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Persistent dysbiosis in pediatric Crohn’s disease patients after resolution of inflammation
A recent study, published in Nature by the University of Virginia school of Medicine, has uncovered that children who achieve clinical remission in Crohn’s disease continue to show signs of microbial dysbiosis which could explain future relapses. This study found lower microbial diversity and notable taxonomic differences, such as decreases in the Lactobacillus and Streptococcus species in the pediatric cohorts’ microbiome. Opposingly, they saw an increase in species such as Oribacterium and Prevotella, which have been previously associated with inflammation. Using flow cytometry, they also noticed an increase in CD4+ T cells which may contribute to the triggering of a future inflammatory flare ups instigated by the increase of pathogenic bacteria. Interestingly, in this study they identified dysbiosis of patients that were in ‘clinical remission’. Previously dysbiosis has been associated with a loss of epithelial integrity. However, in this study, patients had surprisingly strong intestinal epithelial barriers. This contradictory discovery suggests that while current treatments are effective in resolving disease briefly, they may not be targeting the core of the issue.
This study contributes valuable insights into the microbiome involvement in pediatric CD and provides a mechanism behind the cause of disease relapse. This study also highlights the importance of considering the microbiome in CD treatment management even after clinical remission is achieved.