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Inflammatory bowel disease
Original article
A microbial signature for Crohn's disease
  1. Victoria Pascal1,
  2. Marta Pozuelo1,
  3. Natalia Borruel1,2,
  4. Francesc Casellas1,2,
  5. David Campos1,
  6. Alba Santiago1,
  7. Xavier Martinez1,
  8. Encarna Varela1,
  9. Guillaume Sarrabayrouse1,
  10. Kathleen Machiels3,
  11. Severine Vermeire3,
  12. Harry Sokol4,
  13. Francisco Guarner1,2,
  14. Chaysavanh Manichanh1,2
  1. 1Department of Gastroenterology, Vall d'Hebron Research Institute, Barcelona, Spain
  2. 2CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
  3. 3Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium
  4. 4Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine, Paris, France
  1. Correspondence to Dr Chaysavanh Manichanh, Department of Gastroenterology, Vall d'Hebron Research Institute, Pg Vall d'Hebron, Barcelona 119-129, Spain; cmanicha{at}gmail.com

Abstract

Objective A decade of microbiome studies has linked IBD to an alteration in the gut microbial community of genetically predisposed subjects. However, existing profiles of gut microbiome dysbiosis in adult IBD patients are inconsistent among published studies, and did not allow the identification of microbial signatures for CD and UC. Here, we aimed to compare the faecal microbiome of CD with patients having UC and with non-IBD subjects in a longitudinal study.

Design We analysed a cohort of 2045 non-IBD and IBD faecal samples from four countries (Spain, Belgium, the UK and Germany), applied a 16S rRNA sequencing approach and analysed a total dataset of 115 million sequences.

Results In the Spanish cohort, dysbiosis was found significantly greater in patients with CD than with UC, as shown by a more reduced diversity, a less stable microbial community and eight microbial groups were proposed as a specific microbial signature for CD. Tested against the whole cohort, the signature achieved an overall sensitivity of 80% and a specificity of 94%, 94%, 89% and 91% for the detection of CD versus healthy controls, patients with anorexia, IBS and UC, respectively.

Conclusions Although UC and CD share many epidemiologic, immunologic, therapeutic and clinical features, our results showed that they are two distinct subtypes of IBD at the microbiome level. For the first time, we are proposing microbiomarkers to discriminate between CD and non-CD independently of geographical regions.

  • INTESTINAL BACTERIA
  • INFLAMMATORY BOWEL DISEASE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/gutjnl-2016-313235

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    Footnotes

    • VP and MP share co-first authorship

    • Contributors CM: Study concept and design; FC, NB, FG and SV: acquisition of samples; AS, DC, GS, KM, EV and HS: acquisition of data; VP, MP and XM: analysis of data; CM: interpretation of data; CM: drafting of the manuscript; FG, HS, SV and CM: critical revision of the manuscript for important intellectual content; VP, MP: statistical analysis; CM: obtained funding). All the authors contributed to manuscript revision.

    • Funding This study was supported by two grants from the Instituto de Salud Carlos III/FEDER (CP13/00181, PI14/00764). KM is a postdoctoral fellow and SV a senior clinical investigator of the Fund for Scientific Research Flanders, Belgium (FWO-Vlaanderen).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Local Ethical Committee of the University Hospital Vall d'Hebron in Barcelona and the University Hospital Gasthuisberg in Leuven.

    • Provenance and peer review Not commissioned; externally peer reviewed.