The microbiome reflects diagnosis and predicts disease severity in paediatric onset inflammatory bowel disease

Abstract

Objectives: A microbiotic profile characterized by decreased abundance and richness has been described in inflammatory bowel disease (IBD). Recently, sequencing the microbiome to the species level has become possible, which can improve our understanding of the gut to host interaction in IBD. We aimed to describe the microbiotic profile in paediatric IBD and compare it to disease phenotype and disease course.

Methods: Faecal samples were collected from a cross-sectional cohort. The microbiome analysis was performed using 16S and 18S rRNA sequencing with the miSeq instrument. Inflammatory activity was assessed by faecal calprotectin. Data regarding medical treatment and surgery in the year after faecal sampling were collected from patient charts.

Results: One hundred and forty-three (143) paediatric IBD patients and 34 healthy controls (HC) were included. We found a reduced richness in IBD patients compared to HCs (controls vs. ulcerative colitis (UC), p < .001 and controls vs. Crohn’s disease (CD), p = .04)). Moreover, a high degree of intestinal inflammation and extensive disease extent was associated with reduced richness in UC (p = .02 and p = .04, respectively). Nine species were significantly associated with a healthy microbiome and three species were associated with IBD. Lastly, we found that the composition of the microbiome could distinguish between CD, UC and HCs.

Conclusions: In this study, we found that the microbiome could discriminate between IBD phenotypes and predict which patients were at risk of surgery. In the future, this could be included as part of the diagnostic work-up in IBD patients.

Keywords:

• Crohn’s disease
• ulcerative colitis
• dysbiosis
• paediatric
• 16s
• 18s

Acknowledgements

The authors thank Thor Beck Johannesen for invaluable biostatistics guidance.

Author contributions

All authors contributed to study conception, design and critical revision of the final manuscript for important intellectual content. Mikkel Malham and Christian Jakobsen contributed with data extraction from patient charts and drafted the manuscript. Berit Lilje and Paal S. Andersen analysed the microbiome data. Gunnar Houen performed the calprotectin analysis. All authors contributed with important intellectual revision and approved the final version of the article, including the authorship list.

Disclosure statement

No potential conflict of interest was reported by the authors.