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Goloshchapov OV, Shchukina OB, Kusakin AV, Tsai VV, Kalinin RS, Eismont YA, Glotov OS, Chukhlovin AB. Next-Generation Sequencing-Based Monitoring of Intestinal Bacteria and Bacteriophages Following Fecal Microbiota Transplantation in Inflammatory Bowel Diseases. Pathogens 2023; 12:1438. [PMID: 38133321 PMCID: PMC10745900 DOI: 10.3390/pathogens12121438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
Inflammatory bowel diseases (IBD) and acute graft-versus-host disease (GVHD) are associated with persistent intestinal dysfunction preceded by gut bacterial dysbiosis. There are limited data on intestinal bacteriophages in these conditions. The aim of the present work was to detect associations between dominant intestinal bacteria by means of 16S rRNA gene sequencing, and some clinically significant viruses detected with a customized primer panel for NGS-based study. The clinical group included patients with Crohn's disease (IBD, n = 9), or GVHD (n = 6) subjected to fecal microbiota transplantation (FMT) from healthy donors. The stool specimens were taken initially, and 5 times post-FMT until day 120. Using NGS approach, we have found a higher abundance of Proteobacterota phylum in GVHD, especially, at later terms post-FMT. Moreover, we found an early increase of Klebsiella and E. coli/Shigella abundance in GVHD, along with decreased relative content of Faecalibacterium. Upon evaluation of intestinal phageome, the relative amount of Caudoviricetes class was higher in GVHD. A significant correlation was found between Proteobacteria and Caudoviricetes, thus suggesting their association during the post-FMT period. Moreover, the relative amounts of five Caudoviricetes phage species showed distinct correlations with Klebsiella and Enterococcus ratios at different terms of FMT. In conclusion, parallel use of 16S rRNA gene sequencing and targeted NGS viral panel is a feasible and useful option for tracing specific viral strains in fecal microbiota. The developed array of viral primers may be extended to detect other phages infecting the clinically relevant bacteria.
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Affiliation(s)
- Oleg V. Goloshchapov
- R.M. Gorbacheva Memorial Institute of Oncology, Hematology and Transplantation, Pavlov First Saint Petersburg State Medical University, 197022 St. Petersburg, Russia; (O.B.S.); (A.B.C.)
| | - Oksana B. Shchukina
- R.M. Gorbacheva Memorial Institute of Oncology, Hematology and Transplantation, Pavlov First Saint Petersburg State Medical University, 197022 St. Petersburg, Russia; (O.B.S.); (A.B.C.)
| | - Aleksey V. Kusakin
- Pediatric Research and Clinical Center for Infectious Diseases, 197022 St. Petersburg, Russia; (A.V.K.); (R.S.K.); (Y.A.E.); (O.S.G.)
| | | | - Roman S. Kalinin
- Pediatric Research and Clinical Center for Infectious Diseases, 197022 St. Petersburg, Russia; (A.V.K.); (R.S.K.); (Y.A.E.); (O.S.G.)
- Serbalab Laboratory, 199106 St. Petersburg, Russia;
| | - Yury A. Eismont
- Pediatric Research and Clinical Center for Infectious Diseases, 197022 St. Petersburg, Russia; (A.V.K.); (R.S.K.); (Y.A.E.); (O.S.G.)
- Serbalab Laboratory, 199106 St. Petersburg, Russia;
| | - Oleg S. Glotov
- Pediatric Research and Clinical Center for Infectious Diseases, 197022 St. Petersburg, Russia; (A.V.K.); (R.S.K.); (Y.A.E.); (O.S.G.)
| | - Alexei B. Chukhlovin
- R.M. Gorbacheva Memorial Institute of Oncology, Hematology and Transplantation, Pavlov First Saint Petersburg State Medical University, 197022 St. Petersburg, Russia; (O.B.S.); (A.B.C.)
