Markers of dysbiosis in patients with ulcerative colitis and Crohn's disease.

AIM: The aim of the study was to study the taxonomic and functional composition of the gut microbiota in ulcerative colitis (UC) and Crohn's disease (CD) patients to identify key markers of dysbiosis in IBD. MATERIALS AND METHODS: Fecal samples obtained from 95 IBD patients (78 UC and 17 CD) as well as 96 healthy volunteers were used for whole-genome sequencing carried out on the SOLiD 5500 W platform. Taxonomic profiling was performed by aligning the reeds, not maped on hg19, on MetaPhlAn2 reference database. Reeds were mapped using the HUNAnN2 algorithm to the ChocoPhlAn database to assess the representation of microbial metabolic pathways. Short-chain fatty acids (SCFA) level were measured in fecal samples by gas-liquid chromatographic analysis. RESULTS: Changes in IBD patients gut microbiota were characterized by an increase in the representation of Proteobacteria and Bacteroidetes phyla bacteria and decrease in the number of Firmicutes phylum bacteria and Euryarchaeota phylum archaea; a decrease in the alpha-diversity index, relative representation of butyrate-producing, hydrogen-utilizing bacteria, and Methanobrevibacter smithii; increase in the relative representation of Ruminococcus gnavus in UC and CD patients and Akkermansia muciniphila in CD patients. Reduction of Butyryl-CoA: acetate CoA transferase gene relative representation in CD patients, decrease of absolute content of SCFA total number as well as particular SCFAs and main SCFAs ratio in IBD patients may indicate inhibition of functional activity and number of anaerobic microflora and/or an change in SCFA utilization by colonocytes. CONCLUSION: the revealed changes can be considered as typical signs of dysbiosis in IBD patients and can be used as potential targets for IBD patients personalized treatment development.

[Fecal neutrophil gelatinase-associated lipocalin is a surrogate marker of inflammation in inflammatory bowel disease].

AIM: To evaluate the fecal level of neutrophil gelatinase-associated lipocalin (NGAL) in different behavior of inflammatory bowel disease (IBD). MATERIALS AND METHODS: We prospectively included 41 people into the study--30 patients with active IBD and 11 healthy volunteers. The concentration of NGAL in faeces was determined by enzyme immunoassay method. RESULTS: Fecal NGAL level was increased in both UC and CD: in CD--5924.27 ± 2067.6 ng/ml (p < 0.05), in UC--5826.09 ± 891.8 ng/ml (p < 0.05) NGAL levels were higher than in the control group (658.8 ± 237.7 ng/ml). Maximal changes were seen in colonic involvement. NGAL levels increased with the increasing extension of lesion in UC (p < 0.05), while in CD concentration was higher in colitis than in ileitis and ileocolitis (p > 0.05) . NGAL level increased with severity of CD (p < 0.05), in patients with UC difference was not significant. In UC NGAL level was increased with increasing extension of lesions (p < 0.05), in CD this pattern was not marked. Correlation NGAL level with some clinical and laboratory indicators in CD was established. Sensitivity of test in evaluation of exacerbation of IBD was 80%, specificity--90.9%, area under the ROC curve (AUC)--0.9, positive predictive value--96%, negative predictive value--62.5%; positive likelihood ratio--8.8 and negative likelihood ratio--0.22. CONCLUSIONS: The fecal concentration of NGAL significantly increased during IBD. With increasing severity and activity of disease level ofNGAL was increased in CD (p < 0.05). Lipocalin-2 values was higher with the increasing extension of lesions in UC (p < 0.05). There has been established the high diagnostic value of the detection of fecal NGAL as a marker of the active phase of IBD.

[Clinical case of a combination of ulcerative colitis and alopecia areata].

Extraintestinal manifestations of inflammatory bowel diseases (IBD) are common in both ulcerative colitis and Crohn's disease. Dermatological manifestations have been reported in one-third of all extraintestinal manifestations of IBD. Erythema nodosum and pyoderma gangrenosum are the most frequently described in the literature. There is no data on the development of alopecia as a cutaneous manifestation of IBD in most of studies. A clinical case of combination of ulcerative colitis and alopecia in young woman is presented in the article. There are several possible causes of alopecia in patients with IBD, such as nutritional deficiencies, side effects of medications or autoimmune alopecia. Most often there is no correlation between the severity of clinical bowel manifestations and other organs involvement, and response to therapy. So the combination of alopecia with IBD, in particular ulcerative colitis, confirms the importance of autoimmune mechanisms in genesis of these diseases.