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2015 ; 21
(6
): 1219-28
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Recent advances in characterizing the gastrointestinal microbiome in Crohn s
disease: a systematic review
#MMPMID25844959
Wright EK
; Kamm MA
; Teo SM
; Inouye M
; Wagner J
; Kirkwood CD
Inflamm Bowel Dis
2015[Jun]; 21
(6
): 1219-28
PMID25844959
show ga
BACKGROUND: The intestinal microbiota is involved in the pathogenesis of
inflammatory bowel disease. A reduction in the diversity of the intestinal
microbiota as well as specific taxonomic and functional shifts have been reported
in Crohn's disease and may play a central role in the inflammatory process. The
aim was to systematically review recent developments in the structural and
functional changes observed in the gastrointestinal microbiome in patients with
Crohn's Disease. RESULTS: Seventy-two abstracts were included in this review. The
effects of host genetics, disease phenotype, and inflammatory bowel disease
treatment on the gastrointestinal microbiome in Crohn's disease were reviewed,
and taxonomic shifts in patients with early and established disease were
described. The relative abundance of Bacteroidetes is increased and Firmicutes
decreased in Crohn's disease compared with healthy controls. Enterobacteriaceae,
specifically Eschericia coli, is enriched in Crohn's disease. Faecalibacterium
prausnitzii is found at lower abundance in Crohn's disease and in those with
postoperative recurrence. Observed functional changes include major shifts in
oxidative stress pathways, a decrease in butanoate and propanoate metabolism gene
expression, lower levels of butyrate, and other short-chain fatty acids,
decreased carbohydrate metabolism, and decreased amino acid biosynthesis.
CONCLUSIONS: Changes in microbial composition and function have been described,
although a causative role remains to be established. Larger, prospective, and
longitudinal studies are required with deep interrogation of the microbiome if
causality is to be determined, and refined microbial manipulation is to emerge as
a focused therapy.
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