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  1. Mairi H McLean, Education editor
  1. Correspondence to Dr Mairi H McLean, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen AB24 3FX, UK; m.h.mclean{at}abdn.ac.uk

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Basic Science

Microbial mapping to predict disease behaviour in IBD

Yilmaz B, Juillerat P, Oyas O, et al. Microbial network disturbances in relapsing refractory Crohn’s disease. Nature Medicine 2019 25:323–326

Patients with inflammatory bowel disease (IBD) display variability in disease severity, distribution and response to treatment. This cannot be accounted for by host genetic susceptibility. There is focus on mapping environmental exposures, including the microbiota in order to predict these disease behaviours. However, to achieve this, it is necessary to analyse large well-phenotyped cohorts that are followed prospectively over many years. While there are such initiatives, many are in their infancy and will take time for data to become available. Here, the authors studied two Swiss long-term IBD cohorts and defined distinct microbial networks containing taxa belonging to Lachnospiraceae and Ruminococcaceae that were associated with relapsing disease and also poor treatment outcome. They defined these taxa as Cluster CDA and through predictive function analysis suggested that these taxa may increase intraluminal oxygen, thus allowing facultative pathogens, such as Escherichia coli, to bloom. The study also identified a cluster of taxa including short-chain fatty acid producing strains that could distinguish between Crohn disease (CD) and ulcerative colitis (UC) and were predictive of a quiescent disease course and a healthier lifestyle. In addition to the significant original dataset generated, they also conducted a meta-analysis of the currently published IBD microbiome studies. The authors concluded their study by predicting that subsequent attempts to manipulate the gut microbiota in patients with IBD would be most successful if targeted against defects in Cluster CDA.

Adipose tissue dysfunction in NAFLD

Pan Y, Hui X, Hoo RLC et al. Adipocyte-secreted exosomal microRNA-34a inhibits M2 macrophage polarisation to promote obesity-induced adipose inflammation. Journal of Clinical Investigation 2019; 129(2):834–849

Nonalcoholic fatty liver disease (NAFLD) is poised to become much more problematic in the near future with associated morbidity …

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