Characterization of the Gut Microbiota and Mycobiota in Italian Pediatric Patients With Primary Sclerosing Cholangitis and Ulcerative Colitis

• Published in: Inflammatory bowel diseases Vol. 30; no. 4; pp. 529 - 537
• Main Authors: Del Chierico, Federica, Cardile, Sabrina, Baldelli, Valerio, Alterio, Tommaso, Reddel, Sofia, Bramuzzo, Matteo, Knafelz, Daniela, Lega, Sara, Bracci, Fiammetta, Torre, Giuliano, Maggiore, Giuseppe, Putignani, Lorenza
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 03.04.2024
• Subjects: Bacteria - genetics; Bacteroidetes; Child; Cholangitis; Cholangitis, Sclerosing - complications; Colitis, Ulcerative - complications; Dysbiosis - microbiology; Editor's Choice; Gastrointestinal Microbiome; Gut microbiota; Humans; Inflammatory bowel disease; Italy; Leading Off; Microbiota; Patients; Pediatrics; RNA, Ribosomal, 16S - genetics; Italy; gut mycobiota; ulcerative colitis; primary sclerosing cholangitis; gut microbiota; dysbiosis
• ISSN: 1078-0998; 1536-4844; 1536-4844
• DOI: 10.1093/ibd/izad203

Abstract Background Primary sclerosing cholangitis (PSC) is a chronic, fibroinflammatory, cholestatic liver disease of unknown etiopathogenesis, often associated with inflammatory bowel diseases. Recent evidence ascribes, together with immunologic and environmental components, a significant role to the intestinal microbiota or its molecules in the PSC pathogenesis. Methods By metagenomic sequencing of 16S rRNA and ITS2 loci, we describe the fecal microbiota and mycobiota of 26 pediatric patients affected by PSC and concomitant ulcerative colitis (PSC-UC), 27 patients without PSC but with UC (UC), and 26 healthy subjects (CTRLs). Results Compared with CTRL, the bacterial and fungal gut dysbiosis was evident for both PSC-UC and UC groups; in particular, Streptococcus, Saccharomyces, Sporobolomyces, Tilletiopsis, and Debaryomyces appeared increased in PSC-UC, whereas Klebsiella, Haemophilus, Enterococcus Collinsella, Piptoporus, Candida, and Hyphodontia in UC. In both patient groups, Akkermansia, Bacteroides, Parabacteroides, Oscillospira, Meyerozyma and Malassezia were decreased. Co-occurrence analysis evidenced the lowest number of nodes and edges for fungi networks compared with bacteria. Finally, we identified a specific patient profile, based on liver function tests, bacterial and fungal signatures, that is able to distinguish PSC-UC from UC patients. Conclusions We describe the gut microbiota and mycobiota dysbiosis associated to PSC-UC disease. Our results evidenced a gut imbalance, with the reduction of gut commensal microorganisms with stated anti-inflammatory properties (ie, Akkermansia, Bacteroides, Parabacteroides, Oscillospira, Meyerozyma, and Malassezia) and the increase of pathobionts (ie, Streptococcus, Saccharomyces, and Debaryomyces) that could be involved in PSC progression. Altogether, these events may concur in the pathophysiology of PSC in the framework of UC. Lay Summary In this study, we report the gut microbiota and mycobiota dysbiosis in pediatric patients affected by primary sclerosing cholangitis (PSC) associated with ulcerative colitis (UC), with an increase in pro-inflammatory pathobionts and a reduction in anti-inflammatory commensals.