Faster and less invasive tools to identify patients with ileal colonization by adherent-invasive E. coli in Crohn's disease.


Journal

United European gastroenterology journal
ISSN: 2050-6414
Titre abrégé: United European Gastroenterol J
Pays: England
ID NLM: 101606807

Informations de publication

Date de publication:
11 2021
Historique:
received: 25 03 2021
accepted: 27 07 2021
entrez: 18 11 2021
pubmed: 19 11 2021
medline: 22 2 2022
Statut: ppublish

Résumé

The identification of Crohn's disease (CD)-associated adherent and invasive Escherichia coli (AIEC) is time-consuming and requires ileal biopsies. We aimed to identify a faster and less invasive methods to detect ileal colonization by AIEC in CD patients. CD patients requiring ileo-colonoscopy were consecutively enrolled in this prospective multicenter study. Samples from saliva, serum, stools, and ileal biopsies of CD patients were collected. Among 102 CD patients, the prevalence of AIEC on ileal biopsies was 24.5%. The abundance and global invasive ability of ileal-associated total E. coli were respectively ten-fold (p = 0.0065) and two-fold (p = 0.0007) higher in AIEC-positive (vs. AIEC-negative), while abundance of total E. coli in the feces was not correlated with AIEC status in the ileum. The best threshold of ileal total E. coli was 60 cfu/biopsy to detect AIEC-positive patients, with high negative predictive value (NPV) (94.1%[80.3-99.3]), while the global invasive ability (>9000 internalized bacteria) was able to detect the presence of AIEC with high positive predictive value (80.0% [55.2-100.0]). Overall, 78.1% of the AIEC + patients were colonized by two or less different AIEC strains. The level of serum anti-total E. coli antibodies (AEcAb) was higher in AIEC-positive patients (p = 0.038) with a very high negative predictive value (96.6% [89.9-100.0]) (p = 0.038) for a cut-off value > 1.9 × 10 More than two thirds of AIEC-positive CD patients were colonized by two or less AIEC strains. While stools samples are not accurate to screen AIEC status, the AEcAb level appears to be an attractive, rapid and easier biomarker to identify patients with Crohn's disease harboring AIEC.

Sections du résumé

BACKGROUND AND AIMS
The identification of Crohn's disease (CD)-associated adherent and invasive Escherichia coli (AIEC) is time-consuming and requires ileal biopsies. We aimed to identify a faster and less invasive methods to detect ileal colonization by AIEC in CD patients.
METHODS
CD patients requiring ileo-colonoscopy were consecutively enrolled in this prospective multicenter study. Samples from saliva, serum, stools, and ileal biopsies of CD patients were collected.
RESULTS
Among 102 CD patients, the prevalence of AIEC on ileal biopsies was 24.5%. The abundance and global invasive ability of ileal-associated total E. coli were respectively ten-fold (p = 0.0065) and two-fold (p = 0.0007) higher in AIEC-positive (vs. AIEC-negative), while abundance of total E. coli in the feces was not correlated with AIEC status in the ileum. The best threshold of ileal total E. coli was 60 cfu/biopsy to detect AIEC-positive patients, with high negative predictive value (NPV) (94.1%[80.3-99.3]), while the global invasive ability (>9000 internalized bacteria) was able to detect the presence of AIEC with high positive predictive value (80.0% [55.2-100.0]). Overall, 78.1% of the AIEC + patients were colonized by two or less different AIEC strains. The level of serum anti-total E. coli antibodies (AEcAb) was higher in AIEC-positive patients (p = 0.038) with a very high negative predictive value (96.6% [89.9-100.0]) (p = 0.038) for a cut-off value > 1.9 × 10
CONCLUSIONS
More than two thirds of AIEC-positive CD patients were colonized by two or less AIEC strains. While stools samples are not accurate to screen AIEC status, the AEcAb level appears to be an attractive, rapid and easier biomarker to identify patients with Crohn's disease harboring AIEC.

Identifiants

pubmed: 34791806
doi: 10.1002/ueg2.12161
pmc: PMC8598958
doi:

Substances chimiques

Antibodies, Bacterial 0
Biomarkers 0

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1007-1018

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.

