title: Specific members of the predominant gut microbiota predict pouchitis following colectomy and IPAA in UC.
abstract: Pouchitis is the most common complication after colectomy with ileal pouch-anal anastomosis (IPAA) for UC and the risk is the highest within the 1st year after surgery. The pathogenesis is not completely understood but clinical response to antibiotics suggests a role for gut microbiota. We hypothesised that the risk for pouchitis can be predicted based on the faecal microbial composition before colectomy.
  
  
  
  Faecal samples from 21 patients with UC undergoing IPAA were prospectively collected before colectomy and at predefined clinical visits at 1 month, 3 months, 6 months and 12 months after IPAA. The predominant microbiota was analysed using community profiling with denaturing gradient gel electrophoresis followed by quantitative real-time PCR validation.
  
  
  
  Cluster analysis before colectomy distinguished patients with pouchitis from those with normal pouch during the 1st year of follow-up. In patients developing pouchitis, an increase of Ruminococcus gnavus (p<0.001), Bacteroides vulgatus (p=0.043), Clostridium perfringens (p=0.011) and a reduction of two Lachnospiraceae genera (Blautia (p=0.04), Roseburia (p=0.008)) was observed. A score combining these five bacterial risk factors was calculated and presence of at least two risk factors showed a sensitivity and specificity of 100% and 63.6%, respectively.
  
  
  
  Presence of R. gnavus, B. vulgatus and C. perfringens and absence of Blautia and Roseburia in faecal samples of patients with UC before surgery is associated with a higher risk of pouchitis after IPAA. Our findings suggest new predictive and therapeutic strategies in patients undergoing colectomy with IPAA.
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Machiels
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: João
authors.initials: J
authors.lastname: Sabino
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Leen
authors.initials: L
authors.lastname: Vandermosten
authors.affiliation: Department Microbiology and Immunology, KU Leuven, Leuven, Belgium.|Center for the Biology of Disease, VIB, Leuven, Belgium.|Faculty of Sciences and Bioengineering Sciences, Microbiology Unit, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Marie
authors.initials: M
authors.lastname: Joossens
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Arijs
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Magali
authors.initials: M
authors.lastname: de Bruyn
authors.affiliation: Department of Pathology, Bacteriology and Avian Diseases, Ghent University, Merelbeke, Belgium.
authors.forename: Venessa
authors.initials: V
authors.lastname: Eeckhaut
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Gert
authors.initials: G
authors.lastname: Van Assche
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Ferrante
authors.affiliation: Department of Microbiology and Immunology, University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Verhaegen
authors.affiliation: Department of Electrical Engineering and Computer Science, Montefiore Institute, Liège, Belgium.
authors.forename: Kristel
authors.initials: K
authors.lastname: Van Steen
authors.affiliation: Department of Pathology, Bacteriology and Avian Diseases, Ghent University, Merelbeke, Belgium.
authors.forename: Filip
authors.initials: F
authors.lastname: Van Immerseel
authors.affiliation: Laboratory of Microbiology & BCCM/LMG Bacteria Collection, Faculty of Sciences, Ghent University, Ghent, Belgium.
authors.forename: Geert
authors.initials: G
authors.lastname: Huys
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Kristin
authors.initials: K
authors.lastname: Verbeke
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Albert
authors.initials: A
authors.lastname: Wolthuis
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Anthony
authors.initials: A
authors.lastname: de Buck Van Overstraeten
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Andre
authors.initials: A
authors.lastname: D'Hoore
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Rutgeerts
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Séverine
authors.initials: S
authors.lastname: Vermeire
mesh_terms: D000328:Adult; D041963:Bacteroidetes / Q000235:genetics / Q000302:isolation & purification; D003016:Clostridium perfringens / Q000235:genetics / Q000302:isolation & purification; D016000:Cluster Analysis; D003093:Colitis, Ulcerative / Q000382:microbiology* / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects; D004269:DNA, Bacterial / Q000032:analysis*; D005232:Fatty Acids, Volatile / Q000032:analysis; D005243:Feces / Q000737:chemistry / Q000382:microbiology*; D005260:Female; D000069196:Gastrointestinal Microbiome / Q000235:genetics; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D008875:Middle Aged; D019449:Pouchitis / Q000382:microbiology*; D011237:Predictive Value of Tests; D057234:Preoperative Period; D016737:Proctocolectomy, Restorative / Q000009:adverse effects; D011446:Prospective Studies; D045857:Ruminococcus / Q000235:genetics / Q000302:isolation & purification; D013997:Time Factors
chemical_list: D004269:DNA, Bacterial; D005232:Fatty Acids, Volatile; D039841:Leukocyte L1 Antigen Complex
keywords: IBD BASIC RESEARCH; ILEOANAL POUCH; INFLAMMATORY BOWEL DISEASE; INTESTINAL BACTERIA; POUCHITIS