Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2021; 27(28): 4722-4737
Published online Jul 28, 2021. doi: 10.3748/wjg.v27.i28.4722
Relationship between clinical features and intestinal microbiota in Chinese patients with ulcerative colitis
Xu-Xia He, Ying-He Li, Peng-Guang Yan, Xiang-Chen Meng, Chu-Yan Chen, Ke-Min Li, Jing-Nan Li
Xu-Xia He, Ying-He Li, Peng-Guang Yan, Xiang-Chen Meng, Chu-Yan Chen, Ke-Min Li, Jing-Nan Li, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Author contributions: He XX and Li YH contributed equally to this work; He XX, Li YH, and Li JN contributed to study concept and design, data collection, analysis, and interpretation, and review of the manuscript; Yan PG, Meng XC, Chen CY, and Li KM were responsible for the data collection, analysis, and interpretation of the manuscript; all authors contributed to the article and approved the submitted version.
Supported by the 13th Five-Year Plan for National Key R&D Program of China, No. 2018YFC1705402; and National Natural Science Foundation of China, No. 81770559 and No. 81370500.
Institutional review board statement: This study was approved by the Ethical Committee of Peking Union Medical College Hospital (No. JS-1488).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest and financial disclosure with respect to the authorship and/or publication of this article.
Data sharing statement: Technical appendix and other data available from the corresponding author at lijn2008@126.com. Participants gave informed consent for data sharing.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Nan Li, MD, Doctor, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Dongdan Santiao, Dongcheng District, Beijing 100730, China. lijn2008@126.com
Received: January 26, 2021
Peer-review started: January 26, 2021
First decision: February 27, 2021
Revised: March 7, 2021
Accepted: July 5, 2021
Article in press: July 5, 2021
Published online: July 28, 2021
Abstract
BACKGROUND

Dysbacteriosis may be a crucial environmental factor for ulcerative colitis (UC). Further study is required on microbiota alterations in the gastrointestinal tract of patients with UC for better clinical management and treatment.

AIM

To analyze the relationship between different clinical features and the intestinal microbiota, including bacteria and fungi, in Chinese patients with UC.

METHODS

Eligible inpatients were enrolled from January 1, 2018 to June 30, 2019, and stool and mucosa samples were collected. UC was diagnosed by endoscopy, pathology, Mayo Score, and Montreal classification. Gene amplicon sequencing of 16S rRNA gene and fungal internal transcribed spacer gene was used to detect the intestinal microbiota composition. Alpha diversity, principal component analysis, similarity analysis, and Metastats analysis were employed to evaluate differences among groups.

RESULTS

A total of 89 patients with UC and 33 non-inflammatory bowel disease (IBD) controls were enrolled. For bacterial analysis, 72 stool and 48 mucosa samples were obtained from patients with UC and 21 stool and 12 mucosa samples were obtained from the controls. For fungal analysis, stool samples were obtained from 43 patients with UC and 15 controls. A significant difference existed between the fecal and mucosal bacteria of patients with UC. The α-diversity of intestinal bacteria and the relative abundance of some families, such as Lachnospiraceae and Ruminococcaceae, decreased with the increasing severity of bowel inflammation, while Escherichia-Shigella showed the opposite trend. More intermicrobial correlations in UC in remission than in active patients were observed. The bacteria-fungi correlations became single and uneven in patients with UC.

CONCLUSION

The intestinal bacteria flora of patients with UC differs significantly in terms of various sample types and disease activities. The intermicrobial correlations change in patients with UC compared with non-IBD controls.

Keywords: Ulcerative colitis, Intestinal microbiota, Intermicrobial correlation, Bacteria, Fungi, Chinese

Core Tip: Further study is required on gut microbiota alterations in patients with ulcerative colitis (UC). This study aimed to analyze the relationship between clinical features and the intestinal microbiota, including bacteria and fungi, in Chinese patients with UC. Gene amplicon sequencing of 16S rRNA gene and fungal internal transcribed spacer gene was applied. A total of 89 UC patients and 33 controls were enrolled. Results showed that the intestinal bacteria flora of patients with UC differed significantly in terms of various sample types and disease activities. The intermicrobial correlations changed in patients with UC compared with controls.