The gut microbial profile in patients with primary sclerosing cholangitis is distinct from patients with ulcerative colitis without biliary disease and healthy controls

• Published in: Gut Vol. 66; no. 4; pp. 611 - 619
• Main Authors: Kummen, Martin, Holm, Kristian, Anmarkrud, Jarl Andreas, Nygård, Ståle, Vesterhus, Mette, Høivik, Marte L, Trøseid, Marius, Marschall, Hanns-Ulrich, Schrumpf, Erik, Moum, Bjørn, Røsjø, Helge, Aukrust, Pål, Karlsen, Tom H, Hov, Johannes R
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.04.2017
• Subjects: Adult; Aged; Aged, 80 and over; Antibiotics; Area Under Curve; Case-Control Studies; Cholangitis; Cholangitis, Sclerosing - complications; Cholangitis, Sclerosing - drug therapy; Cholangitis, Sclerosing - microbiology; Clinical Medicine; Colitis, Ulcerative - complications; Colitis, Ulcerative - microbiology; Cross-Sectional Studies; Feces - microbiology; Female; Gastroenterologi; Gastroenterology and Hepatology; Gastrointestinal Microbiome; Health risk assessment; Healthy Volunteers; Hospitals; Humans; Klinisk medicin; Liver diseases; Male; Microbiota; Middle Aged; Neutrophils; Pathogenesis; Phosphatase; Prospective Studies; Quality control; RNA, Ribosomal, 16S - analysis; ROC Curve; Severity of Illness Index; Vegetarianism; Veillonella; Veillonella - isolation & purification; Young Adult; United States > US; Norway; California; HEPATOBILIARY DISEASE; PRIMARY SCLEROSING CHOLANGITIS
• ISSN: 0017-5749; 1468-3288; 1468-3288
• DOI: 10.1136/gutjnl-2015-310500

ObjectiveGut microbiota could influence gut, as well as hepatic and biliary immune responses. We therefore thoroughly characterised the gut microbiota in primary sclerosing cholangitis (PSC) compared with healthy controls (HC) and patients with ulcerative colitis without liver disease.DesignWe prospectively collected 543 stool samples. After a stringent exclusion process, bacterial DNA was submitted for 16S rRNA gene sequencing. PSC and HC were randomised to an exploration panel or a validation panel, and only significant results (p<0.05, QFDR<0.20) in both panels were reported, followed by a combined comparison of all samples against UC.ResultsPatients with PSC (N=85) had markedly reduced bacterial diversity compared with HC (N=263, p<0.0001), and a different global microbial composition compared with both HC (p<0.001) and UC (N=36, p<0.01). The microbiota of patients with PSC with and without IBD was similar. Twelve genera separated PSC and HC, out of which 11 were reduced in PSC. However, the Veillonella genus showed a marked increase in PSC compared with both HC (p<0.0001) and UC (p<0.02). Using receiver operating characteristic analysis, Veillonella abundance yielded an area under the curve (AUC) of 0.64 to discriminate PSC from HC, while a combination of PSC-associated genera yielded an AUC of 0.78.ConclusionsPatients with PSC exhibited a gut microbial signature distinct from both HC and UC without liver disease, but similar in PSC with and without IBD. The Veillonella genus, which is also associated with other chronic inflammatory and fibrotic conditions, was enriched in PSC.