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PEG and Mucosal Biofilms in Irritable Bowel Syndrome and Ulcerative Colitis
- Source :
- Gastroenterology
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Background & Aims Irritable bowel syndrome (IBS) and inflammatory bowel diseases result in a substantial reduction in quality of life and a considerable socioeconomic impact. In IBS, diagnosis and treatment options are limited, but evidence for involvement of the gut microbiome in disease pathophysiology is emerging. Here we analyzed the prevalence of endoscopically visible mucosal biofilms in gastrointestinal disease and associated changes in microbiome composition and metabolism. Methods The presence of mucosal biofilms was assessed in 1426 patients at 2 European university-based endoscopy centers. One-hundred and seventeen patients were selected for in-depth molecular and microscopic analysis using 16S ribosomal RNA gene amplicon-sequencing of colonic biopsies and fecal samples, confocal microscopy with deep learning–based image analysis, scanning electron microscopy, metabolomics, and in vitro biofilm formation assays. Results Biofilms were present in 57% of patients with IBS and 34% of patients with ulcerative colitis compared with 6% of controls (P < .001). These yellow-green adherent layers of the ileum and right-sided colon were microscopically confirmed to be dense bacterial biofilms. 16S-sequencing links the presence of biofilms to a dysbiotic gut microbiome, including overgrowth of Escherichia coli and Ruminococcus gnavus. R. gnavus isolates cultivated from patient biofilms also formed biofilms in vitro. Metabolomic analysis found an accumulation of bile acids within biofilms that correlated with fecal bile acid excretion, linking this phenotype with a mechanism of diarrhea. Conclusions The presence of mucosal biofilms is an endoscopic feature in a subgroup of IBS and ulcerative colitis with disrupted bile acid metabolism and bacterial dysbiosis. They provide novel insight into the pathophysiology of IBS and ulcerative colitis, illustrating that biofilm can be seen as a tipping point in the development of dysbiosis and disease.<br />Graphical abstract<br />Bacterial biofilms were observed by colonoscopy as yellow-green membranous layers on the mucosa of the small and large intestinal junction and are specifically prevalent in irritable bowel syndrome and inflammatory bowel disease.
- Subjects :
- ASV, amplicon sequencing variant
medicine.medical_specialty
IBS, irritable bowel syndrome
Functional Gastrointestinal Disorders
Gastroenterology
Irritable Bowel Syndrome
Full Report: Basic and Translational—Alimentary Tract
Internal medicine
PEG ratio
OTU, operational taxonomic unit
Humans
UCDA, ursodeoxycholic acid
Medicine
SEM, scanning electron microscopy
Intestinal Mucosa
Irritable bowel syndrome
Original Research
PEG, polyethylene glycol
BF+, biofilm-positive
IBD, inflammatory bowel disease
Hepatology
business.industry
Microbiota
Biofilm
Endoscopy
BF–, biofilm negative
GI, gastrointestinal
medicine.disease
Ulcerative colitis
rRNA, ribosomal RNA
PAS, periodic acid-Schiff
UC, ulcerative colitis
Biofilms
BA, bile acid
Colitis, Ulcerative
business
Bacterial–Epithelial Interaction
DAPI, 4′,6-diamidino-2-phenylindole
Subjects
Details
- ISSN :
- 00165085
- Volume :
- 162
- Database :
- OpenAIRE
- Journal :
- Gastroenterology
- Accession number :
- edsair.doi.dedup.....5a2a8c979777892e88897573c677f0ec