ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2021
Persistent Diarrhea in Patients With Crohn's Disease After Mucosal Healing Is Associated With Lower Diversity of the Intestinal Microbiome and Increased Dysbiosis.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 36 citations in OpenAlex.
- Irritable bowel syndrome.Nature reviews. Disease primers · 2026Review
- The Structure-Decoding-Conversion-Effect Paradigm of Natural Polysaccharides for Gut Microbiota Remodeling in Ulcerative Colitis.Nutrients · 2026Review
- Phenolamide Extract of Apricot Bee Pollen Alleviates DSS-Induced Ulcerative Colitis in Mice by Reducing Oxidative Stress, Modulating Inflammation, and Regulating Gut Microbiota.Antioxidants (Basel, Switzerland) · 2026Article
- Mucosa-associated bacteria and metabolites in inflammatory bowel disease: from inside to insight.NPJ biofilms and microbiomes · 2026Review
- Irritable Bowel Syndrome in Inflammatory Bowel Disease: An Evidence-Based Practical Review.Journal of clinical medicine · 2025Review
- Gut microbiota as a potential predictor of therapeutic response in adults with Crohn's disease: A systematic review.World journal of gastrointestinal pathophysiology · 2025Article
- Why Symptoms Linger in Quiescent Crohn's Disease: Investigating the Impact of Sulfidogenic Microbes and Sulfur Metabolic Pathways.Inflammatory bowel diseases · 2025Observational
- The Microbiome in Quiescent Crohn's Disease With Persistent Symptoms Show Disruptions in Microbial Sulfur and Tryptophan Pathways.Gastro hep advances · 2024Article
- Limitation of amino acid availability by bacterial populations during enhanced colitis in IBD mouse model.mSystems · 2023Article
- Association between gut microbial change and acute gastrointestinal toxicity in patients with prostate cancer receiving definitive radiation therapy.Cancer medicine · 2023Article
- The long-term gut bacterial signature of a wild primate is associated with a timing effect of pre- and postnatal maternal glucocorticoid levels.Microbiome · 2023Article
- Diarrheal-associated gut dysbiosis in cancer and inflammatory bowel disease patients is exacerbated byFrontiers in cellular and infection microbiology · 2023Article
- Intestinal Ecology Changes in Diarrheic Père David's Deer Revealed by Gut Microbiota and Fecal Metabolites Analysis.Animals : an open access journal from MDPI · 2022Article
- Effects of Decreasing Fishmeal as Main Source of Protein on Growth, Digestive Physiology, and Gut Microbiota of Olive Flounder (Animals : an open access journal from MDPI · 2022Article
- Integrative Analysis of Colonic Biopsies from Inflammatory Bowel Disease Patients Identifies an Interaction Between Microbial Bile Acid-inducible Gene Abundance and Human Angiopoietin-like 4 Gene Expression.Journal of Crohn's & colitis · 2021Article
- Systematic Review: The Gut Microbiome and Its Potential Clinical Application in Inflammatory Bowel Disease.Microorganisms · 2021Review
- Clinical relevance of intestinal barrier dysfunction in common gastrointestinal diseases.World journal of gastrointestinal pathophysiology · 2020Review
- Diarrhea Induced by Small Molecule Tyrosine Kinase Inhibitors Compared With Chemotherapy: Potential Role of the Microbiome.Integrative cancer therapiesReview
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsIn patients with inflammatory bowel diseases (IBDs), symptoms do not always associate with the severity of endoscopic inflammation and can persist after mucosal healing. We investigated whether symptoms in patients with successfully treated IBD are related to the composition of the intestinal microbiome.
methodsWe analyzed 590 tissue biopsy specimens from 215 patients with IBD and 48 healthy individuals (controls). We obtained mucosal biopsy specimens from 2 colon sites (ascending and rectosigmoid) and from the terminal ileum along with clinical data. Bacterial DNA was extracted from the biopsy specimens and the V4 region of 16s ribosomal RNA sequenced by Miseq and processed using the QIIME v1.9 pipeline.
resultsMucosal biopsy specimens from patients with Crohn's disease (CD) who achieved mucosal healing (Mayo scores of 0-1 or segmental endoscopic severity CD scores of 0-5) had lower Chao1 diversity than biopsy specimens from patients with ulcerative colitis (UC) or unclassified IBD (IBD-U), or controls. After endoscopic evidence of improvement in patients with UC or IBD-U, diversity of the tissue-associated microbiota did not differ significantly from that of controls. Colon biopsy specimens from patients with CD had lower microbial diversity, before and after healing (segmental endoscopic severity CD scores, 0-2), than colon biopsy specimens from controls (P < .002). In patients with CD who achieved mucosal healing, residual clinical activity (CD activity index scores >150; P = .03) and persistent diarrhea were associated with reduced microbial diversity (P = .01). Continued diarrhea was associated with a trend toward dysbiosis, based on the microbial dysbiosis index (P = .059). In patients with UC or IBD-U with moderate to severe inflammation, increasing severity of diarrhea was associated with reduced microbial diversity (P = .03).
conclusionsIn an analysis of biopsy specimens from patients with IBD and controls, we found that despite endoscopic evidence of improvement or remission, α-diversity of the tissue-associated intestinal microbiome remained lower in patients with CD than in controls. This observation, along with the reduced Chao1 diversity and greater dysbiosis in intestinal microbiota of patients with residual symptoms of IBD, indicates that microbiome composition could be associated with persistent diarrhea.
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