Mucosa-associated bacteria in ulcerative colitis before and after antibiotic combination therapy.
BACKGROUND
We proposed that Fusobacterium varium is one of the causative agents in ulcerative colitis.


OBJECTIVE
To examine the efficacy of antibiotic combination therapy against F. varium and to investigate the mucosa-associated bacteria before and after the therapy using a new molecular approach.


METHODS
Twenty patients with ulcerative colitis were randomly assigned into the antibiotic treatment group (amoxicillin, tetracycline and metronidazole for 2 weeks) and no-antibiotics group. Clinical assessment, colonoscopic and histological evaluations were performed at 0 and 3-5 months after the treatment. DNA from mucosal bacteria was isolated from biopsy specimens. We investigated the mucosa-associated bacterial components by terminal restriction fragment length polymorphism with the restriction enzyme HhaI and MspI, and quantified the change in the number of bacteria by real-time polymerase chain reaction. Immunohistochemical detection of F. varium in biopsy specimens was also performed.


RESULTS
After the treatment, the clinical assessment, colonoscopic and histological scores improved in the antibiotic group compared with the control group. Three peaks of terminal restriction fragment length polymorphism decreased after treatment only in the antibiotic group. Eubacterium rectale, Dorea formicigenerans, Clostridium clostridioforme and F. varium were included in these peaks. Based on the real-time polymerase chain reaction study, only F. varium was significantly reduced after treatment. In the immunostaining, post-treatment scores in treatment group were significantly lower than that in control group.


CONCLUSIONS
Antibiotics combination therapy was effective for ulcerative colitis. The number of mucosa-associated F. varium significantly decreased after the treatment.
Nomura
T
T
Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Ohkusa
T
T
Okayasu
I
I
Yoshida
T
T
Sakamoto
M
M
Hayashi
H
H
Benno
Y
Y
Hirai
S
S
Hojo
M
M
Kobayashi
O
O
Terai
T
T
Miwa
H
H
Takei
Y
Y
Ogihara
T
T
Sato
N
N
D000658:Amoxicillin / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000382:microbiology*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005673:Fusobacterium / Q000302:isolation & purification; D005674:Fusobacterium Infections / Q000188:drug therapy*; D006801:Humans; D007413:Intestinal Mucosa / Q000382:microbiology; D008795:Metronidazole / Q000627:therapeutic use*; D013752:Tetracycline / Q000627:therapeutic use*
D008795:Metronidazole; D000658:Amoxicillin; D013752:Tetracycline