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Sands BE, Irving PM, Hoops T, Izanec JL, Gao LL, Gasink C, Greenspan A, Allez M, Danese S, Hanauer SB, Jairath V, Kuehbacher T, Lewis JD, Loftus EV, Mihaly E, Panaccione R, Scherl E, Shchukina OB, Sandborn WJ. Ustekinumab versus adalimumab for induction and maintenance therapy in biologic-naive patients with moderately to severely active Crohn's disease: a multicentre, randomised, double-blind, parallel-group, phase 3b trial. Lancet 2022; 399:2200-2211. [PMID: 35691323 DOI: 10.1016/s0140-6736(22)00688-2] [Citation(s) in RCA: 83] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Active-comparator trials are important to inform patient and physician choice. We aimed to evaluate the efficacy and safety of monotherapy with either ustekinumab or adalimumab in biologic-naive patients with moderately to severely active Crohn's disease. METHODS We conducted a randomised, double-blind, parallel-group, active-comparator, phase 3b trial (SEAVUE) at 121 hospitals or private practices in 18 countries. We included biologic-naive patients aged 18 years or older with moderately to severely active Crohn's disease and a Crohn's Disease Activity Index (CDAI) score of 220-450, who had not responded to or were intolerant to conventional therapy (or were corticosteroid dependent) and had at least one ulcer of any size at baseline endoscopic evaluation. Eligible patients were randomly assigned (1:1; via an interactive web response system) to receive ustekinumab (approximately 6 mg/kg intravenously on day 0, then 90 mg subcutaneously once every 8 weeks) or adalimumab (160 mg on day 0, 80 mg at 2 weeks, then 40 mg once every 2 weeks, subcutaneously) through week 56. Study treatments were administered as monotherapy and without dose modifications. Patients, investigators, and study site personnel were masked to treatment group assignment. The primary endpoint was the proportion of patients who were in clinical remission (CDAI score <150) at week 52 in the intention-to-treat population (ie, all patients who were randomly assigned to a treatment group). This trial is registered with ClinicalTrials.gov, NCT03464136, and EudraCT, 2017-004209-41. FINDINGS Between June 28, 2018, and Dec 12, 2019, 633 patients were assessed for eligibility and 386 were enrolled and randomly assigned to receive ustekinumab (n=191) or adalimumab (n=195). 29 (15%) of 191 patients in the ustekinumab group and 46 (24%) of 195 in the adalimumab group discontinued study treatment before week 52. There was no significant difference between the ustekinumab and adalimumab groups in the occurrence of the primary endpoint; at week 52, 124 (65%) of 191 patients in the ustekinumab group versus 119 (61%) of 195 in the adalimumab group were in clinical remission (between-group difference 4%, 95% CI -6 to 14; p=0·42). Safety for both groups was consistent with previous reports. Serious infections were reported in four (2%) of 191 patients in the ustekinumab group and five (3%) of 195 in the adalimumab group. No deaths occurred through week 52 of the study. INTERPRETATION Both ustekinumab and adalimumab monotherapies were highly effective in this population of biologic-naive patients, with no difference in the primary outcome between the drugs. FUNDING Janssen Scientific Affairs.
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Affiliation(s)
- Bruce E Sands
- Dr Henry D Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Peter M Irving
- Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK; School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Timothy Hoops
- Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA, USA
| | | | | | | | | | - Matthieu Allez
- Gastroenterology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), INSERM U1160, Université de Paris, Paris, France
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milan, Italy
| | - Stephen B Hanauer
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Vipul Jairath
- Division of Gastroenterology, Department of Medicine, University Hospital, London, ON, Canada; Division of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Tanja Kuehbacher
- Department of Internal Medicine, Gastroenterology, Diabetology, Hemato-Oncology, and Palliative Medicine, Medius Clinic Nuertingen, Nürtingen, Germany
| | - James D Lewis
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Edward V Loftus
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Emese Mihaly
- Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Remo Panaccione
- Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada
| | - Ellen Scherl
- Weill Department of Medicine, New York Presbyterian Hospital Weill Cornell Medicine, New York, NY, USA
| | - Oksana B Shchukina
- Division The City Center for IBD Diagnosis and Treatment, Saint Petersburg State Budgetary Health Institution, City Clinical Hospital 31, Saint Petersburg, Russia
| | - William J Sandborn
- Division of Gastroenterology, University of California San Diego, La Jolla, CA, USA
