Basic Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2016; 22(40): 8929-8939
Published online Oct 28, 2016. doi: 10.3748/wjg.v22.i40.8929
Fecal microbiota in pouchitis and ulcerative colitis
Kai-Yu Li, Jian-Lin Wang, Jiang-Peng Wei, Sen-Yang Gao, Ying-Ying Zhang, Li-Tian Wang, Gang Liu
Kai-Yu Li, Jiang-Peng Wei, Sen-Yang Gao, Ying-Ying Zhang, Li-Tian Wang, Gang Liu, Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
Jian-Lin Wang, Department of General Surgery, Tianjin NanKai Hospital, Tianjin 300100, China
Author contributions: Li KY conceived and designed the study, acquired the data and contributed to final approval of the version of the article to be published; Wang JL performed the majority of the experiments and analyzed the data; Wei JP and Wang LT analyzed and interpreted the data; Wang JL drafted the manuscript; Gao SY and Zhang YY performed the statistical analysis and drafted the manuscript; Liu G revised the manuscript for important intellectual content, and supplied administrative, technical, and material support.
Supported by Academician Jie-Shou Li Intestinal Barrier Research Foundation, No. LJS_201008.
Institutional review board statement: The study was reviewed and approved by Tianjin Medical University General Hospital Institutional Review Board, Tianjin 300052, China.
Conflict-of-interest statement: This work was presented as a poster at the 10th International Congress on Autoimmunity in Leipzig, Germany, April 6-10, 2016. We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Gang Liu, MD, PhD, Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China.
Telephone: +86-22-60363901 Fax: +86-22-60362365
Received: June 24, 2016
Peer-review started: June 24, 2016
First decision: August 8, 2016
Revised: August 15, 2016
Accepted: August 30, 2016
Article in press: August 30, 2016
Published online: October 28, 2016

To investigate the changes in microbiota in feces of patients with ulcerative colitis (UC) and pouchitis using genomic technology.


Fecal samples were obtained from UC patients with or without an ileal pouch-anal anastomosis (IPAA) procedure, as well as healthy controls. The touchdown polymerase chain reaction technique was used to amplify the whole V3 region of the 16S rRNA gene, which was transcribed from DNA extracted from fecal samples. Denaturing gradient gel electrophoresis was used to separate the amplicons. The band profiles and similarity indices were analyzed digitally. The predominant microbiota in different groups was confirmed by sequencing the 16S rRNA gene.


Microbial biodiversity in the healthy controls was significantly higher compared with the UC groups (P < 0.001) and IPAA groups (P < 0.001). Compared with healthy controls, the UC patients in remission and those in the mildly active stage, the predominant species in patients with moderately and severely active UC changed obviously. In addition, the proportion of the dominant microbiota, which was negatively correlated with the disease activity of UC (r = -6.591, P < 0.01), was decreased in pouchitis patients. The numbers of two types of bacteria, Faecalibacterium prausnitzii and Eubacterium rectale, were reduced in UC. Patients with pouchitis had an altered microbiota composition compared with UC patients. The microbiota from pouchitis patients was less diverse than that from severely active UC patients. Sequencing results showed that similar microbiota, such as Clostridium perfringens, were shared in both UC and pouchitis.


Less diverse fecal microbiota was present in patients with UC and pouchitis. Increased C. perfringens in feces suggest its role in the exacerbation of UC and pouchitis.

Keywords: Pouchitis, Intestinal flora, Ulcerative colitis, Disease activity index, Ileal pouch-anal anastomosis

Core tip: Dysbiosis in pouchitis might be similar to that observed in ulcerative colitis (UC). This study aimed to determine the altered microflora in patients with UC and pouchitis, and to investigate the relationship between them. We demonstrated the reduced biodiversity of the fecal microbiota in UC and pouchitis patients. The altered composition of the intestinal microbiota in UC and pouchitis included decreased numbers of two bacteria commonly observed in UC, and higher levels of Clostridium perfringens in both UC and pouchitis. The increase of this bacterium in feces suggested that it plays a role in exacerbating UC and pouchitis.