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Auteurs

Anthony Buisson (A)

Université Clermont Auvergne/Inserm U1071, USC-INRAe 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Clermont-Ferrand, France.
Université Clermont Auvergne, Inserm, 3iHP, CHU Clermont-Ferrand, Service d'Hépato-Gastro Entérologie, Clermont-Ferrand, France.

Emilie Vazeille (E)

Université Clermont Auvergne/Inserm U1071, USC-INRAe 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Clermont-Ferrand, France.
Université Clermont Auvergne, Inserm, 3iHP, CHU Clermont-Ferrand, Service d'Hépato-Gastro Entérologie, Clermont-Ferrand, France.

Mathurin Fumery (M)

Department of Hepatogastroenterology, Amiens University Hospital, and PeriTox UMR-I 01, Amiens, France.

Benjamin Pariente (B)

Department of Gastroenterology, Claude Huriez Hospital, University of Lille, Lille, France.

Stéphane Nancey (S)

Department of Gastroenterology, Lyon Sud Hospital, Hospices Civils de Lyon, and INSERM U-1111, CIRI, Lyon, France.

Philippe Seksik (P)

Gastroenterology, Sorbonne Universités, AP-HP, Hospital Saint-Antoine, Paris, France.

Laurent Peyrin-Biroulet (L)

Department of Gastroenterology, Nancy University Hospital, Nancy, France.
Inserm U1256 NGERE, Lorraine University, Nancy, France.

Matthieu Allez (M)

Inserm UMR 1160, AP-HP Gastroenterology Hôpital Saint Louis, Université Paris, Diderot, France.

Nathalie Ballet (N)

Lesaffre International, Lesaffre Group, Marcq-en-Barœul, France.

Jérôme Filippi (J)

Gastroenterology and Clinical Nutrition, CHU of Nice and University Côte d'Azur Nice, France.

Clara Yzet (C)

Department of Hepatogastroenterology, Amiens University Hospital, and PeriTox UMR-I 01, Amiens, France.

Maria Nachury (M)

Department of Gastroenterology, Claude Huriez Hospital, University of Lille, Lille, France.

Gilles Boschetti (G)

Department of Gastroenterology, Lyon Sud Hospital, Hospices Civils de Lyon, and INSERM U-1111, CIRI, Lyon, France.

Elisabeth Billard (E)

Université Clermont Auvergne/Inserm U1071, USC-INRAe 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Clermont-Ferrand, France.

Anaëlle Dubois (A)

Université Clermont Auvergne/Inserm U1071, USC-INRAe 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Clermont-Ferrand, France.

Stéphanie Rodriguez (S)

Université Clermont Auvergne/Inserm U1071, USC-INRAe 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Clermont-Ferrand, France.

Caroline Chevarin (C)

Université Clermont Auvergne/Inserm U1071, USC-INRAe 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Clermont-Ferrand, France.

Marion Goutte (M)

Université Clermont Auvergne/Inserm U1071, USC-INRAe 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Clermont-Ferrand, France.
Université Clermont Auvergne, Inserm, 3iHP, CHU Clermont-Ferrand, Service d'Hépato-Gastro Entérologie, Clermont-Ferrand, France.

Gilles Bommelaer (G)

Université Clermont Auvergne/Inserm U1071, USC-INRAe 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Clermont-Ferrand, France.
Université Clermont Auvergne, Inserm, 3iHP, CHU Clermont-Ferrand, Service d'Hépato-Gastro Entérologie, Clermont-Ferrand, France.

Bruno Pereira (B)

Université Clermont Auvergne, CHU Clermont-Ferrand, DRCI, Unité de Biostatistiques, Clermont-Ferrand, France.
Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Ferrand, France.

Xavier Hebuterne (X)

Gastroenterology and Clinical Nutrition, CHU of Nice and University Côte d'Azur Nice, France.

Nicolas Barnich (N)

Université Clermont Auvergne/Inserm U1071, USC-INRAe 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Clermont-Ferrand, France.

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