8th Annual BMRP Investigator Meeting - Abstract
The Bacteriology of Pouchitis: A Molecular Phylogenetic Analysis Using 16S rRNA Gene Cloning and Sequencing
Simon D. McLaughlin1,2,3,b, Alan W. Walker4, Carol Churcher4, Susan K. Clark2, Paris P. Tekkis1,2,a, Matt W. Johnson2,3, Julian Parkhill4, Paul J. Ciclitira3, Gordon Dougan5, R. John Nicholls1 and Liljana Petrovska3
1Department of Biosurgery and Surgical Technology, Imperial College London; 2Department of Gastroenterology & Surgery, St. Mark’s Hospital, London; 3Department of Gastroenterology, Nutritional Sciences Division, King’s College London (United Kingdom); 4Pathogen Genomics Group and 5Microbial Pathogenesis Group, Wellcome Trust Sanger Institute (Cambridgeshire, United Kingdom)
Pouchitis is the most common complication following restorative proctocolectomy (RPC). We investigated the microbiota in patients with and without pouchitis undergoing RPC for UC and familial adenomatous polyposis (FAP). Pouch biopsies were analysed to the species level by cloning and sequencing. There was a significant increase in Proteobacteria (p= 0.019) & a significant decrease in Bacteroidetes (p= 0.001) & Faecalibacterium prausnitzii (p=0.029) in the total UC compared to the total FAP cohort, but only limited differences were found between the UC non-pouchitis and pouchitis groups and the FAP pouchitis and non-pouchitis groups. Bacterial diversity in the FAP non-pouchitis group was significantly greater than in UC non-pouchitis (p= 0.019) & significantly greater in UC non-pouchitis compared to UC pouchitis (p= 0.009). UC pouch patients have a different, less diverse, gut microbiota than FAP patients. A further reduction in bacterial diversity but no significant dysbiosis occurs in those with pouchitis. The study suggests that a dysbiosis occurs in the ileal pouch of UC RPC patients which predisposes to, but may not directly cause, pouchitis.