). F. prausnitzii spp. concentration significantly decreased after 30 d on EEN (Figure). In patients who responded to EEN, the magnitude of the observed changes was greater and the concentration of Bacteroides/Prevotella group also decreased. All these changes reverted to pre-treatment levels when the children returned to their free habitual diet.

Fig. 1. Fecal pH, and concentrations (g/dry feces) of total sulphide, butyrate and F. prausnitzii spp. before, during and after EEN completion (free habitual diet)

EEN impacts on gut microbiota composition and changes faecal metabolic activity. It is difficult to infer a causative association between such changes and disease improvement but the results do challenge the current perception of a protective role for F. prausnitzii in CD.

KG was funded by the Greek State Scholarship Foundation, the Hellenic Foundation of Gastroenterology & Nutrition, the Barr Endowment Fund and the Yorkhill Children Charity.

References

1. Sartor, RB (2008) Gastroenterology 134, 577–94.CrossRefGoogle Scholar
2. Gerasimidis, K et al. (2011) J Clin Gastroenterol 45, 234–9.CrossRefGoogle Scholar
Figure 0

Fig. 1. Fecal pH, and concentrations (g/dry feces) of total sulphide, butyrate and F. prausnitzii spp. before, during and after EEN completion (free habitual diet)

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