Altered Duodenal Microbiota Composition in Celiac Disease Patients Suffering From Persistent Symptoms on a Long-Term Gluten-Free Diet

被引:140
作者
Wacklin, Pirjo [1 ]
Laurikka, Pilvi [2 ]
Lindfors, Katri [3 ,4 ]
Collin, Pekka [2 ,5 ]
Salmi, Teea [2 ,6 ]
Lahdeaho, Marja-Leena [3 ,4 ]
Saavalainen, Palvi [7 ,8 ]
Maki, Markku [3 ,4 ]
Matto, Jaana [1 ]
Kurppa, Kalle [3 ,4 ]
Kaukinen, Katri [2 ,9 ,10 ]
机构
[1] Finnish Red Cross Blood Serv, Helsinki, Finland
[2] Univ Tampere, Sch Med, Tampere 33520, Finland
[3] Univ Tampere, Tampere Ctr Child Hlth Res, Tampere 33520, Finland
[4] Tampere Univ Hosp, Tampere 33520, Finland
[5] Tampere Univ Hosp, Dept Gastroenterol & Alimentary Tract Surg, Tampere, Finland
[6] Tampere Univ Hosp, Dept Dermatol, Tampere, Finland
[7] Univ Helsinki, Haartman Inst, Res Programs Unit, Helsinki, Finland
[8] Univ Helsinki, Haartman Inst, Dept Med Genet, Helsinki, Finland
[9] Tampere Univ Hosp, Dept Internal Med, Tampere, Finland
[10] Seinajoki Cent Hosp, Seinajoki, Finland
基金
芬兰科学院;
关键词
IRRITABLE-BOWEL-SYNDROME; INTESTINAL BACTERIAL OVERGROWTH; QUALITY-OF-LIFE; GASTROINTESTINAL SYMPTOMS; GUT MICROBIOTA; FECAL MICROBIOTA; PREVALENCE; POPULATIONS; DIVERSITY; CHILDREN;
D O I
10.1038/ajg.2014.355
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
OBJECTIVES: A significant fraction of celiac disease patients suffer from persistent symptoms despite a long-term gluten-free diet (GFD) and normalized small bowel mucosa. The commonly suggested reasons, such as inadvertent gluten-intake or presence of other gastrointestinal disease, do not explain the symptoms in all these patients. Recently, alterations in intestinal microbiota have been associated with autoimmune disorders, including celiac disease. This led us to test a hypothesis that abnormal intestinal microbiota may be associated with persisting gastrointestinal symptoms in treated celiac disease patients. METHODS: Duodenal microbiota was analyzed in 18 GFD-treated patients suffering from persistent symptoms and 18 treated patients without symptoms by 16S rRNA gene pyrosequencing. The celiac disease patients had been following a strict GFD for several years and had restored small bowel mucosa and negative celiac autoantibodies. Their symptoms on GFD were assessed with Gastrointestinal Symptom Rating Scale. RESULTS: The results of several clustering methods showed that the treated celiac disease patients with persistent symptoms were colonized by different duodenal microbiota in comparison with patients without symptoms. The treated patients with persistent symptoms had a higher relative abundance of Proteobacteria (P = 0.04) and a lower abundance of Bacteroidetes (P = 0.01) and Firmicutes (P = 0.05). Moreover, their microbial richness was reduced. The results indicated intestinal dysbiosis in patients with persistent symptoms even while adhering to a strict GFD. CONCLUSIONS: Our findings indicate that dysbiosis of microbiota is associated with persistent gastrointestinal symptoms in treated celiac disease patients and open new possibilities to treat this subgroup of patients.
引用
收藏
页码:1933 / 1941
页数:9
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