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dcrname ="iwDCR0_091606"> <header class="-padding--horizontal" itemscope itemtype="http://schema.org/ScholarlyArticle"> <div class="content-header content-container -width--wide -centered"> <div class="tags"> <ul class="tag__list"> <li class="tag__item"> <a class="tag__link" href="/digestive-health/topic.aspx?id=1040">Bowel Disease</a> </li> <li class="tag__item"> <a class="tag__link" href="/digestive-health/specialty.aspx?id=1007">Digestive Health</a> </li> </ul> </div> <h1 class="content-header__heading" itemprop="name">Research Highlights Intestinal Dysbiosis as Defining Feature of Microscopic Colitis</h1> <div class="content-header__metadata"> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2019-12-17" itemprop="datePublished">Published on December 17, 2019 </time> </p> <p data-module="share-links"> </p> <p class="citation"> Originally published on <cite itemprop="citation"><a href="https://www.cghjournal.org/article/S1542-3565(19)30726-8/">Clinical Gastroenterology and Hepatology</a></cite> </p> </div> </div> </header> <div class="-padding--vertical -padding--horizontal"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__main"> <div class="layout-columns__main__content"> <div class="content-summary"> <h3 class="content-summary__heading">Key findings</h3> <ul> <li>Research demonstrated changes in diversity and dysbiosis during the active versus remission phases of microscopic colitis, and in patients with active microscopic colitis versus controls</li> <li>A bacterium previously reported to have anti-inflammatory properties was significantly less abundant in patients with active microscopic colitis than in those with functional diarrhea or those whose colitis was in remission</li> <li>The relative abundance of several metabolic pathways, including those involved in glucose biosynthesis and adaptation to oxidative stress, were decreased in patients with active microscopic colitis</li> </ul> </div> <p> <p>Several years ago, Swedish gastroenterologists reported the case of a woman with intractable microscopic colitis who required a temporary ileostomy and had colonic biopsies analyzed before, during and after fecal stream diversion. The resolution of mucosal inflammation was noted with fecal diversion, and they found that restoration of the fecal stream was associated with recurrence of the disease. Their observations suggest the gut microbiome has a critical role in microscopic colitis.</p><div class="article__signup-container"> <div class="email-signup-inline__container -background--white"> <style> #email-signup-inline { /* 540px */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } @media only screen and (-webkit-min-device-pixel-ratio: 2), only screen and (min--moz-device-pixel-ratio: 2), only screen and (-moz-min-device-pixel-ratio: 2), only screen and (-o-min-device-pixel-ratio: 2/1), only screen and (min-device-pixel-ratio: 2), only screen and (min-resolution: 192dpi), only screen and (min-resolution: 2dppx) { #email-signup-inline { /* 1080 width */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } } </style> <div class="content-container -width--wide -centered email-signup-inline__wrapper" id="email-signup-inline"> <div class="email-signup-inline__logo"> <img alt="Massachusetts General Hospital building" src="/assets/logos/logo-white.svg"> </div> </div> <div class="email-signup-inline"> <h3 class="email-signup-inline__heading">Subscribe to the latest updates from Digestive Health Advances in Motion</h3> <p class="email-signup-inline__subheading"></p>  <meta http-equiv="Content-Type" content="text/html; 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Their findings are published in <a href="https://www.cghjournal.org/article/S1542-3565%2819%2930726-8/" target="_blank"><em>Clinical Gastroenterology and Hepatology</em></a>.</p> <h2>Study Participants</h2> <p>Researchers sequenced the microbiome of stool samples from 60 patients:</p> <ul> <li>20 patients during the active and remission phases of microscopic colitis (80% female, average age 63)</li> <li>20 age- and sex-matched healthy controls</li> <li>20 patients with functional diarrhea (65% female, average age 62)</li> </ul> <p>The active phase of microscopic colitis was defined as at least three bowel movements per day and a Bristol score ≥5. The researchers calculated a <a href="https://www.cell.com/cell-host-microbe/fulltext/S1931-3128%2814%2900063-8" target="_blank" rel="noopener noreferrer">microbial dysbiosis index</a> as the log of [the total abundance of organisms increased] divided by [the total abundance of organisms decreased].</p> <h2>Diversity of the Microbiome</h2> <p>Researchers discovered that, in patients with colitis, there was a significant difference in alpha diversity (the number of different species represented) between the active and remission phases.</p> <p>Alpha diversity was lower in patients with active colitis than in healthy controls or patients with functional diarrhea, although the differences were not statistically significant.</p> <p>The microbial dysbiosis index was significantly higher in patients with active colitis than in healthy controls, patients with functional diarrhea or those whose colitis was in remission.</p> <h2>Growth Dynamics of the Microbiome</h2> <p>The researchers explored whether disease status was more strongly linked to the growth dynamics of the gut microbiome than to the diversity of species. They estimated the peak-to-trough ratio (PTR), a measure of species' growth rates.