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Pazenco EV, Karev VE, Raikhelson KL, Shchukina OB, Botina AV, Kharitonov AG, Semenov NV. [CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF INTESTINAL LESIONS IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS]. Eksp Klin Gastroenterol 2016:18-24. [PMID: 30284417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To compare the clinical, endoscopic picture and morphological changes of the intestinal mucosa in patients with primary sclerosing cholangitis (PSC). MATERIALS AND METHODS 31 patients with PSC (women - 15 men - 16) were included in study group. The diagnosis of ulcerative colitis (UC) was established in 8 patients, Crohn’s disease (CD) - in 5, unclassified colitis (UCC) - in 7, and 11 patients had no clinical and endoscopic signs of IBD. The control group consisted of 30 patients with IBD: UC - 20 patients, CD - 10 persons. All the patients performed ileocolonoscopy (ICS) with multiple biopsy and histological examination of material. RESULTS The prevalence of IBD in patients with PSC was 64.5%. IBD with PSC was characterized by extensive colitis with mild clinical activity. Morphological activity of IBD associated with PSC was usually moderate and severe. Morphological activity of disease in IBD/PSC group was lower than in UC alone (p < 0.05). IBD onset came before PSC symptoms (p < 0.05). Distal gradient of inflammation in colon predominated in IBD/PSC group when disease starts with IBD symptoms, in case of PSC symptoms - proximal gradient was more frequent. In IBD/PSC group affected ileum were detected in a third of cases, including CD ileitis - 60%, backwash ileitis in UC (NCC) in 26.7%, that was significantly frequently than in UC alone (p = 0.02). Within the IBD/PSC group 30% of patients with colitis were without damaging of rectum. In all the patients with PSC without clinical, endoscopic signs of colitis polymorphocellular infiltration of mucosa were founded. Eosinophilic infiltration of mucosa in group of PSC met significantly more frequently than in other study groups. Fibrosis of intestinal mucosa was founded significantly more frequently in group of PSC without IBD compared with UC/PSC and UC patients, but not with CD group. CONCLUSIONS For IBD in PSC extensive colitis without lesions of the rectum, backwash ileitis are common. There are some morphological differences in the intestinal lesions within the IBD/PSC patients depending on the type of disease onset. There is a dissociation between low clinical activity and intensive morphological inflammation. When PSC had no clinical features of IBD, a microscopic ileocolitis (characterized by eosinophilic infiltration and fibrosis of the intestinal mucosa) without nosological classification was founded in all patients.
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Kvetnoĭ IM, Robakidze NS, Kostiuchek IN, Shchukina OB, Proshchaev KI. [Morphological and immunohistochemical characteristic of oral mucosa in patients with inflammatory bowel disease]. Adv Gerontol 2010; 23:371-374. [PMID: 21137207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The aim of presented study was to investigate the morphological and immunohistochemical characteristics of the oral mucosa in patients with Crohn's disease and ulcerative colitis. The study involved 40 patients aged from 18 to 64 years, among them 30 patients with Crohn's disease and 10 patients with ulcerative colitis. Clinical, endoscopic, morphometric and immunohistochemical study have shown that Crohn's disease is characterized by generalized inflammation in the gastrointestinal tract with signs of immune inflammation in the mouth, whereas in ulcerative colitis the pathologic process is limited to the colon. In this context, the defeat of the oral mucosa can be regarded as a distinct phenotypic characteristic of the localization of Crohn's disease, with some differential-diagnostic and prognostic criteria.
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Kvetnoĭ IM, Robakidze NS, Kostiuchek IN, Shchukina OB, Proshchaev KI. [Morphological and immunohistochemical characteristics of oral mucosa in patients with inflammatory intestinal disorders]. Klin Med (Mosk) 2009; 87:49-51. [PMID: 20143567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aim of the work was to study morphological and immunological characteristics of oral cavity in patients with Crohn's disease and ulcerative colitis. The group of 40 patients aged 18-64 yr included 30 with Crohn's disease and 10 with ulcerative colitis. They were examined in clinical, endoscopic, morphometric, and immunohistochemical studies. Crohn's disease was shown to be associated with inflammatory processes in the gastrointestinal tract and oral mucosa; in ulcerative colitis, these processes were confined to the colon. It is supposed that inflammation of oral mucosa may be regarded as a separate phenotypic characteristic of Crohn's disease localization with definitive differential diagnostic and prognostic criteria.
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