ArticleFrontiers in pediatrics2026
Baseline gut microbiome features associated with fecal calprotectin response to exclusive enteral nutrition in pediatric Crohn's disease.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and aims: Exclusive enteral nutrition is an established induction therapy for pediatric Crohn's disease, but biochemical response varies across patients. We assessed whether baseline gut microbiome features were associated with fecal calprotectin response and whether treatment-related taxonomic shifts could be interpreted alongside reported fecal biochemical summaries. Methods: We re-analyzed a public pediatric cohort (PRJEB14084). Paired baseline and end-of-treatment microbiome profiles were summarized as within-subject genus-level changes. Reported stool biochemical summaries were used as contextual data. Baseline model performance was explored by repeated nested cross-validation with calibration assessment. An independent pediatric cohort (PRJEB33603) was used only for summary-level external comparison. Results: Several genera changed consistently during treatment. Stool biochemical summaries showed lower total amino acids and tryptophan and higher secondary bile-acid proportion and hydrophobicity index at the end of treatment. The baseline model showed modest discrimination with broad uncertainty (mean area under the receiver operating characteristic curve, 0.655; 95% confidence interval, 0.450-0.850). In the external comparison, 7 of 12 overlapping genera showed concordant directions. Conclusion: In this public cohort, baseline microbiome features showed an exploratory association with fecal calprotectin response, but the estimates were imprecise. External comparison was limited to published summary tables, and all inferences remain association-based.
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