title: Anti-TNF Therapy Response in Patients with Ulcerative Colitis Is Associated with Colonic Antimicrobial Peptide Expression and Microbiota Composition.
abstract: OBJECTIVE
  Anti-tumour necrosis factor [TNF] therapy is used in patients with ulcerative colitis [UC], but not all patients respond to treatment. Antimicrobial peptides [AMPs] and the gut microbiota are essential for gut homeostasis and may be important for treatment outcome. The aim of this study was to determine AMP and microbiota profiles in patients with UC before anti-TNF therapy start and correlate these data to treatment outcome.
  
  
  METHODS
  Serum and biopsies were obtained from UC patients naïve to biological therapy [n = 56] before anti-TNF therapy start [baseline]. Fecal samples were taken at baseline and Weeks 2 and 6. Quantitative proteomic analysis was performed in mucosal biopsies. Expression of AMPs and cytokines was determined in biopsies and serum. Microbiota analysis of fecal samples was performed using GA-map™ Dysbiosis Test and real-time quantitative polymerase chain reaction [rtPCR]. Treatment response was evaluated 12-14 weeks after baseline.
  
  
  RESULTS
  At baseline, proteomic analysis of biopsies showed that treatment responders and non-responders had differential expression of AMPs. Eleven AMP and AMP-related genes were analysed by rtPCR in mucosal biopsies and could together discriminate responders from non-responders at baseline. The most important nominators for response were increased expression of defensin 5 and eosinophilic cationic protein. Microbiota analysis revealed lower dysbiosis indexes and higher abundance of Faecalibacterium prausnitzii in responders compared with non-responders at baseline. Also, abundance of F. prausnitzii increased during induction therapy in responders.
  
  
  CONCLUSIONS
  Anti-TNF therapy responders and non-responders display distinctly separate patterns of mucosal AMP expression and gut microbiota before treatment start. This indicates that intestinal antimicrobial/microbial composition can influence treatment outcome.
authors.affiliation: Department of Microbiology and Immunology, University of Gothenburg, Institute for Biomedicine, Gothenburg, Sweden Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Institute for Medicine, Gothenburg, Sweden maria.magnusson@microbio.gu.se.
authors.forename: Maria K
authors.initials: MK
authors.lastname: Magnusson
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Institute for Medicine, Gothenburg, Sweden Södra Älvsborg Hospital, Department of Internal Medicine, Borås, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Strid
authors.affiliation: Department of Microbiology and Immunology, University of Gothenburg, Institute for Biomedicine, Gothenburg, Sweden Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Institute for Medicine, Gothenburg, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Sapnara
authors.affiliation: Södra Älvsborg Hospital, Department of Internal Medicine, Borås, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Lasson
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Institute for Medicine, Gothenburg, Sweden Södra Älvsborg Hospital, Department of Internal Medicine, Borås, Sweden.
authors.forename: Antal
authors.initials: A
authors.lastname: Bajor
authors.affiliation: Kärnsjukhuset, Department of Internal Medicine, Skövde, Sweden.
authors.forename: Kjell-Arne
authors.initials: KA
authors.lastname: Ung
authors.affiliation: Department of Microbiology and Immunology, University of Gothenburg, Institute for Biomedicine, Gothenburg, Sweden Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Institute for Medicine, Gothenburg, Sweden School of Health and Education, University of Skövde, Skövde, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Öhman
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D023181:Antimicrobial Cationic Peptides / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology / Q000473:pathology; D016207:Cytokines / Q000097:blood; D000070037:Faecalibacterium prausnitzii / Q000302:isolation & purification; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D005260:Female; D000069196:Gastrointestinal Microbiome; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D007413:Intestinal Mucosa / Q000378:metabolism / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020543:Proteome; D060888:Real-Time Polymerase Chain Reaction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; D016207:Cytokines; D020543:Proteome; D000069285:Infliximab; D000068879:Adalimumab
keywords: Anti-TNF; antimicrobial peptides; microbiota