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Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2022; 10(32): 11671-11689
Published online Nov 16, 2022. doi: 10.12998/wjcc.v10.i32.11671
Role of adherent invasive Escherichia coli in pathogenesis of inflammatory bowel disease
Lie Zheng, Sheng-Lei Duan, Yan-Cheng Dai, Shi-Cheng Wu
Lie Zheng, Sheng-Lei Duan, Department of Gastroenterology, Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi’an 322000, Shaanxi Province, China
Yan-Cheng Dai, Department of Gastroenterology, Shanghai Traditional Chinese Medicine Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
Shi-Cheng Wu, Department of Proctology, Gansu Academy of Traditional Chinese Medicine, Gansu Hospital of Traditional Chinese Medicine, Lanzhou 730050, Gansu Province, China
Author contributions: Zheng L, Duan SL, Dai YC, and Wu SC reviewed the literature, and drafted and revised the manuscript; Zheng L and Wu SC contributed to the design of this work, and performed overall supervision; Zheng L wrote and revised the paper; all authors approved the final manuscript.
Supported by the General Research of Xi’an Science and Technology Planning Project, No. 2022JH-YBYJ-0265; the Shaanxi Province Natural Science Basic Research Program-General Project, No. 2019JM-580; Project of Shaanxi Administration of Traditional Chinese Medicine, No. 2019-ZZ-JC010; and the Shaanxi Provincial Hospital of Traditional Chinese Medicine, No. 2018-04 and No. 2021-07.
Conflict-of-interest statement: All authors declare that there are no conflicts of interest to disclose.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shi-Cheng Wu, Department of Proctology, Gansu Academy of Traditional Chinese Medicine, Gansu Hospital of Traditional Chinese Medicine, No. 418 Guazhou Road, Qilihe District, Lanzhou 730050, Gansu Province, China. 594068860@qq.com
Received: June 12, 2022
Peer-review started: June 12, 2022
First decision: July 29, 2022
Revised: September 4, 2022
Accepted: October 11, 2022
Article in press: October 11, 2022
Published online: November 16, 2022
Processing time: 147 Days and 3.7 Hours
Abstract

Gut microbiota imbalances play an important role in inflammatory bowel disease (IBD), but no single pathogenic microorganism critical to IBD that is specific to the IBD terminal ileum mucosa or can invade intestinal epithelial cells has been found. Invasive Escherichia coli (E. coli) adhesion to macrophages is considered to be closely related to the pathogenesis of inflammatory bowel disease. Further study of the specific biological characteristics of adherent invasive E. coli (AIEC) may contribute to a further understanding of IBD pathogenesis. This review explores the relationship between AIEC and the intestinal immune system, discusses the prevalence and relevance of AIEC in Crohn's disease and ulcerative colitis patients, and describes the relationship between AIEC and the disease site, activity, and postoperative recurrence. Finally, we highlight potential therapeutic strategies to attenuate AIEC colonization in the intestinal mucosa, including the use of phage therapy, antibiotics, and anti-adhesion molecules. These strategies may open up new avenues for the prevention and treatment of IBD in the future.

Keywords: Adherent invasive Escherichia coli; Inflammatory bowel disease; Crohn's disease; Ulcerative colitis; Prevention

Core Tip: Gut microbiota imbalances play an important role in inflammatory bowel disease (IBD), but no single pathogenic microorganism critical to IBD, which is specific to the IBD terminal ileum mucosa or can invade intestinal epithelial cells, has been found. Invasive Escherichia coli (E. coli) adhesion to macrophages is considered to be closely related to the pathogenesis of IBD. Further study of the specific biological characteristics of adherent invasive E. coli (AIEC) may contribute to a further understanding of IBD pathogenesis. This review explores the relationship between AIEC and the intestinal immune system, discusses the prevalence and relevance of AIEC in Crohn's disease and ulcerative colitis patients, and describes the relationship between AIEC and the disease site, activity, and postoperative recurrence. Finally, we highlight potential therapeutic strategies to attenuate AIEC colonization in the intestinal mucosa, including the use of phage therapy, antibiotics, and anti-adhesion molecules. These strategies may open up new avenues for the prevention and treatment of IBD in the future.