Specific members of the predominant gut microbiota predict XXXX following colectomy and IPAA in UC.

@entity1 @entity5042 @entity254 @entity3395 @entity3168
OBJECTIVE: @entity5042 is the most common complication after colectomy with ileal pouch-anal @entity254 (IPAA) for UC and the risk is the highest within the 1st year after surgery. The pathogenesis is not completely understood but clinical response to antibiotics suggests a role for gut microbiota. We hypothesised that the risk for @entity5042 can be predicted based on the faecal microbial composition before colectomy. DESIGN: Faecal samples from 21 @entity1 with UC undergoing IPAA were prospectively collected before colectomy and at predefined clinical visits at 1 month, 3 months, 6 months and 12   months after IPAA. The predominant microbiota was analysed using community profiling with denaturing gradient gel electrophoresis followed by quantitative real-time PCR validation. RESULTS: Cluster analysis before colectomy distinguished @entity1 with @entity5042 from those with normal pouch during the 1st year of follow-up. In @entity1 developing @entity5042 , an increase of Ruminococcus gnavus (p<0.001), @entity3395 (p=0.043), @entity3168 (p=0.011) and a reduction of two Lachnospiraceae genera (Blautia (p=0.04), Roseburia (p=0.008)) was observed. A score combining these five bacterial risk factors was calculated and presence of at least two risk factors showed a sensitivity and specificity of 100% and 63.6%, respectively. CONCLUSIONS: Presence of R. gnavus, @entity3395 and @entity3168 and absence of Blautia and Roseburia in faecal samples of @entity1 with UC before surgery is associated with a higher risk of @entity5042 after IPAA. Our findings suggest new predictive and therapeutic strategies in @entity1 undergoing colectomy with IPAA.
