Escherichia coli in chronic inflammatory bowel diseases: An update on adherent invasive Escherichia coli pathogenicity

Abstract

Escherichia coli (E. coli), and particularly the adherent invasive E. coli (AIEC) pathotype, has been increasingly implicated in the ethiopathogenesis of Crohn’s disease (CD). E. coli strains with similar pathogenic features to AIEC have been associated with other intestinal disorders such as ulcerative colitis, colorectal cancer, and coeliac disease, but AIEC prevalence in these diseases remains largely unexplored. Since AIEC was described one decade ago, substantial progress has been made in deciphering its mechanisms of pathogenicity. However, the molecular bases that characterize the phenotypic properties of this pathotype are still not well resolved. A review of studies focused on E. coli populations in inflammatory bowel disease (IBD) is presented here and we discuss about the putative role of this species on each IBD subtype. Given the relevance of AIEC in CD pathogenesis, we present the latest research findings concerning AIEC host-microbe interactions and pathogenicity. We also review the existing data regarding the prevalence and abundance of AIEC in CD and its association with other intestinal diseases from humans and animals, in order to discuss the AIEC disease- and host-specificity. Finally, we highlight the fact that dietary components frequently found in industrialized countries may enhance AIEC colonization in the gut, which merits further investigation and the implementation of preventative measures.

Keywords: Adherent invasive Escherichia coli, Inflammatory bowel disease, Crohn’s disease, Pathogenesis, Epidemiology

Core tip: In this review we critically revise the findings on Escherichia coli (E. coli) populations associated with Crohn’s disease and ulcerative colitis. Then we focus on adherent invasive E. coli (AIEC), especially in its mechanisms of pathogenicity and epidemiology. We discuss about AIEC disease- and host-specificity and we underline the importance of discovering specific molecular tools to detect AIEC for further epidemiologic studies. Finally we point out to a putative role of diet on AIEC gut colonization.