Gut Microbiota Offers Universal Biomarkers across Ethnicity in Inflammatory Bowel Disease Diagnosis and Infliximab Response Prediction

• Published in: mSystems Vol. 3; no. 1
• Main Authors: Zhou, Youlian, Xu, Zhenjiang Zech, He, Yan, Yang, Yunsheng, Liu, Le, Lin, Qianyun, Nie, Yuqiang, Li, Mingsong, Zhi, Fachao, Liu, Side, Amir, Amnon, González, Antonio, Tripathi, Anupriya, Chen, Minhu, Wu, Gary D., Knight, Rob, Zhou, Hongwei, Chen, Ye
• Format: Journal Article
• Language: English
• Published: United States American Society for Microbiology 01.01.2018
• Subjects: Biomarkers; Crohn's disease; Diagnosis; Disease; disease activity; Dysbacteriosis; Fecal microflora; Feces; Firmicutes; Gastroenterology; Geography; gut microbiota; Health care; Hospitals; Host-Microbe Biology; Immunotherapy; Inflammatory bowel disease; Inflammatory bowel diseases; Infliximab; infliximab treatment; Intestinal microflora; Intestine; Laboratories; Microbiomes; Microbiota; Minority & ethnic groups; Monoclonal antibodies; Multiculturalism & pluralism; Noninvasive evaluation; Pathogenesis; Research Article; Studies; TNF inhibitors; Tumor necrosis factor-TNF; Tumor necrosis factor-α; Ulcerative colitis; Beijing China; La Jolla California; California; United States > US; China; disease activity; infliximab treatment; gut microbiota; inflammatory bowel disease
• ISSN: 2379-5077; 2379-5077
• DOI: 10.1128/msystems.00188-17

In the present report, we show that the human fecal microbiota contains promising and universal biomarkers for the noninvasive evaluation of inflammatory bowel disease severity and IFX treatment efficacy, emphasizing the potential ability to mine the gut microbiota as a modality to stratify IBD patients and apply personalized therapy for optimal outcomes. Gut microbiota dysbiosis contributes to the onset and perpetuation of inflammatory bowel disease (IBD). Given that gut microbiotas vary across geography and ethnicity, it remains obscure whether any universal microbial signatures for IBD diagnosis and prognosis evaluation exist irrespective of populations. Here we profiled the fecal microbiota of a series of Chinese IBD patients and combined them with two Western IBD cohorts, PRISM and RISK, for meta-analyses. We found that the gut microbial alteration patterns in IBD are similar among Chinese and Westerners. Our prediction model based on gut microbiome for IBD diagnosis is robust across the cohorts, which showed 87.5% and 79.1% prediction accuracy in Crohn’s disease (CD) and ulcerative colitis (UC) patients, respectively. A relative increase in the levels of Actinobacteria and Proteobacteria ( Enterobacteriaceae ) and a relative decrease in the levels of Firmicutes ( Clostridiales ) were strongly correlated with IBD severity ( P < 0.05). Additionally, restoration of gut microbiota diversity and a significant increase in Clostridiales relative abundance were found in patients responding to infliximab (IFX [Remicade]) treatment compared to those in relapse. Moreover, certain microbes, mainly Clostridiales , predicted the treatment effectiveness with 86.5% accuracy alone and 93.8% accuracy in combination with calprotectin levels and Crohn’s disease activity index (CDAI). Taking the results together, we conclude that gut microbiota can offer a set of universal biomarkers for diagnosis, disease activity evaluation, and infliximab treatment response prediction in IBD. IMPORTANCE In the present report, we show that the human fecal microbiota contains promising and universal biomarkers for the noninvasive evaluation of inflammatory bowel disease severity and IFX treatment efficacy, emphasizing the potential ability to mine the gut microbiota as a modality to stratify IBD patients and apply personalized therapy for optimal outcomes.