</p> <ul> <li>Compared to healthy controls, patients with active colitis showed significant increases in the global PTR and the <em>Alistipes finegoldii</em>–specific PTR</li> <li>There were no significant differences in PTRs when patients with active colitis were compared to those with functional diarrhea or those whose colitis was in remission</li> </ul> <p><em>Alistipes </em>species are butyrate-producing bacteria that demonstrated anti-inflammatory properties in a mouse model of colitis and are depleted in pediatric patients with new-onset inflammatory disease.</p> <h2>Composition of the Microbiome</h2> <p><em>Alistipes putredinis </em>was significantly less abundant in patients with colitis than in healthy controls or patients with functional diarrhea.</p> <p><em>Haemophilus</em> <em>parainfluenzae</em>, <em>Veillonella</em> <em>parvula </em>and <em>Veillonella </em>unclassified species were significantly more abundant in patients with colitis than in healthy controls.</p> <p>There were no significant differences at the species level when patients with active colitis were compared with those whose colitis was in remission.</p> <h2>Functional Profiling</h2> <p>The gluconeogenesis I pathway (involved in glucose synthesis) and the inosine-5-phosphate biosynthesis III pathway (involved in adaptation to oxidative stress) were decreased in patients with active colitis compared to healthy controls.</p> <p>Researchers also found that degradation of purine deoxyribonucleoside was increased in patients with active colitis compared to healthy controls.</p> <p>They conclude that, <a href="https://www.gastrojournal.org/article/S0016-5085%2814%2900220-0/" target="_blank">similar to the case of inflammatory bowel disease</a>, dysbiosis is the defining feature of the gut microbiome in patients with microscopic colitis.</p> <p></p> <p></p> <p></p> </p><p class="fat-link__wrapper u-text-right"> <a class="fat-link -caret -large" href="https://www.cghjournal.org/article/S1542-3565(19)30726-8/">view original journal article <em>Subscription may be required</em></a> </p> <div class="article-attribution" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="article-attribution__logo" itemscope itemtype="http://schema.org/Periodical"> <a href="https://www.cghjournal.org/article/S1542-3565(19)30726-8/"> <span class="a11y-sr-only" itemprop="name">Clinical Gastroenterology and Hepatology</span> </a> </p> <p class="article-attribution__metadata" itemscope itemtype="http://schema.org/PublicationIssue"> <span> Journal Article Published: <time datetime="2019-06-26" itemprop="datePublished">June 26, 2019</time> </span> </p> </div> <p class="cta">Refer a patient to the <a href="https://www.massgeneral.org/digestive/contact/">Digestive Healthcare Center</a></p> <p class="cta">Visit the <a href="https://www.massgeneral.org/digestive/treatments-and-services/crohns-colitis">Crohn's and Colitis Center</a></p> </div> </div> <aside class="layout-columns__sidebar -article__contributors"> <div class="layout-columns__sidebar__content"> <div class="profile-compact__wrapper"> <p class="u-no-margin"> <strong>Contributors</strong> </p> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=1324" itemprop="url">Hamed Khalili, MD, MPH ›</a></h3><p class="profile__title" itemprop="jobTitle">Gastroenterologist, Clinical and Translational Epidemiology Unit, Director of Clinical Research in Inflammatory Bowel Disease in the Division of Gastroenterology, Associate Professor of Medicine, Harvard Medical School</p> </div> <p class="profile__image"> <img alt="" itemprop="image" srcset="/assets/images/contributors/hamed_khalili_advances.png, /assets/images/contributors/hamed_khalili_advances_2x.png 2x" src="/assets/images/contributors/hamed_khalili_advances.png"> </p> </div> </div> </div> </aside> <section class="topics-layout -article__related"> <div class="topics-layout__inner"> <div class="topics-layout__sidebar"> <h2 class="section-heading">Related topics</h2> </div> <div class="topics-layout__main"> <ul class="topics-list" data-module="topics-list"> <li><a href="/digestive-health/topic.aspx?id=1040">Bowel Disease</a></li> </ul> </div> </div> </section> <section class="-padding--horizontal -padding--vertical -article__related"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/digestive-health/journal.aspx?id=1413" itemprop="url">New Female-centric Research Provides Dietary Guidance for Preventing Diverticulitis</a> </h3> <p itemprop="description"> <p>Gastroenterologists at Massachusetts General Hospital have conducted the first comprehensive, prospective evaluation of dietary fiber intake in relation to the risk of diverticulitis in women.</p></p> <p class="content-tease__related"> <a href="/digestive-health/topic.aspx?id=1040" itemprop="relatedLink">Bowel Disease</a>, <a href="/digestive-health/specialty.aspx?id=1007" itemprop="relatedLink">Digestive Health</a>, <a href="/digestive-health/topic.aspx?id=1104" itemprop="relatedLink">Diverticulitis</a> </p> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2019-12-02" itemprop="datePublished">December 2, 2019</time> </p> </div> </div> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/digestive-health/journal.aspx?id=1418" itemprop="url">Dual Immunosuppression Linked to Better Outcomes in Complicated Crohn's Disease</a> </h3> <p itemprop="description"> <p> <p> <p>In a prospective multicenter cohort, combination therapy with a TNF inhibitor and an immunomodulator was associated with decreased rates of hospitalization, surgery and other adverse outcomes in patients with complicated Crohn's disease.</p> <p></p> <p></p> <p></p> <p></p> <p></p> </p> </p></p> <p class="content-tease__related"> <a href="/digestive-health/topic.aspx?id=1040" itemprop="relatedLink">Bowel Disease</a>, <a href="/digestive-health/specialty.aspx?id=1007" itemprop="relatedLink">Digestive Health</a> </p> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2019-12-09" itemprop="datePublished">December 9, 2019</time> </p> </div> 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