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Local appendiceal dysbiosis: the missing link between the appendix and ulcerative colitis?
  1. X Roblin1,
  2. C Neut2,
  3. A Darfeuille-Michaud3,
  4. J F Colombel4,5
  1. 1Department of Hepato-Gastroenterology, University Hospital of Saint-Etienne, Saint-Etienne, France
  2. 2Laboratoire de Bacteriologie, Faculte de Pharmacie et INSERM U995, Universite Lile Nord de France, Lille, France
  3. 3Clermont Université, Université d'Auvergne, Jeune Equipe, Clermont-Ferrand, France
  4. 4Department of Hepatogastroenterology and INSERM U995, Universite Lille Nord de France, Lille, France
  5. 5Mount Sinai Medical School of Medicine, New York, New York, USA
  1. Correspondence to Dr X Roblin, Department of Hepato-Gastroenterology, University Hospital of Saint-Etienne, Saint-Etienne, France; xavier.roblin{at}chu-st-etienne.fr

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We read with great interest the article by Swidsinski et al reporting on a possible link between acute appendicitis and a local invasion by Fusobacteria. Investigating sections of 70 appendixes with confirmed appendicitis using rRNA-based fluorescence in situ hybridisation, the authors found bacteria deeply infiltrating the appendix. Fusobacteria (mainly Fusobacterium nucleatum/necrophorum) were specific components of epithelial and submucosal infiltrates in 62% of patients and were not found in various controls. The presence of Fusobacteria correlated positively with the severity of appendicitis. Conversely, main faecal microbiota including Faecalibacterium prausnitzii groups were significantly decreased with an inverse relationship with the severity of the disease.1

Altogether, these observations point to the presence …

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