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  1. Mairi H McLean, Education editor
  1. School of Medicine, Medical Sciences & Nutrition, University of Aberdeen , Aberdeen, UK
  1. Correspondence to Dr Mairi H McLean; m.h.mclean{at}

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Temporal fluctuations in the microbiome in inflammatory bowel disease

Schirmer M, Denson L, Vlamakis H et al. Compositional and temporal changes in the gut microbiome of pediatric ulcerative colitis patients are linked to disease course. Cell Host Microbe 2018; 24:600–610.

Investigations into the molecular pathogenesis of inflammatory bowel disease (IBD) indicate a complex interplay between host genetics, mucosal immune responses and environmental factors including the gut microbiome. Microbial diversity is consistently reduced in IBD. There is a loss of bacteria that contribute to the production of beneficial metabolites, including short-chain fatty acids. This, in turn, alters the induction of a robust immune response. The IBD microbiome fluctuates more than the healthy microbiome, but little is known about how this fluctuation is affected by treatment and impacts disease progression. To address this, Schirmer et al tracked the intestinal microbiome in 405 treatment-naïve paediatric ulcerative colitis patients and characterised changes in the microbiome alongside disease progression and severity. Patients were monitored for 1 year from treatment initiation and microbial taxonomic composition was assessed in both stool samples and rectal biopsies. Patients with inactive disease were used as a control group. There was a significant increase in bacterial strains, more typically found in the oral cavity, in patients with more severe disease. This finding was consistent throughout the sampling period and included taxa belonging to Aggregatibacter, Fusobacterium, Veillonellaceae, Enterobacteriaceae, Neisseriaceae and Haemophilus parainfluenzae. There was also evidence that steroid treatment was significantly associated with altered gut microbial abundances. The study also assessed microbial associations with disease-associated serological markers, concluding that it is possible to use this approach to improve treatment strategies. For example, potentially directing more aggressive treatment regimens for patients at risk of progressive disease based on microbiome analysis.

Triggering receptor expressed on myeloid cells-1 expression in hepatic fibrosis

Nguyen-Lefebvre AT, Ajith A, Portik-Dobos V et al. The innate immune receptor TREM-1 promotes liver injury and fibrosis. J Clin Invest …

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  • Contributors Georgina Hold, Richard Parker, Stuart McDonald, Sebastian Zeki, Michael Burkitt, Ashis Mukhopadhya.

  • Competing interests None declared.

  • Patient consent Not required.

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

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