Successful dietary therapy in paediatric Crohn’s disease is associated with shifts in bacterial dysbiosis and inflammatory metabotype towards healthy controls

Verburgt, C. M. et al. (2023) Successful dietary therapy in paediatric Crohn’s disease is associated with shifts in bacterial dysbiosis and inflammatory metabotype towards healthy controls. Journal of Crohn's and Colitis, 17(1), pp. 61-72. (doi: 10.1093/ecco-jcc/jjac105) (PMID:36106847)

Abstract

Background and aims: Nutritional therapy with the Crohn’s Disease Exclusion Diet + Partial Enteral Nutrition [CDED+PEN] or Exclusive Enteral Nutrition [EEN] induces remission and reduces inflammation in mild-to-moderate paediatric Crohn’s disease [CD]. We aimed to assess if reaching remission with nutritional therapy is mediated by correcting compositional or functional dysbiosis. Methods: We assessed metagenome sequences, short chain fatty acids [SCFA] and bile acids [BA] in 54 paediatric CD patients reaching remission after nutritional therapy [with CDED + PEN or EEN] [NCT01728870], compared to 26 paediatric healthy controls. Results: Successful dietary therapy decreased the relative abundance of Proteobacteria and increased Firmicutes towards healthy controls. CD patients possessed a mixture of two metabotypes [M1 and M2], whereas all healthy controls had metabotype M1. M1 was characterised by high Bacteroidetes and Firmicutes, low Proteobacteria, and higher SCFA synthesis pathways, and M2 was associated with high Proteobacteria and genes involved in SCFA degradation. M1 contribution increased during diet: 48%, 63%, up to 74% [Weeks 0, 6, 12, respectively.]. By Week 12, genera from Proteobacteria reached relative abundance levels of healthy controls with the exception of E. coli. Despite an increase in SCFA synthesis pathways, remission was not associated with increased SCFAs. Primary BA decreased with EEN but not with CDED+PEN, and secondary BA did not change during diet. Conclusion: Successful dietary therapy induced correction of both compositional and functional dysbiosis. However, 12 weeks of diet was not enough to achieve complete correction of dysbiosis. Our data suggests that composition and metabotype are important and change quickly during the early clinical response to dietary intervention. Correction of dysbiosis may therefore be an important future treatment goal for CD.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Svolos, Dr Vaios and Gerasimidis, Professor Konstantinos
• Authors: Verburgt, C. M., Dunn, K. A., Ghiboub, M., Lewis, J. D., Wine, E., Sigall Boneh, R., Gerasimidis, K., Shamir, R., Penny, S., Pinto, D. M., Cohen, A., Bjorndahl, P., Svolos, V., Bielawski, J. P., Benninga, M. A., de Jonge, W. J., and Van Limbergen, J. E.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Journal of Crohn's and Colitis
• Publisher: Oxford University Press
• ISSN: 1873-9946
• ISSN (Online): 1876-4479
• Published Online: 15 September 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Journal of Crohn's and Colitis 17(1): 61-72
• Publisher Policy: Reproduced under a Creative Commons License